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

[dblack]

ACA is actually worse than doing nothing. It doubles down on all the mistakes that have created the health care mess in the first place. It's a last ditch effort to preserve the failed system for the special interests who are deeply invested in it.

While the ACA is a bad solution it better than what was before it. Pre-existing condition riders, jacking up rates when someone get sick and generally making insurance unavailable to the sick was a huge problem. We forget this because the ACA at least fixed that.

This is what I mean when I say ACA doubles "down on all the mistakes" that created the health care fiasco in the first place. The notion that insurance must cover people who are already sick is delusional. And delusional desires tend to produce irrational laws - ACA.

So what do you do for those sick people? Let them die?

No, I wouldn't. I'd do whatever I could to help out. Wouldn't you?

 

[debbiedowner]

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!

There are no deductibles associated with this plan ?

There are co-pays but no "in network" deductibles.
Also, St Luke's is the largest health care provider in Idaho and my plan is St Luke's centric - so there are hundreds if not thousands of specialists who are in network
Last year my deductible was $800 so this one is even better!
Seriously - find a really good independent broker specializing in ACA-complient policies next time the opportunity comes around.
I realize that not all states offer a plan as good as mine OR have any competition, but you never know what you might find.

Sure all states do offer something as good as yours if one is under a certain percentage of federal poverty level. I had more than ever this year with 0 premium, 0 deductible and $1 or $2 co-pay to primary doc and $5 to a specialist. All on exchange policies bronze ended up being zero premium after they used their tax credit towards those plans.

 

[debbiedowner]

For a Silver plan? I call bullshit.

Call it whatever you like Hook .. Typed it directly off my card - do you need to see redacted copies of my last cancelled check and policy?

If that is the case that is not too bad of a plan. From then people I have talked to in IL who got Obamacare they have stated differently.

See Hook - Therein lies the problem. Hearsay as in "people i have talked to"

People: It varies (BIGLY if you will) from state to state.
Was anyone denying these problems with Obamacare - Obama perhaps?
Nope - Everyone PLEASE stop being simplistically STOOPID and offer solutions
Thanks

It also varies very much on percentage of federal poverty level.

 

[DrLove]

It also varies very much on percentage of federal poverty level.

Hmmm - my plan is unsubsidized - Don't qualify - Is that what you mean?

 

[emilynghiem]

I'd like to see what plan participants paid total for a year vs what the insurance companies paid in claims that would be quite telling. My co-pay is 10% after a $1,300 deductible and they pay 100% after I have paid $2,500 out of pocket for the year.

By law insurance companies have to pay out 80% on claims for individual plans or 85% on group plans, it was a lot less before obamacare.

Obamacare Bronze only pays 60% hello.

Before the ACA they didn't HAVE TO pay shit.

Dear LoneLaugher and debbiedowner
Thanks for your posts that are very informative.
But this reminds me of FEMA recipients who are only getting a fraction of what they need to rebuild or repair their homes.
A "partial payment" means they can't afford to get the work done.
You can't afford part of a procedure, so you don't get help at all.
You get stuck.

If you two look at the miserable rates of processing claims
and getting any service from federal govt, when this is only about 1/3 of the populations in concentrated areas, in 3 states roughly (Texas LA and FL) plus PR,
what makes you think the federal govt can handle
and process health care claims for 300 million people
across 50 states. We can't even manage claims for
a small fraction of that in 3 states, and people are suffering.

This seems pretty solid proof of why we need to manage
social service programs LOCALLY, I mean down to the
DISTRICT level. That's what's happening in Houston where
people are getting help by working within their COMMUNITIES
so people know who has a VALID claim and real needs at what cost
to reduce fraud and bureaucracy around claims that backlogs the system.

Clearly this cannot be managed on FEDERAL levels.
It has to be delegated to state then local levels to
accommodate the needs of people, or it just takes so
long PEOPLE GIVE UP.

My friends who can't afford help and can't afford to wait
in lines at the county hospital suffered worse health deterioriation.
the backlog isn't working, and trying to CENTRALIZE it all
through the FEDERAL govt is a BUREAUCRATIC NIGHTMARE.

Wake up folks. The way we can expect to serve the whole population, with all the diverse needs and financial disparities, is to LOCALIZE IT.

Not try to mandate one program fits all through federal govt.
This is way too overwhelming and the FEMA response to
3 hurricanes hitting 3 major areas pretty much proves the limits on that
approach. The mega funds that raised millions of dollars, from Red Cross to the JJ Watts fund, still couldn't reach all the people in need on a grassroots level. So the whole system should have been managed from the grassroots UP not the top down for the people in need to get help on their level.

Could this be made any more clear???

 

[debbiedowner]

It also varies very much on percentage of federal poverty level.

Hmmm - my plan is unsubsidized - Don't qualify - Is that what you mean?

Well, shit man you got a hell of a deal if you're not receiving a subsidy. It looked like you were receiving cost share reductions.

 

[debbiedowner]

I'd like to see what plan participants paid total for a year vs what the insurance companies paid in claims that would be quite telling. My co-pay is 10% after a $1,300 deductible and they pay 100% after I have paid $2,500 out of pocket for the year.

By law insurance companies have to pay out 80% on claims for individual plans or 85% on group plans, it was a lot less before obamacare.

Obamacare Bronze only pays 60% hello.

Before the ACA they didn't HAVE TO pay shit.

Dear LoneLaugher and debbiedowner
Thanks for your posts that are very informative.
But this reminds me of FEMA recipients who are only getting a fraction of what they need to rebuild or repair their homes.
A "partial payment" means they can't afford to get the work done.
You can't afford part of a procedure, so you don't get help at all.
You get stuck.

If you two look at the miserable rates of processing claims
and getting any service from federal govt, when this is only about 1/3 of the populations in concentrated areas, in 3 states roughly (Texas LA and FL) plus PR,
what makes you think the federal govt can handle
and process health care claims for 300 million people
across 50 states. We can't even manage claims for
a small fraction of that in 3 states, and people are suffering.

This seems pretty solid proof of why we need to manage
social service programs LOCALLY, I mean down to the
DISTRICT level. That's what's happening in Houston where
people are getting help by working within their COMMUNITIES
so people know who has a VALID claim and real needs at what cost
to reduce fraud and bureaucracy around claims that backlogs the system.

Clearly this cannot be managed on FEDERAL levels.
It has to be delegated to state then local levels to
accommodate the needs of people, or it just takes so
long PEOPLE GIVE UP.

My friends who can't afford help and can't afford to wait
in lines at the county hospital suffered worse health deterioriation.
the backlog isn't working, and trying to CENTRALIZE it all
through the FEDERAL govt is a BUREAUCRATIC NIGHTMARE.

Wake up folks. The way we can expect to serve the whole population, with all the diverse needs and financial disparities, is to LOCALIZE IT.

Not try to mandate one program fits all through federal govt.
This is way too overwhelming and the FEMA response to
3 hurricanes hitting 3 major areas pretty much proves the limits on that
approach. The mega funds that raised millions of dollars, from Red Cross to the JJ Watts fund, still couldn't reach all the people in need on a grassroots level. So the whole system should have been managed from the grassroots UP not the top down for the people in need to get help on their level.

Could this be made any more clear???

the government isn't processing your health care claims the respective insurance companies are.

Yes, I have dealt with FEMA in the past and it's no picnic.

 

[MadChemist]

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!

There are no deductibles associated with this plan ?

There are co-pays but no "in network" deductibles.
Also, St Luke's is the largest health care provider in Idaho and my plan is St Luke's centric - so there are hundreds if not thousands of specialists who are in network
Last year my deductible was $800 so this one is even better!
Seriously - find a really good independent broker specializing in ACA-complient policies next time the opportunity comes around.
I realize that not all states offer a plan as good as mine OR have any competition, but you never know what you might find.

Sure all states do offer something as good as yours if one is under a certain percentage of federal poverty level. I had more than ever this year with 0 premium, 0 deductible and $1 or $2 co-pay to primary doc and $5 to a specialist. All on exchange policies bronze ended up being zero premium after they used their tax credit towards those plans.

Just because it is subsidized does not mean it is cheap or a good deal overall.

It appears you benefit from the wealth re-distribution policies of Obama.

 

[dblack]

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!

There are no deductibles associated with this plan ?

There are co-pays but no "in network" deductibles.
Also, St Luke's is the largest health care provider in Idaho and my plan is St Luke's centric - so there are hundreds if not thousands of specialists who are in network
Last year my deductible was $800 so this one is even better!
Seriously - find a really good independent broker specializing in ACA-complient policies next time the opportunity comes around.
I realize that not all states offer a plan as good as mine OR have any competition, but you never know what you might find.

Sure all states do offer something as good as yours if one is under a certain percentage of federal poverty level. I had more than ever this year with 0 premium, 0 deductible and $1 or $2 co-pay to primary doc and $5 to a specialist. All on exchange policies bronze ended up being zero premium after they used their tax credit towards those plans.

Just because it is subsidized does not mean it is cheap or a good deal overall.

It appears you benefit from the wealth re-distribution policies of Obama.

But the subsidies at least ensure that insurance company profits are "covered".

 

[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!

There are no deductibles associated with this plan ?

There are co-pays but no "in network" deductibles.
Also, St Luke's is the largest health care provider in Idaho and my plan is St Luke's centric - so there are hundreds if not thousands of specialists who are in network
Last year my deductible was $800 so this one is even better!
Seriously - find a really good independent broker specializing in ACA-complient policies next time the opportunity comes around.
I realize that not all states offer a plan as good as mine OR have any competition, but you never know what you might find.

Sure all states do offer something as good as yours if one is under a certain percentage of federal poverty level. I had more than ever this year with 0 premium, 0 deductible and $1 or $2 co-pay to primary doc and $5 to a specialist. All on exchange policies bronze ended up being zero premium after they used their tax credit towards those plans.

Just because it is subsidized does not mean it is cheap or a good deal overall.

It appears you benefit from the wealth re-distribution policies of Obama.

But the subsidies at least ensure that insurance company profits are "covered".

True, but lest there be a misunderstanding - When Trump says that the insurance companies are getting fat with subsidies, he's lying. Subsidies make it possible for those who receive them to afford a health insurance policy. IOW, they directly benefit the enrollee - not the insurance company.

 

[debbiedowner]

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!

There are no deductibles associated with this plan ?

There are co-pays but no "in network" deductibles.
Also, St Luke's is the largest health care provider in Idaho and my plan is St Luke's centric - so there are hundreds if not thousands of specialists who are in network
Last year my deductible was $800 so this one is even better!
Seriously - find a really good independent broker specializing in ACA-complient policies next time the opportunity comes around.
I realize that not all states offer a plan as good as mine OR have any competition, but you never know what you might find.

Sure all states do offer something as good as yours if one is under a certain percentage of federal poverty level. I had more than ever this year with 0 premium, 0 deductible and $1 or $2 co-pay to primary doc and $5 to a specialist. All on exchange policies bronze ended up being zero premium after they used their tax credit towards those plans.

Just because it is subsidized does not mean it is cheap or a good deal overall.

It appears you benefit from the wealth re-distribution policies of Obama.

Again and what don't you understand about Federal Poverty Level? Yes, between 100 and 250% of FPL is cheap and a good deal to that particular person. I never said the full cost of the plan withouth the CSR's were a good deal.

 

[debbiedowner]

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!

There are no deductibles associated with this plan ?

There are co-pays but no "in network" deductibles.
Also, St Luke's is the largest health care provider in Idaho and my plan is St Luke's centric - so there are hundreds if not thousands of specialists who are in network
Last year my deductible was $800 so this one is even better!
Seriously - find a really good independent broker specializing in ACA-complient policies next time the opportunity comes around.
I realize that not all states offer a plan as good as mine OR have any competition, but you never know what you might find.

Sure all states do offer something as good as yours if one is under a certain percentage of federal poverty level. I had more than ever this year with 0 premium, 0 deductible and $1 or $2 co-pay to primary doc and $5 to a specialist. All on exchange policies bronze ended up being zero premium after they used their tax credit towards those plans.

Just because it is subsidized does not mean it is cheap or a good deal overall.

It appears you benefit from the wealth re-distribution policies of Obama.

But the subsidies at least ensure that insurance company profits are "covered".

So one may have let's say a $1000 per month policy but is subsidized $900 of that, therefore their premium is $100. Sure the insurance company for that year is receiving $12,000 premium for that person and probably claims that surpass the $12000. Where's the profit in that?

 

[dblack]

There are no deductibles associated with this plan ?

There are co-pays but no "in network" deductibles.
Also, St Luke's is the largest health care provider in Idaho and my plan is St Luke's centric - so there are hundreds if not thousands of specialists who are in network
Last year my deductible was $800 so this one is even better!
Seriously - find a really good independent broker specializing in ACA-complient policies next time the opportunity comes around.
I realize that not all states offer a plan as good as mine OR have any competition, but you never know what you might find.

Sure all states do offer something as good as yours if one is under a certain percentage of federal poverty level. I had more than ever this year with 0 premium, 0 deductible and $1 or $2 co-pay to primary doc and $5 to a specialist. All on exchange policies bronze ended up being zero premium after they used their tax credit towards those plans.

Just because it is subsidized does not mean it is cheap or a good deal overall.

It appears you benefit from the wealth re-distribution policies of Obama.

But the subsidies at least ensure that insurance company profits are "covered".

True, but lest there be a misunderstanding - When Trump says that the insurance companies are getting fat with subsidies, he's lying. Subsidies make it possible for those who receive them to afford a health insurance policy. IOW, they directly benefit the enrollee - not the insurance company.

Of course the subsidies directly benefit the insurance company. Many of the people wouldn't be able to afford, and would not buy, the overpriced policies without the subsidies, so the insurance company is selling policies it ordinarily would not. Rather than face the fact that their policies aren't financially viable, they're able to continue business as usual.

 

[DrLove]

Of course the subsidies directly benefit the insurance company. Many of the people wouldn't be able to afford, and would not buy, the overpriced policies without the subsidies, so the insurance company is selling policies it ordinarily would not. Rather than face the fact that their policies aren't financially viable, they're able to continue business as usual.

That's an interesting way to look at it but they were really selling more policies, then why are so many of them exiting the exchanges?
My suspicion is that a lot of it has to do with the fact that Trump continues to threaten subsidy payments.

 

[dblack]

Of course the subsidies directly benefit the insurance company. Many of the people wouldn't be able to afford, and would not buy, the overpriced policies without the subsidies, so the insurance company is selling policies it ordinarily would not. Rather than face the fact that their policies aren't financially viable, they're able to continue business as usual.

That's an interesting way to look at it but they were really selling more policies, then why are so many of them exiting the exchanges?
My suspicion is that a lot of it has to do with the fact that Trump continues to threaten subsidy payments.

Sure, there's no guarantee that the subsidies will be enough to keep them afloat. But there's no doubt the subsidies help them and contribute to their bottom line.