Obamacare / Affordable Care Act : classic or dud?

no thread on this (i'm pretty sure) except

Roberts vs Obama: Affordable Health Care Act goes to SCOTUS

the website

https://www.healthcare.gov/

is so swamped you can't sign up for anything

still as much of an insurance-company bonanza as when Bob Dole ran on it.

(yes, it make some improvements over the shit we've had the last 40 years, well chronicled)

The affordable care act is so unpopular with Americans that even our patriotic internet hates it huh

Millions of Americans flocking to that website to verify their incredible disinterest in the whole thing

Big fan.

we should join the civilized world and institute single-payer. oh, i forget -- jesus was anti-healing

i'm self-employed and have a high deductible plan with BCBS TN - something most likely in line withe ACA's bronze plan. there's a chance my monthly premiums will go up by a few bucks if I go through the exchange. but i will likely do it anyway, mostly out of spite.

this truly is the best of all possible worlds

i will likely do it anyway, mostly out of spite.

You are a true American.

USA!!

I'm at the security questions page and none of the boxes have anything in them. What do i do?

Via Balloon Juice:

Commenter Emerald:

HaHaHaHa! I’ve been without coverage for nearly 13 years. (Took care of my Dad for 10 of those).

I qualify for the “Enhanced Silver” plan in California. Cheapest for me would be $3 per month for an HMO. Most expensive would be $159 for the Anthem Blue Cross HMO.

But unless my doctor is in that $3 plan (he might be–he takes more insurance than most), I’ll be deciding between the $94 Anthem EMO or Blue Cross PPO at $122.

Without the subsidies these all would be from $679 to well over $700 per month.

And I’m turning 63 in Dec and have been diagnosed with gallstones.

Commenter MomSense:

Just went to ObamaCare and filled in the information and I am going to get insurance much cheaper. Was paying 1,600 a month for years because I have a pre-existing condition and then because of some life changes I couldn’t afford it anymore so have been waiting and praying to be healthy until I could sign up. Starts at $243 a month so now I am going to decide on the plan! I can manage this!!!

Commenter BotSplainer:

I looked at Kentucky’s exchange. I can insure 4 of us (eldest daughter living away undoubtedly qualifies for enough subsidy to bring her a separate policy under $100) for somewhere between $850 and $950. Even if I get no tax credit at all,…. we’ll get a plan that has a $1500 deductible for the same price as our current tub of shit with a $15000 deductible.

This kind of plan has never been available to me at rates like this. Also, it ensures that my youngest daughter is insurable (she would never pass underwriting on the individual market – a biopsy…

I'm kind of excited to remain underemployed and still have coverage. Maybe not GREAT coverage like I had under my giant corporation job but still.

Those comments are incredible. We have friends with a daughter recovering from leukemia, and she was telling us how without the new laws, her daughter likely would have been denied coverage outright, or at least maxed out on coverage as the medical costs inched into the five or six figures.

Tried 5x to register, no luck. I think I know how GTA: Online players are feeling right now.

To test it, I tried it about ten minutes ago and answered a bunch of questions w/out a glitch.

not working for me, glad it's working for someone tho

I'm kind of excited to remain underemployed and still have coverage. Maybe not GREAT coverage like I had under my giant corporation job but still.

― Tottenham Heelspur (in orbit), Tuesday, October 1, 2013 11:54 AM Bookmark Flag Post Permalink

The law makes me feel like I have a better shot at ever leaving my job to try something more risky (e.g. starting a coffee business).

I'm also wondering how it will work out if H goes on prolonged childcare leave again, i.e. curious whether we can get a plan that's actually cheaper than my office plan, which has pretty high premiums AND high copays/deductible.

The law makes me feel like I have a better shot at ever leaving my job to try something more risky

OTMFM. I've made the argument for a long time that a lot of business owners are probably shitting bricks over ACA if only because of the potential number of employees who are clinging to awful jobs just to keep from losing their insurance.

lol Adam

*fistpump* at more ppl being able to get medical coverage

http://www.wnyc.org/story/faqs-about-health-care-exchanges/

day one glitch watch

http://nymag.com/daily/intelligencer/2013/10/obamacare-glitches-day-one-roundup.html

The original bill's timeline for getting the exchanges up and running was optimistic. That long period of uncertainty while the SCOTUS mulled over the ACA probably didn't assist the development process any.

Fox News, of course, has a "glitch watch" section on its website...

Did they ever have a glitch watch for the Iraq war? Because...

I'm 100% sure the glitches are part of the shutdown plan. Shut down the government the day this takes effect, make everyone stay home with nothing to do but go on the internet and crash the one health website! Republicans no doubt saw this happening and it's working like a charm!

The thing they realize is that it matters not who gets the blame. "Government" will get the blame! Because ultimately they have found a way to make government employees stand in the way of me and my health care: by temporarily laying them off, forcing everyone to stay home, clogging up the health website, and making it so I can't register.

I guess it's a good argument against centralization. Hopefully they will have it back up and running in a hot minute.

The law makes me feel like I have a better shot at ever leaving my job to try something more risky

OTMFM. I've made the argument for a long time that a lot of business owners are probably shitting bricks over ACA if only because of the potential number of employees who are clinging to awful jobs just to keep from losing their insurance.

Yes, this is all exactly correct. If ACA can break the non-sensical link between a certain type of employment and healthcare, it will help many people beyond just the uninsured.

and making it so I can't register.

You know you have six months, right?

Was gonna say, it's not Glasto tickets

http://www.youtube.com/watch?feature=player_embedded&v=sx2scvIFGjE&list=UUa6vGFO9ty8v5KZJXQxdhaw

You really don't have to think very many steps beyond "everyone gets access to affordable healthcare" before you start seeing net benefits. Re: breaking the nonsensical link between work and healthcare, doesn't this spur innovation? How many people would take a chance on something they're passionate about if it weren't for the spectre of losing health coverage? For instance, an underpaid high school teacher with health problems could quit the job he's hanging onto just for the insurance and go work at, say, a carwash while he puts the bulk of his time into a startup venture that puts more money into the economy.

i'm not sure if obamacare motivating a high school teacher to quit is the best example

LOL

FUCK THESE KIDS, i'm going to use my newfound flexibility to enter the realm of venture capitalism!

and be the one who knocks

Was gonna say, it's not Glasto tickets

Ha, my first thought was hey, if we can navigate buying concert tickets, we can handle this. Not a lot of Americans buying Glasto tickets, tho.

I made a similar joke on fb earlier, but used Bieber as the punchline.

I know, and that had more relevance.

Still, tho

Ugh a disaster

http://articles.philly.com/2006-01-12/news/25410200_1_medicare-spokeswoman-medicare-beneficiaries-medicare-prescription-drug-program

Posted: January 12, 2006

you missed the joke

idgi

seriously guys?

prescription drug package has awful roll-out in 2006; today nobody complains

I got my 2014 rate pamphlet from my health insurance company yesterday, and my new plan's premiums are $28 less a month, but the copays and prescription costs and the deductibles for serious stuff have all doubled. Is that what other insurance companies are doing?

Was this posted? It's been making the rounds:

http://www.hulu.com/watch/539715

(Jimmy Kimmel Obamacare vs. ACA bit)

sarahell do you have an individual plan or an employer plan?

Companies are generally increasing deductibles and going to cheaper plans like HDHPs with built in HSAs, and what your plan did sounds like another way of cost-cutting, trying to empower you to save up the money to pay for the 'gap' in expenses by...saving you a measly $28/month.

I have a corporate exchange plan, so it's probably staying the same, but the price is being jacked up.

I have an individual plan.

Wow. That's absolutely massive. Like more than 12 times what I pay, which indexed to taxable income anyway, so the less you earn the less you pay. Healthcare would be the number one reason why I don't think I could live in the US.

I am not going to lie, it's fucking terrifying.

If your employer doesn't pay your health insurance, if you're not rich and not poor, then you're fucked.

― Randall Jarrell (dandydonweiner), Sunday, November 12, 2017 7:09 PM (fourteen minutes ago) Bookmark Flag Post Permalink

otm

i have employer provided health insurance

Mine is for me only.

This year: $485 premium - $250 tax credit = $235 monthly premium out of my pocket
(I qualified for $329 tax credit but only used $250 so I'll get the other $948 applied to my tax bill in the spring)

Next year: $745 premium - $578 tax credit = $167 monthly premium out of pocket
(my deductible is going from $1750 to $5000, generic drugs from $1 to $15, primary care copay from $1 to $25, so despite a lower premium my monthly health care costs are going to be a bit higher, because I take 8 drugs and have to go to my PCP 4x/year)

Terrifying is right. Fuck a Republican who wants to make America more "free" and less safe.

I have paid for my own insurance and healthcare out of pocket for 10 years now. The amount of fuckery in the system is much, much worse EXCEPT for the fact that you can't get denied coverage and you can't get booted for a preexisting condition. And those two items are a life saver and bankruptcy protector for thousands (if not millions) of people, so I'm glad to pay to address that moral/financial lapse of the past...until of course, I can't afford it anymore.

Obamacare was a baseball bat to the hornet's nest of healthcare.

Really makes me wonder how anyone who isn't rich could ever vote Republican.

I'm currently in Australia - the health system is far from perfect, and if you need elective surgery and don't have private health insurance you can wait a long time for it... but in general I have no complaints with the way it's treated me or my family. And that's included some surgery and a couple of hospital stays. And I never, ever have to worry about how I'm going to pay for my healthcare. That's a burden I really wouldn't want in life.

And I can only imagine funding healthcare through tax revenue is way more efficient anyway.

which means it's doing exactly what it was designed to do--bring on single payer.

You may or may not recall that all the basic ideas incorporated in the ACA were proposed by the conservative Heritage Foundation and first implemented under Mitt Romney in Massachusetts, where it worked more or less reasonably.

Far from being designed to bring on single payer, it was democrats from conservative-leaning states like Montana who ensured that the ACA did not have a government-run option, but required citizens to seek their insurance from the private sector.

Lastly, the rises in premiums we've experienced under the ACA are largely due to sabotage by the republican congress, which could not repeal the ACA due to lack of votes, but who were able to throw a monkey wrench into the works by failing to fund the subsidies to insurance companies written into the original law, that should have buffered the market from the lag between when the sickest people signed up and when the healthy laggards were persuaded to sign up, via slowly escalating penalties for not participating.

You have the history and facts of the matter wrong, or else the facts are in your possession, but you are drawing a stupid conclusion entirely unwarranted by them.

thank u aimless

which means it's doing exactly what it was designed to do--bring on single payer.

There were many in Congress/Senate/elsewhere in the Obama Adminstration (whose goal was a single payer system) who had their hands all over the writing and execution of the ACA. The basic tenets ACA were borrowed from Romneycare, sure. But as you note, the weak execution of the ACA allowed the Republican Congress (and Republican leadership in general) to fuck with it, including a challenge in the Supreme Court. During the writing and passage of the bill (and after it was passed, and after the Court made its landmark ruling), these weaknesses (particularly in the funding mechanisms) were discussed and if you didn't see the many comments about how it would lead to single payer, then I guess you missed it. But thanks Aimless, I appreciate your comments and I'll try not to make a stupid comment next time.

I don't believe there were too many in Congress/Senate/Administration whose goal was a single-payer system and I don't recall any of them publicly saying they were creating this too FAIL to lead to single payer (and I find it hard to imagine any of them would be playing such a long game as that anyway). I do agree that it's a Frankenstein's monster of a bill and that it's complexity has lent itself to sabotage (which the Republicans are happy to do) but I don't think that was the intent (rather to upset the existing the system as little as possible was).

Lastly, the rises in premiums we've experienced under the ACA are largely due to sabotage by the republican congress

I don't know the size of the effect on premiums relative to Repub sabotage, but lower-than-expected number of young and healthy people buying ACA policies is the other big factor.

the weak execution of the ACA allowed the Republican Congress (and Republican leadership in general) to fuck with it

This is true. But your suggestion would require that the Democrats designed the ACA in order to purposely lose control of the House and Senate in the next election. Yeah. Right. Very cunning of them, I'm sure.

im having a real hard time imagining they ever wanted single payer. more like furthering the entrenched industry deathgrip.

the Obama Adminstration (whose goal was a single payer system)

in the same way that his goal *wink wink* was also shutting down gitmo

i hope the republicans throw 13,000,000 lazy bum americans off health care to cut taxes on the hardworking and virtuous wealthy. #mrga

BARBARA EHRENREICH: WHY I’M GIVING UP ON PREVENTATIVE CARE

The piece itself belies the headline a bit.

But still.

I have been more intimate with the current medical system than I ever would have chosen and I agreed with the major thrust of that piece. Health and illness are extremely personal, science is extremely impersonal, and capitalism is extremely greedy and uncaring, and physicians are pushed around chaotically by all these influences, so medical practice is caught in a maelstrom of irreconcilable conflict. This doesn't conduce to the reinforcement of reasonable and caring medical practice.

TEN BUCKS HUH

The beauty of this system is that the mega-rich and their servants feel unashamed about rubbing your nose in their shit. Like they're doing you a favor. And sadly, too many people love it and ask for more. https://t.co/iDtEizfziB

— Dennis Perrin (@DennisThePerrin) December 10, 2019

Still amazed by how many people know jack shit about this law. See stuff like "Trump didn't get rid of Obamacare but at least he made it so ppl aren't forced to buy Obamacare, they can now buy thru private insurers". Just change the name of this country to Dunning-Krugerstan already.

and of course Trump obv doesn't understand it at all

Still amazed by how many people know jack shit about this law.

That's because, other than the expansion of Medicaid, they made it too damned complicated so as to preserve as much of the for-profit aspects of the system as possible. The whole web-based Marketplace idea that maintains 50 different state-of-residence variations, multiple tiers of coverage, alongside individualized subsidies recalculated annually, was always a shambles waiting to happen, even before the Republicans started undercutting its funding.

I just qualified for Medicare and was enrolled automatically in the two main parts A & B, which is pretty sweet, but compared to comprehensive universal health care such as UK's NHS, Medicare has gaps in coverage and a bunch of sidecar programs - like part D, various commercially sold supplementary plans and Medicare Advantage - that can be quite confusing, too.

The US Congress is so in the thrall of the capitalist health care system they are incapable of legislating a straightforward, comprehensive system that just ensures that people get health care.

I agree that it resulted in an even more convoluted system (most of my work time is devoted to correcting "discrepancies" between govt records and insurance Co records), but the 3 core provisions of the law are simple enough to understand. At this point there's no excuse to think that "obamacare didn't allow ppl to buy thru private insurers" or other stuff you here conservatives regurgitate.

it does seem like a good portion of people have literally no clue what medicaid expansion means, like literally i think their brain shuts off at "medicaid" and they just stop thinking at that point, assuming that there is absolutely no hope that they would understand. because otherwise you'd think there'd be riots over states choosing to let more of their own people die rather than accept federal money that was already put aside for them to expand medicaid.

riots over states choosing to let more of their own people die rather than accept federal money

At the risk of being trenchant, I think you are underestimating how warped people's thinking becomes when it comes to money. in terms of powerfully modifying behavior, money is on a par with addictive drugs.

I wonder how many people's lives a law has to save before some people would be fine with paying more taxes because of it. 5 million? 10 million? What if a lot of them are children? 2 million sick kids' lives = what, 20 million normal adults?
It just disgusts me to see people moaning about having to pay more post ACA when that money is literally going to save lives.

tried to sign up for same ACA plan i had last year in December; thought i did

failed to notice "Premier" dangling from plan name as NY State phoneguy walked me thru process

new member card shows deductible $3000 higher than 2019

pray i can get this changed

(that added cost is more than a month's takehome pay)

Health insurance in this country, on balance, can die in a fire

I get that insurance co's are seen as unnecessary middlemen who live to deny claims & I'm for single payer, but hospital and pharma companies LOVE having them around as whipping boy. Insurance companies have to have their premiums approved by govt, and legally must pay out 85 cents of every dollar they receive to members' claims. Meanwhile hospitals can charge $60 for an aspirin and pharma can charge whatever they want for life-sustaining medications. Insurers respond to prices set by those 2 groups.

Don't forget the massive doctor salaries propped up by absurd protectionist policies

But yeah

and that the Catholic church keeps buying up hospitals and clinics in the US to add to their portfolio.

xpost Drs often get their own absurdly high insurance to pay.

Lol first time I've seen the Catholic church blamed for insane healthcare costs in the USA

I mean Catholic hospitals are a menace to society regardless

they are the largest owner of private healthcare in the US and have been heavily involved in m&a in the last decade. In some rural areas they are the only game in town and can deny you for care based on whatever their faith says. I mean this is a crude summary but there has been a lot written about this.

Fair enough, thanks for clarifying

they own a lot of hospitals all over the world but at least in the US their work is not "charitable". They are as capitalist as everyone else.

Yeah the mindset that health care should lean more towards charity than profiteering has gone out the window in last few decades. Everyone from aspiring doctors to religious orgs like Catholic "charities" view it as ticket to $$$$$$. There are obv many great, caring docs that got into the profession to help ppl, but there are also a shit ton of ppl who picked it because doctor=$$$$. Anecdote alert: my sister is office mgr for OBGYN grp, and out of 20 OBGYN docs only 1 or 2 strike her as truly caring about their patients. The rest are in it for the cash.

When I was younger I ran across a couple of OBGYNs that would not prescribe birth control. It didn't even occur to me to ask before my appt because I was like "HOW IS THIS A THING???"

one of those shockingly old thing I learned today is about how Mother Theresa was kind of terrible and likely has all her hoarded billions still stored in the Vatican.

a family member worked at a USA catholic hospital where anyone who couldn’t pay had their costs paid for by the church. menace to your neoliberal society!

back to obamacare, but I used it for 2 years? and I chose a empire blue cross plan because my gyno of 10 years accepted it. When I went to make an appt I learned they didn't accept the obamacare version of blue cross. No one in the office knew why. I called their billing and they were just like "it was too difficult" to deal with.

insurance is a fuckin scam

'tis

abolishing it (the mersh version) wd improve our moral fiber

it should be illegal to get a bill months later for services that have already been rendered because insurance whimsically chooses to later deny something.

I changed the problem described earlier by selecting the plan I originally wanted, effective Feb 1. However nothing I spend this month (and there's plenty) will count toward the new deductible. So I suspect I will lose about a grand instead of three (unless I get a goddamn benefits job by mid-year). I'd do the math but it's too depressing.

can avoid those charges by getting stuff pre-approved

it could be something as dumb as your doc office coding something the wrong way causing claim to be denied, but see it's really fun to just blame insurance co's for everything wrong with our fucked up system

example of backasswards way we do things:
I'm advised to have colonoscopies every few years due to Crohn's. If I do, it's coded as "preventative" and isn't covered by insurance. So one might choose to forego regular screenings. Then, things that can be addressed at early stages progress, and now I'm needing to get admitted to a hospital, which will most likely order a colonoscopy anyway except now it's coded as "diagnostic" and is covered by insurance. But obv now the ins co has to pay out $$$ for my hospitalization, in addition to the diagnostic colonoscopy! And I'm in poorer health. Lose-lose situation.