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[Name removed]

[NYC_SKP]

1. Go-Bama!

And congrats to the family and I hope they they their friends and VOTE!

[msanthrope]

2. Go BAMA! nt

[Whiskeytide]

23. Roll Tide!

[Ikonoklast]

35. Here We Go Steelers, Here We.....oops, sorry.

Well, they *do* have a perfect record.





























Sorry, I had to.

[awoke_in_2003]

117. I am waving at you...

and I am not saying you are number 1 Seriously, this sucks. The Steelers haven't gone 0 and 4 since 68- the year I was born.

[Ikonoklast]

147. What's the deal with their OC? Is he clueless?

[Whiskeytide]

153. A "perfect record"...

(heh heh)... I'm going to use that. Yep. Not much fun being a Steeler fan these days.

[NM_Birder]

173. HA ! My Giants have perfect record AND shattering NFL records !

most sacks
most fumbles
most interceptions
most points given up

least amount of yardage gained
least number of 3rd down conversions
least percentage of completions



and on......and on.....and on.... in like the last 25 frickin YEARS

We are just playing for draft picks now.

[JoDog]

102. Bear down, Chicago Bears....

er I meant "Chicago Dems"!

[Warren Stupidity]

3. CA's silver plan is considerably better than my corporate insurance and less expensive.

Too bad there isn't an opt out option for corporate plans.

[roamer65]

12. If that is the case, highly likely your company will drop employer-based...

coverage and let you all go to the exchanges. For many companies it will make sense for the business and it's employees.

I hope my company drops our coverage and lets us go to the exchange next year. I want to switch to a plan that I hear serves its enrollees better.

[jeff47]

13. That's kind of the long-term plan.

The "Cadillac plan tax" is poorly indexed. Intentionally. More and more "regular" plans will fall into it. Raising the cost of employer health care far above the tax for not providing insurance.

Which is kinda the point - it separates health insurance from employment. And those two should not be connected.

[enlightenment]

21. Health care shouldn't be connected to

for-profit insurance companies. Any hope that's part of the "long-term" plan (and is there a link to this "long-term" plan anywhere?)

[jeff47]

37. Yes, government options.

Some blue states are already working on them. Other blue states will pass them due to pressure from voters like you.

With no need to profit, they should be cheaper than the private insurance plans. That will cause some people to switch. Those people won't die, dismantling the FUD against "government healthcare!!". That will cause more people to switch. As the private pool dries up, their expenses will get higher and eventually you're left with just the government option. And since these are "blue" states, the Republicans will have a much harder time stopping it at the state level.

Purple states will see people in blue states paying less and getting better care. They will pressure their states to follow suit.

With most states already doing single-payer, making it a federal reality becomes far easier. Not to mention the insurance companies would be a lot poorer by this time, and thus not nearly as able to buy Congresspeople.

It's more-or-less how Canada got single-payer.

As for a link to a written "long-term plan", I don't know of one. It just strikes me as the most obvious way forward, and not all that hard of a path. It will take time and patience to traverse. But Congress is never going to leap to "Medicare for all" without some ground work at the state level.

[enlightenment]

57. Then perhaps you should present it

as your envisioned best-case scenario rather than something that exists. It is slightly disingenuous.

I disagree with your assessment of the potential progress toward a real healthcare program, but you're entitled to your opinion.

[jeff47]

66. Why would California fight that plan?

The key element of that plan is it's state-level. We've got plenty of states where Republicans are becoming utterly ineffective.

Why, specifically, is there so little potential?

[enlightenment]

110. Because the for-profit nature of the

insurance companies is encoded into the federal law. You have to get that out of there, first. Have you seen any politicians with the ethical conviction and political chops to accomplish that lately? I haven't.

Also, you cannot talk about a move to a true, single-payer system if you're going to suggest that it operate state by state. A system of healthcare cannot be dependent on the states; it has to be national or it defeats the purpose of healthcare for all.

California probably wouldn't fight it - and a handful of other states as well. But that only helps the people in those states and fails as a system of healthcare similar to the civilized nations.

We are a nation divided, more and more. It's easy to say (and I'm not saying you have said this, but I've seen it many times on DU) "move somewhere else" - but that's a version of "let them eat cake" and is completely unrealistic, particularly in the current economic climate.

The conversation has to come from the leaders of the nation and what they have told us is that the PPACA is the best they can do.

[jeff47]

119. Politicians have one primary goal: Get and remain elected.

Their obsession for fundraising is to achieve that goal. But they still have to win. Which means if we convince blue state voters that a "government option" is a good idea, they will support it in order to remain in office.

Also, you cannot talk about a move to a true, single-payer system if you're going to suggest that it operate state by state. A system of healthcare cannot be dependent on the states; it has to be national or it defeats the purpose of healthcare for all.

So, Canada doesn't have single-payer?

Snark aside, the state-by-state phase is a step along the path.

California probably wouldn't fight it - and a handful of other states as well. But that only helps the people in those states and fails as a system of healthcare similar to the civilized nations.

In the short run.

The successes in those states will make it easier to expand to other states. And that expansion makes it easier to accomplish at the federal level.

Yes, living in Alabama is going to suck for a while from a healthcare perspective. But eventually we'll get the pieces in place for a true healthcare system.

The conversation has to come from the leaders of the nation and what they have told us is that the PPACA is the best they can do.

For now.

It's step 1. There will be many subsequent steps. That's why the Republicans are so desperate to stop it today - they won't be able to stop the next dozen-or-so steps, because they will be taking place in "blue" states.

So again, your previous post was claiming this state-by-state plan isn't going to work. I'm still looking for specifics as to why you think this is the case.

[redstatebluegirl]

4. Once people see this and the benefits

the republicans are sunk....

[GreenPartyVoter]

5. Gonna cost a lot more than that for us here in Maine. :^( I am dreading losing my medicaid.

[Liberal_Stalwart71]

16. You have a Teabag governor who refuses to expand Medicaid or institute the exchanges.

Have you tried looking at the federal exchanges yet?

[GreenPartyVoter]

24. Working on that now. Still wish they weren't taking away MaineCare, though. *blah*

[nobodyspecial]

26. Doesn't matter

If you would have qualified for extended Medicaid and your governor opted out, you don't get ANY subsidy. Literally, the GOP idiots are screwing thousands of low-wage workers out of coverage. If you had no income or assets, you would qualify, but if you are working but still not making ends meet, you get the shaft. On the positive side, you are exempt from the penalty.

[Liberal_Stalwart71]

46. O.K., I get it now. WOW! I am so sorry. That really sucks!!!

[SiobhanClancy]

166. We have to get rid of LaPage...

I have insurance available through work (Hannaford),but I can't afford it,and certainly can't afford what's available through the exchange,either. I have hopes that this will change with a new governor...and fear that LePage might somehow sneak back in again in a three-way contest. All the best to you

[roamer65]

6. Finally, we are last major industrialized nation...

...to embrace the idea of universal health insurance.

Finally.

Let the new America begin.

[BlueCheese]

98. Just to quibble...

... we don't have universal health insurance, even with the ACA. The government expects only half of those who are currently uninsured to get insurance, leaving some 30 million still uninsured. Ironically, these are expected to be among the most vulnerable-- people who are so poor they don't fall under the individual mandate.

[karynnj]

108. So poor that their subsidy would pay all or almost all?

If that is the case, it would be a great idea for an NGO or the interfaith community to take this up as a challenge. This would work best for those already trusted by the community. At that level, it would seem the problem is education and the ability to access the system - which can be daunting especially for some.

[BlueCheese]

115. I don't know why exactly people will remain uninsured.

It's just what the projections are. I know people under a certain income aren't subject to the mandate, but not sure if they also qualify for subsidies.

[karynnj]

130. I don't know either - but under the conjecture that they wouldn't

because they don't have the time, strength or information to get what they could. That's why I wondered if the groups that have worked to help them for other needs might be the best resource to get them signed up.

[riqster]

154. Part of that pool are the Teabagger eedjits who won't be "forced into" getting health insurance.

...all the while knowing that the law requires hospitals to treat them if needed. Freeloaders by any other name.

[jtuck004]

138. Exactly. The ACA relies on Medicaid expansion by the states to cover the most vulnerable, and

about half of the states have chosen not to expand it, leaving millions with no coverage, no options, at all. None. There is nothing an "interfaith" community can do with no money.

The 30 million number is the best case scenario put forward by the WH and other proponents of the ACA, which may in fact be too conservative a number...there are lots of articles out there, here's just one.

"...
When the ACA was passed it was estimated by its proponents that it would cover 35 million more people than before. Now these same proponents are using the figure 31 million new people covered instead. Meanwhile the population of the United States has grown by 9 million people, and due to the effect of the crash of 2008, millions of people who were insured before the crash are now uninsured. So, though there are no hard figures on this it is likely that estimates of 30 million still uninsured are on the low side. And when we consider that HHS, today, for actuarial reasons, is marketing to the young and healthy, and not the vulnerable and disengaged, it seems quite possible that the 45,000 fatalities per year will not decrease significantly, if at al
..."

Here.

[karynnj]

157. Thanks

It is hard to think of how Congress could pass anything to deal with the states that did not pass the expansion of Medicaid. First of all, the vast majority of Democrats do not represent those states - though some do.

I agree when there is NO program there that pays for all or most of it, it is not lack of information - it is a lack of options. Other than making it clear that their governor deprived them of what they needed - which solves nothing - and many might have voted against the governor in the first place.

It is very easy to forget things like that living here in VT and previously in NJ, where the Republican governor knew he could not get away with that.

[Thinkingabout]

7. This is great news, as this continues to roll out and more are insured the games being played out in

The House, Ted Cruz needs to be washed out to sea never to be seen again. I am happy for your family, thanks for sharing.

[PowerToThePeople]

8. Cali has good weather too. Hmmm.

May have to move back to my birthplace.

[pipoman]

22. Twice as much for everything else there...

food, utilities, rent/house prices, taxes...etc..

[PowerToThePeople]

25. In some areas.

You would have to plan well in order to make it. You couldn't just jump into SanFran from out of state and think you could make it well.

[Spitfire of ATJ]

70. When I moved to Las Vegas from Anaheim I was shocked to find my auto insurance doubled.

[stevenleser]

9. That's the other part of the reason for the shutdown. The GOP must have seen reports that said

how good the premiums were going to be. I'm sure they had the intel on that.

[Keefer]

10. Great! What about

Deductibles, co-pays, and prescriptions?

[enlightenment]

30. Oh, heavens no.

Wouldn't want to toss reality in there - not at all, at all.

[NoOneMan]

40. Covered? So what do they have to do to use that coverage?

Sell their souls?

Do you not get it? Or do you not want to get it?

Aside from treating runny noses, that family is still fucked.

[NoOneMan]

82. Thats called a straw man.

I think nothing is absolute shit (been there, done that).

I think less shitty than absolute shit is still shitty.

[crim son]

68. I'm one of those people who isn't poor enough

to have qualified for assistance, but not rich enough to be able to afford a regular checkup + followup. Believe me, having to shell out for a copay but know I'm covered in in case of catastrophe, is a huge, magnificent load off my mind. Unless you've lived uninsured and in fear of getting into a car accident or developing a major illness then you probably won't get it. But why not try?

[enlightenment]

61. Get back to me

when you can hear over the crash of cymbals, beating of drums and wail of horns. I don't want to rain on your parade, after all.

[tkmorris]

89. Hold up. You are referring to some long-term DUers

DUers with well established credentials. YOU on the other hand, just showed up and the majority of your posts seem to be in this one thread. You are accusing someone else of having an agenda? With your bare face hanging out?

[Marrah_G]

174. Your accusations towards long time DUers is not appreciated

It's also a good way to find yourself kicked off the site. I suggest you go read the rules.... since you are "new".

[Marrah_G]

179. Actually I am "miffed" because the RI healthcare website isn't working correctly at the moment

Again, your baseless accusations toward DUers is against the rules.

[Marrah_G]

182. "always the victim"? You don't know me

And I have already gotten past the price section and was thrilled.

I don't know what game you are playing here and why you are acting like such a jerk.

[cui bono]

185. What is your problem?

Why do you come to this site with such an attitude? If you really support the ACA you are not going to win anyone over by storming in here with your combative style. This is supposed to be a place to discuss things in a reasonable manner.

[NoOneMan]

91. "Obamacare is not going away."

And that's unfortunate. The "pathway to single payer" crap is then just crap. If it's here to stay, were stuck with the lower classes getting mediocre coverage they can't afford to use, which ends up ensuring the lower classes have worse health care outcomes.

[NoOneMan]

104. Im not sure what you are even getting at anymore. Are you?

Who and what I personally am has little to do with the facts of this system, which institutionalizes inequality in health care coverage and health care outcomes. Its better than the cowboy market that fucked people, but it will do some fucking on its own while teaching a society at large that the government condones such fucking (as it is law and tiers are in fact permissible and legislated). Either you realize that and work to fix it, or just go about your day celebrating. I'm trying to be a nice guy here, but it means little to me either way.

[Keefer]

33. I'm not trying

To "rain on any parade." Just asking.

[Ms. Toad]

123. Those who are subisdized for insurance

Are generally eligible for a lower out of pocket cap, as well. (Which means that there will be no deductibles, co-pays, or additional prescription costs once reach the (lower) cap.)

[NoOneMan]

11. Plus Copays and Deductibles

So hint for family of 4 making 45,000: don't get cancer

[jeff47]

14. Because it was so much better to get cancer without insurance.

Yes, single-payer would be better. We'll get there. Just like Canada, it'll take a while to shatter the FUD.

[NoOneMan]

27. You've just codified non-egalitarian, tiered healthcare that hinges upon self-rationing

ACA should not be mentioned in the same passing breath as single-payer. You are going somewhere. But moving in 1 direction (when yes, there are 4 directions on a compass) doesn't guarantee you will get to a specific destination without a roadmap; one that is diametrically opposed to what was just passed as law.

You mention Canada. In Canada it costs nothing to goto the doctor. It costs nothing to have a procedure done. The poor do not need to balance treatment against food. They do not have to see how they can treat their cancer on their "bronze" plans (while the rich pay little to nothing for treatment with their "gold" plans). I am so fucking tired of people saying this is a "pathway". That just double-speak. Meaningless bullshit.

This is its own thing. Maybe its better than where the country will be last year (absurd land). But being less absurd doesn't mean you are sane. Poor will still have, by law, an acceptable level of health care that is mediocre in comparison to what the rich will afford. That is a pathway to hell.

[stevenleser]

44. No, they noted that you are making assumptions about details of a plan that are not in evidence. nt

[NoOneMan]

53. What assumptions am I making? That the plan has copays and deductibles?

Does it not? Are you purposely being obtuse?

[stevenleser]

62. This is the part where I quote Jon Stewart. You're F**king with us, right?

To directly answer your question. We don't know either way. Some cadillac plans do not have deductibles.

How do you know the plan this family has gotten is not one of those?

[NoOneMan]

72. Because its been explained as the Bronze 60!

http://www.coveredca.com/shopandcompare/

$5000 deductible

30% copay on hospital stuff.

Are you fucking with us?

[stevenleser]

74. After you already made assumptions and started complaining about it.

You're like the person whose spouse is angry at them for betting their $500 rent on a horse race and then gloating because that horse happened to win.

You made a poor assumption and lucked out.

Oh, and by the way, the person that bought that policy, the OP, is thrilled with it.

[NoOneMan]

81. Its a solid "assumption" based on the price of the coverage stated in the OP

Coverage the lower classes can easily afford will not be coverage they can easily afford to use.

It's a very simple concept that the insurance companies themselves use to set the price points for the actual healthcare. They know the poor will self ration with these plans. It comes down to math (actuarial science).

[Safetykitten]

103. Agree.. Why is this a concept that is so hard for people to understand?

[Hoyt]

124. There are certain preventive services that aren't subject to coinsurance and deductibles.

Further, someone who gets cancer -- god forbid -- will exceed the maximum out-of-pocket quickly. All care after that, is covered 100%. Most folks could deal with extended payments on the out-of-pocket max, but not tens of thousands of dollars one would have to pay without a cap.

The ACA is such an improvement over what we had, that I'm surprised at the criticism at this point.

Yes, I'd like single payer, or a public option, or Medicare for all, but we did not get that. What we got is much better than what we had before. Medicare for all, would not have been better than the ACA with respect to maximum out-of-pocket costs. ACA is a good start, considering the opposition..

[Sheepshank]

116. My current employers offers an HSA

Employer puts $3500 into the account annually

We have a $6000 out of pocket max.

until we hit the max, we have to pay everything 100%.....for all dr and hospital visits. Once we meet the out of pocket max everything is paid 100% through the insurance. The initial deposit the employer puts into the account is spend first so we are 1/2 way to the max by the time that money is spent.
>>>>>>>>>>>>>>>>>>>>>>>
If this $2 a month plan in the OP only has a $5000 max, doesn't matter what the hospital bill is for catastrophic care, after $5000 all is covered.

[NoOneMan]

136. No

If this $2 a month plan in the OP only has a $5000 max, doesn't matter what the hospital bill is for catastrophic care, after $5000 all is covered.

No, $5000 deductible and 12K out of pocket max. You pay $5000 first, then you copay 30% until you shell in another $7K. Each year. Until you kick cancer.

[Sheepshank]

155. My husbands plan has a $7500 annual out of pocket max

still sound like pretty darned good deal.

I don't see the difference between deductable and out of pocket max..meeting one is applied to the other.

[Safetykitten]

161. This is correct. They just do not get it. Thank you for explaining this.

[jeff47]

59. History. It is important.

You mention Canada. In Canada it costs nothing to goto the doctor

Today.

This was not always the case. One province started single-payer. It worked so well that the other provinces followed suit. Even today, Canada doesn't have a national single-payer plan - the plan is administered by the provinces.

The ACA gives us the framework to repeat that. Some blue states are already doing "government options" in their exchanges. Other blue states will be pressured by voters like you to do so. With no need to profit, those options will be cheaper, causing people to switch.

Those people won't die, destroying the FUD about "government healthcare". Causing more to switch due to price. That shrinks the pool for private insurers, driving up their costs, causing more to switch until the only thing left is the "government option".

Purple states will see people paying less and not dying, and voters will demand their own government options. The "not dying" part will greatly weaken the Republican arguments, leaving them with "we should pay more because capitalism is good!" - which isn't terribly convincing.

With blue and purple states already having more-or-less single-payer, Federal action becomes much, much easier. And likely.

Poor will still have, by law, an acceptable level of health care that is mediocre in comparison to what the rich will afford.

This is true everywhere in the world. Including in the UK, where every doctor works for the government. The wealthy have options that the poor do not - such as flying to another country and paying out of pocket for treatment.

That problem will not be solved as long as we have "wealthy" and "poor"....which means barring a "Star Trek"-style utopian society we won't be solving it. Some doctor will always be "better". He will be able to operate in such a way that the poor can not see him.

[Phentex]

77. ...

[NoOneMan]

78. Medical tourism is not the same as a government codifying tiered health care

If a government doesn't tolerate the rich getting special treatment and they go elsewhere, so fucking what? At least the people and society take a stand for themselves against inequality. But a society throwing in the towel and embracing non-egalitarianism because it will happen anyway (somewhere else) is just part of the insanity that the US is suffering.

Remember, when single-payer started in Sask there wasn't a national system that codified tiered coverage among the classes. To think that you will naturally "fix" a system that creates a framework for inequality is a bit crazy. Can it be fixed? Sure. Is it guaranteed to? Not one bit.

[jeff47]

93. The point of bringing up history is today's system is not eternal.

Yes, the ACA has tiered plans. Because it's the first stepping stone for separating health insurance from employment. As such it's going to be relatively close to the existing, fully-private, system.

But just like Social Security and Medicare were expanded and improved over the years, so will the system created by the ACA. Today isn't the end of time.

Instead of throwing up our hands and assuming today is the end, we should use the framework of the ACA to create the healthcare system we should have. And that means not sitting around bitching about it as a fait accompli, but instead pressuring our state legislatures to expand and improve it.

Because the new battle starts today (well, probably Jan 1) and it's on much, much more favorable terrain.

[NoOneMan]

97. "but instead pressuring our state legislatures to expand and improve it"

Excuse me, but if no one sees the obvious problems, who is going to pressure who?

You get what I'm starting? The next step. And it doesn't start with balloons and willful ignorance

[jeff47]

112. Why do you think no one sees the obvious problems?

The ACA is what could be passed. That's it. Lieberman and friends created problems. There is no one saying it is perfect, they are saying it is an improvement.

Again, you keep writing as if the ACA is the end-state. It's not. It's step 1. So was the Social Security Act. And just like that act, over time problems were fixed and programs were expanded.

Again, the battle continues. It is now in blue state legislatures, a place where we can do far more, far more quickly.

[AgingAmerican]

121. In this day and age nothing is fixed

Things are weakened and diluted in this age of Republican lunacy.

[jeff47]

134. Nihilism may be cool, but all it does is help the status quo. (nt)

[NoOneMan]

133. Because I get attacked for pointing them out

We do not know if ACA is the end state or not. We don't know. Others assume without evidence that it is a "start" more often

[jeff47]

137. You point them out as if they are the end state.

Your post is based on the ACA being the end-of-the-line. That's what leads to the attacks. You come off as fighting the past instead of fighting for the future.

Others assume without evidence that it is a "start" more often

There is no end-of-the-line, as long as humans still exist.

There will be changes in the future. Our job is to pressure blue state legislatures to fix the problems you are complaining about.

[stevenleser]

19. In the absence of evidence, you propose the worst possible scenario

Interesting.

[NoOneMan]

31. Lower income familes do not face major medical procedures?

Huh? It happens constantly. I don't consider it "the worst possible scenario". Its called "life". Its something the rich folk who will have the "Gold" plans should of thought of when drafting the law. But hell, they probably did.

[stevenleser]

42. Back up to the part where you commented on the plan when the plan details are not in evidence. nt

[NoOneMan]

65. Back up the part when you make any sense at all

The link to the plan is below. Is a fucked up shitty bronze piece of shit that would drive me into the poor house personally if I, with my family of 4, had any major health problem. Im not special enough to society to have the Gold treatment

[stevenleser]

67. Oh I make sense. I only comment on facts in evidence. I dont imagine things to be upset about. nt

[NoOneMan]

83. Imagine things to get upset about? WTF are you talking about?

You don't have to imagine that there are bronze, silver and gold plans, and the bronze are pretty meager in terms of their coverage, and thus, will induce self-rationing and lead to less than optimal health care outcomes. That isn't imagining. That's the bottom line. Your responses are just becoming transparent here.

[LanternWaste]

69. And for this particular life, I can finally afford health care coverage when previously I couldn't..

And for this particular life, I can finally afford health care coverage when previously I couldn't...

[NoOneMan]

85. Yes, but its health care outcomes we need to really focus in on

People need to be able to use their coverage effectively (without going broke). The poor will not have an equal opportunity to do so, and ultimately, they will not have an equal opportunity at health as the upper classes.

This is a large concern I have. Apparently few others do.

[Safetykitten]

90. I completely agree. I am one of those that voiced this throughout.

[DLevine]

101. You make an excellent point. nt

[questionseverything]

150. it is not just the poor

for a family of 3 in illinois,parents in their 50s ,yearly income $75 grand the subsidized part of the premium is $7125

the out of pocket cap (that doesnt go in til 2015) will be $12,700

so that is $19,825 or 26% of income...who has 26% of their income available,that is not already spoken for?

same family would already be paying 20% plus of income in taxes

keep asking questions,we can not fix anything if we do not first identify the problems

[Safetykitten]

163. True^

[Ikonoklast]

41. Even many employer-based healthcare plans had those, too.

People forget the old system was broken, this is the first step forward toward fixing it.

[NoOneMan]

58. No doubt. Let's just not get ahead of ourselves here

Its not fantasy land. Its less insane. Its still fucking insane. Its sucks for the poor. Maybe less-so. It still sucks. It also sucks for the economy, which will still see the highest per capita health costs in the world.

People "celebrating" want to ignore the full picture. Its still an absolute nightmare. Just less-so. Celebrating a nightmare is meh-ish. Calling it a pathway to a non-nightmare is laughable, especially when people seem so satiated with this.

[hunter]

84. WTF?

We thought we had "good" insurance, but now we've got bills we haven't paid and our credit rating is crap. Plus we became "uninsurable." My wife recovered and has a job with insurance now.

All this was still better than the alternative.

The ACA is a step in the right direction.

At this point I loathe the health insurance and I think there are insurance company high executives who ought to be rotting in prison, bunking with the other murderers, but until the U.S.A. has a first world health care system, this is an improvement.

[NoOneMan]

87. Yes, its an improvement!

You've gone from night terror to nightmare. I get that. Yay. Its also a super political win. Its still shit for many people.

[cbdo2007]

92. So your argument is....they were better off before??

[NoOneMan]

94. No, thats your Strawman argument

My argument is that a lot people are still going to be fucked (which sort of makes the political celebration look crass). A whole lot of celebrators have to be suffering some type of mass psychosis to overlook this obvious fact. But hey, you'll always have the "better than" argument. I'm not sure that going to pay for everyone's copays

[cbdo2007]

96. My argument is facts....your argument is that my argument is a "strawman argument" that

you don't back up with facts.

So facts vs name calling....no wonder you don't understand what's going on here.

[NoOneMan]

100. .

yawn

[cbdo2007]

105. LOL - funny how quickly arguments end when you bring up the f word (facts)

It just isn't as much fun to argue about our feelings.

[Historic NY]

152. Sounds like them Congress critters.....

there were bumps in every program SS, Medicare, Medicade etc...this is just rolling out. The GOP want to delay it because they know it will work in due time.

[Liberal_Stalwart71]

15. You're fucking kidding?!??! That's great! I live in Maryland and I expect similar!

Thanks to Obama and your governor Jerry Brown who instituted the state health exchanges. That's amazing!!!!

---

[Demo_Chris]

17. Link the plan please. nt

[enlightenment]

43. Website is down (after sign in)

Care to fill us in on the basics? Co-pays? Deductibles? Number of allowed dr. visits? "Allowable charge" rates?

[AgingAmerican]

127. $5k yearly deductible

$12k yearly out of pocket

Why did Obama delay the cap on out of pocket expenses until 2015? He says the insurers aren't ready for it yet but they have had four years to get ready.

[Myrina]

149. Because they need to soak us as much as possible for another year to pad their reserves ...

....silly us. We're going to pay through the nose one way or another. When will we figure that out??

[Safetykitten]

165. "Why did Obama delay the cap on out of pocket expenses until 2015?" The deal...all part of the deal.

We give, they take.

People think that insurance companies actually care about what they do.

They are companies. They make money. That's it. Really.

[Bluenorthwest]

29. Interesting that 4 people making double the money would pay a fraction of what one

elderly person in poverty would pay for Medicare. Hard to figure how that works.

[leftstreet]

45. So Obamacare is replacing Medicare?

[leftstreet]

56. Will seniors face the mandate fine if they don't sign up?

[roamer65]

63. Highly unlikely.

Much of the pricing for the private insurance is based on those who reach 65 will be switched over to Medicare, as I understand it. I strongly believe that Medicare will be the eventual single payor system under this current scheme.

[Bluenorthwest]

64. I think it is more reasonable to assume the OP is speaking about a policy with high

deductible and large co-pays and probably has the math a bit wrong.

[madrchsod]

145. 100% coverage for my medicare would be 50% of my social security payment

i just filed bankruptcy on the medical debt i accrued this year. it was a staggering amount of money

[cilla4progress]

32. My premium and deductible going way up under ACA!

Don't understand why.

My previous individual policy, offered through the state for middle income families, is going away. Everything being substituted is much more expensive.

Only good thing is all free preventive care (already in place, due - I believe - to ACA) and max annual out of pocket capped @ $6K - same as deductibe.

[enlightenment]

49. Keep in mind that the

rule for caps maximum out-of-pocket costs has been waived until 2015.

http://www.nytimes.com/2013/08/13/us/a-limit-on-consumer-costs-is-delayed-in-health-care-law.html?pagewanted=all&_r=0
http://www.healthcarefinancenews.com/blog/delay-out-pocket-cost-caps-boosts-importance-front-end-price-transparency

[subterranean]

175. That rule has NOT been waived for ALL insurance plans.

As the NYT article says, the cap on out-of-pocket costs has only been postponed for GROUP plans with separate administrators for medical and prescription drug coverage.

The cap on out-of-pocket costs for other group plans and all of the individual plans on the exchanges will go into effect on January 1, 2014, as scheduled.

I just wanted to clear that up since there seems to be a widespread misconception that the rule has been waived across the board.

[Fix The Stupid]

34. Help me out here...

What was the cost before?

Who is making up the difference between the old cost and the new cost?

Are the insurance companies just taking this hit, or is the difference offset by subsidies and give-aways to the insurance companies so they are still profitable?

How can it be one price one day and then drastically lower the next?

If the insurance companies can still be profitable with these new plans - whats that say about how they were screwing everyone before these changes?

[Fix The Stupid]

52. Quite the contrary...

But thanks for the rude reply.

Better tax dollars spent on health then war...

[grantcart]

48. Many factors

1) Lower income families get a subsidy that are raised through fees and taxes that Obamacare imoses.

2) Basically you are taking all of the uninsured and putting them into a single pool making them the largest group plan in the country

3) The ACA limits the Medical Loss Ratio (the overhead the insurance companies get to work on) at 20%

4) Plans have to be pre approved by OPM (the entity that negotiates plans for the federal employees.

[NoOneMan]

51. Subsidies, regulated MLR, and usage rates (which will likely drop by percent)

If you increase the pool by 50% (subsidized partially be government), but only a fraction of the new people can actually afford the co-pays to use the insurance then you have a whole lot more money in the pool that wont be used for medical care. In the end you can drop the rates because the subsidies of the poorest will cover the medical care of the not-so-poorest who were already on the roles in the first place.

[tomm2thumbs]

54. part of it is health insurance companies are limited in non-direct-medical expenses

Plus there is cost savings in the numbers and preventative care vs. emergency-only care

An article on some other background.
http://www.jsonline.com/news/opinion/obamacare-a-major-step-toward-fairness-b99108436z1-225816261.html

[NV Whino]

73. The insurance companies will make it up with more people in the mix

Translated to more deductibles and more co pays, which are no bargain. The insurance companies will make out like the bandits they are.

[aroach]

55. Discouraged

Yes, I'm glad that some families will be able to benefit but I'm very discouraged that my family, as usual, will not be one of them. We have shitty insurance through my husband's employer that cost as much as our mortgage. We have a $2500 deductible and 30% co-pay after that. My son's meds are not covered and would cost over $200 a month if I hadn't had to stop giving them to him months ago. The primary care providers on our plan cost us $280 for any office visit until we have met that deductible. After that they cost us 30% of $280.

I stepped on a nail weekend before last and it went all the way through my foot. I've been limping around for over a week now. I should have gotten a tetanus shot but if I had we wouldn't have been able to eat in October. We pay and pay and pay for insurance that we don't dare use. I'm going to have to file bankruptcy on last years medical bills but I can't even afford to do that.

My daughter has not had lunch one time this school year. We can't afford it. My son has at least had the famous cheese sandwich. But once again we don't qualify for the help it seems everyone but us will be getting because we have crappy insurance through my husband's employer. I wish I could afford a divorce. Then maybe me and the kids could get insurance for $2 a month.

[tomm2thumbs]

71. I may be wrong it could be that Missouri's governor rejected Obamacare provisions to expand Medicare

which may have assisted things -- perhaps someone can correct me on that

'Missouri will be unable to implement a key provision of federal health care law, Gov. Jay Nixon announced Thursday.'
from an older article

[bunnies]

75. This is a huge problem for bunnies-mr as well.

His work offers shit insurance that now he's forced to take. I was shocked to find out that you cant go to the marketplace if you employer offers insurance. It costs next to nothing but what good is it when the deductible is so high that you still cant get care? EVERYBODY should have the opportunity to join the marketplace. Everybody.

I know (kinda) how you feel. I cant get coverage under the ACA either. I dont make enough to qualify for subsidies. I'll luck out, I guess, if my state expands Medicaid. But right now, its dragging its feet.

Im very sorry about your situation. Not having kids, I cant pretend to know how hard it is for you. Any chance hubbys employer will stop offering coverage?

[cynatnite]

111. As I understood it you can still go on the marketplace...

You just may not qualify for the subsidies.

They told me that when it rolls out that I should go ahead and sign up. I can check out the different plans and compare it to what we already have. I can choose which one would be the best for us.

Perhaps you should check it out and see if you have other options.

[bunnies]

118. Yeah. I did a few days ago.

$300 a month is a bit out of my range. Considering that Im out of a job due to needing a joint replaced. Im pretty sure NH will expand medicaid though. If they dont, Im in the same position as I am now.

[cynatnite]

139. That sucks...

[BlueCheese]

120. It's really weird that not everyone can buy through the exchange.

What was the motivation for such a rule?

[bunnies]

122. I have no idea.

I think it sucks to keep people chained to employer based health care. Doesnt make sense to me at all.

[Puzzledtraveller]

125. When I had the training last month

many fellow caseworkers were concerned about your scenario, among others. We found instances where some family members would be eligible and other would not also. I really want it to work, for everyone. It's scenarios like yours that got me really upset and supporting a delay for the individual mandate. Hopefully time will prove me wrong.

[bunnies]

143. Hopefully though,

now that these situations will be realities, The President will adjust the law accordingly. We were very disappointed that he doesnt have the option to opt-out of his employers crap sandwich. But maybe if they hadnt delayed the employer mandate, his employer would be able to offer said crap sandwich.

It only makes sense to let people like my bf opt-in given the delay of the mandate.

[bunnies]

76. Wait! I just remembered something!

If your hubbys shitty insurance costs more then 8.5% of your household income, you ARE eligible to get insurance through the marketplace.

[tomm2thumbs]

88. that's good info

thanks for posting

[aroach]

158. Key wording is HIS portion

Yes, our coverage costs more than 8.5% of our income. Way more. But his portion alone has to exceed that for any of us to be able to use the exchange. And his portion of the premium alone is not more than 8.5% of our income. They won't count the part of the premium that is for me and the kids nor will they let me and the kids opt out of his craptastic plan and use the exchange instead.

[bunnies]

159. They break it down by portions?

Seriously?

[aroach]

164. I think so unless I'm reading this wrong.

"In general, employees who are offered insurance through work are not eligible for subsidized exchange coverage, so long as their insurance meets specified requirements. You would only be eligible for subsidized exchange coverage if your income is between 1 and 4 times the federal poverty level and you would have to pay more than 9.5% of your household income for your own coverage through the insurance offered by your employer."

"If the cost of a plan from your employer that would cover you (and not any other members of your family) is more than 9.5% of your household income for the year, or if the coverage your employer provides does not meet the "minimum value" standard set by the
Affordable Care Act, you may be eligible for a tax credit."

[bunnies]

167. Looks like youre reading it right.

Geezus. Will it let you apply on your own? I mean, will it let you get coverage for just you and the kids? YOUR employer doesnt offer healthcare, right?

[aroach]

176. Looks like I will need a divorce to do that

I don't have an employer so, no, they don't offer insurance.

[bunnies]

177. That really sucks.

Seems to me that you are a perfect example of the family the ACA is supposed to help. They should never have delayed the employer mandate for just this reason. Im sorry.

[cbdo2007]

95. what meds is your son on that is $200/month?

[aroach]

160. Autism

He was on Risperdal and it was actually closer to $240 a month. Our insurance does not cover any prescriptions at all. That's okay. We quit all his therapies when it became clear there was never going to be any help for us. He couldn't get on Medicaid even after qualifying for Social Security Disability. They said no because he has insurance. Never mind that insurance won't pay for anything.

He had been going to occupational and physical therapy too which is why I need to file bankruptcy.

[cbdo2007]

184. I'm sorry for what you are having to go through and hope

through the Affordable Care Act or through subsidies or something you all can get the health care you need for your whole family.

[efhmc]

80. Please also laud the Democrats who put their jobs on the line and lost them

to vote for this bill.

[PeteSelman]

86. What? Where is that info from?

I'd like to spread it around.

[PeteSelman]

168. Thank you.

And this is due to the exchanges?

[liberal N proud]

106. Go-bama

[LaydeeBug]

107. Welcome to DU andtheBeast!!! GOBAMA!!!! nt

[BlueCheese]

113. I see the same argument here that we've seen so many other times.

Alice: Things are improved now than they were before.
Bob: But they could have been a lot better.
Alice: But before they had nothing.
Bob: But now they have something that's not so great.
Alice: Not so great is better than nothing.
Bob: Not so great isn't as good as great.
Alice: Better than before!
Bob: Not as good as it could be!
Alice: You just hate Obama!
Bob: You're just a fanbot!

It's always between people whose baseline is what it was before, and people whose baseline is what it might have been.

[AgingAmerican]

114. Obama delayed the cap on copays and deductibles until 2015

This means they can charge a $5000 a year deductible.

[Hoyt]

129. No it does not.

http://www.nytimes.com/2013/08/13/us/a-limit-on-consumer-costs-is-delayed-in-health-care-law.html?pagewanted=all&_r=1&


The deductibles are set, depending on the level plan one acquires.

A cap on out-of-pocket costs still applies to most insurance plans, however may be a bit more for 2014 than originally proposed. But there is still a cap for health insurance policies bought on the exchange.

[AgingAmerican]

132. It means insurers can set their own limits

Until the cap kicks in.

thehill.com/blogs/healthwatch/health-reform-implementation/316747-administration-delays-obamacare-cap-on-out-of-pocket-costs

[AgingAmerican]

146. See

http://thehill.com/blogs/healthwatch/health-reform-implementation/316747-administration-delays-obamacare-cap-on-out-of-pocket-costs

[subterranean]

183. See this...

http://abcnews.go.com/Politics/obamacare-cap-health-costs-delayed/story?id=19950052

The hiccup in implementation primarily affects people enrolled in group health plans with separate administrators for medical services and prescription drug benefits, government officials and industry representatives told ABC News.

Under the law, combined out-of-pocket spending on medical care and prescription drugs cannot exceed $6,350 a year for an individual or $12,700 a year for a family, including co-payments and deductibles, starting in 2014.

Those caps will take effect as planned for all health plans sold in the new insurance exchanges and offered through employers whose medical and drug benefits are administered by the same entity. But Americans enrolled in other plans could still face higher costs.

[leftstreet]

169. Prove it

The poster is correct

Caps on costs have been delayed, as has the employer mandate

[freshwest]

126. Go-bama! Go-bama! Go-bama!

[Autumn Colors]

128. Connecticut Health Exchange

It's impossible to get through. Recording on the phone said the wait will be over 10 minutes and I've been trying to get through to their website with no luck. It just hangs and hangs. I guess everyone's jamming the lines and their site.

Maybe I'll wait til tomorrow ....

https://www.accesshealthct.com

EDIT: Has anyone here been able to get through to their website today?

[JDPriestly]

131. And wait until doctors and hospitals discover that they are going to get paid for ALL their work.

And they won't have to chase people and take them to court to get the money.

Doctors and hospitals are being pretty quiet right now. Just wait.

A lot of them would be happy to charge slightly less per procedure per patient if they could also save on collection costs. This is especially true when they deal with very sick patients without insurance and have to collect from the patient's estate when there may be nothing there.

There will still be people who are uninsured -- homeless people -- mentally ill people. But in time most people will want to be insured.

[Ikonoklast]

148. GOOD POINT.

[Safetykitten]

162. This? This you just wrote? Fantasy.

[leftstreet]

170. Only 'homeless' and 'mentally ill' people can't afford coverage?

Jesus

[calimary]

135. Welcome to DU, andtheBeast! And GOBAMA!!!!!!!!!

Glad you're here! GOBAMA!!!!!! This is GREAT!!! All those uninsured families - they now have a chance!!!

We're finally emerging from the Dark Ages, into the family of nations! No longer the ONLY industrialized nation on earth that doesn't believe in helping its people! And we can get accomplishments like this here in California because we're a BLUE state, we have a Democratic governor, and we have a super-majority in the state legislature - not enough of the obstructionist bad guys to be able to do ANY damage!!! Which is how it should be!

GOBAMA!!!!!!!!!!

[Wait Wut]

140. How many Reps/Cons are...

...

1. Chanting, "FUCK! FUCK! FUCK!"?

2. Hiding in the closet, sobbing?

3. Smashing all the computers and TVs in their houses so the family doesn't find out how stupid the GOP is?

4. Thinking of moving to Brazil...oh, wait...

[Bigredhunk]

151. YES!!

Giddeyup!

[TxDemChem]

156. I would never wish for anyone to not be able

to receive medical care just because they're not rich. Life is too precious. Good for the ACA!

[Safetykitten]

172. Well, actually we did that. Bronze people plans....Platinum plans....