Author Topic: 2015 Obamacare  (Read 22593 times)

alchem

  • 5 O'Clock Shadow
  • *
  • Posts: 5
2015 Obamacare
« on: December 02, 2014, 08:39:21 PM »
Sharing a personal experience

Background:2014 - FIRE in June; TW has major medical issues (cancer)
Purchased a BCBS platinum plan for 2014 - premiums out of pocket At $1460/mo for 2 people.  Too much income to qualify for subsidy in 2014.

2015
Smarter money management enables us to manage our AGI =$25000, a nice figure that keeps us above the floor in our state (Fl) but still eligible for subsidy.  The same platinum plan would be $1840/mo, but with subsidy, only $940/mo.

Found out thru a visit to our local BCBS at that income & in our state, we qualify for a Silver plan that has the same deductible and OOP MAX as the platinum plan we had.  Total Monthly cost, with subsidy - $450/mo.

Wow.  Be sure to ask questions as you enroll for 2015.  Very happy to have scored essentially a $1000/mo change in monthly cash flow!


sol

  • Walrus Stache
  • *******
  • Posts: 8438
  • Age: 48
  • Location: Pacific Northwest
Re: 2015 Obamacare
« Reply #1 on: December 02, 2014, 08:44:12 PM »
Yea, the colors of the plans don't seem to mean a whole lot.  Looking through the offerings recently, it seemed that many of the silver plans were better deals than many gold plans.  Like the gold plans charged a whole lot more for coverage with identical deductibles and even higher out of pocket maximums. 

Maybe the gold plans cover additional stuff like acupuncture or having your aura balanced.  But on a strictly financial comparisons, it looks like the "higher quality" plans just cost more for equivalent coverage.

GizmoTX

  • Handlebar Stache
  • *****
  • Posts: 1450
Re: 2015 Obamacare
« Reply #2 on: December 02, 2014, 10:23:41 PM »
The "quality" is now supposed to be the same regardless of what the metal label is. The silver is unusual because it appears to be the one that allows the most subsidy if you qualify for it.

DS will have a much bigger hit in 2015. Age 21, so he's now categorized as an adult. His deductible went from $1,500 to $6,600, premium went from $160 to $220 per month for the least expensive PPO available, from bronze to catastrophic. And no, he can't be on his parents' plan or get a subsidy because we're stuck with Medicare & pay extra for IRMAA.

Mr. Frugalwoods

  • Bristles
  • ***
  • Posts: 296
  • Location: Greater Boston Area
    • Frugalwoods
Re: 2015 Obamacare
« Reply #3 on: December 03, 2014, 05:31:50 AM »
Anecdotally, the couple of folks I know who are re-upping their Obamacare coverage are doing the math and finding that their actual healthcare spending levels make the silver plans a no-brainer.  Many of them originally reflexively chose a better plan, under a "Don't want bargain basement health coverage!" mentality.

Which is the idea.  The silver plans (at least in MA) look pretty decent.  Unless you have a major chronic medical condition... silver seems to be the way to go as long as you can budget to cover your out of pocket max in the case of a real emergency.

jprince7827

  • Stubble
  • **
  • Posts: 148
Re: 2015 Obamacare
« Reply #4 on: December 03, 2014, 08:50:44 AM »
I'm a 27 y/o male who makes six figures, but my startup doesnt offer healthcare. I got on the Bronze plan in IL, which is 120$/month. I only ever use vision/dental, but it has no vision/dental. My deductible is either 5k or 10k.

It's essentially another tax, because with a deductible that high it's unlikely I'll ever use the actual healthcare for anything. Overall, very disappointed with Obamacare. My job is apparently to support those who make much less and are much riskier.

Plus: I do have maternity care covered, should I ever get pregnant ;)

Next level up, silver, was well over 500$/mo if I recall. Wasn't really worth it. Such a shame it worked out this way.

pzxc

  • Stubble
  • **
  • Posts: 196
Re: 2015 Obamacare
« Reply #5 on: December 03, 2014, 08:57:43 AM »
I'm a 27 y/o male who makes six figures, but my startup doesnt offer healthcare. I got on the Bronze plan in IL, which is 120$/month. I only ever use vision/dental, but it has no vision/dental. My deductible is either 5k or 10k.

It's essentially another tax, because with a deductible that high it's unlikely I'll ever use the actual healthcare for anything. Overall, very disappointed with Obamacare. My job is apparently to support those who make much less and are much riskier.

Correct!  That's why they were focused so intently on getting as many "young people" to sign up as possible.  Who do you think is going to pay for all the people with pre-existing conditions that can no longer be denied coverage?

Until now, never in the history of the U.S. have you been forced to buy a product.  Your cold-hard money was yours to do with as you please.  Even auto insurance is not required if you don't drive a car.  But if you don't purchase "health insurance" (which is not insurance at all, it's really prepaid medical care that covers things like checkups and medication) -- if you don't buy it, you are *FINED* for running away from your duty to support all the McDonalds-eating people riding the electric carts at Walmart!

oinkette

  • Stubble
  • **
  • Posts: 196
  • Age: 47
  • Location: New York
  • Well behaved women rarely make history.
Re: 2015 Obamacare
« Reply #6 on: December 03, 2014, 09:26:14 AM »

Correct!  That's why they were focused so intently on getting as many "young people" to sign up as possible.  Who do you think is going to pay for all the people with pre-existing conditions that can no longer be denied coverage?

Until now, never in the history of the U.S. have you been forced to buy a product.  Your cold-hard money was yours to do with as you please.  Even auto insurance is not required if you don't drive a car.  But if you don't purchase "health insurance" (which is not insurance at all, it's really prepaid medical care that covers things like checkups and medication) -- if you don't buy it, you are *FINED* for running away from your duty to support all the McDonalds-eating people riding the electric carts at Walmart!

Woah there Mr. Judgy.  Not everyone with pre-existing conditions are McDonald's eating couch potatoes.  If that 27 year healthy guy suddenly found himself with cancer before Obamacare...he'd find out really quick why those of us with pre-existing conditions (a lot of us not our own fault, yours truly included) like having this "tax."  Or if he actually had to carry a baby healthily to term.

Like you said, it's a tax on a service (not my ideal but better than the "be healthy or die quick" formula we had before).  We pay for police, fire, military, etc.  Your money is still yours to do with as you please...after taxes. Just like it was before Obamacare.   

GizmoTX

  • Handlebar Stache
  • *****
  • Posts: 1450
Re: 2015 Obamacare
« Reply #7 on: December 03, 2014, 02:03:13 PM »
There are better ways to accomplish health insurance than Obamacare. Increasing numbers are finding it completely unaffordable, so how are they now better off? Even those who ante up are postponing needed health visits and/or losing their doctors.

Beric01

  • Handlebar Stache
  • *****
  • Posts: 1156
  • Age: 34
  • Location: SF Bay Area
  • Law-abiding cyclist
Re: 2015 Obamacare
« Reply #8 on: December 03, 2014, 02:10:51 PM »
I'm a 27 y/o male who makes six figures, but my startup doesnt offer healthcare. I got on the Bronze plan in IL, which is 120$/month. I only ever use vision/dental, but it has no vision/dental. My deductible is either 5k or 10k.

It's essentially another tax, because with a deductible that high it's unlikely I'll ever use the actual healthcare for anything. Overall, very disappointed with Obamacare. My job is apparently to support those who make much less and are much riskier.

Correct!  That's why they were focused so intently on getting as many "young people" to sign up as possible.  Who do you think is going to pay for all the people with pre-existing conditions that can no longer be denied coverage?

Until now, never in the history of the U.S. have you been forced to buy a product.  Your cold-hard money was yours to do with as you please.  Even auto insurance is not required if you don't drive a car.  But if you don't purchase "health insurance" (which is not insurance at all, it's really prepaid medical care that covers things like checkups and medication) -- if you don't buy it, you are *FINED* for running away from your duty to support all the McDonalds-eating people riding the electric carts at Walmart!

As a 24-year-old, I 100% agree with your perspective.

Iron Mike Sharpe

  • Bristles
  • ***
  • Posts: 396
Re: 2015 Obamacare
« Reply #9 on: December 03, 2014, 02:58:21 PM »
How do low income people actually pay their premiums before the subsidy?  Are they actually supposed to float the full amount for a whole year and then get their money back come tax time?

If you are making $35,000/year, after taxes and normal living expenses for most Americans, where does the money come from to pay for Obamacare?

taekvideo

  • Bristles
  • ***
  • Posts: 273
Re: 2015 Obamacare
« Reply #10 on: December 03, 2014, 03:23:54 PM »
Until now, never in the history of the U.S. have you been forced to buy a product.

You're forced to buy roads, public schools, military, etc... been that way for a long time.
Just because you have control over which health insurance you buy instead of the government taking your money and choosing for you, doesn't mean it's some new concept.

jawisco

  • Stubble
  • **
  • Posts: 194
Re: 2015 Obamacare
« Reply #11 on: December 03, 2014, 03:37:39 PM »
Back to the OP - the silver plans are the only ones that take into account your income relative to the poverty level and then if you meet their criteria, they also subsidize your deductable, copays, and total out-of-pocket costs.  That is why a silver plan can be way cheaper, but even better than a gold plan.

I'm a 27 y/o male who makes six figures, but my startup doesnt offer healthcare. I got on the Bronze plan in IL, which is 120$/month. I only ever use vision/dental, but it has no vision/dental. My deductible is either 5k or 10k.

It's essentially another tax, because with a deductible that high it's unlikely I'll ever use the actual healthcare for anything. Overall, very disappointed with Obamacare. My job is apparently to support those who make much less and are much riskier.

Plus: I do have maternity care covered, should I ever get pregnant ;)

Next level up, silver, was well over 500$/mo if I recall. Wasn't really worth it. Such a shame it worked out this way.

Before Obamacare, if you had a pre-existing condition (not that hard to have), you wouldn't have been able to find insurance at ANY PRICE, and your entire six-figure income/any savings you had/and even future earnings would have been vulnerable to a health emergency. 

I would have preferred single payer, but I am glad Obamacare is around.  I think the subsidies are very generous, but then I also think it is generous to not tax employee compensation in the form of high-quality healthcare. 

I also think the high deductables will indeed be the start of a more market driven health care - it can't get any more opaque than it is now - at least I hope so.  I know I ask more questions when it is my money getting spent.

All that being said, I don't blame folks who hate the mandate part of the law - it is odious to "have" to buy anything.  And the law certainly won't benefit everyone - some will pay more and lose some of their healthcare benefits.

boognish

  • Stubble
  • **
  • Posts: 130
Re: 2015 Obamacare
« Reply #12 on: December 03, 2014, 03:38:33 PM »
Who do you think is going to pay for all the people with pre-existing conditions that can no longer be denied coverage?
Who do you think paid for uninsured folks prior to the ACA?

pzxc

  • Stubble
  • **
  • Posts: 196
Re: 2015 Obamacare
« Reply #13 on: December 03, 2014, 03:58:08 PM »
Who do you think is going to pay for all the people with pre-existing conditions that can no longer be denied coverage?
Who do you think paid for uninsured folks prior to the ACA?

- Some of them did not go to the doctor/hospital/ER or went less often, knowing they were uninsured
- Some of them were turned away / refused care because they were uninsured
- Some of them received care despite the lack of insurance / ability to pay, because the doctor/hospital took them at their word that they would pay cash despite not having insurance (some of those actually did pay, either through savings or borrowing money or setting up payment plans, and some of those did NOT pay)
- Some of them received care despite the lack of insurance / ability to pay, because it was emergency care needed to stabilize/save their life

Hospitals are pretty smart and generally won't do anything except stabilize you if you are uninsured unless you pay in advance.

For the percentage of uninsured folks who ALSO were unable/unwilling to pay and ALSO received care despite not having the ability/will to pay, well the debt is sent to collections, so some part of it is paid to the hospital by the buyers of the debt (pennies on the dollar most likely, but it is still some amount of money received by the healthcare providor).  Then if the debt collector can't get the money out of the debtor, they either sell the debt again to another collection agency, or they write it off.  In this last case, it is a cost of doing business for the debt collection agency -- some debts they collect on, some they don't. As long as they collect on more of them than they don't, they are profitable and stay in business.  If not, they go out of business.

I think the answer you WANTED me to say is "the taxpayers paid for it!" but that's not actually true.

MrsK

  • Stubble
  • **
  • Posts: 117
  • Age: 55
Re: 2015 Obamacare
« Reply #14 on: December 03, 2014, 04:11:04 PM »
Who do you think is going to pay for all the people with pre-existing conditions that can no longer be denied coverage?
Who do you think paid for uninsured folks prior to the ACA?
My daughter works in the ER.  This is where the poor, the uninsured, the mentally ill, etc go for all of their health care.  They are not turned away, they may have to wait a very long time for their non-emergency, but they are seen and treated.  Who pays for this?  We do.  Not via taxes, but higher hospital bills that our insurance pays for by increasing our rates.  The ACA is not perfect, but it is one tiny step in the right direction.

You can't compare healthcare to car insurance.  I am OK with the fact that I have a car and others do not.  I am not OK with me having access to healthcare and others don't.  In a moral society, you need a safety net. 

jprince7827

  • Stubble
  • **
  • Posts: 148
Re: 2015 Obamacare
« Reply #15 on: December 03, 2014, 04:26:53 PM »

Before Obamacare, if you had a pre-existing condition (not that hard to have), you wouldn't have been able to find insurance at ANY PRICE, and your entire six-figure income/any savings you had/and even future earnings would have been vulnerable to a health emergency. 

I would have preferred single payer, but I am glad Obamacare is around.  I think the subsidies are very generous, but then I also think it is generous to not tax employee compensation in the form of high-quality healthcare. 

I also think the high deductables will indeed be the start of a more market driven health care - it can't get any more opaque than it is now - at least I hope so.  I know I ask more questions when it is my money getting spent.

All that being said, I don't blame folks who hate the mandate part of the law - it is odious to "have" to buy anything.  And the law certainly won't benefit everyone - some will pay more and lose some of their healthcare benefits.

Before Obamacare, I had a health care plan that cost about the same, but had a lower deductible and dental/vision coverage. All that changed is I was forced to have other useless things(like Maternity and Insanity coverage) such that I couldn't have nice extras like dental/vision. It seems that the change involved forcing me to buy more and get less.

But, I expected this to happen. Obamacare is essentially a wealth transfer from young and healthy people to old, poor and/or infirm people. Maybe one day I can get some of that government cheese! ;)

Beric01

  • Handlebar Stache
  • *****
  • Posts: 1156
  • Age: 34
  • Location: SF Bay Area
  • Law-abiding cyclist
Re: 2015 Obamacare
« Reply #16 on: December 03, 2014, 04:27:59 PM »
In a moral society, you need a safety net.

I'd agree, but I don't see why that safety net should be through forced charity (taxation) rather than voluntary charity.  Cut these programs and give people back their money, and you will see charitable giving skyrocket (and the US is already the most generous country in the world). If we're such a moral society, why do we need to force people to be moral?

pzxc

  • Stubble
  • **
  • Posts: 196
Re: 2015 Obamacare
« Reply #17 on: December 03, 2014, 04:39:15 PM »
My daughter works in the ER.  This is where the poor, the uninsured, the mentally ill, etc go for all of their health care.  They are not turned away, they may have to wait a very long time for their non-emergency, but they are seen and treated.  Who pays for this?  We do.  Not via taxes, but higher hospital bills that our insurance pays for by increasing our rates.  The ACA is not perfect, but it is one tiny step in the right direction.

You can't compare healthcare to car insurance.  I am OK with the fact that I have a car and others do not.  I am not OK with me having access to healthcare and others don't.  In a moral society, you need a safety net.

Maybe your daughter's ER will treat non-emergency situations of uninsured people, but most won't.

And, yeah I guess hospital prices are probably dictated in part by the amount of written off debt from uninsured patients.  However the prices are dictated much MORE so by negotiations with insurance companies, etc.  Hospitals, and businesses in general, charge what the market will bear.  In a situation where the uninsured are quotes prices TEN TIMES HIGHER or more than what insurance companies pay, I have little sympathy if the hospitals are then unable to collect on those vastly inflated prices.

And I don't think anyone has a "right to healthcare".  Healthcare is a nebulous concept anyway.  It means anything from "trim this hangnail of mine" to "perform experimental surgery to try and save me from this cancer".

You say, "in a moral society, you need a safety net."  Well where does it stop?  You can spend millions of dollars trying to treat diseases or conditions that, 50 years ago, you simply would have died from.  You can BANKRUPT YOUR ENTIRE COUNTRY paying for ridiculously expensive experimental procedures that have 0.000000001% chance of success.  You have to draw the line somewhere.

I draw the line at "stabilizing patients in the emergency room".  I think society should absolutely pay for that, insurance or no insurance. I guess you draw the line somewhat higher than I do.  /shrug

It's a tradeoff, certainly not a "right" and not a question of "morality".  There is no such thing as a free lunch.  Somebody pays.  I thought it was the hospitals and/or collection agencies that ultimately write off the debt that pay.  If it translates into higher prices, then I guess indirectly we all pay (though I find this proposition dubious, I think uncollectible debt plays has only a peripheral influence on medical prices, as compared to say, insurance company negotiations).  Either way, somebody has to pay the cost, and whatever the cost, that money/wealth/value is NOT being spent elsewhere.  So yeah, you can spend your entire nation's budget on "free healthcare" for your citizens if you want, but that means you won't be spending it on education, infrastructure, etc etc.

HOWEVER (and this is a big however), even though I don't think healthcare is a right, I do accept the fact that, even without universal coverage, the US spends far more in healthcare for less effectiveness than many other countries.  That is certainly sad.  But the solution is NOT to sweep the cost under the rug as some sort of morality guilt trip on the rest of us.  Throughout hundreds of thousands of years of evolution, we have mostly died in our 30s or younger due to largely preventable things like poor dental health and infant mortality.  It is only in the last 50 years that our civilization has been productive, profitable, and prodigious enough to allow for all the things we take for granted.

boognish

  • Stubble
  • **
  • Posts: 130
Re: 2015 Obamacare
« Reply #18 on: December 03, 2014, 05:13:44 PM »
Acute inpatient services are exponentially more expensive than routine preventative services, and I think it's worth considering that it might be more cost effective on a national scale.




tofuchampion

  • Bristles
  • ***
  • Posts: 372
  • Age: 41
  • Location: Wilmington, NC
    • MadeByMarilynM
Re: 2015 Obamacare
« Reply #19 on: December 03, 2014, 05:14:58 PM »
My daughter works in the ER.  This is where the poor, the uninsured, the mentally ill, etc go for all of their health care.  They are not turned away, they may have to wait a very long time for their non-emergency, but they are seen and treated.  Who pays for this?  We do.  Not via taxes, but higher hospital bills that our insurance pays for by increasing our rates.  The ACA is not perfect, but it is one tiny step in the right direction.

You can't compare healthcare to car insurance.  I am OK with the fact that I have a car and others do not.  I am not OK with me having access to healthcare and others don't.  In a moral society, you need a safety net.

Maybe your daughter's ER will treat non-emergency situations of uninsured people, but most won't.


Private hospitals can turn you away, but public ones can't - it's the law.  My (public) hospital treats a LOT of people - beyond just stabilization - with no insurance.  And we're doing really well financially, despite that.

As far the pre-existing conditions, I will also add the example of my husband, who is 29 and has had type one diabetes since the age of 10.  There was nothing he could have done to prevent it, but there it is.  Without Obamacare, he could not get any insurance except through a job, and even then, they didn't have to cover diabetes-related stuff.  We spent a period of time paying out of pocket for insulin and supplies - I don't remember exact numbers, but it was hundreds every month, and we were making maybe $30K/yr at the time.  But we had no choice; he'd die in days without it.

So yeah, I like Obamacare.  It's not perfect, but it's a step in the right direction, and it's been a huge improvement for us.

Dan_at_Home

  • 5 O'Clock Shadow
  • *
  • Posts: 87
Re: 2015 Obamacare
« Reply #20 on: December 03, 2014, 05:24:40 PM »
To the OP thanks for sharing the advice, maybe next time post this under the "Share your badassity" section because you found a smart way to keep your monthly expenses in FI down.

2lazy2retire

  • Guest
Re: 2015 Obamacare
« Reply #21 on: December 04, 2014, 06:23:12 AM »
My daughter works in the ER.  This is where the poor, the uninsured, the mentally ill, etc go for all of their health care.  They are not turned away, they may have to wait a very long time for their non-emergency, but they are seen and treated.  Who pays for this?  We do.  Not via taxes, but higher hospital bills that our insurance pays for by increasing our rates.  The ACA is not perfect, but it is one tiny step in the right direction.

You can't compare healthcare to car insurance.  I am OK with the fact that I have a car and others do not.  I am not OK with me having access to healthcare and others don't.  In a moral society, you need a safety net.

Maybe your daughter's ER will treat non-emergency situations of uninsured people, but most won't.

And, yeah I guess hospital prices are probably dictated in part by the amount of written off debt from uninsured patients.  However the prices are dictated much MORE so by negotiations with insurance companies, etc.  Hospitals, and businesses in general, charge what the market will bear.  In a situation where the uninsured are quotes prices TEN TIMES HIGHER or more than what insurance companies pay, I have little sympathy if the hospitals are then unable to collect on those vastly inflated prices.

And I don't think anyone has a "right to healthcare".  Healthcare is a nebulous concept anyway.  It means anything from "trim this hangnail of mine" to "perform experimental surgery to try and save me from this cancer".

You say, "in a moral society, you need a safety net."  Well where does it stop?  You can spend millions of dollars trying to treat diseases or conditions that, 50 years ago, you simply would have died from.  You can BANKRUPT YOUR ENTIRE COUNTRY paying for ridiculously expensive experimental procedures that have 0.000000001% chance of success.  You have to draw the line somewhere.

I draw the line at "stabilizing patients in the emergency room".  I think society should absolutely pay for that, insurance or no insurance. I guess you draw the line somewhat higher than I do.  /shrug

It's a tradeoff, certainly not a "right" and not a question of "morality".  There is no such thing as a free lunch.  Somebody pays.  I thought it was the hospitals and/or collection agencies that ultimately write off the debt that pay.  If it translates into higher prices, then I guess indirectly we all pay (though I find this proposition dubious, I think uncollectible debt plays has only a peripheral influence on medical prices, as compared to say, insurance company negotiations).  Either way, somebody has to pay the cost, and whatever the cost, that money/wealth/value is NOT being spent elsewhere.  So yeah, you can spend your entire nation's budget on "free healthcare" for your citizens if you want, but that means you won't be spending it on education, infrastructure, etc etc.

HOWEVER (and this is a big however), even though I don't think healthcare is a right, I do accept the fact that, even without universal coverage, the US spends far more in healthcare for less effectiveness than many other countries.  That is certainly sad.  But the solution is NOT to sweep the cost under the rug as some sort of morality guilt trip on the rest of us.  Throughout hundreds of thousands of years of evolution, we have mostly died in our 30s or younger due to largely preventable things like poor dental health and infant mortality.  It is only in the last 50 years that our civilization has been productive, profitable, and prodigious enough to allow for all the things we take for granted.

 so who my friend pays for you healthcare?

Schaefer Light

  • Handlebar Stache
  • *****
  • Posts: 1328
Re: 2015 Obamacare
« Reply #22 on: December 04, 2014, 07:37:48 AM »
Until now, never in the history of the U.S. have you been forced to buy a product.

You're forced to buy roads, public schools, military, etc... been that way for a long time.
Just because you have control over which health insurance you buy instead of the government taking your money and choosing for you, doesn't mean it's some new concept.
So you're saying it's a tax?  Sure don't remember Obama selling it as a tax back when this bill was being debated ;).

2lazy2retire

  • Guest
Re: 2015 Obamacare
« Reply #23 on: December 04, 2014, 08:05:33 AM »
Until now, never in the history of the U.S. have you been forced to buy a product.

You're forced to buy roads, public schools, military, etc... been that way for a long time.
Just because you have control over which health insurance you buy instead of the government taking your money and choosing for you, doesn't mean it's some new concept.
So you're saying it's a tax?  Sure don't remember Obama selling it as a tax back when this bill was being debated ;).

Whats in a name?? Off to Fox "News" for a "fair and balanced" debate ;)

Gin1984

  • Magnum Stache
  • ******
  • Posts: 4945
Re: 2015 Obamacare
« Reply #24 on: December 04, 2014, 08:28:15 AM »
So, my school finally moved from a grandfathered plan to a ACA compliant plan for 2015.  My increase was $12.91 from $65.10 every two weeks except my employer was sneaky, they also change the amount I pay. For family we used to pay 25% of the total cost, now we pay 27%.  So many people would assume the whole $12.91 is ACA costs but it is not.   The 2% change moved me $5.21, so ACA increase was only $7.70 every two weeks or about $200/year.

likeavision

  • 5 O'Clock Shadow
  • *
  • Posts: 17
Re: 2015 Obamacare
« Reply #25 on: December 04, 2014, 08:59:37 AM »
Sharing a personal experience

Background:2014 - FIRE in June; TW has major medical issues (cancer)
Purchased a BCBS platinum plan for 2014 - premiums out of pocket At $1460/mo for 2 people.  Too much income to qualify for subsidy in 2014.

2015
Smarter money management enables us to manage our AGI =$25000, a nice figure that keeps us above the floor in our state (Fl) but still eligible for subsidy.  The same platinum plan would be $1840/mo, but with subsidy, only $940/mo.

Found out thru a visit to our local BCBS at that income & in our state, we qualify for a Silver plan that has the same deductible and OOP MAX as the platinum plan we had.  Total Monthly cost, with subsidy - $450/mo.

Wow.  Be sure to ask questions as you enroll for 2015.  Very happy to have scored essentially a $1000/mo change in monthly cash flow!

Congrats on getting your premiums lowered.  Hopefully it helps to give you a little peace of mind and to defray some of the other costs that likely accompany a serious illness like cancer that no health insurance plan is designed to cover.  The big drop in premium from the platinum to silver plans is probably due to the cost-sharing reductions under the ACA (which are almost as beneficial as the premium subsidies and are only available for silver plans).  Given your income, you probably were able to increase the actuarial value of your silver plan from 70% to as much as 94%.  That makes a big difference in deductibles, co-pays, max out of pocket costs, etc.   

For me, I have a BCBS silver plan for 2014 with a monthly premium (after subsidies) of $63.00/month.  For 2015, the premium for the same plan dropped to $45.41/month.  I could have enrolled in several other plans with premiums as low as $5.91/month but they were all for HMOs.  I prefer a PPO plan so I'm willing to pay a little more for it every month.

pzxc

  • Stubble
  • **
  • Posts: 196
Re: 2015 Obamacare
« Reply #26 on: December 04, 2014, 09:06:59 AM »
Private hospitals can turn you away, but public ones can't - it's the law.  My (public) hospital treats a LOT of people - beyond just stabilization - with no insurance.

I don't think that is true.

The Emergency Medical Treatment and Active Labor Act (EMTALA) of 1986 says that hospitals must examine you.  "If the examination indicates that an emergency medical condition exists (including the active labor of a pregnant woman), the hospital must stabilize the patient or provide for transfer to another medical facility."

That's it. Nothing more.  Maybe your hospitals chooses to do more. I can't find a legal requirement for them to do so.  I can't imagine a law that says "If you wait in the emergency room long enough, they have to treat your lung cancer, even if you have no insurance and no ability to pay." (although that's an extreme, you get the point, some medical care is lifesaving and some is elective, they are not required to do anything other than save your life and send you out the door -- at least that is my understanding)

Gin1984

  • Magnum Stache
  • ******
  • Posts: 4945
Re: 2015 Obamacare
« Reply #27 on: December 04, 2014, 09:35:02 AM »
Private hospitals can turn you away, but public ones can't - it's the law.  My (public) hospital treats a LOT of people - beyond just stabilization - with no insurance.

I don't think that is true.

The Emergency Medical Treatment and Active Labor Act (EMTALA) of 1986 says that hospitals must examine you.  "If the examination indicates that an emergency medical condition exists (including the active labor of a pregnant woman), the hospital must stabilize the patient or provide for transfer to another medical facility."

That's it. Nothing more.  Maybe your hospitals chooses to do more. I can't find a legal requirement for them to do so.  I can't imagine a law that says "If you wait in the emergency room long enough, they have to treat your lung cancer, even if you have no insurance and no ability to pay." (although that's an extreme, you get the point, some medical care is lifesaving and some is elective, they are not required to do anything other than save your life and send you out the door -- at least that is my understanding)
Some public hospitals are required by either state or county law to treat without considering the ability to pay.  That is why they are county hospitals, they are for everyone.

pzxc

  • Stubble
  • **
  • Posts: 196
Re: 2015 Obamacare
« Reply #28 on: December 04, 2014, 10:04:34 AM »
Ah, I didn't think about state or local law.  I guess all the uninsured should move there!

tofuchampion

  • Bristles
  • ***
  • Posts: 372
  • Age: 41
  • Location: Wilmington, NC
    • MadeByMarilynM
Re: 2015 Obamacare
« Reply #29 on: December 04, 2014, 12:00:11 PM »
Private hospitals can turn you away, but public ones can't - it's the law.  My (public) hospital treats a LOT of people - beyond just stabilization - with no insurance.

I don't think that is true.

The Emergency Medical Treatment and Active Labor Act (EMTALA) of 1986 says that hospitals must examine you.  "If the examination indicates that an emergency medical condition exists (including the active labor of a pregnant woman), the hospital must stabilize the patient or provide for transfer to another medical facility."

That's it. Nothing more.  Maybe your hospitals chooses to do more. I can't find a legal requirement for them to do so.  I can't imagine a law that says "If you wait in the emergency room long enough, they have to treat your lung cancer, even if you have no insurance and no ability to pay." (although that's an extreme, you get the point, some medical care is lifesaving and some is elective, they are not required to do anything other than save your life and send you out the door -- at least that is my understanding)

I didn't mean that public hospitals are required to do all that.  I just meant that they can't turn you away from the ED.

I'm not sure how much my hospital is required to do and how much is by choice.  I just know what happens.  We had a pt once on my floor who stayed for over 6 months, had multiple surgeries, etc., and as far as I know, no insurance.  I'd imagine the bill was well over a million dollars.  We'll never see that money.  Obviously that's a rare case, but it happens.

Skyhigh

  • Bristles
  • ***
  • Posts: 420
Re: 2015 Obamacare
« Reply #30 on: December 05, 2014, 05:52:58 PM »


Obamacare is a huge score for those who are interested in FIRE.

Skyhigh

kpd905

  • Handlebar Stache
  • *****
  • Posts: 2044
Re: 2015 Obamacare
« Reply #31 on: December 05, 2014, 08:08:31 PM »
For those who are using Obamacare, how long does it take to get set up?  I am looking to get it for two months between jobs.  Will it take me a few hours or just a few minutes?

GizmoTX

  • Handlebar Stache
  • *****
  • Posts: 1450
Re: 2015 Obamacare
« Reply #32 on: December 05, 2014, 08:51:49 PM »
For two months of healthcare insurance, you want short term health insurance, not Obamacare. You can specify start & stop dates to purchase just what you need & you don't have to wait for an open enrollment period. Search for this with one of the major insurers, like Blue Cross.

surfhb

  • Guest
Re: 2015 Obamacare
« Reply #33 on: December 05, 2014, 10:20:19 PM »
Eventually things will go to a single payer system.     Obamacare was just a really poor way to get the ball rolling.     

Sorry, but as a Citizen of the US and the civilized world, its my right not to die or go into debt just because I get sick.     

Beric01

  • Handlebar Stache
  • *****
  • Posts: 1156
  • Age: 34
  • Location: SF Bay Area
  • Law-abiding cyclist
Re: 2015 Obamacare
« Reply #34 on: December 05, 2014, 10:54:44 PM »
Sorry, but as a Citizen of the US and the civilized world

Bandwagon fallacy. Just because the rest of the "civilized world" does something doesn't make it any more correct.

its my right not to die or go into debt just because I get sick.

Since when do you (or anyone else) have this right?

surfhb

  • Guest
Re: 2015 Obamacare
« Reply #35 on: December 05, 2014, 11:33:08 PM »
Sorry, but as a Citizen of the US and the civilized world

Bandwagon fallacy. Just because the rest of the "civilized world" does something doesn't make it any more correct.

its my right not to die or go into debt just because I get sick.

Since when do you (or anyone else) have this right?

You honestly believe someone who cant afford proper health care  should be allowed to die because they become ill or are denied coverage?   Because thats what it sounds like  and exactly the situation we had before the ACA.   
« Last Edit: December 06, 2014, 12:06:23 AM by surfhb »

CDP45

  • Pencil Stache
  • ****
  • Posts: 509
Re: 2015 Obamacare
« Reply #36 on: December 05, 2014, 11:36:05 PM »
Wow obamacare is so great I wonder why all the government Union workers don't switch already???


sol

  • Walrus Stache
  • *******
  • Posts: 8438
  • Age: 48
  • Location: Pacific Northwest
Re: 2015 Obamacare
« Reply #37 on: December 06, 2014, 12:47:47 AM »
Wow obamacare is so great I wonder why all the government Union workers don't switch already???

If by "government Union workers" you mean federal employees like me, then I can tell you why.   

It's because Obamacare is only available to people who don't have employer-sponsored health insurance, and every federal employee has employer-sponsored health insurance.

Now don't you feel silly?

MoneyCat

  • Handlebar Stache
  • *****
  • Posts: 1752
  • Location: New Jersey
Re: 2015 Obamacare
« Reply #38 on: December 06, 2014, 08:08:54 AM »
Wow obamacare is so great I wonder why all the government Union workers don't switch already???

If by "government Union workers" you mean federal employees like me, then I can tell you why.   

It's because Obamacare is only available to people who don't have employer-sponsored health insurance, and every federal employee has employer-sponsored health insurance.

Now don't you feel silly?

You can't reason with people like that because all they see is a law passed by Democrats.  That automatically makes it bad, no matter what the law actually does.

CDP45

  • Pencil Stache
  • ****
  • Posts: 509
Re: 2015 Obamacare
« Reply #39 on: December 06, 2014, 09:40:37 AM »
Wow obamacare is so great I wonder why all the government Union workers don't switch already???

If by "government Union workers" you mean federal employees like me, then I can tell you why.   

It's because Obamacare is only available to people who don't have employer-sponsored health insurance, and every federal employee has employer-sponsored health insurance.

Now don't you feel silly?

Oh what a bummer for that technicality, I haven't read all 2400 pages of the bill (apparently many of the democrat congressmen who voted for it but are out if office now didn't either). I'm sure the new congress would happily remedy that and Obama should be happy to sign that bill. I guess there's no need for spouse coverage then either because we wouldn't want to hold them back from superior coverage found on the government website.
« Last Edit: December 06, 2014, 09:48:36 AM by CDP45 »

CDP45

  • Pencil Stache
  • ****
  • Posts: 509
Re: 2015 Obamacare
« Reply #40 on: December 06, 2014, 09:55:16 AM »
Wow obamacare is so great I wonder why all the government Union workers don't switch already???

If by "government Union workers" you mean federal employees like me, then I can tell you why.   

It's because Obamacare is only available to people who don't have employer-sponsored health insurance, and every federal employee has employer-sponsored health insurance.

Now don't you feel silly?

You can't reason with people like that because all they see is a law passed by Democrats.  That automatically makes it bad, no matter what the law actually does.

I just can't recall any other legislation passed without even one vote from the other party since like the civil war...

MoneyCat

  • Handlebar Stache
  • *****
  • Posts: 1752
  • Location: New Jersey
Re: 2015 Obamacare
« Reply #41 on: December 06, 2014, 10:51:54 AM »
Wow obamacare is so great I wonder why all the government Union workers don't switch already???

If by "government Union workers" you mean federal employees like me, then I can tell you why.   

It's because Obamacare is only available to people who don't have employer-sponsored health insurance, and every federal employee has employer-sponsored health insurance.

Now don't you feel silly?

You can't reason with people like that because all they see is a law passed by Democrats.  That automatically makes it bad, no matter what the law actually does.

I just can't recall any other legislation passed without even one vote from the other party since like the civil war...

This past Congress hasn't passed anything because the GOP is unwilling to work with the Democrats or compromise on anything at all.  That's not going to change with the next Congress either.  It's a very strange time in American politics.  If the GOP was willing to negotiate, then maybe we'd have a better ACA, but unfortunately ideology is winning and nothing can be done about it so we have a stalemate going on three years now.

GizmoTX

  • Handlebar Stache
  • *****
  • Posts: 1450
Re: 2015 Obamacare
« Reply #42 on: December 06, 2014, 10:56:42 AM »
Compromise works both ways. The Senate has refused to bring any GOP legislation to the floor. If the American people were so unhappy with the GOP, how did the last election turn out the way it did?

CDP45

  • Pencil Stache
  • ****
  • Posts: 509
Re: 2015 Obamacare
« Reply #43 on: December 06, 2014, 11:01:42 AM »
Wow obamacare is so great I wonder why all the government Union workers don't switch already???

If by "government Union workers" you mean federal employees like me, then I can tell you why.   

It's because Obamacare is only available to people who don't have employer-sponsored health insurance, and every federal employee has employer-sponsored health insurance.

Now don't you feel silly?

You can't reason with people like that because all they see is a law passed by Democrats.  That automatically makes it bad, no matter what the law actually does.

I just can't recall any other legislation passed without even one vote from the other party since like the civil war...

This past Congress hasn't passed anything because the GOP is unwilling to work with the Democrats or compromise on anything at all.  That's not going to change with the next Congress either.  It's a very strange time in American politics.  If the GOP was willing to negotiate, then maybe we'd have a better ACA, but unfortunately ideology is winning and nothing can be done about it so we have a stalemate going on three years now.

Obamacare was passed solely by democrats, they could have passed a law repealing gravity and had enough votes to do it, the dems could have passed whatever healthcare law they wanted and the republicans (obviously) couldn't have stopped it. the failures of obamacare are the sole responsibility of the democrats.

MoneyCat

  • Handlebar Stache
  • *****
  • Posts: 1752
  • Location: New Jersey
Re: 2015 Obamacare
« Reply #44 on: December 06, 2014, 11:08:25 AM »
Wow obamacare is so great I wonder why all the government Union workers don't switch already???

If by "government Union workers" you mean federal employees like me, then I can tell you why.   

It's because Obamacare is only available to people who don't have employer-sponsored health insurance, and every federal employee has employer-sponsored health insurance.

Now don't you feel silly?

You can't reason with people like that because all they see is a law passed by Democrats.  That automatically makes it bad, no matter what the law actually does.

I just can't recall any other legislation passed without even one vote from the other party since like the civil war...

This past Congress hasn't passed anything because the GOP is unwilling to work with the Democrats or compromise on anything at all.  That's not going to change with the next Congress either.  It's a very strange time in American politics.  If the GOP was willing to negotiate, then maybe we'd have a better ACA, but unfortunately ideology is winning and nothing can be done about it so we have a stalemate going on three years now.

Obamacare was passed solely by democrats, they could have passed a law repealing gravity and had enough votes to do it, the dems could have passed whatever healthcare law they wanted and the republicans (obviously) couldn't have stopped it. the failures of obamacare are the sole responsibility of the democrats.

Ok, explain the failures of the law.  It's not perfect but it has saved lots of lives so far.  Is it a failure in terms of the fact that poor people now have insurance so they don't die of easily treatable conditions?  I suppose that's a failure in the "reduce the surplus population" sort of way.  Is it a failure because it's reduced the costs of insurance for the majority of people with individual health insurance plans?  Is it a failure because the number of uninsured in the United States is now the lowest it's been in decades?  Explain your reasoning.

Oh, and the Democrats only had that majority for about two years and it was impossible to make reforms to the law after that, because the Republicans refuse to do anything about the ACA other than take health insurance away from millions of people.  That is undeniable.

CDP45

  • Pencil Stache
  • ****
  • Posts: 509
Re: 2015 Obamacare
« Reply #45 on: December 06, 2014, 11:41:37 AM »


Obamacare was passed solely by democrats, they could have passed a law repealing gravity and had enough votes to do it, the dems could have passed whatever healthcare law they wanted and the republicans (obviously) couldn't have stopped it. the failures of obamacare are the sole responsibility of the democrats.

Ok, explain the failures of the law.  It's not perfect but it has saved lots of lives so far.  Is it a failure in terms of the fact that poor people now have insurance so they don't die of easily treatable conditions?  I suppose that's a failure in the "reduce the surplus population" sort of way.  Is it a failure because it's reduced the costs of insurance for the majority of people with individual health insurance plans?  Is it a failure because the number of uninsured in the United States is now the lowest it's been in decades?  Explain your reasoning.

Oh, and the Democrats only had that majority for about two years and it was impossible to make reforms to the law after that, because the Republicans refuse to do anything about the ACA other than take health insurance away from millions of people.  That is undeniable.
I'd love to see evidence that obamacare actually saved any lives, and we have to assess the current and future costs of this partisan regulation. Just from basic economics, having he government spend trillions more on health care to increase the demand won't result in lower costs.
Here's an actual study on how much health insurance has been taken away by obamacare: http://www.heritage.org/research/reports/2013/12/10-broken-obamacare-promises
"Promise #1: 的f you like your health care plan, you値l be able to keep your health care plan, period.納2]
Reality: Millions of Americans have lost and will lose their coverage due to Obamacare.
Obamacare has significantly disrupted the market for those who buy coverage on their own by imposing new coverage and benefit mandates, causing a reported 4.7 million health insurance cancelations of an existing policy in 32 states.[3]
For those with employer-sponsored insurance in the group market, the Congressional Budget Office (CBO) projects that 7 million fewer people will have employment-based insurance by 2018.[4]"




surfhb

  • Guest
Re: 2015 Obamacare
« Reply #46 on: December 06, 2014, 12:16:24 PM »


Obamacare was passed solely by democrats, they could have passed a law repealing gravity and had enough votes to do it, the dems could have passed whatever healthcare law they wanted and the republicans (obviously) couldn't have stopped it. the failures of obamacare are the sole responsibility of the democrats.


Ok, explain the failures of the law.  It's not perfect but it has saved lots of lives so far.  Is it a failure in terms of the fact that poor people now have insurance so they don't die of easily treatable conditions?  I suppose that's a failure in the "reduce the surplus population" sort of way.  Is it a failure because it's reduced the costs of insurance for the majority of people with individual health insurance plans?  Is it a failure because the number of uninsured in the United States is now the lowest it's been in decades?  Explain your reasoning.

Oh, and the Democrats only had that majority for about two years and it was impossible to make reforms to the law after that, because the Republicans refuse to do anything about the ACA other than take health insurance away from millions of people.  That is undeniable.
I'd love to see evidence that obamacare actually saved any lives, and we have to assess the current and future costs of this partisan regulation. Just from basic economics, having he government spend trillions more on health care to increase the demand won't result in lower costs.
Here's an actual study on how much health insurance has been taken away by obamacare: http://www.heritage.org/research/reports/2013/12/10-broken-obamacare-promises
"Promise #1: 的f you like your health care plan, you値l be able to keep your health care plan, period.納2]
Reality: Millions of Americans have lost and will lose their coverage due to Obamacare.
Obamacare has significantly disrupted the market for those who buy coverage on their own by imposing new coverage and benefit mandates, causing a reported 4.7 million health insurance cancelations of an existing policy in 32 states.[3]
For those with employer-sponsored insurance in the group market, the Congressional Budget Office (CBO) projects that 7 million fewer people will have employment-based insurance by 2018.[4]"


Hello!  It's already been said it isn't a perfect plan but to say that the ACA hasnt done any good to help an already failling healthcare system is rather strange.    The points you bring up are reasons why a single payer solution (socialized HC) would have been a far better option. 

The Democrats and the Pres did a terrible job of bringing this online but at least someone did something.    The opposition did nothing to bring options to the table due to partisan conflicts.

BTW.  I personally know 2 people who would never had access to HC due to pre existing conditions....these are the scenarios that save lives. 

Gin1984

  • Magnum Stache
  • ******
  • Posts: 4945
Re: 2015 Obamacare
« Reply #47 on: December 06, 2014, 12:16:35 PM »


Obamacare was passed solely by democrats, they could have passed a law repealing gravity and had enough votes to do it, the dems could have passed whatever healthcare law they wanted and the republicans (obviously) couldn't have stopped it. the failures of obamacare are the sole responsibility of the democrats.

Ok, explain the failures of the law.  It's not perfect but it has saved lots of lives so far.  Is it a failure in terms of the fact that poor people now have insurance so they don't die of easily treatable conditions?  I suppose that's a failure in the "reduce the surplus population" sort of way.  Is it a failure because it's reduced the costs of insurance for the majority of people with individual health insurance plans?  Is it a failure because the number of uninsured in the United States is now the lowest it's been in decades?  Explain your reasoning.

Oh, and the Democrats only had that majority for about two years and it was impossible to make reforms to the law after that, because the Republicans refuse to do anything about the ACA other than take health insurance away from millions of people.  That is undeniable.
I'd love to see evidence that obamacare actually saved any lives, and we have to assess the current and future costs of this partisan regulation. Just from basic economics, having he government spend trillions more on health care to increase the demand won't result in lower costs.
Here's an actual study on how much health insurance has been taken away by obamacare: http://www.heritage.org/research/reports/2013/12/10-broken-obamacare-promises
"Promise #1: 的f you like your health care plan, you値l be able to keep your health care plan, period.納2]
Reality: Millions of Americans have lost and will lose their coverage due to Obamacare.
Obamacare has significantly disrupted the market for those who buy coverage on their own by imposing new coverage and benefit mandates, causing a reported 4.7 million health insurance cancelations of an existing policy in 32 states.[3]
For those with employer-sponsored insurance in the group market, the Congressional Budget Office (CBO) projects that 7 million fewer people will have employment-based insurance by 2018.[4]"
My mom is one of those who won't have an employment based insurance any more.   That is because she was able to retire 3 years earlier than she expected thanks to the ACA.  She had medical issues that meant she had to keep employment based insurance prior to this even though her quality of life suffered because of her job and job related stress.

Davids

  • Pencil Stache
  • ****
  • Posts: 978
  • Location: Somewhere in the USA.
Re: 2015 Obamacare
« Reply #48 on: December 06, 2014, 01:57:02 PM »
I hate Obamacare but it did get my wife a free breast pump.

sol

  • Walrus Stache
  • *******
  • Posts: 8438
  • Age: 48
  • Location: Pacific Northwest
Re: 2015 Obamacare
« Reply #49 on: December 06, 2014, 04:34:12 PM »
Oh what a bummer for that technicality, I haven't read all 2400 pages of the bill

Lol, this isn't a technicality.  This is the fundamental nature of the entire law and I'm astounded that you somehow missed it, given the volume of your denunciations.

Look, the ACA doesn't change anything if you already have health insurance through your employer.  It only offers additional options to people who aren't already covered, or couldn't get covered.  Why are you opposed to giving people more options? 

Is it maybe because your party didn't think of it first?  Well if it's any consolation, they did!  Obamacare was a Republican idea, pushed by the conservative think tanks as an alternative to singler-payer healthcare, that protected the profits of the healthcare industry.  They outlined the idea, they drafted the bill, and they passed it in Massachusetts with a Republican governor signing off and taking all the credit. 

All Obama did was steal the idea and take it national.