Poll

How has the ACA (obamacare) affected your health insurance costs so far?

I've seen an increase in costs
77 (36.7%)
I've seen a decrease in costs
40 (19%)
I've seen no change in costs
65 (31%)
I don't know.
28 (13.3%)

Total Members Voted: 202

Author Topic: How has the ACA affected your current healthcare costs?  (Read 46533 times)

historienne

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Re: How has the ACA affected your current healthcare costs?
« Reply #100 on: August 29, 2014, 02:46:10 PM »

What the ACA has done is forced our group to take on an individual who will have high healthcare cost and guarantee that our out of pocket expenses will increase.  While at the same time taxing us to pay that person's share because they can't "afford" it. 


The problem is that if higher-risk individuals are going to be able to buy insurance on the open market, they need to be in a risk pool with lower-risk people.   We used to "solve" that problem by just allowing insurance companies to exclude high-risk people, and/or charge them risk-adjusted prices.  As a result,  lots of people were either totally unable to get a policy or only able to get an extremely expensive policy.  The ACA tries to solve the problem through a combination of the individual mandate and requiring insurers to offer roughly the same policy to everyone.   This combination "forces" higher and lower risk individuals into the same risk pool, raising costs for lower-risk folks and lowering costs for higher-risk folks.  I'd prefer to solve it by having a single-payer system, so that there's just one big nation-wide risk pool.  But it is a real problem that does need to be solved.

Also, this is maybe pedantic, but the risk pool issue and subsidies are separate issues.  There are plenty of low-risk folks who still need a subsidy to afford insurance, and there are plenty of high-risk folks who do not get or need subsidies. 




Cassie

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Re: How has the ACA affected your current healthcare costs?
« Reply #101 on: August 29, 2014, 02:53:29 PM »
I would definitely prefer single pay-or health care.  NOt only is our premium very expensive but our max out of pocket for a serious illness is also a lot.  So we pay a ton of $ for a so-so plan.  Other countries do it much better then we do and we should follow their examples.

johnhenry

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Re: How has the ACA affected your current healthcare costs?
« Reply #102 on: August 29, 2014, 03:20:28 PM »
Here's the thing I agree people should not be refused healthcare.  But how do we go about getting everyone the care they need while at the same time having everyone contribute.

Universal, single-payer coverage.  If other nations can do it, we can do it.  If we can "afford" highways for all of us to drive on and schools to educate our kids, we can afford healthcare for everyone who needs it.

This is an easy problem to solve when you only worry about getting everyone the care they need and not about having everyone contribute.  Because once you agree that everyone must contribute, you have to determine how much they contribute.  And every time you have someone who can't meet their contribution you have a "lackie" (from your quote below).

The problem is you can't.  There are always going to be the lackies that take the benefit and don't contribute.  That's my problem.

Luckily the "problem" at hand is one of perception and not reality.  When you view every transaction as having a winner and a loser and every citizen as either a giver or taker.... you will see this "problem" everywhere you look.

Riddle me this.  When someone buys a big life insurance policy and then dies in accident, who is the winner and who is the loser?  Insurance company or the beneficiary? 

Surely you are not proposing an "insurance" system where we all contribute more than we get back in benefits.  What would be the point?  We can't all be givers, you know.

Who are the "lackies" in the current (medicaid + ACA) system.  Is it anyone on medicaid?  Or is it also those in the lowest income (highest subsidy) pool covered by the ACA?  Or does it include any family getting a subsidy under the ACA (which includes those all the way up to 400% of the poverty line)?  Or are none of those lackies as long as they can actually afford the premiums?  Are they lackies if they fall behind and miss one payment?  Or must they miss multiple payments?

Or is a "lackie" not determined by what income level one is at, but whether he believes that he's deserving of the subsidy towards his premium.  Or to be a lackie does he have to hold the opinion that his subsidy should be even greater than it is?  If merely holding a belief like that isn't sufficient to make one a lackie, surely it is enough if someone takes active steps, planning, precautions so that his income is at a level that gets him the biggest subsidy within his reach.  I just hope there are no "lackies" lurking on this site where they may learn to "game the system" by hearing some of us discuss strategies for maximizing ACA subsidies in ER.  Sometimes we discuss things like that when we aren't talking about maximizing our tax deductions and credits or "minimizing our tax" burden by how we allocate across tax-deferred vs tax free accounts.

I'm just glad to be rich enough that I'm "minimizing my tax burden" rather than "chasing a handout", like a lackie.




usmarine1975

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Re: How has the ACA affected your current healthcare costs?
« Reply #103 on: August 29, 2014, 08:38:55 PM »
As stated initially my family's premium and deductibles have increases and my wife's employers cost has also went up. For us the ACA has been a negative. Sorry OP did not mean to take us so far off topic.

Thanks for the discussion. 

For the record I spent 10 years without health insurance then purchased a major medical policy.  And now have coverage through my wife and the VA.  I donate money to help those in need etc... 

Good luck.

randymarsh

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Re: How has the ACA affected your current healthcare costs?
« Reply #104 on: August 29, 2014, 08:49:31 PM »
I think this price comparison is somewhat meaningless because prices aren't the only thing that changed. The benefits changed too. In many cases, I think people who are paying more are getting more. Whether they wanted more is another argument. I also imagine people are comparing what comes out of their paycheck now vs. before. But it's possible your employer simply decided to use the ACA as a scapegoat to cut your benefits/increase prices. Just like some restaurant in Seattle added some bullshit "Minimum Wage" fee as a line item on receipts when they passed the increase. Except it doesn't take effect until 2015...

CanuckExpat

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Re: How has the ACA affected your current healthcare costs?
« Reply #105 on: August 29, 2014, 09:33:01 PM »
But it's possible your employer simply decided to use the ACA as a scapegoat to cut your benefits/increase prices.

Yes, we had a notice about increased premiums due to "health care reform", but without specifics of why. I think when you dig further some of it is a convenient excuse for premiums that would have raised anyways, some is related to insurance companies thinking they will be less profitable overall and passing on the cost, and some is related to employers thinking ahead.

Quote
Nearly half of upper-middle-income Americans who have employer-based health insurance say the Affordable Care Act has had a negative effect on their health insurance. This is likely because 46 percent of this demographic reports paying more for insurance and also being hit with higher out-of-pocket expenses, including deductibles and co-payments, than they were a year ago.  But analyst Doug Whiteman said this may be a case of companies passing along more of the health insurance costs to employees and using Obamacare as an excuse
..
Businesses are passing along more of the insurance costs to their covered employees, though this is a trend that has been going on for years, since before Obamacare. One example of the apparent disconnect: Some companies are blaming the ACA's 40 percent tax on higher-cost "Cadillac" health insurance as reason to raise plan costs or curtail coverage. But that aspect of the law doesn't take effect until 2018. It would appear companies are acting very preemptively
http://www.cbsnews.com/news/obamacare-blamed-for-increases-in-insurance-costs/

Quote
Employees' costs are expected to rise 5 to 7 percent next year, according to early estimates. Those annual increases have been a fixture for years. But in some 2014 open enrollment documents companies are specifically citing the law as a factor in next year's pricing.But most of the language in open enrollment guides is not specific about the portion of the increases attributable to the Affordable Care Act, allowing companies and insurers to use the new law as an excuse for increases they might have implemented anyway.
...
But insurance providers say they are already passing on costs that are a direct result of the health care law.The requirement that children be allowed to remain on their parents' plans until age 26 has added millions of people to employer-provided coverage rolls with little corresponding increase in revenues. Another factor in rising premiums: the law's protections for people with pre-existing conditions. The law is designed to offset the cost of covering people with pre-existing conditions by guaranteeing millions of new customers for insurance companies. But with the ultimate number of new customers still unclear, insurers are raising prices pre-emptively
http://www.cnbc.com/id/101158964

So in the end it is complicated :)

Chuck

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Re: How has the ACA affected your current healthcare costs?
« Reply #106 on: September 16, 2014, 06:06:45 PM »

My plan was amazing. Now it will not be, and despite the decrease in the quality of service, I'm still likely to pay more both in premium and deductible.

I get that this law is fashionable here, but it is in the process of impacting me in a pretty negative way.

Not to split hairs, but the "Cadillac Plan Tax" components of the ACA aren't scheduled to come into affect until 2018 (http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=99)

If your employer is changing their plan now, that is at their discretion, or possibly because they are planning ahead to 2018, by which time the law could change for all we know :)

But it's not being mandated or taxed yet..
The plan downgrade won't happen until the tax does. However we are all paying more for our premiums already. That started this fiscal year.


Quote from: thefinancialstudent
I think this price comparison is somewhat meaningless because prices aren't the only thing that changed. The benefits changed too. In many cases, I think people who are paying more are getting more. Whether they wanted more is another argument.
Indeed. Why am I suddenly paying for prenatal care? I don't have ovaries.

Cheddar Stacker

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Re: How has the ACA affected your current healthcare costs?
« Reply #107 on: September 16, 2014, 08:36:02 PM »
Update - our work plan which is already very expensive was hit with an accross the board 33% increase for our renewal. That shit won't fly. We are negotiating and re-quoting but that was a shocker to me.

Beric01

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Re: How has the ACA affected your current healthcare costs?
« Reply #108 on: September 16, 2014, 08:45:38 PM »
Update - our work plan which is already very expensive was hit with an accross the board 33% increase for our renewal. That shit won't fly. We are negotiating and re-quoting but that was a shocker to me.

Wow, very interesting. As mentioned previously I'm opting out of my work's plan (and getting paid to do so) due to being on my parents' plan, but I'm definitely watching my company's prices to predict what they will be like once I hit age 26. I guess this is the first year for the ACA to really affect health costs, so it will be interesting.

johnhenry

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Re: How has the ACA affected your current healthcare costs?
« Reply #109 on: September 17, 2014, 02:54:36 PM »
Update - our work plan which is already very expensive was hit with an accross the board 33% increase for our renewal. That shit won't fly. We are negotiating and re-quoting but that was a shocker to me.

Have you priced insurance through the exchange?  Even if you don't qualify for a subsidy you may be able to save quite a bit by buying on the exchange.  Especially if you are only 36.  Younger folks are more likely to have this as an option since plans on the exchange do take age into account.  But *most* employer plans throw everyone into the same pool and don't charge younger employees less.

usmarine1975

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Re: How has the ACA affected your current healthcare costs?
« Reply #110 on: September 17, 2014, 03:01:24 PM »
Younger employee's are not charged the same rate as older employee's on company plans.  The benefit of a company plan is the pooling aspect of the company which lowers the premiums across the board compared to the individual getting their own coverage.  They do have age brackets that an employee is put into and it's not a 25 age bracket but a range of ages. 

geekette

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Re: How has the ACA affected your current healthcare costs?
« Reply #111 on: September 17, 2014, 03:46:35 PM »
Update - our work plan which is already very expensive was hit with an accross the board 33% increase for our renewal. That shit won't fly. We are negotiating and re-quoting but that was a shocker to me.

Interesting - per the WSJ this Sunday (about half way down the page), according to a Kaiser Family Foundation poll, the increase this year was around 3%, lower than last year's 4%.  Looks like this poll was taken earlier this year, though.  Could be regional, or we could be in shock too, when the new rates show up on healthcare.gov in November. 

randymarsh

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Re: How has the ACA affected your current healthcare costs?
« Reply #112 on: September 17, 2014, 05:57:42 PM »
Wow, very interesting. As mentioned previously I'm opting out of my work's plan (and getting paid to do so) due to being on my parents' plan, but I'm definitely watching my company's prices to predict what they will be like once I hit age 26. I guess this is the first year for the ACA to really affect health costs, so it will be interesting.

I did the same thing. When I accepted my job offer a month ago, medical for an employee (no family) was ~$20 per month. At that price, I was going to just use my employer's since it'd be easier for me to manage any paperwork and not have to ask my parents' questions about coverage or anything. Then they announced new plans and my cost would double. It's not a hardship to pay $40 for insurance, but it made me look closer and realize how much better my parents' plan is. Lower copays, lower coinsurance, out of network coverage, etc.

So I'm staying on mine as well. And I'm getting $200 a month from my employer to use for flex spending and Aflac coverage. Contacts and glasses just became free!

Beric01

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Re: How has the ACA affected your current healthcare costs?
« Reply #113 on: September 17, 2014, 06:28:45 PM »
So I'm staying on mine as well. And I'm getting $200 a month from my employer to use for flex spending and Aflac coverage. Contacts and glasses just became free!

They just give me cash, though it is taxable. I'm doing the math right now and buying a catastrophic plan off the exchange and then getting paid by my company for not enrolling in my health plan may make me come out ahead once I reach 26. Of course, my per-paycheck payment for buying a health plan through my company is pre-tax, so it's pretty close.

Cheddar Stacker

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Re: How has the ACA affected your current healthcare costs?
« Reply #114 on: September 17, 2014, 07:31:48 PM »
Update - our work plan which is already very expensive was hit with an accross the board 33% increase for our renewal. That shit won't fly. We are negotiating and re-quoting but that was a shocker to me.

Have you priced insurance through the exchange?  Even if you don't qualify for a subsidy you may be able to save quite a bit by buying on the exchange.  Especially if you are only 36.  Younger folks are more likely to have this as an option since plans on the exchange do take age into account.  But *most* employer plans throw everyone into the same pool and don't charge younger employees less.

I priced it a few months ago. It would've been roughly the same cost as my current plan. Now with the 33% increase I wil revisit once our re-negotiated rates come back. This is for a plan year beginning december 2014 for a company of around 20 people.

Also, it's not just about me, I have to bear a big chunk of the cost of employee coverage as an owner. This will take our annual cost from ~50k to ~67k. Frownyface.

Gin1984

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Re: How has the ACA affected your current healthcare costs?
« Reply #115 on: September 17, 2014, 07:41:30 PM »
Younger employee's are not charged the same rate as older employee's on company plans.  The benefit of a company plan is the pooling aspect of the company which lowers the premiums across the board compared to the individual getting their own coverage.  They do have age brackets that an employee is put into and it's not a 25 age bracket but a range of ages.
It depends on the insurance company and the plan.  Under my mom's Cadillac plan everyone, regardless of age, was charged the same.

Beric01

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Re: How has the ACA affected your current healthcare costs?
« Reply #116 on: September 17, 2014, 07:43:44 PM »
Younger employee's are not charged the same rate as older employee's on company plans.  The benefit of a company plan is the pooling aspect of the company which lowers the premiums across the board compared to the individual getting their own coverage.  They do have age brackets that an employee is put into and it's not a 25 age bracket but a range of ages.
It depends on the insurance company and the plan.  Under my mom's Cadillac plan everyone, regardless of age, was charged the same.

My company's insurance is also the same regardless of age - hence why I'm considering avoiding it completely. It's a bad deal for a very young person, though I'm sure great for almost anyone else.

Gin1984

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Re: How has the ACA affected your current healthcare costs?
« Reply #117 on: September 18, 2014, 01:00:02 PM »
Younger employee's are not charged the same rate as older employee's on company plans.  The benefit of a company plan is the pooling aspect of the company which lowers the premiums across the board compared to the individual getting their own coverage.  They do have age brackets that an employee is put into and it's not a 25 age bracket but a range of ages.
It depends on the insurance company and the plan.  Under my mom's Cadillac plan everyone, regardless of age, was charged the same.

My company's insurance is also the same regardless of age - hence why I'm considering avoiding it completely. It's a bad deal for a very young person, though I'm sure great for almost anyone else.
Depends on your level of health.  I seriously benefited from my mom's plan in ways people who were older, yet healthier did not. 

forummm

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Re: How has the ACA affected your current healthcare costs?
« Reply #118 on: September 19, 2014, 12:27:01 PM »
My husband carries our insurance and works for a large corporation. 
....
Our annual family out of pocket went from $4000 to $25K (this is an issue)

Potentially if I am able to get pregnant again (and the pregnancy spans 2 insurance years) I will be paying 50K. 
....
I'm really not loving the ACA at the moment.

If your employer-provided coverage isn't good, you can buy insurance through the Marketplace. You'd have to pay out of pocket if your employer coverage is "affordable" under the law, but at least you wouldn't have a $25k OOP max. An individual policy can be had for as little as $100 in many states and depending on age with a $6250 annual OOP max.

forummm

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Re: How has the ACA affected your current healthcare costs?
« Reply #119 on: September 19, 2014, 12:38:12 PM »
My costs increased... or maybe they've decreased depending on how you look at it. I am ER'd on a fairly low taxable income so pay for my own health insurance. My self-funded Blue Cross plan was cancelled as of Jan. 1st, 2014 and the new plan I got had a monthly premium increase three-times the former costs and a greater annual out of pocket costs by about $2,500 (from $4000 to $6500 annually).  It will now cost me over $14,000/year in premiums and deducibles BEFORE my insurance company has to start paying.  I do not qualify for subsidies because I am TOO low income, however I live in a Medicaid expanded state so could get that if I choose now that they no longer require means testing of assets. I don't wish to get Medicaid though. So, being that I have a military service-connected disability, I can use the VA hospital for free or low cost and that's what I intend to do. While I don't like doing that anymore than I would have liked going on Medicaid, I really don't like paying the new much higher private insurance costs I have too either. If I couldn't use the VA like most people, or wasn't in a Medicaid expanded state like many people, and had my same low income (mustachian income!) then I would be SOL and have to pay the increased amount (which is more than I live on per year), do without coverage, or go out a get a job (OH THE HORROR!)

I'm curious what your objection to enrolling in the Medicaid expansion plan is. Technically, it has at least the same minimum coverage requirements of all the private plans in the Marketplace (including free preventive services). Interestingly, the Medicaid expansion benefits are actually different than the benefits people get on traditional Medicaid (i.e. the Medicaid that existed before the ACA, and still continues to exist). And it's currently 100% paid for by the federal government, so it's nearly the same financial cost to the government as if you had the largest possible tax credit (at 139% of the federal poverty level in a state that expands Medicaid). And if you don't actually use any of the services, the cost to the government is nothing. And in some states, the Medicaid agency is just a pass-through to a private plan. Some states literally just enroll the beneficiaries of the Medicaid expansion into private plans on the Marketplace.

It's nice that you can afford to pay the premium out of pocket. But if you can't in the future, it's nice that the Medicaid expansion will be there for you.

forummm

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Re: How has the ACA affected your current healthcare costs?
« Reply #120 on: September 19, 2014, 12:46:32 PM »
My costs went down because I changed jobs, totally unrelated to ACA. My wife though, has been on private insurance for years (we have VERY different medical needs).

This year the plans changed drastically with ACA but we were able to get what looked like a much better plan for her for only a little bit more money. The problem is that our insurer is now realizing that they underestimated the cost of that plan and got tons more sign ups on the exchange that they didn't expect because the plan was the best value available. So they are slowly, month after month, changing the policies making prescriptions more expensive every month. Its now not so good of a deal (its about as good as we had last year for slightly more cost).

If you got the plan on the Marketplace, then I think it's illegal for plans to change the benefits deleteriously in the middle of the policy year. I believe they have to wait until the next policy year begins (January 1) to increase the costs of services, providing you with the opportunity to pick a different plan. In fact, there's a special provision to insure the insurers in these first few years of the Marketplace to that if some insurers get unlucky (all the sick people join) they get some surplus funds collected by the lucky insurers (with all healthy people) that didn't go to paying for medical care. In other words, it sounds like your insurer may be acting appropriately.

If you got the plan through your employer, then people signing up on the exchange shouldn't affect the cost of your employer-provided benefits, so that sounds like a fishy excuse. Raising costs may also against your employer's contract with the insurer.

forummm

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Re: How has the ACA affected your current healthcare costs?
« Reply #121 on: September 19, 2014, 12:54:59 PM »
As a health policy analyst, I feel compelled to jump in just to point out one thing --- healthcare costs have been rising an average of 10% for year for ever 20 years, in fact, it was exactly the reason we needed serious health reform (that and the fact that tens of millions of people were uninsured). 

Businesses and insurance companies have done a great job of passing off increases as a result of the ACA but in many cases its misleading, outright lies in some instances.  Health care inflation has been about double regular inflation for a long time, so it's not so easy to disentangle your health care costs going up due to the ACA or just general cost growth. 

There are certainly winners and losers in any sort of reform and there are millions in the U.S. today who have seen premiums and/or deductibles go up as a result of the ACA, but there are also millions who are seeing their rates go down or are obtaining health insurance for the first time.  The real impact of the ACA will not be known for years to come when we can determine, and no longer speculate, whether health care cost growth has slowed down and whether more people have access to care.

100% agree. It's really complicated to compare pre-ACA plans to post-ACA plans, and the monthly dollar amount and copays and deductibles don't get all the way there either. It's really hard to put an accurate value on the additional benefits plans have to provide, the guaranteed issue of insurance to anyone who wants it, not being able to exclude coverage for pre-existing conditions, and not being able to drop you from coverage when you do get sick.

The real problem is that the health care system itself is so terribly broken. The ACA is a patch and some tinkering on a system that needs fundamental reform. I think it's a net positive, but would love to see more being done. If you look at the polls that say the ACA is unpopular (which is silly because it's so complicated that almost no one knows what's in it), half of the people who don't like the bill are opposed to it because it doesn't go far enough. Strangely that's not well reported.

forummm

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Re: How has the ACA affected your current healthcare costs?
« Reply #122 on: September 19, 2014, 01:21:25 PM »


Finally, of course now I'm paying for seniors and women, both groups which have higher expenses than me. Young males got the raw deal in the ACA. But of course nobody cares that the government discriminates against men in this way. It's illegal to discriminate against women in health insurance, even if they're riskier, but perfectly fine to discriminate against men in car insurance, just because men are riskier. Double standards! Note both forms of insurance are required by law.
I believe men, especially young men, have the most injuries needing medical care for car, motorcycle, boating, skiing, biking, etc... accidents as well as team and competitive sports related injuries (as well as dumb ass stuff like jumping off roofs just for the heck of it kinds of injuries) - all things that can be very costly for insurers to cover.

Nope.  Women have significantly higher health care costs: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361028/

Actually, I should say that even with those injuries, young men have the lowest medical costs of any group: http://www.amcp.org/data/jmcp/JMCPSupp_April08_S2-S6.pdf

Women are 3x as likely to visit the doctor regularly. They also live longer, meaning they can die from conditions that men don't even live long enough to experience.
I stand corrected! Of course I wonder if the fact that women visit a doctor more regularly then men is the reason they live longer? That plus not jumping off roofs just for the heck of it :-)!

The biggest reason women are more expensive is that they have a very expensive health condition called pregnancy. And, the last time I checked, men are significantly responsible for the development of that condition.

forummm

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Re: How has the ACA affected your current healthcare costs?
« Reply #123 on: September 19, 2014, 01:23:57 PM »
I'm not, at least not personally. I support healthcare changes, and the ACA is a good start, but I don't like that a 70 year old man has to effectively carry maternity coverage. I get the idea, I don't like implementation.

I'm also a bit jaded on this topic as we were considering finding health coverage that didn't cover maternity since we were done having babies. Oh well, you can't win them all.

I need more information about this hypothetical 70-year old man to form an opinion.  Was he born of a woman?  Or did he spring fully formed from Zeus' brow?

In the prior case, it seems like he has some vested interest in women having babies, and has benefited personally from the practice.  In the latter case, I agree that this seems unjust.

Plus, why isn't that hypothetical 70-year old man on Medicare?

forummm

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Re: How has the ACA affected your current healthcare costs?
« Reply #124 on: September 19, 2014, 01:28:34 PM »
My health costs have increased by 18% so far. We are due to get hit by the "Cadillac Heath Plan" tax starting next year. The tax is 40%, and will be passed directly on to us. Because God fucking forbid that my employer give his employees an excellent health plan.

Thanks Obama.

The "Cadillac tax" doesn't start until 2018. And it's only 40% of the amount of the cost above the threshold ($10,200 for individuals and $27,500 for families, adjusted for inflation). So if your super expensive health plan costs $28k for the family (guessing since you said "we"), your tax would be $200 for the family for the year.

http://www.uhc.com/united_for_reform_resource_center/health_reform_provisions/excise_tax_on_high_cost_coverage.htm

forummm

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Re: How has the ACA affected your current healthcare costs?
« Reply #125 on: September 19, 2014, 01:44:36 PM »
My health costs have increased by 18% so far. We are due to get hit by the "Cadillac Heath Plan" tax starting next year. The tax is 40%, and will be passed directly on to us. Because God fucking forbid that my employer give his employees an excellent health plan.

Thanks Obama.

Chuck, I would like it if an Obamacare apologist would step up here to explain why the employers of Chucks all over the country, employers who go above and beyond for their employees (I thought that was a good thing???) are being taxed this way.

I haven't delved into it, having been busy trying to identify how the POS legislation will benefit me. Because it really is all about me, haha.

But anyway--What's the idea behind this tax on "Cadillac" health plans, other than just another way this beast raises money to pay for itself?

Not an ACA apologist (but an ACA expert), but I believe the idea behind the "Cadillac tax" (which Chuck doesn't accurately characterize--see my previous response) is that it will help reduce healthcare expenses. From an economic perspective, if people have health plans that are that expensive, they are covering "too much" optional and unnecessary care. One of the fundamental problems with insurance is that it hides the cost of the actual services that you are consuming, which economic theory says will lead to overconsumption of those services. So by taxing these diamond studded plans a bit, it will encourage the plans to slim down and provide more of a price signal to beneficiaries and encourage them to make more economically rational decisions about the care they get. The "skin in the game" phrase is used for this. If it's going to save their life, they will still have coverage to get it. If it's not needed, maybe they won't. Not sure how I feel about this idea, but that's my understanding of the reasoning.

And to be clear, this is a very prominent line of thought in conservative Republican arguments around healthcare. Republican elected officials are making that argument today. It's not something that liberal Democrats advocated for (in fact the unions almost fought against the ACA due to its inclusion in the bill). It's one of the many aspects of the bill that makes it a generally conservative approach to healthcare reform. The ACA is essentially the approach Mitt Romney took in Massachusetts. It's similar to the approach that the conservative Heritage Foundation endorsed in the 90's. It's similar to the approach that Republican Senators Bob Dole and Orrin Hatch proposed in the 90's. The opposition is almost entirely disingenuous politics. There are plenty of legitimate arguments against the ACA, but those aren't being made, because almost no one in Congress would support the changes those legitimate arguments would move us towards (i.e. to a system like every other major industrialized nation has).

forummm

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Re: How has the ACA affected your current healthcare costs?
« Reply #126 on: September 19, 2014, 01:53:46 PM »
I wasn't surprised.  My point was she is upset because she won't have FREE healthcare (at least to her) 

Medicaid isn't "free". Many states charge premiums to those with incomes above the poverty level (just lower premiums than the cost of the insurance) and there are copays charged for care as well. People on Medicaid tend to be very poor, and research shows that they actually skip getting needed care at times when the copays are as low as $1-$4 because that's such a large part of their budget. I think when things are free, people are probably going to overuse them. But I also don't want people to not get what they need because they can't afford it. Tough policy choices.

forummm

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Re: How has the ACA affected your current healthcare costs?
« Reply #127 on: September 19, 2014, 02:13:02 PM »
Update - our work plan which is already very expensive was hit with an accross the board 33% increase for our renewal. That shit won't fly. We are negotiating and re-quoting but that was a shocker to me.

Interesting - per the WSJ this Sunday (about half way down the page), according to a Kaiser Family Foundation poll, the increase this year was around 3%, lower than last year's 4%.  Looks like this poll was taken earlier this year, though.  Could be regional, or we could be in shock too, when the new rates show up on healthcare.gov in November.

It sounds like something else is going on with that kind of increase. If it's a small group plan, perhaps some people had some really big expenses and they are passing it along in this next year's premiums. That has happened a lot over the years. Or perhaps they are using the ACA as an excuse to raise premiums dramatically. Or perhaps it's a negotiating tactic. The KFF poll is a national poll, so they should detect any kind of increase of that size in a region as well.

From what I've read (I think it was a KFF or RWJF report), the rates on healthcare.gov in November are going to be about the same as this past year. Some states had single digit % increases and some had single digit % decreases.

Spartana

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Re: How has the ACA affected your current healthcare costs?
« Reply #128 on: September 19, 2014, 02:21:27 PM »
My costs increased... or maybe they've decreased depending on how you look at it. I am ER'd on a fairly low taxable income so pay for my own health insurance. My self-funded Blue Cross plan was cancelled as of Jan. 1st, 2014 and the new plan I got had a monthly premium increase three-times the former costs and a greater annual out of pocket costs by about $2,500 (from $4000 to $6500 annually).  It will now cost me over $14,000/year in premiums and deducibles BEFORE my insurance company has to start paying.  I do not qualify for subsidies because I am TOO low income, however I live in a Medicaid expanded state so could get that if I choose now that they no longer require means testing of assets. I don't wish to get Medicaid though. So, being that I have a military service-connected disability, I can use the VA hospital for free or low cost and that's what I intend to do. While I don't like doing that anymore than I would have liked going on Medicaid, I really don't like paying the new much higher private insurance costs I have too either. If I couldn't use the VA like most people, or wasn't in a Medicaid expanded state like many people, and had my same low income (mustachian income!) then I would be SOL and have to pay the increased amount (which is more than I live on per year), do without coverage, or go out a get a job (OH THE HORROR!)

I'm curious what your objection to enrolling in the Medicaid expansion plan is. Technically, it has at least the same minimum coverage requirements of all the private plans in the Marketplace (including free preventive services). Interestingly, the Medicaid expansion benefits are actually different than the benefits people get on traditional Medicaid (i.e. the Medicaid that existed before the ACA, and still continues to exist). And it's currently 100% paid for by the federal government, so it's nearly the same financial cost to the government as if you had the largest possible tax credit (at 139% of the federal poverty level in a state that expands Medicaid). And if you don't actually use any of the services, the cost to the government is nothing. And in some states, the Medicaid agency is just a pass-through to a private plan. Some states literally just enroll the beneficiaries of the Medicaid expansion into private plans on the Marketplace.

It's nice that you can afford to pay the premium out of pocket. But if you can't in the future, it's nice that the Medicaid expansion will be there for you.
It's an ethical issue for me not a practical Medicaid-related one. I just don't feel that the taxpayers should have to pay 100% of my total healthcare/insurance costs so I can retire at 40 to play beach volleyball all day long. I feel that if I have the money to retire early, it's up to me to fund my own healthcare and insurance unless (until) we have true Universal health insurance/care for all. I know other's here feel differently though so don't want to debate the politics of the ACA. However I do like the availability to all people regardless of pre-existing condition thing about the ACA.
« Last Edit: September 19, 2014, 02:27:18 PM by Spartana »

forummm

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Re: How has the ACA affected your current healthcare costs?
« Reply #129 on: September 19, 2014, 02:23:03 PM »
My personal healthcare costs are about the same as pre-ACA (large employer health plan).

My brother went from not being able to afford coverage for him, his wife, and his 4 children, to being fully insured with a great plan from the Marketplace that they can afford.

My parents are still uninsured but could get affordable coverage if they chose (my dad really wants coverage and hasn't been able to afford it in years but my mom is against the ACA and won't even buy the private insurance plans available).

My uncle, aunt, and cousin went from being uninsured to having good coverage (the cost is one-third what their previous option was).

Another cousin went from being uninsurable to having good coverage.

forummm

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Re: How has the ACA affected your current healthcare costs?
« Reply #130 on: September 19, 2014, 02:27:45 PM »
It's an ethical issue for me not a practical Medicaid-related one. I just don't feel that the taxpayers should have to pay 100% of my total healthcare/insurance costs so I can retire at 40 to play beach volleyball all day long. I feel that if I have the money to retire early, it's up to me to fund my own healthcare and insurance unless (until) we have true Universal health insurance/care for all. I know other's here feel differently though so don't want to debate the politics of the ACA.

In most states, enrolling in Medicaid doesn't cost the government anything. It only costs something if you actually use the insurance to get care. Nothing stops you from having the coverage (in case something really bad and unaffordable happens) but paying out of pocket. Or even if you use the insurance you could make a donation to the Treasury for the amount you don't need.

My brother was fundamentally opposed to taking CHIP coverage for his 4 kids. If something happened to them he wouldn't have any way of taking care of them. I felt that was irresponsible. He could always not use the coverage or pay it back later if he wanted to, but at least his kids would have the care they needed. Fortunately his income went up a bit and the Marketplace plans are affordable for him.

Spartana

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Re: How has the ACA affected your current healthcare costs?
« Reply #131 on: September 19, 2014, 02:35:05 PM »
It's an ethical issue for me not a practical Medicaid-related one. I just don't feel that the taxpayers should have to pay 100% of my total healthcare/insurance costs so I can retire at 40 to play beach volleyball all day long. I feel that if I have the money to retire early, it's up to me to fund my own healthcare and insurance unless (until) we have true Universal health insurance/care for all. I know other's here feel differently though so don't want to debate the politics of the ACA.

In most states, enrolling in Medicaid doesn't cost the government anything. It only costs something if you actually use the insurance to get care. Nothing stops you from having the coverage (in case something really bad and unaffordable happens) but paying out of pocket. Or even if you use the insurance you could make a donation to the Treasury for the amount you don't need.

My brother was fundamentally opposed to taking CHIP coverage for his 4 kids. If something happened to them he wouldn't have any way of taking care of them. I felt that was irresponsible. He could always not use the coverage or pay it back later if he wanted to, but at least his kids would have the care they needed. Fortunately his income went up a bit and the Marketplace plans are affordable for him.
Yes I understand it doesn't cost anything (other then paperwork and associated costs to get me on the system) to have Medicaid, and if I didn't have an alternative to affordable care (I do via the VA healthcare system or can afford to buy my own plan if I want) then I would sign up. I am not against Medicaid for those in need (or against any social service for those in need like your brothers family) but technically I am not in need cause I have the big stache, plus a small government pension, plus a tax-free disability benefit from the VA, plus a paid off house, plus...well you get it :-)!  I would rather see less people like me, low taxable income but high asset, be exempt from qualifying for Medicaid so that money can be used to fund programs for the truly needy. However, I was pretty disappointed when my inexpensive catastrophic plan was cancelled.

ETA: I even accidentally got put on Medicaid when I tried to apply for insurance on my state's exchange. I ended up cancelling it but the massive reams of paperwork and all the other stuff involved was pretty over the top.
« Last Edit: September 19, 2014, 02:36:38 PM by Spartana »

forummm

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Re: How has the ACA affected your current healthcare costs?
« Reply #132 on: September 19, 2014, 06:32:17 PM »
Yes I understand it doesn't cost anything (other then paperwork and associated costs to get me on the system) to have Medicaid, and if I didn't have an alternative to affordable care (I do via the VA healthcare system or can afford to buy my own plan if I want) then I would sign up. I am not against Medicaid for those in need (or against any social service for those in need like your brothers family) but technically I am not in need cause I have the big stache, plus a small government pension, plus a tax-free disability benefit from the VA, plus a paid off house, plus...well you get it :-)!  I would rather see less people like me, low taxable income but high asset, be exempt from qualifying for Medicaid so that money can be used to fund programs for the truly needy. However, I was pretty disappointed when my inexpensive catastrophic plan was cancelled.

ETA: I even accidentally got put on Medicaid when I tried to apply for insurance on my state's exchange. I ended up cancelling it but the massive reams of paperwork and all the other stuff involved was pretty over the top.

Understood. I think the attitude of many in this thread--of not taking something meant to help those who are less fortunate when that help is not needed--is very admirable.

Even though it was a pain for you to cancel it, I'm glad the system worked to auto-enroll you in Medicaid. So many people have trouble enrolling and staying enrolled that they have setup the system to help lower the burden to get covered. It's the rare case like yours where people try to keep out. :)

Heart of Tin

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Re: How has the ACA affected your current healthcare costs?
« Reply #133 on: September 19, 2014, 07:43:23 PM »
Update - our work plan which is already very expensive was hit with an accross the board 33% increase for our renewal. That shit won't fly. We are negotiating and re-quoting but that was a shocker to me.

Interesting - per the WSJ this Sunday (about half way down the page), according to a Kaiser Family Foundation poll, the increase this year was around 3%, lower than last year's 4%.  Looks like this poll was taken earlier this year, though.  Could be regional, or we could be in shock too, when the new rates show up on healthcare.gov in November.

It sounds like something else is going on with that kind of increase. If it's a small group plan, perhaps some people had some really big expenses and they are passing it along in this next year's premiums. That has happened a lot over the years. Or perhaps they are using the ACA as an excuse to raise premiums dramatically. Or perhaps it's a negotiating tactic. The KFF poll is a national poll, so they should detect any kind of increase of that size in a region as well.

From what I've read (I think it was a KFF or RWJF report), the rates on healthcare.gov in November are going to be about the same as this past year. Some states had single digit % increases and some had single digit % decreases.

I thought that small groups had moved to single risk pool rating, and would therefore be rated with respect to the entire small group market, not the individual group's health status. Have I misunderstood this part of ACA?
« Last Edit: September 19, 2014, 07:47:33 PM by Heart of Tin »

forummm

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Re: How has the ACA affected your current healthcare costs?
« Reply #134 on: September 19, 2014, 08:38:02 PM »
Update - our work plan which is already very expensive was hit with an accross the board 33% increase for our renewal. That shit won't fly. We are negotiating and re-quoting but that was a shocker to me.

Interesting - per the WSJ this Sunday (about half way down the page), according to a Kaiser Family Foundation poll, the increase this year was around 3%, lower than last year's 4%.  Looks like this poll was taken earlier this year, though.  Could be regional, or we could be in shock too, when the new rates show up on healthcare.gov in November.

It sounds like something else is going on with that kind of increase. If it's a small group plan, perhaps some people had some really big expenses and they are passing it along in this next year's premiums. That has happened a lot over the years. Or perhaps they are using the ACA as an excuse to raise premiums dramatically. Or perhaps it's a negotiating tactic. The KFF poll is a national poll, so they should detect any kind of increase of that size in a region as well.

From what I've read (I think it was a KFF or RWJF report), the rates on healthcare.gov in November are going to be about the same as this past year. Some states had single digit % increases and some had single digit % decreases.

I thought that small groups had moved to single risk pool rating, and would therefore be rated with respect to the entire small group market, not the individual group's health status. Have I misunderstood this part of ACA?

Some small groups have, others haven't. There are still many grandfathered plans out there that are not subject to many of the ACA's requirements. Small employers can move into a single risk pool rating if they want to.

PeachFuzzInVA

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Re: How has the ACA affected your current healthcare costs?
« Reply #135 on: September 20, 2014, 08:19:00 PM »
My coverage stayed about the same, but that's because I had to drop my employer-sponsored health plan, as it was no longer affordable, and switch to a non-compliant, short term, private health plan. At work, we suddenly had the choice, pay about the same with a ridiculous deductible or pay 3x as much and keep the same deductible. Neither of which were affordable in my situation. Since there's a provision in the ACA that allows up to 2 years of non-compliant plans, I plan to ride out 2 years worth of short term plans and reevaluate what the current options are when time runs out.

Chuck

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Re: How has the ACA affected your current healthcare costs?
« Reply #136 on: November 22, 2014, 09:51:27 PM »
An update on ACA's affect on my company health care policy.

Shit just got so much worse. My premium is staying within 10% of where it was (thanks to my being only 26) However my deductible just went up to 4000, and my copays all went up- some doubling.

This law can go fuck it's self.

Tyler

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Re: How has the ACA affected your current healthcare costs?
« Reply #137 on: November 22, 2014, 10:38:18 PM »
So I retired early this month.  :)  That's worthy of a whole 'nother discussion, but for the purpose of this one it allows me to directly compare the full cost of my former employer provided coverage (via the full COBRA rate) with all of the options on the exchange.

Setting aside subsidies, the most similar plan to the old one (which I used for a surgery and was very happy with) with the exact same provider is about 25% cheaper per month (for the two of us) with a slightly lower deductible.  The tradeoffs are that the exchange version does not cover out of network doctors at all while my former one does (with 30% co-insurance), now I have to get referrals to see a specialist where I did not before, and the max OoP is a little higher.  Frankly, those are tradeoffs I'm willing to make.  So for us, having multiple options to choose from vs taking the only one offered by the employer seems to work out well.

Of course one could also compare costs with subsidies and employer contributions, but the base cost to the insurer isn't so bad.


chucklesmcgee

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Re: How has the ACA affected your current healthcare costs?
« Reply #138 on: November 22, 2014, 10:59:13 PM »
This law can go fuck it's self.

They're just lubing us up for when the other bills come due for all the other old timers.

Cressida

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Re: How has the ACA affected your current healthcare costs?
« Reply #139 on: November 22, 2014, 11:36:13 PM »
An update on ACA's affect on my company health care policy.

Shit just got so much worse. My premium is staying within 10% of where it was (thanks to my being only 26) However my deductible just went up to 4000, and my copays all went up- some doubling.

This law can go fuck it's self.

How do you know this is the ACA's fault?

Cheddar Stacker

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Re: How has the ACA affected your current healthcare costs?
« Reply #140 on: November 23, 2014, 05:49:14 AM »
I mentioned upthread about a 33% increase in premiums on our company renewal. We ended up quoting other carriers and got a 5% reduction in premiums. Not too bad.

Pigeon

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Re: How has the ACA affected your current healthcare costs?
« Reply #141 on: November 23, 2014, 06:38:01 AM »
The anti health care reform folks like to phase the question this simply. They seem to conveniently forget that health insurance costs weren't exactly flat before the ACA.

We need universal, single payer healthcare like most other developed nations.

Chuck

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Re: How has the ACA affected your current healthcare costs?
« Reply #142 on: November 23, 2014, 09:14:14 AM »
An update on ACA's affect on my company health care policy.

Shit just got so much worse. My premium is staying within 10% of where it was (thanks to my being only 26) However my deductible just went up to 4000, and my copays all went up- some doubling.

This law can go fuck it's self.

How do you know this is the ACA's fault?
Because prior to this year certain criteria could be considered, apart from age, when determining pricing. Then, pricing was averaged across the whole company, and that was the rate that each employee paid: The heathier workers subsidizing the sicker.

Now only age and number of family members can be considered. So, rates just went up, up up for almost everyone in the company. We had to get out of our low deductible, high rate plan because we simply can't afford it as a company anymore. So we went to a higher deductible and STILL slightly higher premium plan... and got across the board copay increases as well. I was actually pleased with the amount of detail that HR and our Heath Rep went into in describing exactly why all this is happening. And yes, apologists, it's the ACA.

But my wife's birth control is free now, instead of 10 bucks, so there's that. Heh.

Gin1984

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Re: How has the ACA affected your current healthcare costs?
« Reply #143 on: November 23, 2014, 10:00:43 AM »
An update on ACA's affect on my company health care policy.

Shit just got so much worse. My premium is staying within 10% of where it was (thanks to my being only 26) However my deductible just went up to 4000, and my copays all went up- some doubling.

This law can go fuck it's self.

How do you know this is the ACA's fault?
Because prior to this year certain criteria could be considered, apart from age, when determining pricing. Then, pricing was averaged across the whole company, and that was the rate that each employee paid: The heathier workers subsidizing the sicker.

Now only age and number of family members can be considered. So, rates just went up, up up for almost everyone in the company. We had to get out of our low deductible, high rate plan because we simply can't afford it as a company anymore. So we went to a higher deductible and STILL slightly higher premium plan... and got across the board copay increases as well. I was actually pleased with the amount of detail that HR and our Heath Rep went into in describing exactly why all this is happening. And yes, apologists, it's the ACA.

But my wife's birth control is free now, instead of 10 bucks, so there's that. Heh.
What kind of criteria?

BEN_BANNED

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Re: How has the ACA affected your current healthcare costs?
« Reply #144 on: November 23, 2014, 11:27:24 AM »
I just received paperwork from the company benefits coordinator .

My premiums will rise approximately $36/mo. at the beginning of next year. That's after they essentially doubled last year.

So much for the ACA keeping increases from spiraling out of control.

usmarine1975

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Re: How has the ACA affected your current healthcare costs?
« Reply #145 on: November 23, 2014, 05:08:31 PM »
The ACA was designed not to fix the issues but to  spiral us into a one payer system. Those who supported it know it and openly admit it.  Those who oppose it either understand and are in denial or totally misunderstand its intent.  And for those who think one payer is great talk to those that actually have it and get their opinion.  Its not free its paid for using tax dollars. It will increase our taxes and be less efficient. One only needs to examine other government entities books to see how intelligent it is to hand anything to the federal gov. 

I am not anti gov. I realize we need limited gov but also have seen the waste first hand in the military and the mentality that its gov money.  I would kindly remind those individuals that tax payers foot the bill.

Gin1984

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Re: How has the ACA affected your current healthcare costs?
« Reply #146 on: November 23, 2014, 05:35:31 PM »
The ACA was designed not to fix the issues but to  spiral us into a one payer system. Those who supported it know it and openly admit it.  Those who oppose it either understand and are in denial or totally misunderstand its intent.  And for those who think one payer is great talk to those that actually have it and get their opinion.  Its not free its paid for using tax dollars. It will increase our taxes and be less efficient. One only needs to examine other government entities books to see how intelligent it is to hand anything to the federal gov. 

I am not anti gov. I realize we need limited gov but also have seen the waste first hand in the military and the mentality that its gov money.  I would kindly remind those individuals that tax payers foot the bill.
Most Canadians I know, (I live in Buffalo and know quite a few) do like their system.  And if you do the math comparing their costs of taxes, and ours plus the cost of medical care (average), we spend just as much.

usmarine1975

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Re: How has the ACA affected your current healthcare costs?
« Reply #147 on: November 23, 2014, 05:42:41 PM »
Most Canadians I know and have talked to dislike their system.  Most common complaint is long waits especially for children and specialist. I even know a few that carry dual citizenship so they have easy access to American healthcare.  That goes back from a conversation within the last month and over ten years ago.  Maybe my circle is limited or the theme is the same.

I did not do a cost analysis. I prefer the Gov less involved in some of my life not more.

Every trip I make to the VA hospital I get to see the vast amount of money our Gov is spending on veteran healthcare and we have all heard about the quality and efficiency of that system. I have no complaints but have talked to others that do.

Gin1984

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Re: How has the ACA affected your current healthcare costs?
« Reply #148 on: November 23, 2014, 05:47:10 PM »
Most Canadians I know and have talked to dislike their system.  Most common complaint is long waits especially for children and specialist. I even know a few that carry dual citizenship so they have easy access to American healthcare.  That goes back from a conversation within the last month and over ten years ago.  Maybe my circle is limited or the theme is the same.

I did not do a cost analysis. I prefer the Gov less involved in some of my life not more.

Every trip I make to the VA hospital I get to see the vast amount of money our Gov is spending on veteran healthcare and we have all heard about the quality and efficiency of that system. I have no complaints but have talked to others that do.
That's weird, you can just buy private insurance there and skip the wait.  Why use the US system?

usmarine1975

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Re: How has the ACA affected your current healthcare costs?
« Reply #149 on: November 23, 2014, 07:43:31 PM »
I don't know just relaying what has been shared with me. 

My own thinking is 1 payer doesn't fix the problems of why healthcare is expensive it just changes how its paid for.

Unfortunately politics has gotten so toxic its no longer OK to disagree because if you do you are miss informed stupid or whatever else decides to label you.  Because of the toxic politics we can't have a good discussion regarding the facts. And it doesn't matter which party a person subscribes too.