let me try one more time to explain it

the ACA has nothing to do with sex workers. no part of it is created to aid sex workers. no part of it is created to aid criminals. its a non-issue.

11/1/2013 11:12:01 AM

I got you the first time.

I was just using the article as an example for my point, which is why is it moral for someone to pay so much more, so much in fact that it could break a family financially, to support someone's poor decisions? Granted, these poor decision makers that I like to reference are probably only going to be a smaller percentage of people who eventually sign up that need it.

But 1100? There are many other examples, some less extreme, some more extreme. But many are not affordable at all for the middle class.

11/1/2013 11:21:18 AM

1) its incorrect to claim that anyone who can't afford health insurance is in that position because of poor decisions, or because they are criminals 2) its incorrect to assume that they are able to lift themselves up from that situation and be able to afford health insurance and 3) healthcare should still be accesible to someone even if they have made poor decisions

11/1/2013 11:25:50 AM

Haha, wow. 6 people enrolled on day one.

That's just... I mean, 6. Really.

http://oversight.house.gov/release/102-healthcare-gov-meeting-notes-6-enrollments-occurred-far/

11/1/2013 9:48:32 PM

^^^
Are you just parroting Fox News or what?

All healthcare "insurance" is healthy people paying for the sick. ACA doesn't force anyone to pay for another's poor decisions, this is how things have always been.

http://www.businessinsider.com/your-private-health-insurance-is-really-a-government-program-2013-10

11/2/2013 1:30:03 AM

Its insane how many people have no idea how insurance works or how much of a pain in the ass it is. Most just sign a document their employer gives them and never understand the process of purchasing health insurance.

11/2/2013 8:25:43 AM

Here's another worth a watch:

http://www.youtube.com/watch?v=GvSa9nC4JcQ

The guy wrote a book, so he's researched a lot. It's still heavily opinionated but not like the 24-hour news crap that our society has mostly regressed to. His points are generally:

- Almost all heath care needs to be NOT covered by insurance (paid out of pocket) or else it all goes to hell in a hand-basket
- The ACA is mostly ignorant of this and goes in the wrong direction, but it's a mixed bag
-- Depending on the level of plan, it includes more routine health care stuff, which is bad
-- It mandates covering "preventative" medicine, which is extremely bad, because that will cause the price of these services to skyrocket and efficiency to plummet (note, this is a prediction, see thread title)
-- As an unintended consequence, it will cause more people to get "bare bones" health insurance because of a) Cadillac plan taxes and b) price increases overall. These plans include more price sharing, which means individuals will negotiate for lower prices and accept lower costs treatments. This will help keep prices in check.

This is really quite terrifying. I can't bring myself to understand his main point, because there are going to be too many complications. If you're doing 50-50 cost sharing with insurance, then as a consumer you don't want to negotiate down the sticker price. You want to lower your share without lowering the insurance's share - and I believe people often do this exact thing. With the new system, and with more people in the system, and with the insurance market further commodified, I don't believe this will work. Without transparent pricing it leads to an impasse, and I don't think the game theory of this situation encourages transparency.

- The ACA won't make health care more simple and easier to navigate
- currently, drug companies prefer to keep their drugs as prescription, because they can sell them at a higher price that way, which is an example of his main theory that health care has been incentivized to do anything and everything in a more expensive and less efficient way

11/2/2013 11:02:00 AM

Quote :

"Haha, wow. 6 people enrolled on day one. That's just... I mean, 6. Really."

I'd expect the process to take more than a day to get the quoted and pick a plan, especially when you are relying on outside companies to do everything after the initial request for information is submitted.

11/2/2013 11:36:43 AM

Why would you expect that? On other sites that have existed for years, you could get a quote in minutes. There is no reason to expect it to take days to get a quote.

I hope your post was sarcasm and not blind partisan defensiveness

11/2/2013 1:46:19 PM

Yeah, most health care should be paid out of pocket. You shouldn't expect your health insurance to pay for your annual check up any more than you would expect your car insurance to pay for new tires, or your home owner's insurance to pay for a new refrigerator.

These are things that you can easily afford, it's not actually that expensive to see a doctor or a specialist.

Most people would be best served by a HSA and coverage for diagnostics and catastrophic events.

I don't understand the expectation that insurance should pay for everything. It's not reasonable and it's going to cost a ton in premiums and raise costs across the board.

Quote :

"I'd expect the process to take more than a day to get the quoted and pick a plan, especially when you are relying on outside companies to do everything after the initial request for information is submitted."

What I posted is really, really damning from a technology standpoint and also proves, once again, that the administration lied about stuff they knew full well. When they kept on insisting that they didn't know what the number or people enrolled the first few days it was a lie. I understand why they lied, it was an appalling failure of a rollout, but sometimes you just have to admit you screwed up, especially when it's pretty clear that the truth is going to come out eventually.

[Edited on November 2, 2013 at 2:34 PM. Reason : sdfsdf]

11/2/2013 2:31:53 PM

This current administration really hasn't admitted to any mistakes.

And I agree 100% about relying upon insurance to cover every little thing related to medical procedures. There should be no reasonable expectation that you should only pay 20 dollars for an annual checkup. If doctors would require cash payments, and only charge what they would end up getting paid out by insurance, then we could maybe eventually right the system. If a doctor only gets 50 from insurance for your annual wellness visit, but puts up a charge to you of 75, then that doctor should just require a cash payment of 50, and not even involve insurance.

If exchanges like this could occur across the board, much less insurance would be used. Premiums would eventually go down in price, and people would probably start saving money. That cheaper insurance policy can cover things like emergency room visits and higher cost procedures. And maybe, just maybe, the ER might eventually become a place where people go for emergencies, not sniffles.

11/2/2013 9:43:27 PM

Quote :

"Yeah, most health care should be paid out of pocket. You shouldn't expect your health insurance to pay for your annual check up any more than you would expect your car insurance to pay for new tires, or your home owner's insurance to pay for a new refrigerator. These are things that you can easily afford, it's not actually that expensive to see a doctor or a specialist. Most people would be best served by a HSA and coverage for diagnostics and catastrophic events. I don't understand the expectation that insurance should pay for everything. It's not reasonable and it's going to cost a ton in premiums and raise costs across the board. "

For most insurance plans, the cost of these visits are less that the deductible, so most people pay for these out of pocket anyway.

Are you arguing that ACA should raise deductibles as a cost control?

Quote :

"This current administration really hasn't admitted to any mistakes. And I agree 100% about relying upon insurance to cover every little thing related to medical procedures. There should be no reasonable expectation that you should only pay 20 dollars for an annual checkup. If doctors would require cash payments, and only charge what they would end up getting paid out by insurance, then we could maybe eventually right the system. If a doctor only gets 50 from insurance for your annual wellness visit, but puts up a charge to you of 75, then that doctor should just require a cash payment of 50, and not even involve insurance. If exchanges like this could occur across the board, much less insurance would be used. Premiums would eventually go down in price, and people would probably start saving money. That cheaper insurance policy can cover things like emergency room visits and higher cost procedures. And maybe, just maybe, the ER might eventually become a place where people go for emergencies, not sniffles. "

I can't see how this is true at all. This system might save a few dollars, but isn't the statistic something like 10-20% of the people chew up 80+% of the costs? This isn't from routine checkups. These are people with grave illnesses (cancer, major accidents, etc.), then the other big expense is emergency procedures/surgeries (my friend's wife went to the ER for a horrible stomach cramp, ended up with a $25k appendectomy). They've literally got their money's worth of the past few years of health insurance from that 1 visit.

[Edited on November 4, 2013 at 2:41 PM. Reason : ]

11/4/2013 2:36:55 PM

Its funny and sad at the same time watching Obama trying to spin the promises he made every American from 2009 onward regardng their current plans.

"You can just go shop around" he says. He doesn't mention anything about the premium hikes.

He also isn't talking about the extremely narrow justification for allowing grandfathered policies to remain on the market. And who is the government to decide if a plan is worthy or not? I just don't get why so many folks put their full faith into the government to make their decisions for them.

"Yes...I see you had a plan you liked, but unbeknownst to you, you are too stupid to know what is really good for you and your family, so we've cancelled your plan. Since we know better than you your families situation and needs, we've provided another plan for you. Yea, it might be more expensive, but hey, think of all the good this insurance is doing for everybody else."

11/5/2013 10:24:21 AM

Double post...the speech he never gave, but should have:

Hello, St. Paul! It is so good to be back in the great state of Minnesota. Go Gophers! [We love you!] I love you back! [Stomping, cheers.]

I don’t know if you’ve noticed, but I’ve been talking about health-care reform a little lately. [Laughter.] I want to set the record straight on a few things today.

Republicans are out there scaring folks, and saying that they’ll lose their insurance. [Boos, jeers.] No, no — hey, just because they don’t care about people doesn’t mean they are wrong about everything. [Laughter, applause.]

And they’re right about this. Some folks are going to lose their insurance. Millions of them, in fact.

Let me be clear: Just because you have insurance you like, doesn’t mean you can keep it. If it doesn’t meet the new federal standards, your plan is going to get canceled. I guarantee it.

Some of my political advisers say, “Hey, you can’t go out and tell people that, Obama. It doesn’t test well. People hate it in the polls.”

And you know what I told them? “I . . . don’t . . . care . . . about . . . the polls.” [Applause]

I said: “That’s the old politics. That’s what’s wrong with Washington, DC, right there. If you think I’m going to go out and lie about my plan, you’ve got the wrong guy. What did you think hope and change were all about?” [Laughter, applause.]

So, yeah, some of you are going to lose your insurance. Now, because of the marketplace we’ll set up, you’re going to go online and shop for new insurance. Some of you are going to get a better deal. If you don’t make much money, you’re going to get help from the government. [Cheers.]

But let me be clear again — and Axelrod hates this part [Laughter] — many of you are going to pay more than you did before. Maybe double. Because all of these new regulations cost money. You don’t believe in a free lunch, do you? [Confused murmurs.]

What we’re proposing is to get young, healthy people onto the exchanges so they can subsidize everyone else, by buying coverage they don’t want or need at a price that is higher than before. Why would they do that, you ask? [Faint laughter.] That’s what the individual mandate is all about. We’ve got to force them.

As for the doctor you like, you might not be able to keep him or her, either. [Murmurs.] If you have to change your plan, your doctor may not be in the network. And to try to keep costs down, the networks in the exchanges are really narrow. By the way, top hospitals probably aren’t going to accept a lot of plans from the exchanges, either.

Some of my friends on my side of the aisle try to minimize all this. They say that the bill has a grandfather clause. Wait until you see the regulations we write on that one — there will barely be a grandfather clause left. They say that only the 5 percent of people who get their insurance through the individual market will lose their plans. But that’s still millions of people.

Now, I can hear some of you right now saying that universal coverage is worth it. [Yeah.] But let’s be careful about that. The respected Congressional Budget Office says under my plan tens of millions of people will still be uninsured in 2020.

So that’s why I wanted to come here today, St. Paul. I wanted to tell you the hard truths. I know you can handle them. [Isolated clapping.] I know you will still support my plan, which, admittedly, is a little complicated. But we put a man on the moon! There’s no way we’re going to mess up a health-care law. Not on my watch.

Thank you, St. Paul.

11/5/2013 10:36:18 AM

no one is going to read your forwarded email

11/5/2013 10:49:07 AM

It isn't a forwarded email, it was something posted on a conservative leaning news site (not Fox). I figured if I gave the link you people would just trash it.

11/5/2013 10:54:54 AM

no one is going to read it, regardless of whether or not you posted a link. so don't worry about it.

it says a lot about you though that you thought it was worth posting, none of it good.

11/5/2013 11:03:30 AM

Not mine. This is obviously a GOP photoshop to make Obama look bad, right guys? Right?

11/5/2013 11:21:29 AM

I mean, for all we know Humana is still offering "Option A" (although compliant with ACA now) at the exact same price, they just decided to auto-enrolled everyone in the more expensive "Option B" for the new year. Since the two plans are so different, its pretty hard to compare them.

It just seems like we would need a lot more info for that pic to be damning.

11/5/2013 11:45:27 AM

^^
http://talkingpointsmemo.com/dc/insurance-companies-misleading-letters-obamacare

11/5/2013 11:49:17 AM

As tax credits are only available through the exchanges, the letters are as accurate as they can be.

Quote :

"I mean, for all we know Humana is still offering "Option A" (although compliant with ACA now) at the exact same price, they just decided to auto-enrolled everyone in the more expensive "Option B" for the new year."

No. we know. Option A is gone. That the two plans differ so is because Humana has no plan in 2014 on the exchange that matches Option A. That was the case with me here in Wake county with Coventry.

[Edited on November 6, 2013 at 11:14 AM. Reason : .,.]]

11/6/2013 11:08:58 AM

You "know" that, huh? Even though Humana has already been fined for misleading customers in nearly the way that I described, you "know" they don't offer a more similar plan to Option A because the same thing happened to you that one time, with a totally different provider in a (likely) totally different state.

real convincing.

11/6/2013 12:09:28 PM

Quote :

"I mean, for all we know Humana is still offering "Option A" (although compliant with ACA now) at the exact same price"

I will guarantee you any amount of money Humana is not still offering Option A "at the exact same price"

They most likely didn't offer Option A at the exact same price going between 2012 and 2013. They damn sure aren't going to do it between 2013 and 2014.

11/6/2013 1:01:01 PM

I can admit that they are probably slightly adjusting their prices on a yearly basis. But I also guarantee they are offering a plan that is either bronze or catastrophic, whose coverage is very nearly the same as the previous Option A.

That new plan is what Humana should have been auto-enrolling its customers, that had the previous option A, into. Instead they enrolled them into a much more expensive plan and represented it as the customers only option. That's why they are currently being fined $Kentucky.

11/6/2013 1:33:18 PM

http://www.businessinsider.com/here-are-the-five-big-reasons-obamacare-changes-insurance-premiums-2013-11

Read the last paragraph only if tl;dr.

11/6/2013 1:51:29 PM

Good read on some Obama lovers who are "shocked" that their health care plan got cancelled due ACA

http://www.propublica.org/article/loyal-obama-supporters-canceled-by-obamacare

11/6/2013 4:11:49 PM

I'm gonna spin this and say that ACA encourages people to shack up rather than get married. Not true, but a good spin nonetheless.

http://money.cnn.com/2013/11/07/news/economy/obamacare-marriage-penalty/index.html?hpt=hp_t2

11/7/2013 9:14:23 AM

Quote :

"Here's why: The federal poverty level of a two-person household ($15,510) is less than double that of a one-person household ($11,490). "

...why?

11/7/2013 9:24:10 AM

another story on how insurance companies are ripping you off"

Insurance Scam; How Private Insurance Companies Are Using Obamacare Fears To Rip People Off
http://www.addictinginfo.org/2013/11/05/insurance-companies-obamacare-scam/

Quote :

"By now you’ve probably heard horror stories about how the Affordable Care Act (ACA), otherwise known as Obamacare, has forced so many people to lose their insurance policies. You’ve heard that affordable health insurance policies are being canceled and replaced with policies that are far more expensive than the canceled policies. But have you heard that across the country, insurance regulators are cracking down on the private insurance companies, because of the scam they are running on their customers? Probably not. [...] "

11/7/2013 11:21:09 AM

But is it really a "scam" when these people file their taxes, they will get the premiums back?

11/7/2013 12:05:00 PM

why would that happen?

11/7/2013 12:44:18 PM

Nope. The democrats love monopoly, so the tax credits are only available to those buying through the exchange. If you buy an identical policy directly from the insurance company you are ineligible. It is because of this fact that insurance companies are unable to include subsidies in their mailings.

As they don't have income information on their customers, the insurance companies have no way of knowing which of their customers qualify for subsidies. Also, is it really misleading not to volunteer that cheaper plans are possibly available from a third party elsewhere? While it is certainly the polite thing to do, I don't see any moral obligation to do so. That said, I know the ACA imposed numerous legal obligations on insurance companies to help advertise healthcare.gov. My insurance company, and probably all others, made sure to get that free advertising for their competitor out of the way months before the real shit hit the fan.

11/7/2013 1:18:01 PM

I thought you could received the subsidy if you purchased an eligible health insurance plan. However, the Premium Tax Credit is only on plans PURCHASED THROUGH THE MARKETPLACE. So not only is their an individual mandate, but there is a Government Broker.

If one was to purchase insurance through the Marketplace, but did not receive a subsidy at the time of purchase. When they filed taxes for that year, and it was determined they were eligible for a subsidy, would they receive a tax credit?

If the Premium Tax Credit is only available through the Marketplace (the carrot for using the marketplace), why is it that one cannot purchase ineligible health insurance outside of the marketplace and opt to pay the penalty. If you purchase eligible insurance outside the marketplace, who is policing the penalties to verify that your insurance was eligible/why wouldn't you received the subsidy if you were eligible at the time you file your taxes? How can this be a tax credit and not a tax credit dependent upon how the service was purchased?

http://www.irs.gov/uac/Affordable-Care-Act-Tax-Provisions

In short, it is not a tax credit....the subsidy is an entitlement disguised as a tax credit.

[Edited on November 7, 2013 at 1:34 PM. Reason : .]

11/7/2013 1:26:26 PM

I still want to know why you are punished financially for being married.

11/7/2013 2:37:20 PM

you should read the link that you posted then

11/7/2013 2:41:46 PM

Quote :

"why is it that one cannot purchase ineligible health insurance outside of the marketplace and opt to pay the penalty"

It is a crime to sell insurance that does not conform to the ACA's requirements starting in 2014. However, if the policy is purchased in 2013, it can continue into 2014 without the owners of the insurance company (and possibly the insurance customer) being arrested. However, if they try to renew a non-conforming policy after January 1st, 2014, they will be charged with a crime. This is why my health insurance company had us all renew our policies on December 1st rather than January 1st like we normally do (they want to keep their customers insured, but don't want to break the law).

Now, even though this loophole keeps my insurer out of prison, it is still true my policy is non-conforming, as it does not cover mental health problems or male pregnancy, therefore come tax time in 2015 I will be charged by the IRS to pay the $95 penalty. That is right after my policy is finally and truly cancelled on December 1st, 2014, after the open enrollment has ended and I may be unable to apply for health insurance anywhere, even healthcare.gov.

11/7/2013 2:46:55 PM

1) Why would you not be able to enroll somewhere else? 2) Heatlthcare.gov enrollment will be open until December 7th, so its not an issue 3)even if your plan ended outside of the open enrollment if you are on an individual plan why could you not end your plan early?

11/7/2013 3:01:08 PM

Quote :

"male pregnancy"

Yeah, I'm going to take everything else you said seriously.

11/7/2013 3:34:15 PM

I stopped at sending insurers to prison. Should've stopped at monopoly.

11/7/2013 3:43:00 PM

^ Wait, one obvious joke discredits a whole post?
Joking aside, I suspect my existing coverage would cover male pregnancy.

^^ I said may (however unlikely). There is no law that insurers accept applicants outside of the exchanges. And it is an open question whether losing non-comforming insurance counts as "losing coverage" when it comes to an exception allowing you to use the healthcare.gov website after open-enrollment ends.

11/7/2013 3:44:41 PM

Can you think of no reasons why it would be a good idea to have insurance to cover the off chance that you get someone pregnant?

11/7/2013 3:46:20 PM

^^ like i said before, Dec 1 is during open enrollment so its not even an issue. But even if it was outside of open enrollment, you can still get whatever individual insurance you want. or if you were in a situation where your grandfathered plan ended just outside of open enrollment, you could always leave it early and go into an exchange plan to make the open enrollment period.

so, again, what's your problem?

[Edited on November 7, 2013 at 4:09 PM. Reason : ^she has her own mandated insurance seems like a good reason]

11/7/2013 4:09:13 PM

It is not. Open enrollment ends March 31st.

11/7/2013 5:37:37 PM

uh... they have an open enrollment every year. You said your plan runs through December 1st, 2014. The open enrollment runs October 15 to December 7. December 1st, 2014 is between October 15, 2014 and December 7, 2014.

soooo, what exactly is your issue?

even if you were right, and there was only one open enrollment session ever, why would you not be able to get insurance outside of the exchange or cancel your individual coverage before March 31? Because both of those are options



[Edited on November 7, 2013 at 7:09 PM. Reason : wait wait wait, did you think there was only one enrollment period?]

11/7/2013 7:05:30 PM

Wow. thank you for that information. I genuinely did not know that. Good work

Do you know any reason I'm not going to be fined the $95, since my insurance is non-conforming?

11/7/2013 10:13:03 PM

Quote :

" Can you think of no reasons why it would be a good idea to have insurance to cover the off chance that you get someone pregnant? "

Personally I'm looking forward to the first legally married gay couple that files a federal lawsuit over being required to carry maternity coverage

[Edited on November 7, 2013 at 10:19 PM. Reason : Dhd]

11/7/2013 10:18:42 PM

I don't see how the forced maternity coverage is going to hold up.

11/8/2013 7:02:55 AM

Makes as much sense as requiring all policies to cover mammograms or prostate exams.

You've legislated into law a bunch of stuff that makes no mathematical sense, of course there will be completely illogical results.

11/8/2013 8:16:37 AM

I didn't realize you guys were being serious about the maternity coverage stuff. there is some confusion here, obamacare does not force men to buy maternity coverage, it requires insurance agencies to provide pregnancy healthcare coverage in all plans. Because of the ACA, pregnant women can no longer be turned down when applying for maternity health coverage, or charged more for coverage.

Before ACA, maternity coverage was particularly hard to get and only 12% of individual plans included maternity coverage. You could also make the point that of course insurance companies should be allowed to charge women more, like I have before, although you might change your mind when you learn that 92% of the best selling plans charged women significantly more even though only 3% of those plans included maternity coverage.

11/8/2013 8:56:53 AM

Yes, but even without maternity coverage women are more expensive to cover based on prescription coverage costs, more frequent doctor visits, things like mammograms, etc.

That's the illogical part. That and shifting cost of coverage on to people that will not use it, whether that's the young and healthy paying for the sick or men paying for women's coverage.

11/8/2013 9:11:52 AM