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Health Care Reform is Dead

jimmydean

jimmydean

The Official Meat of Ridemonkey
Sep 10, 2001
43,072
15,162
Portland, OR
EVERY condition is "pre-existing" prior to going to the doctor to have it pointed out to you.

"You broke your arm BEFORE you came to the hospital? That is a pre-existing condition, you will not be covered."
 
$tinkle

$tinkle

Expert on blowing
Feb 12, 2003
14,591
6
jimmydean said:
EVERY condition is "pre-existing" prior to going to the doctor to have it pointed out to you.

"You broke your arm BEFORE you came to the hospital? That is a pre-existing condition, you will not be covered."
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1: it does not need to be pointed out to me
2: this is incorrect; pre-existing means "before you were covered on this plan", not "before this moment in time"

i could be wrong, but i am not
 
jimmydean

jimmydean

The Official Meat of Ridemonkey
Sep 10, 2001
43,072
15,162
Portland, OR
$tinkle said:
1: it does not need to be pointed out to me
2: this is incorrect; pre-existing means "before you were covered on this plan", not "before this moment in time"

i could be wrong, but i am not
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I could be joking, because I was. Sorry you missed it, it was funny in my head.

The bottom line is that BEFORE ACA, you could lose your bennies simply because you cost the for-profit insurer to lose profit. While ACA is far from perfect, this is one of the major benefits of ACA and I am willing to pay a little more for that assurance.
 
$tinkle

$tinkle

Expert on blowing
Feb 12, 2003
14,591
6
sarc meter has been disabled, as it creates a race condition while trying to figure out puppet manifests
 
jimmydean

jimmydean

The Official Meat of Ridemonkey
Sep 10, 2001
43,072
15,162
Portland, OR
$tinkle said:
sarc meter has been disabled, as it creates a race condition while trying to figure out puppet manifests
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I think I might have plagiarized as well from some comedic type. I doubt I was that cleaver on my own, so I botched the delivery as well. That's my jorb.
 
jimmydean

jimmydean

The Official Meat of Ridemonkey
Sep 10, 2001
43,072
15,162
Portland, OR
GOP has a NEW plan...

The New York Times reported today that Republicans now plan to use town hall meetings in April to present alternatives that could be part of a Republican health care bill . Then … well, there’s no timeline beyond that. It may not be impossible to write a bill, get it through committee, and bring it to the House floor before Congress is finished for the year.
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They continue to shop ideas hoping to find SOMETHING that will stick with the old folks.
 
$tinkle

$tinkle

Expert on blowing
Feb 12, 2003
14,591
6
if there's one thing old folks look forward to & do well, it's changing systems & learning new methods.

that's the #1 reason why congress is so effective
 
mattmatt86

mattmatt86

Turbo Monkey
Feb 9, 2005
5,347
10
Bleedmore, Murderland
Can anyone recommend a low cost Catastrophic plan? I'm 28, healthy, non smoker, no kids, and I haven't used a cent of health coverage in the 2.5 years I was at my last job. New job has a pretty ****ty plan so I'm trying to shop around.
 
$tinkle

$tinkle

Expert on blowing
Feb 12, 2003
14,591
6
why bother? you can't be turned down, and just pay the penalty when it comes time you need to sign up.

i guess i'm not seeing any financial incentive to get coverage if your shop's plan suxxors
 
mattmatt86

mattmatt86

Turbo Monkey
Feb 9, 2005
5,347
10
Bleedmore, Murderland
$tinkle said:
why bother? you can't be turned down, and just pay the penalty when it comes time you need to sign up.

i guess i'm not seeing any financial incentive to get coverage if your shop's plan suxxors
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I guess I'm jaded from my last company, I worked for a national company and only paid about 70 bucks a month for full coverage and dental. My new company is smallish where most people are either on Gov't assistance (the clerical workers, admin assistants) or they are on their spouses' plans (the engineers, designers, project managers, owners) so there are far less people on the company offered plan which means it's not exactly cheap, I think it's almost 200 a month.
 
Jeremy R

Jeremy R

<b>x</b>
Nov 15, 2001
9,701
1,056
behind you with a snap pop
$tinkle said:
why bother? you can't be turned down, and just pay the penalty when it comes time you need to sign up.

i guess i'm not seeing any financial incentive to get coverage if your shop's plan suxxors
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Because you literally CANNOT buy health insurance after March 31 until it opens back up in November, and then it that is for a January 1 effective date. So, if Matt wants to buy individual insurance in April, he cannot get it until January. The only way it is possible, is if you have a "life event" determined by the gov't. For example, if Matt loses his job, he would be able to sign up then or if he got married etc... Otherwise he is stuck until January.
Lord Decider set it up this way, so people can't just sign up when they need it. AKA as open enrollment.
Also, if his group insurance is determined "good enough" by the gov't, he can't even get a plan on the exchange, and he has to take the group plan or have no coverage at all and take the penalty.
I have done nothing but sign people up for health insurance since October, and it has by far been the most unnecessarily stressful and craziest time of my work life ever. That said, I have helped more people in the last few months than I have in the last ten years.
 
Pesqueeb

Pesqueeb

bicycle in airplane hangar
Feb 2, 2007
41,808
19,126
Riding the baggage carousel.
Jeremy R said:
Because you literally CANNOT buy health insurance after March 31 until it opens back up in November, and then it that is for a January 1 effective date. So, if Matt wants to buy individual insurance in April, he cannot get it until January. The only way it is possible, is if you have a "life event" determined by the gov't. For example, if Matt loses his job, he would be able to sign up then or if he got married etc... Otherwise he is stuck until January.
Lord Decider set it up this way, so people can't just sign up when they need it. AKA as open enrollment.
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So, just like any other healthcare plan then.
 
Jeremy R

Jeremy R

<b>x</b>
Nov 15, 2001
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1,056
behind you with a snap pop
Pesqueeb said:
So, just like any other healthcare plan then.
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No. Not at all. There was no open enrollment in individual/family plans before the ACA. You could sign up all year long. That said, you could also be turned down, not covered pre-existing conditions or rated up because of a health condition or if your
ass is too big.
Ha, fat people are loving the ACA here. I am signing them up left and right because there is literally no incentive at all to take care of yourself. Murica!
 
Pesqueeb

Pesqueeb

bicycle in airplane hangar
Feb 2, 2007
41,808
19,126
Riding the baggage carousel.
Jeremy R said:
There was no open enrollment in individual/family plans before the ACA.
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I could't speak to individual plans, but I've never been part of a group plan that didn't have the exact same "enrollment period" restrictions.

Jeremy R said:
That said, you could also be turned down, not covered pre-existing conditions or rated up because of a health condition or if your
ass is too big.
Ha, fat people are loving the ACA here. I am signing them up left and right because there is literally no incentive at all to take care of yourself. Murica!
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There were no obese people before March 23, 2010?
 
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Jeremy R

Jeremy R

<b>x</b>
Nov 15, 2001
9,701
1,056
behind you with a snap pop
Pesqueeb said:
I could't speak to individual plans, but I've never been part of a group plan that didn't have the exact same "enrollment period" restrictions.



They were all taking such good care of themselves before?
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No they were not. Ha, but in the old way, a health insurance company would flat say, "You are too fat to even buy coverage from us, lose 70 pounds or stay uninsured." I had some clients lose weight to get coverage, and I had even more to say screw that, pass the cake, Diabeeeetusss! Nom Nom Nom..."

What's funny is that our country is so split, that I found I cannot even have an honest conversation with ANYONE about what Obamacare is truly like. What is really good bad about it, or what really stinks about it. So many partisan douchbags have already drawn their line in the sand, and they think it is either the worst thing ever, or it is absolutely perfect. I work in the trenches in it everyday, but people don't want to hear actual facts about it. They want to listen to pretend news channels or biased articles written about it. You can even see this same situation in this thread here.....

The truth of the matter is that Obamacare is setup to REALLY help 2 types of people. One is the sick who can now sign up for coverage no matter what. They may or may not get help paying for it, depending on their income, but they at least cannot get turned down. This obviously is a really good thing, and I have helped a ton of them get coverage.
The second type of people it is meant to help is people with lower incomes get help paying for it. This can be a great thing or it can be totally unfair $hitshow. I will give you two real examples:

I have been helping people get coverage like this janitor lady for a local college. This lady is working to the most of her ability, but is getting screwed by the system. She wants to work full time, but they will just let her work enough to NOT qualify for benefits. She is older and does have the education to get a better job. I helped her get a $600 plan for $48 a month. Because of the cost sharing feature, she has a zero deductible and full awesome coverage. Win.

Example number 2: I wrote a couple who were both in their early sixties. Both smokers. The wife did not work, and the husband worked part time. Because of their tobacco use, their premium for their health insurance was $1400, but they got a subsidy from the government for $1250 a month. So, their monthly premium for both was $150 a month. Same plan as above. Zero deductible and great coverage. As a matter of fact, with the cost sharing benefit the gov't made on the silver plans, you cannot walk in and buy that great of coverage for ANY price. Its crazy.

Now if you take, for example, a married couple who both have decent jobs and work full time, then they are not gonna qualify for a subsidy at all. If they are non smokers, their premium here will fall into $650 to $1000 range depending on age. Not only will they not get a subsidy, but no cost sharing either, so that silver plan I mentioned above now has a $3750 deductible per person and an out of pocket max of $6300 per person. If you are just over the line for a subsidy, these plans are not affordable at all for normal working families.

It is all based on income or the redistribution of it, and not health. So this law is going to help a certain segment of the population a lot, and it is going to hurt a certain segment a lot as well. Like I said before, I have helped a ton people get affordable coverage with this law, and I feel really good about most if it, but it needs some tweaking for it be to better and help a broader range of people.
(And don't even get me started on having to deal with healthcare.gov on the daily) Worst site since bikerfox.
 
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Pesqueeb

Pesqueeb

bicycle in airplane hangar
Feb 2, 2007
41,808
19,126
Riding the baggage carousel.
Jeremy R said:
Now if you take, for example, a married couple who both have decent jobs and work full time, then they are not gonna qualify for a subsidy at all. If they are non smokers, their premium here will fall into $650 to $1000 range depending on age. Not only will they not get a subsidy, but no cost sharing either, so that silver plan I mentioned above now has a $3750 deductible per person and an out of pocket max of $6300 per person. If you are just over the line for a subsidy, these plans are not affordable at all for normal working families.
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Hey look, It's my exact situation with employer provided healthcare, but slightly cheaper and with slightly better coverage!
 
mattmatt86

mattmatt86

Turbo Monkey
Feb 9, 2005
5,347
10
Bleedmore, Murderland
I guess what is really pissing me off is that there is no young adult/in great health/catastrophic plans. For ACA to work they need people like me to pay 150+ a month even though I don't use any healthcare to balance out the people who pay nothing a month and use 1000+ a month in healthcare.
 
syadasti

syadasti

i heart mac
Apr 15, 2002
12,690
290
VT
mattmatt86 said:
I guess what is really pissing me off is that there is no young adult/in great health/catastrophic plans. For ACA to work they need people like me to pay 150+ a month even though I don't use any healthcare to balance out the people who pay nothing a month and use 1000+ a month in healthcare.
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Hospitals weren't refusing those who could not pay prior to ACA either - everyone was paying then to a great degree and it caused more catastrophic and expensive emergencies rather than the significantly cheaper preventative visits to a normal physician.
 
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mattmatt86

mattmatt86

Turbo Monkey
Feb 9, 2005
5,347
10
Bleedmore, Murderland
syadasti said:
Hospitals weren't refusing those who could not pay prior to ACA either - everyone was paying then to a great degree and it caused more catastrophic and expensive emergencies rather than the significantly cheaper preventative visits to a normal physician.
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I know, I just like to pretend I'm a victim now ;)

There are 120732840 things I could bitch about "paying" for via taxes that I don't want or need.
 
dan-o

dan-o

Turbo Monkey
Jun 30, 2004
6,499
2,805
Jeremy R said:
Now if you take, for example, a married couple who both have decent jobs and work full time, then they are not gonna qualify for a subsidy at all. If they are non smokers, their premium here will fall into $650 to $1000 range depending on age. Not only will they not get a subsidy, but no cost sharing either, so that silver plan I mentioned above now has a $3750 deductible per person and an out of pocket max of $6300 per person. If you are just over the line for a subsidy, these plans are not affordable at all for normal working families.
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This basically describes my family.
Self employed/insured for the past 10+ years.
2013 was $1215/mo $4k individual deductible for family of four (2 mid-40s, 2 kids under 11 all healthy).
2014 premiums jumped over $250/mo for same coverage (plus pediatric dental but our 2013 kids dental costs INCLUDING braces on one was less than the premium upcharge).

So, to keep an affordable plan we upped our deductible to $5k individ, lost coverage on prescriptions and still pay a little more than pre-ACA. I think that's BS.

I'm happy about the no denials for pre-existing conditions, which was my reason for supporting the ACA, as my schitzo and cancer-ridden brothers can now get coverage. But I would've rather seen their cost of coverage taken from corporate profits as a cost/risk of business than being paid for by the healthy who already fund the insurance industry.
 
jonKranked

jonKranked

Detective Dookie
Nov 10, 2005
88,786
26,996
media blackout
dan-o said:
I'm happy about the no denials for pre-existing conditions, which was my reason for supporting the ACA, as my schitzo and cancer-ridden brothers can now get coverage. But I would've rather seen their cost of coverage taken from corporate profits as a cost/risk of business than being paid for by the healthy who already fund the insurance industry.
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another part of the ACA mandates insurance provides to spend at least 80% of the money they take in from premiums, etc on actually providing health related services.
 
jimmydean

jimmydean

The Official Meat of Ridemonkey
Sep 10, 2001
43,072
15,162
Portland, OR
And after all the insurance companies bitch about ACA, they will go on to record even higher record profits. Yay!
 
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