Bronze and Silver Obamacare Program are GARBAGE - Liberals let’s not forget this.

[beagle9]

I have a buddy who is a small business owner. He selected a provider on Obamacare (it was maybe 3 yrs back).

He paid I believe $750 for him and his wife. To his dismay, he discovered that not one Healthcare provider accepted his insurance. By not one, I mean no one. It was useless. The Government made an exception to the open enrollment period and allowed him to select a new more expense insurer, but it took 90 days to fix the problem and 60 days to get a new insurer. Ridiculous

The salient point here is that, under ACA, government is the "decider". That's the goal of greenbeard and the rest of the insurance industry shills here on the board. They know that it's easier to manipulate regulation than to satisfy customers.

The Government is the decider of what?

Winners and losers ?

 

[Greenbeard]

I have a buddy who is a small business owner. He selected a provider on Obamacare (it was maybe 3 yrs back).

He paid I believe $750 for him and his wife. To his dismay, he discovered that not one Healthcare provider accepted his insurance. By not one, I mean no one. It was useless. The Government made an exception to the open enrollment period and allowed him to select a new more expense insurer, but it took 90 days to fix the problem and 60 days to get a new insurer. Ridiculous


Sent from my iPhone using USMessageBoard.com

It's not 2014 anymore. They've added lots of feature to the website since the first bare bones version opened four years ago.

These days you can filter plans by whether they include your preferred providers.

 

[Greenbeard]

Ok, in respect to people that can only purchase employer offered plans, is it fair that the employees of companies pay for these high cost plans with very high deductibles, and worse these 70/30 splits ? Isn't it true that if a company offers health insurance that these workers aren't allowed to join up for a plan in the ACA, and if were able to join up, wouldn't they be subjected to rates or plans based on their incomes in which would place them right back into the very same situation they had at work with those plans offered ?? So otherwise there isn't any relief for the working class, but if one is poor by choice as we have seen in many cases, then a person or family comes out looking like bandits in their Healthcare savings and plans offered them ??????

You can buy any plan you want, even if you have employer-based insurance available to you--you just can't get any federal tax credits for it. Employer-based plans get a pretty tax benefit already.

Anyway, if you're in an employer plan your deductible doesn't have anything to do with plans bought in the marketplaces so I don't know what connection you're making.

 

[debbiedowner]

Affordable coverage

A job-based health plan covering only the employee that costs 9.69% or less of the employee’s household income. If a job-based plan is “affordable,” and meets the “minimum value” standard, you're not eligible for a premium tax credit if you buy a Marketplace insurance plan instead.

• The plan used to define affordability is the lowest priced “self-only” plan the employer offers — meaning a plan covering only the employee, not dependents. This is true even if you’re enrolled in a plan that costs more or covers dependents.
• The cost is the amount the employee would pay for the insurance, not the plan’s total premium.
• The employee’s total household income is used. Total household income includes income from everybody in the household who’s required to file a tax return.

Example 1

• Employee’s monthly household income = $4,083 (about $49,000 per year)
• 9.69% of the employee’s monthly household income = $396
• Monthly cost to the employee of the lowest-priced plan the employer offers for self-only coverage = $300
• Is the plan affordable? YES. The employee’s share of the lowest cost self-only plan ($300) is less than 9.69% of the employee’s household income ($396).

Example 2

• Employee’s monthly household income = $2,333 (about $28,000 per year)
• 9.69% of the employee’s monthly household income = $226
• Monthly cost to the employee of the lowest-priced plan the employer offers for self-only coverage = $275
• Is the plan affordable? NO. The employee’s share of the lowest-cost self-only plan ($275) is morethan 9.69% of the employee’s household income ($226).

To find out if your employer’s plan meets the affordability standard, ask your employer. You can also ask them to fill out the Employer Coverage Tool (PDF).

Affordable coverage - HealthCare.gov Glossary

 

[dblack]

I have a buddy who is a small business owner. He selected a provider on Obamacare (it was maybe 3 yrs back).

He paid I believe $750 for him and his wife. To his dismay, he discovered that not one Healthcare provider accepted his insurance. By not one, I mean no one. It was useless. The Government made an exception to the open enrollment period and allowed him to select a new more expense insurer, but it took 90 days to fix the problem and 60 days to get a new insurer. Ridiculous

The salient point here is that, under ACA, government is the "decider". That's the goal of greenbeard and the rest of the insurance industry shills here on the board. They know that it's easier to manipulate regulation than to satisfy customers.

The Government is the decider of what?

You're not familiar with ACA? It establishes all kinds of requirements and standards deciding what kind of insurance we're allowed to have, deciding who qualifies for subsidies and how much, etc, etc..... I assume you know this, so I'm wondering why you asked?

 

[debbiedowner]

I have a buddy who is a small business owner. He selected a provider on Obamacare (it was maybe 3 yrs back).

He paid I believe $750 for him and his wife. To his dismay, he discovered that not one Healthcare provider accepted his insurance. By not one, I mean no one. It was useless. The Government made an exception to the open enrollment period and allowed him to select a new more expense insurer, but it took 90 days to fix the problem and 60 days to get a new insurer. Ridiculous

The salient point here is that, under ACA, government is the "decider". That's the goal of greenbeard and the rest of the insurance industry shills here on the board. They know that it's easier to manipulate regulation than to satisfy customers.

The Government is the decider of what?

You're not familiar with ACA? It establishes all kinds of requirements and standards deciding what kind of insurance we're allowed to have, deciding who qualifies for subsidies and how much, etc, etc..... I assume you know this, so I'm wondering why you asked?

You made it sound like the government decided which plan a person has to choose and that is not so unless then again there is only one company and one plan for that company, but the applicant doesn't have to take it.

 

[dblack]

I have a buddy who is a small business owner. He selected a provider on Obamacare (it was maybe 3 yrs back).

He paid I believe $750 for him and his wife. To his dismay, he discovered that not one Healthcare provider accepted his insurance. By not one, I mean no one. It was useless. The Government made an exception to the open enrollment period and allowed him to select a new more expense insurer, but it took 90 days to fix the problem and 60 days to get a new insurer. Ridiculous

The salient point here is that, under ACA, government is the "decider". That's the goal of greenbeard and the rest of the insurance industry shills here on the board. They know that it's easier to manipulate regulation than to satisfy customers.

The Government is the decider of what?

You're not familiar with ACA? It establishes all kinds of requirements and standards deciding what kind of insurance we're allowed to have, deciding who qualifies for subsidies and how much, etc, etc..... I assume you know this, so I'm wondering why you asked?

You made it sound like the government decided which plan a person has to choose and that is not so unless then again there is only one company and one plan for that company, but the applicant doesn't have to take it.

The government decides which plans, and which companies, they are allowed to choose from. Which might be one, or a handful.

 

[debbiedowner]

I have a buddy who is a small business owner. He selected a provider on Obamacare (it was maybe 3 yrs back).

He paid I believe $750 for him and his wife. To his dismay, he discovered that not one Healthcare provider accepted his insurance. By not one, I mean no one. It was useless. The Government made an exception to the open enrollment period and allowed him to select a new more expense insurer, but it took 90 days to fix the problem and 60 days to get a new insurer. Ridiculous

The salient point here is that, under ACA, government is the "decider". That's the goal of greenbeard and the rest of the insurance industry shills here on the board. They know that it's easier to manipulate regulation than to satisfy customers.

The Government is the decider of what?

You're not familiar with ACA? It establishes all kinds of requirements and standards deciding what kind of insurance we're allowed to have, deciding who qualifies for subsidies and how much, etc, etc..... I assume you know this, so I'm wondering why you asked?

You made it sound like the government decided which plan a person has to choose and that is not so unless then again there is only one company and one plan for that company, but the applicant doesn't have to take it.

The government decides which plans, and which companies, they are allowed to choose from. Which might be one, or a handful.

No, you have that ass backwards the companies decide if they want to offer plans on the exchanges. But they must have the 10 EHB's in them, so on that point you are correct.

 

[dblack]

The salient point here is that, under ACA, government is the "decider". That's the goal of greenbeard and the rest of the insurance industry shills here on the board. They know that it's easier to manipulate regulation than to satisfy customers.

The Government is the decider of what?

You're not familiar with ACA? It establishes all kinds of requirements and standards deciding what kind of insurance we're allowed to have, deciding who qualifies for subsidies and how much, etc, etc..... I assume you know this, so I'm wondering why you asked?

You made it sound like the government decided which plan a person has to choose and that is not so unless then again there is only one company and one plan for that company, but the applicant doesn't have to take it.

The government decides which plans, and which companies, they are allowed to choose from. Which might be one, or a handful.

No, you have that ass backwards the companies decide if they want to offer plans on the exchanges. But they must have the 10 EHB's in them, so on that point you are correct.

The point is, the whole thing herds the market toward government approved vendors.

 

[LoneLaugher]

For the millionth time, Obama meant that when he said it. And for 95%+ of Americans who had insurance before the ACA were able to keep their plans and their doctors.

Yes. This is the nature of statists programs. They take care of the 95% by fucking the 5%.

Incorrect.

The 95% has already been taken care of and were not effected by the law. They had coverage through their employers.

Millions of the 5% gained coverage or got better coverage. You fail.

 

[LoneLaugher]

I have a buddy who is a small business owner. He selected a provider on Obamacare (it was maybe 3 yrs back).

He paid I believe $750 for him and his wife. To his dismay, he discovered that not one Healthcare provider accepted his insurance. By not one, I mean no one. It was useless. The Government made an exception to the open enrollment period and allowed him to select a new more expense insurer, but it took 90 days to fix the problem and 60 days to get a new insurer. Ridiculous


Sent from my iPhone using USMessageBoard.com

Bull.

 

[dblack]

For the millionth time, Obama meant that when he said it. And for 95%+ of Americans who had insurance before the ACA were able to keep their plans and their doctors.

Yes. This is the nature of statists programs. They take care of the 95% by fucking the 5%.

Incorrect.

The 95% has already been taken care of and were not effected by the law. They had coverage through their employers.

Millions of the 5% gained coverage or got better coverage. You fail.

Try to focus. You were talking about whether anyone was forced to ditch their insurance plan or their doctor. You acknowledge this wasn't true for some people, but wrote it off because "95%+ of Americans who had insurance before the ACA were able to keep their plans and their doctors." - this is always the claim of democracy worshippers when they're plans end up fucking people.

 

[LoneLaugher]

For the millionth time, Obama meant that when he said it. And for 95%+ of Americans who had insurance before the ACA were able to keep their plans and their doctors.

Yes. This is the nature of statists programs. They take care of the 95% by fucking the 5%.

Incorrect.

The 95% has already been taken care of and were not effected by the law. They had coverage through their employers.

Millions of the 5% gained coverage or got better coverage. You fail.

Try to focus. You were talking about whether anyone was forced to ditch their insurance plan or their doctor. You acknowledge this wasn't true for some people, but wrote it off because "95%+ of Americans who had insurance before the ACA were able to keep their plans and their doctors." - this is always the claim of democracy worshippers when they're plans end up fucking people.

I'm focused. You are math impaired.

 

[dblack]

I'm focused. You are math impaired.

You could prove it by actually responding to my point. Clearly some people weren't able to keep their insurance or their doctor. Why should government have the power to push people around that way?

 

[DrLove]

My unsubsidized ACA-complient plan for 2018 for which I will pay a little under $700 per month (straight off the card):

Silver Option 2 94 Link

In-Network Co-Pay

Primary Care Physician $10
Specialist $25
Urgent care 10%
Emergency $100
RX: $5 per for generic

In-Network Deductible

Individual $0
Family $0

Preventative Services in Network
N/C

THANKS OBAMA!

*Suggestion: Not all states have competition or choices such as we do in Idaho. Call a broker who specializes in ACA policies and shop it - Never know what ya might find!

 

[LoneLaugher]

I'm focused. You are math impaired.

You could prove it by actually responding to my point. Clearly some people weren't able to keep their insurance or their doctor. Why should government have the power to push people around that way?

Very few people. And those were due to the fact that the plans they had were garbage or changes in provider networks as happened before the law was passed.

Nutbags put forth a MASSIVE disinformation campaign which has dummies like you believing that there was widespread disruption of policies and doctors. There wasn't.

 

[dblack]

I'm focused. You are math impaired.

You could prove it by actually responding to my point. Clearly some people weren't able to keep their insurance or their doctor. Why should government have the power to push people around that way?

Very few people. And those were due to the fact that the plans they had were garbage ...

According to whom? See that's the conceit of your position: the conviction that you, or government, know what's best for people, even when those very people disagree.

Nutbags put forth a MASSIVE disinformation campaign which has dummies like you believing that there was widespread disruption of policies and doctors. There wasn't.

I've never said it was widespread. The insurance industry has already done a pretty thorough job of herding people into their pens with state regulation. ACA is just icing on the cake - an attempt to go after the remaining outliers who have refused to play along.

 

[LoneLaugher]

I'm focused. You are math impaired.

You could prove it by actually responding to my point. Clearly some people weren't able to keep their insurance or their doctor. Why should government have the power to push people around that way?

Very few people. And those were due to the fact that the plans they had were garbage ...

According to whom? See that's the conceit of your position: the conviction that you, or government, know what's best for people, even when those very people disagree.

Nutbags put forth a MASSIVE disinformation campaign which has dummies like you believing that there was widespread disruption of policies and doctors. There wasn't.

I've never said it was widespread. The insurance industry has already done a pretty thorough job of herding people into their pens with state regulation. ACA is just icing on the cake - an attempt to go after the remaining outliers who have refused to play along.

According to facts that proved the shit policies to be shit policies....ripoffs. Simple. The government regulates businesses to protect consumers. It is how shit is done in places with laws and stuff. Catch up.

 

[flacaltenn]

Oh no.. Of COURSE not genius. . So you give a low wage family a shitty O'Care for nearly free. Maybe they pay 15% of the outrageous premium. Say $220/month. Has an 80/20 benefit. With a $2500 individual deductible. $4000 per family. Kid breaks a clavicle has a mild concussion. Hospital and ER and follow up bills after "negotiated payment adjustment" is $6500. You're a genius -- give me that YEARLY cost of that "medical insurance" and care. You can round to the nearest $100.

THEY -- cannot afford it. If you can't calculate it, maybe you shouldn't be calling people charlatans --- if you get the number wrong.

This exercise is pretty straightforward using healthcare.gov. Say, a family in Nashville of two mid-30-somethings with two young kids making 39K.

They could get a zero premium bronze plan and be on the hook for only out-of-pocket costs (not advisable). Or they could buy a silver plan and get cost-sharing reductions that drop their deductibles and OOP maxes (advisable!).

So they buy the cheapest silver plan (Cigna Connect 800-3) for $82/month.

If they had a $6,500 hospital bill for one of the kids, they'd pay a $800 deductible and then 10% coinsurance on the rest [(0.1 * ($6,500 - $800)) = $570].

So $984 in premiums for the year and $1,370 out of pocket is about $2,350 on health expenses for the year. About 6% of their income and well below the actual costs they incurred that year.

(I should say I actually think in your example their out-of-pocket would really only be the $250 ER copay in that plan but I'm just going with the worst-case scenario.)

That was selected out of GROUP of Cigna plans and has the most MINIMAL network of providers. I've looked at the networks. To get a REASONABLE network of providers (if you like your doctors -- you can keep your doctors) the premiums are likely twice as high and they are 80/20 plans. Not 80/10.. They can offer 80/10 on these plans and lower deductibles because they are strong-arming the providers to GET on these "skinny networks". Skinny networks are a large step toward rationing by scarcity. If you want appointments in less than 2 months -- you have to pay.. Skinny networks are DOMINATED by nurse practioners and walk-in clinics. Not full MDs..

For instance. I looked at one of these plans. I have bi-annual derm appointments. They are BOOKED 4 to 6 months in advance. The skinny plan that you picked uses a network with ONE dermatology group within 20 miles of my location... And it wasn't anyone that I WANTED to use.

So the truth is -- MOST can't afford or choose not to pay for better insurance. And you trade off coinsurance fractions for access to the doctors/services that you WANT to use. If you want to health care access BY CHOICE -- my math says the kid's care for that incident costs $2500 plus the insurance cost per year which is about TWICE what your "skinny network" plan is.

And NEITHER of these calculations account for the ACTUAL health needs of the REST of that family..
That year- it's VERY likely that on THAT plan -- they would come close or exceed the FAMILY deductible of $1600.. Another $500 or $800 out of their pockets.

 

[Greenbeard]

That was selected out of GROUP of Cigna plans and has the most MINIMAL network of providers.

Looks like virtually every acute care hospital in Nashville is in that plan's network. So whichever one your hypothetical kid went to was in.

For instance. I looked at one of these plans. I have bi-annual derm appointments. They are BOOKED 4 to 6 months in advance. The skinny plan that you picked uses a network with ONE dermatology group within 20 miles of my location... And it wasn't anyone that I WANTED to use.

Not sure why we need a dermatologist to fix the child's clavicle. But that network has at least 30 dermatologists within 20 miles of Nashville.

And NEITHER of these calculations account for the ACTUAL health needs of the REST of that family..
That year- it's VERY likely that on THAT plan -- they would come close or exceed the FAMILY deductible of $1600.. Another $500 or $800 out of their pockets.

If more people break more bones and use more services, they'll pay more for health care, sure. Their income is still substantially protected by their out-of-pocket limit. Hitting the family OOP max would require two family members to each incur costs of at least $17.3K. That is to say, family costs of $34.6K. Hard to argue in that situation their premiums + OOP contributions aren't worth it.

But I guess we could further expand Medicaid to even higher incomes so they pay nothing if that's what you're getting at.