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Meds, Mind, Body & Benefits => Insurance, Benefits Programs & HIV => Topic started by: mitch777 on September 25, 2013, 05:05:24 pm

Title: Obamacare.
Post by: mitch777 on September 25, 2013, 05:05:24 pm
Heads up! The countdown for enrollment is 5 days away!

So far from what has been reported is that the cost of the options are better than expected. I will wait to pass judgment until I see what kind of coverage is offered compared to my current plan.

For those of you who might find it beneficial you also have to look at the tax breaks involved to help defray the cost as well. :)

Starting 1/1/2014 insurance companies can no longer deny anyone for having a pre-existing condition. (whether you take part in the plan or get/keep new or existing insurance) Yay!

Also, the max out of pocket expense for these plans has an annual cap. :)

I know that Obamacare has issues and tweeks to still be addressed. If the balance of power shifts we might see it happen. We also might see it happen if the many lives of people taking advantage of it are overwhelmingly positive. Word spreads fast.

Guess we will see how it plays out across the country.
Title: Re: Obamacare.
Post by: tednlou2 on September 25, 2013, 05:17:12 pm
I was just reading this article about some aspects of it. 

http://www.poz.com/articles/ACA_costs_761_24543.shtml
Title: Re: Obamacare.
Post by: mitch777 on September 25, 2013, 05:22:08 pm
I was just reading this article about some aspects of it. 

http://www.poz.com/articles/ACA_costs_761_24543.shtml

Well that sounds a bit discouraging depending on where you live and who is providing medical care.

I plan on checking every aspect out. Costs and limitations.
Title: Re: Obamacare.
Post by: thunter34 on September 25, 2013, 05:23:24 pm
I'm on ADAP and not even considering enrolling right away.  GA hasn't even figured out what they are going to do regarding ADAP and the ACA - hell...GA hasn't even agreed to get on board with the ACA in general.
Title: Re: Obamacare.
Post by: Jeff G on September 25, 2013, 05:29:21 pm
We need some kind of formula that regulates profitable corporation's preventing them from cutting workers hours to 30 hours or less simply to sidestep the insurance requirement .

The conservatives are using the insurance avoidance tactic corporations are implementing as proof that Obama Care is a job killer , its sick and convoluted .
Title: Re: Obamacare.
Post by: Miss Philicia on September 25, 2013, 05:31:49 pm
I honestly have no idea if this will even affect my coverage. Our lame-o Rethuglican governor didn't even make up his mind until two weeks ago whether our state would participate. Fortunately his poll numbers are so bad we will be having a Democrat for governor come the 2014 election.
Title: Re: Obamacare.
Post by: mecch on September 25, 2013, 05:38:27 pm
I thought EVERY state must participate, but its a question of who foots the bill, for the moment.
Title: Re: Obamacare.
Post by: buginme2 on September 25, 2013, 05:39:35 pm
I really wonder what's going to happen to the people on ADAP and Ryan White.

The law requires that everyone buys insurance and if you don't then you will be charged a fine.  So, if your on ADAP that would mean you don't have insurance.  So will you be forced to buy insurance effectively removing you from ADAP coverage?

Most states will be expanding Medicade coverage to include people who are now on ADAP which would be beneficially for them since Medicade would cover more than just hiv related issues. 

But what happens if your in one of the states that threw up their middle finger to the Feds?

Title: Re: Obamacare.
Post by: buginme2 on September 25, 2013, 05:41:25 pm
I thought EVERY state must participate, but its a question of who foots the bill, for the moment.

The law expanded Medicaid coverage to cover those people who can't afford insurance.  The Supreme Court said states didn't have to participate in this so some states are not expanding their Medicare.  This will leave a pretty big group of low income people without insurance or state assistance.

I think

Edited:changed Medicare to caid. Autocorrect
Title: Re: Obamacare.
Post by: mitch777 on September 25, 2013, 05:42:19 pm
We need some kind of formula that regulates profitable corporation's preventing them from cutting workers hours to 30 hours or less simply to sidestep the insurance requirement .

The conservatives are using the insurance avoidance tactic corporations are implementing as proof that Obama Care is a job killer , its sick and convoluted .

It's sad isn't it?

I honestly have no idea if this will even affect my coverage. Our lame-o Rethuglican governor didn't even make up his mind until two weeks ago whether our state would participate. Fortunately his poll numbers are so bad we will be having a Democrat for governor come the 2014 election.

A silver lining. :)

I'm on ADAP and not even considering enrolling right away.  GA hasn't even figured out what they are going to do regarding ADAP and the ACA - hell...GA hasn't even agreed to get on board with the ACA in general.

Sad to see people who live in Republican stronghold states suffer from the elected idiots who are cold hearted when it comes to what most people in this country face. :(
Title: Re: Obamacare.
Post by: mitch777 on September 25, 2013, 05:45:10 pm
I really wonder what's going to happen to the people on ADAP and Ryan White.

The law requires that everyone buys insurance and if you don't then you will be charged a fine.  So, if your on ADAP that would mean you don't have insurance.  So will you be forced to buy insurance effectively removing you from ADAP coverage?

Most states will be expanding Medicade coverage to include people who are now on ADAP which would be beneficially for them since Medicade would cover more than just hiv related issues. 

But what happens if your in one of the states that threw up their middle finger to the Feds?

I have insurance and am also on ADAP. I think this might vary from state to state.
Dunno.
Title: Re: Obamacare.
Post by: mitch777 on September 25, 2013, 05:48:53 pm
The law expanded Medicare coverage to cover those people who can't afford insurance.  The Supreme Court said states didn't have to participate in this so some states are not expanding their Medicare.  This will leave a pretty big group of low income people without insurance or state assistance.

I think

I think you are right. Once again it is the Republican controlled states that will suffer from ignorant and cold hearted politicians. Sad.
Title: Re: Obamacare.
Post by: phildinftlaudy on September 25, 2013, 05:53:15 pm
It's already beginning to have an impact (although I can't gauge whether it will be good or bad) on the coverage I have with my employer....

Up til this point, I have had Aetna HMO with premiums paid 100% by employer and $25 primary doctor co-pay and $45 specialist co-pay and $65 for my HIV meds...

Well, as of January 1st - employer is switching to HRA (Health Reimbursement Account) through Aetna. Basically, my employer (employees are not allowed to contribute) will put $750 in HRA.... I will have a $1,250 deductible (which employer's $750 will go to meeting).... I will have to pay the additional $500 out-of-pocket.... Once I hit the $1,250 the actual HMO style insurance with previous co-pays, etc will kick in.... Than, when I hit $2,500, everything will be covered 100%.....

So, I can expect to have to pay $500 out of pocket in January toward my meds - after that, I will pay the $65 co-pay....  I plan on increasing my FSA (Flex Spending Account) - which I contribute fully to... I will take it to $1,000 per year (it is at $600 right now)  -- Even though it will come out at a bit over $40 per check, the $1,000 will be fully available on January 1.... and it is pre-tax, so lowers my tax burden a little bit...

I figure between the $500 I put out in January toward meds and the money I will put out rest of year for co-pays, I should be okay... (especially since my co-pay for meds is covered - at least for now - through co-pay assistance program).

I'm sure there will be pros and cons.... such is the game known as "insurance" and health care in the U.S.
Title: Re: Obamacare.
Post by: Jeff G on September 25, 2013, 05:56:58 pm
The insurance and health care lobby will put tremendous pressure on any governor who try's to opt out of excepting federal funding . Healthcare reform may not have been something these lobby's wanted to see happen but now that its law they will be there to collect the hundreds of millions of dollars coming in to each state .

Lots of work and tweaks has to be done to make the new law work for consumers , I just hope that conservatives are not able to defund it before people have the chance to see its going to be of benefit . 
Title: Re: Obamacare.
Post by: mitch777 on September 25, 2013, 06:18:14 pm
@Phil- complicated isn't it? ???
@ Jeff- I think it's too late. It won't be defunded before taking effect. :)
Title: Re: Obamacare.
Post by: BT65 on September 25, 2013, 07:03:51 pm
Well, Hoosierville's idiot governor (Pence) is not expanding Medicaid. 

It's going to be a mess here.  Though I can say that our clients who have the insurance we get them on, will have no issues.  The insurance they have right now is called ICHIA, which will dissolve Dec. 31st.  Then the coverage will change to ADAP and EIP.  This will cover everything other than hospital for 3 months, then the State Dept of Health will have contracted with another insurance similar to ICHIA, and the clients will roll into that.  Except for the undocumented.  They have to stay on ADAP and EIP since the new insurance(s) will require people to prove citizenship. 

The insurance our clients are on that we, the case managers, got them on, is a really good deal.  They have to make less than 300% of the FPL, and of course that amount increases per family member.  And they do not have to pay a dime for the insurance, and no co-pays on doctor visits and meds. 

However, there are those that may want to take advantage of the marketplace.  Also, I there are those clients who have Medicare and Mdap, which is run through the State Dept of Health. Mdap raps around Medicare A and B.  That's basically for people who would have a huge spend down on Medicaid, so they do not seek that out.  The State is not sure what will happen with that. 

It's going to be insane, and we're trying to prepare.  Of course we have no idea yet exactly what we're preparing for.  We did have a training on this in Indy a couple weeks ago, and there was a lady from Indiana Insurance Assoc who was saying Anthem had the corner on the market here in Indiana, and most single people would be paying around $250/month for coverage, but of course that depends on which plan they have.  The downside is that the choice of plans will be limited depending on which region the person seeking coverage lives in.  Plus, if the person has a doctor in another region, that doctor will no longer be covered.  So, say someone lives in Lafayette but has a cancer specialist in Indianapolis.  That cancer specialist will no longer be covered.

It's so detailed it gives me a headache.  If you read this far, you're doing better than I would do.
Title: Re: Obamacare.
Post by: mitch777 on September 25, 2013, 07:29:58 pm
I read that far. Thanks for the details Betty. I really hope this helps most of your clients. Government details.  ::)
I applaud you for your efforts!!!
Title: Re: Obamacare.
Post by: phildinftlaudy on September 25, 2013, 09:03:45 pm
@Phil- complicated isn't it? ???
@ Jeff- I think it's too late. It won't be defunded before taking effect. :)

Very complicated -
They are having some informational sessions for the employees...
Both my younger brother and younger sister work for large insurance companies - they said even the insurance companies are unsure of how things are going to roll out and actually work....

My brother said lots of employers are switching to HRAs - with some getting rid of insurance and just letting employees use the funds in the HRA to put toward insurance that the employee purchases.... He also said that many are raising the deductibles to around $3,500... that would have put a dent in my monthly budget as I would have had to cough up the $1,250 for my Atripla for all of January(assuming my employer had a $750 HRA set up w/ that high of a deductible) and $1,600+ in February before I would have met that kind of deductible.... I probably would have switched to the PPO plan - but that would have been $140 per paycheck (or $3,360 per year), but at least it would have spread the hit out over 12 months....

I think Obamacare will be great for those w/ no insurance and those part-timers who either have no insurance or very limited insurance coverage.... For those w/ full-time employment w/ fairly good current plans (I suppose some would be called "cadillac" plans), the changes to these plans or dilution of them may not be as well received.... But, overall I am reserving judgment - as I definitely believe that universal health care is needed.

It is funny though that an Aetna video module I watched on HRAs basically blames increasing health care costs for the burden being faced by employers in providing coverage - when I think employers are struggling more with insurance rates going up 27% a year.... as the increases that insurers are facing from health care providers don't match 27% (or at least I doubt it).

Title: Re: Obamacare.
Post by: tednlou2 on September 25, 2013, 11:35:36 pm
I would suggest picking up a copy of the November edition of Consumer Reports.  I know, November?  October isn't even here yet.  I got mine in the mail today.  They gave me more info so far, than I've learned over the last few years.  You may be able to find some articles on their website.  They've also set up an exclusive website at

healthlawhelper.org

Some of the highlights:

"If you don't have insurance and don't buy in, you will pay a penalty of $95 per adult and up to $285 per family for the 2014 tax year.  That escalates to $695 for adult and $2,085 for families in 2016.  These health marketplaces open in every state Oct 1, whether the state is willing or not. 

More than half of people will have income-based tax credits to help pay premiums.  80% of Americans either get insurance through work, Medicare/Medicaid, and the VA.  4 million will have access to the Medicaid expansion.  (Although, you can look at their map and see that the states not going along with the expansion fall into the political red states.  Kentucky and W. Virginia are participating.  They still list PA as undecided.  That is just sad.  I'm still not sure what happens to those folks--whether they will get subsidies to buy into the market, or whether they will have to rely on ER care.)

In early 2015, your employer insurance company will send you proof of insurance, that you will have to file on your 2014 taxes.  If your employer cancels your plan for 2014, which may happen to many, you may be able to get better coverage in the marketplace and possibly qualify for subsidies to help pay for it.  On Oct 1, employers have to give employees a form that gives them the cheapest individual plan they offer.  If that number is more than 9.5% of your household income, and your income is below certain levels, you can turn the plan down and purchase your own through the state marketplace.  But, if it is less than 9.5% you can only get a subsidy if your plan covers less than a "minimum value" of expected medical costs.  But an important catch may ensnare some families with multiple members covered on the same plan.  If for instance, your employer charges you $20 a month but $750 more to add your spouse and $250 more to add your kids, even if the total premium adds up to more than 9.5% of your family's income, you can't get a marketplace subsidy because the employee-only contribution is the one that counts.  It's unfair and may need to be fixed with new legislation.  If that happens to you, price out plans in the marketplace for your dependents anyway.  Even at full price, it might be cheaper than keeping them on your employer plan.  If you're in Medicare, you don't have to do anything.

If you buy your own insurance or don't have any, the marketplace is designed for people like you.  Investigate whether you qualify for income-based assistance with your premiums, lower out-of-pocket costs, or free or almost free Medicaid.  You can still buy private insurance outside the marketplace, but you can qualify for and receive financial assistance only within the marketplace.  This help will come in the form of a tax credit that you can use right away to lower your premium.  Lower-income households will also receive help with out-of-pocket costs.  For details, download our free brochure at consumerreports.org/healthtaxcredit."
Title: Re: Obamacare.
Post by: tednlou2 on September 25, 2013, 11:39:14 pm
Sorry for the bad phone pic.  You will obviously have to zoom in.


(http://i666.photobucket.com/albums/vv22/tedunk/20130925_231231_zpsd55846f0.jpg)
Title: Re: Obamacare.
Post by: BT65 on September 26, 2013, 04:18:01 am
We were told, at the training in Indy, that some states not expanding Medicaid at this time, may in the future.  We were told they are looking at states like Arkansas, who apparently is writing something like their own version of Medicaid expansion?  Something like that.

The tax credits will be paid directly to the insurers.  People can request they be paid directly to the tax payer, but then if they do not pay the insurance premiums, they will face a fine, and not have insurance. 

I think universal health coverage is needed also.   I'm sure it will take a while to iron out all the kinks, just as with any new program.  We got an e-mail at work from a lawyer who works at NASTAD with links in it.  I will look at that later today, and try to post the links we were provided with for more info for people.  Nothing like getting it straight from the source.
Title: Re: Obamacare.
Post by: BT65 on September 26, 2013, 04:33:56 am
http://kff.org/interactive/subsidy-calculator/

http://www.cms.gov/cciio/index.html

http://marketplace.cms.gov/training/get-training.html


From the e-mail:

"With regard to the change in income necessary to report to the Marketplace, the rules don’t specify a threshold amount (though this may change in the next couple of weeks as the federal Marketplaces come online). A few state-based Marketplaces have set their threshold at $150 change in a given month which might serve as a ballpark idea. We should be looking out for this information starting October 1st.
·         If an insured individual who qualifies for advance payment of premium tax credits does not pay his/her portion of the premium, QHPs are required to allow a 3-month grace period of nonpayment of premiums before discontinuing coverage.
·         In order to be eligible for premium tax credits to purchase Marketplace coverage, a person cannot have access to affordable employer-sponsored coverage. Affordability is defined as employee premiums costing over 9.5% of the employee’s annual income (note: this does not include any out of pocket costs, just premiums).


    The following circumstances constitute triggering events that would allow someone to apply for Marketplace coverage outside of the open enrollment period:
o   A qualified individual or dependent loses minimum essential coverage;
o   A qualified individual gains a dependent or becomes a dependent through marriage, birth, adoption or placement for adoption;
o   An individual, who was not previously a citizen, national, or lawfully present individual gains such status;
o   A qualified individual's enrollment or non-enrollment in a QHP is unintentional, inadvertent, or erroneous and is the result of the error, misrepresentation, or inaction of an officer, employee, or agent of the Marketplace or HHS
o   An enrollee adequately demonstrates to the Marketplace that the QHP in which he or she is enrolled substantially violated a material provision of its contract in relation to the enrollee;
o   An individual is determined newly eligible or newly ineligible for advance payments of the premium tax credit or has a change in eligibility for cost-sharing reductions, regardless of whether such individual is already enrolled in a QHP. The Marketplace must permit individuals whose existing coverage through an eligible employer-sponsored plan will no longer be affordable or provide minimum value for his or her employer's upcoming plan year to access this special enrollment period prior to the end of his or her coverage through such eligible employer-sponsored plan;
o   A qualified individual or enrollee gains access to new QHPs as a result of a permanent move;
o   An Indian, as defined by section 4 of the Indian Health Care Improvement Act, may enroll in a QHP or change from one QHP to another one time per month; and
o   A qualified individual or enrollee demonstrates to the Marketplace, in accordance with guidelines issued by HHS, that the individual meets other exceptional circumstances as the Marketplace may provide.
 
Amy Killelea, JD
Associate Director, Health Care Access"

I wish I knew how to post a power point we got e-mailed to us from the above person (Amy Killelea) that really explains things.  But, alas, I do not know how and have been trying for the last 20 minutes lol.  I don't know if the above helps anyone, hopefully it does.
Title: Re: Obamacare.
Post by: mitch777 on September 26, 2013, 08:44:10 am
I would suggest picking up a copy of the November edition of Consumer Reports.  I know, November?  October isn't even here yet.  I got mine in the mail today.  They gave me more info so far, than I've learned over the last few years.  You may be able to find some articles on their website.  They've also set up an exclusive website at

healthlawhelper.org

Some of the highlights:

"If you don't have insurance and don't buy in, you will pay a penalty of $95 per adult and up to $285 per family for the 2014 tax year.  That escalates to $695 for adult and $2,085 for families in 2016.  These health marketplaces open in every state Oct 1, whether the state is willing or not. 


The description of the penalties was incomplete. This is what I found on the Connecticut Affordable Health Care Website:

2014  2015  2016 
 
 
 $95 per person
 or 1% of household income, whichever is greater*
 $325 per person
 or 2% of household income, whichever is greater*
 $695 per person
 or 2.5% of household income, whichever is greater* 
 
 

* The percentage penalty is imposed on gross household income over the federal income tax filing threshold. Certain people may not be subject to a penalty, such as those whose gaps in coverage are less than a continuous three month period in a single year. In addition, the penalty may be subject to a cap.
Title: Re: Obamacare.
Post by: tednlou2 on September 27, 2013, 03:15:30 pm
I plugged in a family income of $30k in KY with 2 non-smoking adults and 2 kids.  I checked no employer insurance.  The premium was $600 a year with possible tax credits.  KY is going along with the Medicaid expansion, so the kids could probably go on that.  Our Governor just told people to get out of the way, and that the people of KY need this terribly.


http://www.npr.org/blogs/health/2013/09/26/226456791/how-much-will-obamacare-cost-me-try-our-calculator?utm_content=socialflow&utm_campaign=nprfacebook&utm_source=npr&utm_medium=facebook
Title: Re: Obamacare.
Post by: J.R.E. on September 27, 2013, 05:35:22 pm


I can't wait for for Florida's gov Scott to be thrown out of office :

"The Florida Department of Health has become the latest arm of state government to distance itself from  the federal Affordable Care Act. It has ordered county health units not to allow outreach workers called Navigators onto their property to help uninsured people sign up for subsidized health coverage. "

http://www.dailykos.com/story/2013/09/12/1238467/-Florida-health-department-chief-bans-navigators-from-community-health-nbsp-centers


I so despise this guy this criminal governor...


Ray >:(
Title: Re: Obamacare.
Post by: J.R.E. on September 27, 2013, 05:58:53 pm

A little more to add on my post above:

http://www.huffingtonpost.com/2013/09/24/florida-navigators-obamacare_n_3981942.html

"Yet heavily Democratic Broward and Pinellas counties have found a way around the directive."


 Florida Counties To Defy State Ban On Obamacare Navigators



One week away from the start of the Affordable Care Act, at least two Florida counties have announced plans to defy the state's ban on Obamacare navigators.

Citing identity theft concerns, Florida officials recently prohibited "navigators," counselors hired under the Affordable Care Act to help the uninsured sign up for the state's expanded insurance program, at county health departments.

"Privacy has been a big issue for me," Gov. Rick Scott (R) said regarding the navigators. "We don't know how this information is going to be used."

The "cruel and irresponsible" ban inspired the New York Times editorial board to write that Scott should "hang his head in shame," and incited harsh criticism from U.S. Health and Human Services Secretary Kathleen Sebelius.

Yet heavily Democratic Broward and Pinellas counties have found a way around the directive.

Pinellas County Health Department Director Dr. Claude Dharamraj, a state employee, pointed out that health department buildings are county property, adding "I believe I am not in the position to dictate to (the county) what kind of staff they put in their office," reports the Tampa Bay Times.

WSUF reports that eventually a compromise was reached, allowing navigators inside Pinellas County buildings but outside of Department of Health offices.

Broward Mayor Kristin Jacobs recently sided with Pinellas, saying “It is criminal that anyone would put their foot out to trip up that process for sharing (Affordable Care Act) information," as reported by Broward Bulldog. "You can’t tell us that we can’t do that in our own facility."

The heavily Democratic Broward County Commission is expected to approve the mayor's resolution Tuesday.

Jacobs expected more Florida counties to follow suit after last week's Florida Association of Counties meeting, where she says “Everybody was having the same conversation. ‘What were they thinking? Why are they doing this?’”

Despite having the second-highest uninsured population in the U.S., Florida has continually tried to thwart expanding coverage to its residents under Obamacare.

The state led an unsuccessful suit to stop the law, voted to use state funds to expand a private program to just 130,000 residents as opposed to using federal dollars to cover more than a million uninsured, declined to set up its own state exchange, and relaxed Tallahassee's ability to regulate rates in the state.

"In states like Florida that seem determined to sabotage reform," wrote the New York Times editorial board, "the uninsured may have a very hard time getting the coverage they need and deserve."
Title: Re: Obamacare.
Post by: bocker3 on September 27, 2013, 06:14:04 pm
It's already beginning to have an impact (although I can't gauge whether it will be good or bad) on the coverage I have with my employer....

Up til this point, I have had Aetna HMO with premiums paid 100% by employer and $25 primary doctor co-pay and $45 specialist co-pay and $65 for my HIV meds...

Well, as of January 1st - employer is switching to HRA (Health Reimbursement Account) through Aetna. Basically, my employer (employees are not allowed to contribute) will put $750 in HRA.... I will have a $1,250 deductible (which employer's $750 will go to meeting).... I will have to pay the additional $500 out-of-pocket.... Once I hit the $1,250 the actual HMO style insurance with previous co-pays, etc will kick in.... Than, when I hit $2,500, everything will be covered 100%.....

So, I can expect to have to pay $500 out of pocket in January toward my meds - after that, I will pay the $65 co-pay....  I plan on increasing my FSA (Flex Spending Account) - which I contribute fully to... I will take it to $1,000 per year (it is at $600 right now)  -- Even though it will come out at a bit over $40 per check, the $1,000 will be fully available on January 1.... and it is pre-tax, so lowers my tax burden a little bit...

I figure between the $500 I put out in January toward meds and the money I will put out rest of year for co-pays, I should be okay... (especially since my co-pay for meds is covered - at least for now - through co-pay assistance program).

I'm sure there will be pros and cons.... such is the game known as "insurance" and health care in the U.S.

Check this out - I do not think you can have both a HSA and FSA.  However, you should be able to contribute pre-tax into your HSA (above the $750 from your employer).  Sid has this high-deductible plan and that is the info that I have pulled out go it.  The benefit of an HSA over FSA, you do not have the user it or lose it aspect.  You can add up to some max (can't remember the amount) and roll it over year to year AND it accrues interest.

Mike
Title: Re: Obamacare.
Post by: mitch777 on September 27, 2013, 06:30:52 pm
I read in the Hartford Courant today that Connecticut is Health Exchange Costs are the 4th highest in the nation. I guess it goes along being the 4th highest in medical costs but the only states that seem to be charging more are Alaska, Mississippi, and Wyoming. Other factors must be in play.

The "benchmark silver plan" will cost an individual $436. per month (before subsidies). I'm sure I will need the best plan available. Not sure of the cost or benefits yet. It still might prove to be a huge savings. We shall see.

Ray, pathetic and disgusting!!!  >:( The repubs WANT to see this fail at any cost. So sad they will be disappointed. :)
Title: Re: Obamacare.
Post by: buginme2 on September 27, 2013, 06:37:52 pm
I went onto the Washington state website.

They have a calculator where you can enter your income and stats and it tells you how much your insurance  will be.

For a single male, 40 years old making 35,000 dollars per year the cost for a "silver" health insurance policy is $277 per month.

For a family of 4 making 35,000 the premium is $114

To me, those sounds reasonable.   Now it doesn't say what constitutes a "silver" plan, I guess we need to wait till after the first.
Title: Re: Obamacare.
Post by: buginme2 on September 27, 2013, 06:39:24 pm


Ray, pathetic and disgusting!!!  >:( The repubs WANT to see this fail at any cost. So sad they will be disappointed. :)

It's appalling


I can't wait for this to take effect, finally. If I lose my job or quit I don't have to worry about losing my healthcare .... I have thought and worried about that since, well, since October 2010
Title: Re: Obamacare.
Post by: Jeff G on September 27, 2013, 07:08:48 pm
The one question that hits me like a punch in the gut is when a new member of this forum who just found out they have HIV ask us how am I going to get treatment or says that they do not have insurance , how do I get my meds .

The lack of resources for many people who work but are uninsured and living with a chronic condition is something I dread having to discuss with the newly infected , its just another cruel blow to somebody who is already reeling . 
Title: Re: Obamacare.
Post by: mitch777 on September 27, 2013, 07:29:25 pm
The one question that hits me like a punch in the gut is when a new member of this forum who just found out they have HIV ask us how am I going to get treatment or says that they do not have insurance , how do I get my meds .

The lack of resources for many people who work but are uninsured and living with a chronic condition is something I dread having to discuss with the newly infected , its just another cruel blow to somebody who is already reeling .

me too and I hope this turns out to be the answer.
Title: Re: Obamacare.
Post by: RobbyR on September 27, 2013, 07:32:11 pm
I have partial insurance and am on Ryan White it has been a lifesaver for me literally. I live in Kentucky, a very very red state. My insurance pays a portion of my doctor visits & co-pays, while Ryan White enables me to get my essential medications that otherwise would be totally unaffordable even with my insurance. In fact I only use Ryan White when it comes to my HIV meds, everything else goes on my insurance or I pay a minimal co-pay out of pocket. I don't know much about nor have I been following the Obamacare debate or the legislation. I just hope it keeps the status quo in my state for people who can have partial insurance like I do, & also utilize Ryan White. And maybe makes it easier for people who do work & need affordable healthcare especially people with HIV who need chronic care.

I work full time for a company that pays zero benefits because work is so hard to find in my state that I had to take what was available through a temp agency. I also work part time for a small family business. I am lucky to have even partial insurance although if I had to go to the ER, it would still pay nothing. The amount of people who are hardworking & don't have insurance is appalling in this country. Healthcare should be a right for all working people not a privilege for a few rich people.

It's very disturbing how the Republicans always seem to want to deny hardworking people access to good healthcare. It's not surprising given their track record, but they always talk a big game about babies yet seems people who are already here on the planet they could care less about unless they are billionaires & can buy any insurance they want. Pretty nasty if you ask me. A quote I read somewhere online sums it up best..Most Republicans are pro-life..if you're a fetus that is!
Title: Re: Obamacare.
Post by: WillyWump on September 27, 2013, 10:19:20 pm

The "benchmark silver plan" will cost an individual $436.

I went onto the Washington state website.

They have a calculator where you can enter your income and stats and it tells you how much your insurance  will be.

For a single male, 40 years old making 35,000 dollars per year the cost for a "silver" health insurance policy is $277 per month.

For a family of 4 making 35,000 the premium is $114

To me, those sounds reasonable.   Now it doesn't say what constitutes a "silver" plan, I guess we need to wait till after the first.


I'm hearing alot about these "silver plans" does anyone know what the annual deductables are?

I went to the Washing State calculator, just to see, and it says I would pay $507 in Washington (for me and my son whom I'm court ordered to pay ins for) but I cant find anything on deductables, etc.... Of course I live in Texas and our calculator tells me nothing.**

I'm self employed and currently pay about $1000/mo for a private policy (just increased), which may sound cheap for private insurance but I pay high deductables also. It wont be long with the increases and I wont be able to afford insurance.

I originally thought that anyone making over $45k a year such as myself would not see any benefit from Obamacare, but apparently I am wrong??

I am so confused and no one seems to be able to tell me if I will benefit. I just get the ol' Nancy Pelosi, "Let's wait till its here and see"   ::)


** this is what the Federal healthcare exchange (in 23 states including Texas) tells me when I punch in all my income etc..

You may be eligible to get quality health insurance through the Health Insurance Marketplace. But based on the information you provided, you probably won’t qualify to save money on your monthly premiums or out-of-pocket costs. You'll find out for sure when you apply for coverage starting October 1, 2013

Edited to add: I guess I should stop panicking and just wait 3 days to find out  ;)
Title: Re: Obamacare.
Post by: buginme2 on September 27, 2013, 10:33:11 pm
From my understanding there will be bronze, silver, gold, and platinum plans.

The difference will be the amount of the deductible and coverage amounts but they will all have to maintain a certain level of coverage.

No matter which plan you choose the maximum out of pocket expense will be approx $6500 per year.

Of course each state may vary

I think there will be definite benefits for most people and maybe some negatives for some people.   

One thing that hasn't been discuss much.  With all these new people getting insured there may be an increase in the number of people going to the doctor.  That would make it harder to get an appointment etc. 
Title: Re: Obamacare.
Post by: tednlou2 on September 27, 2013, 11:03:41 pm
I read in the Hartford Courant today that Connecticut is Health Exchange Costs are the 4th highest in the nation. I guess it goes along being the 4th highest in medical costs but the only states that seem to be charging more are Alaska, Mississippi, and Wyoming. Other factors must be in play.

The "benchmark silver plan" will cost an individual $436. per month (before subsidies). I'm sure I will need the best plan available. Not sure of the cost or benefits yet. It still might prove to be a huge savings. We shall see.

Ray, pathetic and disgusting!!!  >:( The repubs WANT to see this fail at any cost. So sad they will be disappointed. :)

I noticed on the NPR calculator I posted, it didn't ask for zip code for KY.  When I put in CT, it wanted a zip code. 

About longer wait times at docs due to more patients, will we see a supply and demand thing happen?  Will those interested in medicine be given incentives to be various types of docs, by giving more scholarships or forgiving loan debt? 
Title: Re: Obamacare.
Post by: phildinftlaudy on September 28, 2013, 01:47:14 am
Check this out - I do not think you can have both a HSA and FSA.  However, you should be able to contribute pre-tax into your HSA (above the $750 from your employer).  Sid has this high-deductible plan and that is the info that I have pulled out go it.  The benefit of an HSA over FSA, you do not have the user it or lose it aspect.  You can add up to some max (can't remember the amount) and roll it over year to year AND it accrues interest.

Mike

Hi Mike:
Ours is an HRA - only the employer can contribute, but we are still allowed to have a separate FSA - which the employee contributes to exclusively... I will be using it to make up the difference between my employer funded HRA and the deductible portion I will have to pay out of pocket.  It should work out okay....
Title: Re: Obamacare.
Post by: BT65 on September 28, 2013, 05:48:49 am
Will, try this:

http://kff.org/interactive/subsidy-calculator/

Title: Re: Obamacare.
Post by: tednlou2 on September 28, 2013, 05:35:35 pm
Nice cartoon explaining The Affordable Care Act, or Obamacare.  Lots of info in this cartoon.

http://www.upworthy.com/the-simplest-explanation-of-obamacare-ever?g=4&c=huf1
Title: Re: Obamacare.
Post by: mecch on September 28, 2013, 06:07:45 pm
I hope dems keep their nerve though the shut down.  And god forbid if both houses cave somewhat and send some shitty alteration to Obama to sign, I hope he keep his nerve and vetoes it...   Enough is enough.  This is excruciating to watch... Such childishness.
Title: Re: Obamacare.
Post by: mitch777 on September 28, 2013, 06:54:19 pm
I hope dems keep their nerve though the shut down.  And god forbid if both houses cave somewhat and send some shitty alteration to Obama to sign, I hope he keep his nerve and vetoes it...   Enough is enough.  This is excruciating to watch... Such childishness.
Don't worry. Ain't gonna happen. The government might shut down for a day or 2. Who knows, but the Senate and Obama are not budging.
Childish AND costly.
Title: Re: Obamacare.
Post by: mecch on September 28, 2013, 07:19:56 pm
Especially stomach turning is Ted Cruz.  And the widely held belief (self-fulling? truism?) that no publicity is bad publicity.  Its the Miley Cyrus school of win.  Act like a complete idiot and it makes you Presidential candidate material.  Princeton - Harvard and champion debater, he's so freaking cynical I want to vomit at his lowbrow mugging to the peanut gallery.  And that speech!  Geezuz..... 
Title: Re: Obamacare.
Post by: buginme2 on September 28, 2013, 07:59:37 pm
Don't worry. Ain't gonna happen.

Probably not, but I'm a little scared.  I saw earlier today that they were going to compromise and delay Obamacare a year.  I cringed but didn't see the whole story.


Especially stomach turning is Ted Cruz. 

Even more stomachs turning was I read today that the state of Texas has the highest percentage of uninsured residents in the US.  How can a senator from a state with the highest rate of uninsured people act this way. I can't wrap my brain around it.
Title: Re: Obamacare.
Post by: J.R.E. on September 28, 2013, 08:43:34 pm
Probably not, but I'm a little scared.  I saw earlier today that they were going to compromise and delay Obamacare a year.  I cringed but didn't see the whole story.




The vote in the house is scheduled for tonight. But it's official:

 Speaker Boehner just announced that the House will attach a one-year Obamacare delay to their bill funding the government. The vote is set for TONIGHT.


Ray

Title: Re: Obamacare.
Post by: WillyWump on September 29, 2013, 09:17:24 am
Will, try this:

http://kff.org/interactive/subsidy-calculator/

Thanks Betty!
Title: Re: Obamacare.
Post by: bocker3 on September 29, 2013, 10:36:05 am
Hi Mike:
Ours is an HRA - only the employer can contribute, but we are still allowed to have a separate FSA - which the employee contributes to exclusively... I will be using it to make up the difference between my employer funded HRA and the deductible portion I will have to pay out of pocket.  It should work out okay....

Oops - saw HRA, read HSA!
Title: Re: Obamacare.
Post by: WillyWump on October 01, 2013, 10:21:54 am
Anybody get any quotes yet?

I've been stuck on the "wait here" page for about 45 mins.


Edited to add: "Could not create account check back later"


Title: Re: Obamacare.
Post by: buginme2 on October 01, 2013, 11:10:44 am
I just read that the websites are getting so much traffic they are having a hard time processing.  let us know how it goes.
Title: Re: Obamacare.
Post by: Jeff G on October 01, 2013, 11:14:36 am
Tee Hee . Its going to be almost impossible to defund the affordable care act now that its being accessed .

This is the reason the conservatards where having a cow last night trying to delay this from happening today .
Title: Re: Obamacare.
Post by: leatherman on October 01, 2013, 11:33:53 am
I would suggest that anyone here actually interested in the Marketplace Exchange Insurance policies - WAIT! Not because I don't approve of "obamacare" but because you have until January before it even goes into effect.

Wait and you don't have to deal with the start-up issues
Wait and you won't have to fight the uneducated crowd
Wait and your ASO will have time to evaluate the plans
Wait and your ASO and health dpts can suggest the right ones for you
Wait and let the bugs get worked out of the system

unless you're in need of immediate care and coverage, waiting for a while is wiser choice to make sure you get a plan that will really cover your needs.


In states that didn't set up their own exchanges and are relying on the Federal government to handle things (seems those red state Legislators don't always mind BIG government after all ;) ), most agencies have been given little to NO information about the federal programs.

here in SC they passed a law banning any state employees from implementing any of the ACA, so there has be NO pre-planning or training about the Marketplace or the insurances available. my SC HIV Task Force joined with our allies at Harvard Law and have held a special training of case-managers on the ACA, Marketplace and how to evaluate insurance plans. It was SRO and quite a success as we had case managers from agencies (mostly NON-HIV!) from all over the state. The Task Force has also "hired" a special consultant/training to assist our ASOs since the State won't and the Feds can't.

That's why the official SCHTF position is for all HIV poz people needing insurance to consult with their case managers and to WAIT all long as possible, until the situation can be properly assessed to get the best coverage for our clients.
Title: Re: Obamacare.
Post by: Dachshund on October 01, 2013, 11:36:01 am
It allows me to create a name and password but won't show me the security questions I need to answer. Live chat is down. I guess I'll wait until the traffic slows down.
Title: Re: Obamacare.
Post by: mitch777 on October 01, 2013, 12:58:44 pm
Not sure if this affects everyone but the deadline in CT is Dec. 15th if you need insurance by 1/1/2014. Might be important to find out depending on your own situation.

Tried today to get quotes. No luck yet. Expected glitch. I'm sure it will get smoothed out.

I am hoping that the ACA proves SO successful in those of the states that tried their best to implement it that it will shame the other states to take better care of their own citizens. Not sure if it's realistic. I wish the best to those of you living in one of these states. So sad.


here in SC they passed a law banning any state employees from implementing any of the ACA, so there has be NO pre-planning or training about the Marketplace or the insurances available. my SC HIV Task Force joined with our allies at Harvard Law and have held a special training of case-managers on the ACA, Marketplace and how to evaluate insurance plans. It was SRO and quite a success as we had case managers from agencies (mostly NON-HIV!) from all over the state. The Task Force has also "hired" a special consultant/training to assist our ASOs since the State won't and the Feds can't.

That's why the official SCHTF position is for all HIV poz people needing insurance to consult with their case managers and to WAIT all long as possible, until the situation can be properly assessed to get the best coverage for our clients.

So very sad.
Title: Re: Obamacare.
Post by: Jeff G on October 01, 2013, 01:01:55 pm
I was impressed . I could buy the silver plan for $1300 a year if I wasn't already insured .
Title: Re: Obamacare.
Post by: mitch777 on October 01, 2013, 01:17:39 pm
I was impressed . I could buy the silver plan for $1300 a year if I wasn't already insured .
wow.
I'm just hoping to get a plan comparable to what I've got now, but cheaper, much cheaper. Currently pay around $12,000 per year and have already paid well over $3000 out of pocket thus far. (not to mention another $5-6000 in dental bills >:(.)

PS- I have a zero deductible policy. Out of pocket costs were for co-pays.
It really was my best option.
Title: Re: Obamacare.
Post by: tednlou2 on October 01, 2013, 02:49:34 pm
It allows me to create a name and password but won't show me the security questions I need to answer. Live chat is down. I guess I'll wait until the traffic slows down.

The president said today that more than a million people were already on the federal govt site by 7am.  He said that's more than Medicare.gov sees in an entire day.  He said they are working on getting that fixed.  So, I imagine the state websites are just as clogged.
Title: Re: Obamacare.
Post by: tednlou2 on October 01, 2013, 03:50:47 pm
I'm sure most here know all these, but interesting anyway.  There were a few I was uncertain about.  Sarah told me there were death panels, and I always listen to her.  No, I was unclear whether Congress was exempt.


http://www.politifact.com/truth-o-meter/article/2013/sep/24/top-16-myths-about-health-care-law/
Title: Re: Obamacare.
Post by: mecch on October 01, 2013, 04:41:52 pm
here in SC they passed a law banning any state employees from implementing any of the ACA, so there has be NO pre-planning or training about the Marketplace or the insurances available.

Speechless.

Leatherman, thanks for your advocacy and public information! Bravo bravo bravo.
Title: Re: Obamacare.
Post by: tednlou2 on October 01, 2013, 04:53:26 pm
Speechless.

Leatherman, thanks for your advocacy and public information! Bravo bravo bravo.

And that's causing the federal government to have to come in and handle it.  This is true for Indiana.  And, this makes the premiums more expensive in those states, no?  I thought I read Indiana premiums would cost more, due to the state Republicans acting so childish.
Title: Re: Obamacare.
Post by: BT65 on October 01, 2013, 05:15:07 pm
And that's causing the federal government to have to come in and handle it.  This is true for Indiana.  And, this makes the premiums more expensive in those states, no?  I thought I read Indiana premiums would cost more, due to the state Republicans acting so childish.

Ted, yes, the state did not implement any state run exchanges.  For our clients, most that are not on Medicaid/Medicare have the insurance called ichia, which will dissolve at the end of the year.  However, they will roll into adap/eip, then starting April one ISDH (Indiana State Dept of Health) will have contracted with an insurer similar to ichia.  And there is -0- premium, deductible, or co-pays to the clients.  They have to be within 300% of the FPL, which is pretty good actually.  I believe I said this in a similar post. 

At the training I went to last week in Indy, there was a lady there from, like Indiana Insurance, or some such.  She talked about the different plans, and a few facts.  Most of our clients are not affected.  I have very few clients covered on their employer's insurance.  Most are either on Medicaid, Medicaid/Medicare, or ICHIA. 

Indiana did screw themselves.  Pence wanted to expand HIP but that's not going to happen from what I heard.  I was told that the higher-up's in Indiana are watching (of all places) Arkansas, and how they are going to implement expanded Medicaid in their state.  Indiana still does have the opportunity to expand Medicaid at whatever point they think they should (which should be right now!).
Title: Re: Obamacare.
Post by: mitch777 on October 01, 2013, 05:22:25 pm
Best wishes to your clients and the people of Indiana Betty! Grrr...
Title: Re: Obamacare.
Post by: BT65 on October 01, 2013, 05:52:18 pm
I was going to add this to my post, but apparently we cannot modify anymore?  Anyway:

http://www.state.in.us/isdh/17740.htm

This talks a little about Indiana's HIV Medical Services program.

I just tried to modify this and it didn't take.  Anyway, we'll see if this works.  When EIP and ADAP take back over the only benefit people will not have is hospital or ER.  But, when the state contracts with another insurer that will be re-instated.  Clients can get dental, mental health coverage, and with EIP, even vision.  A single person can make up to $32,000 a year and get this benefit, with -0- out of pocket for premiums, co-pays or deductibles.  Not a bad deal really considering it's Indiana.
Title: Re: Obamacare.
Post by: leatherman on October 01, 2013, 06:20:45 pm
Not sure if this affects everyone but the deadline in CT is Dec. 15th if you need insurance by 1/1/2014. Might be important to find out depending on your own situation.
those deadlines are the national deadlines set by the ACA.

Technically you can still enroll up until Mar 15th 2014. However when you sign up between 12/15/13 and 3/15/14, the date the policy goes into effect is NOT 1/1/13. (it's delayed but I don't remember that date off the top of my head. you'd like I would after talking to so many groups about this LOL)

edited to add:
https://www.healthcare.gov/quick-answers/#step-1
181 days left of open enrollment
Title: Re: Obamacare.
Post by: leatherman on October 01, 2013, 06:36:36 pm
Speechless.
actually was really horrifying is when I compared the original draft of HR 3101 (the SC house resolution to enforce state employees from implementing Obamacare) to the SC Declaration of Session 1852. The documents read pretty similarly: SC is a sovereign state, 10th amendment, 4th amendment, states rights, blah, blah blah. and then either "we don't want to abolish slavery" or "we don't want obamacare".

god/karma/buddha/jebus/somebody! save us from the SC Tea Party wingnuts!
Title: Re: Obamacare.
Post by: buginme2 on October 01, 2013, 08:51:25 pm
Did anyone get through on any of the exchanges today
Title: Re: Obamacare.
Post by: mitch777 on October 01, 2013, 10:07:15 pm
those deadlines are the national deadlines set by the ACA.

Technically you can still enroll up until Mar 15th 2014. However when you sign up between 12/15/13 and 3/15/14, the date the policy goes into effect is NOT 1/1/13. (it's delayed but I don't remember that date off the top of my head. you'd like I would after talking to so many groups about this LOL)

edited to add:
https://www.healthcare.gov/quick-answers/#step-1
181 days left of open enrollment
Just wanted to clarify the deadline for those who were in need Mikie. ;)
PS- you meant 1/1/14. enough confusion already about ACA. lol.
Title: Re: Obamacare.
Post by: Jeff G on October 01, 2013, 10:15:04 pm
Does anyone know what % the exchange plans cover for medications ?
Title: Re: Obamacare.
Post by: leatherman on October 01, 2013, 10:16:01 pm
PS- you meant 1/1/14. enough confusion already about ACA. lol.
gosh! I had typed 2015 at one point and then something else. My fingers kept typing stuff my brain wasn't thinking LOL. Thanks for the catch! So Yes, this upcoming New Years Day of 1 /1/2014 is the date these marktetplace policies will start if you enroll in this December 12/15/13, just before Christmas;)
Title: Re: Obamacare.
Post by: mitch777 on October 01, 2013, 10:16:41 pm


god/karma/buddha/jebus/somebody! save us from the SC Tea Party wingnuts!
or angry mobs. feel bad that the mentality of the politicians and the gerrymandering that keeps them in office makes people suffer so much. each decade that goes by seems to bring more challenges to the average citizen. the pressure cooker is heating up once again.
Title: Re: Obamacare.
Post by: mitch777 on October 01, 2013, 10:18:15 pm
Does anyone know what % the exchange plans cover for medications ?
it all depends on the plans offered from state to state.
and from plan to plan.
Title: Re: Obamacare.
Post by: Jeff G on October 01, 2013, 10:24:55 pm
it all depends on the plans offered from state to state.
and from plan to plan.

I guess a better way to frame the question would be does the maximum out of packet expense a year apply to prescription drugs as well . I ask because many people cant afford treatment even with insurance due to copays . 
Title: Re: Obamacare.
Post by: Jeff G on October 02, 2013, 08:35:52 am
This is telling . When I quiz my republican family I have got the same results .


http://news.yahoo.com/blogs/sideshow/all-in-a-name--jimmy-kimmel-quizzes-americans-on-%E2%80%98obamacare%E2%80%99-vs--%E2%80%9Caffordable-care-act%E2%80%99-214544505.html
Title: Re: Obamacare.
Post by: mitch777 on October 02, 2013, 12:13:19 pm
I guess a better way to frame the question would be does the maximum out of packet expense a year apply to prescription drugs as well . I ask because many people cant afford treatment even with insurance due to copays .
hope this is helpful.
https://www.healthcare.gov/glossary/out-of-pocket-maximum-limit/

This is telling . When I quiz my republican family I have got the same results .


http://news.yahoo.com/blogs/sideshow/all-in-a-name--jimmy-kimmel-quizzes-americans-on-%E2%80%98obamacare%E2%80%99-vs--%E2%80%9Caffordable-care-act%E2%80%99-214544505.html

I saw that. Frightful. ::)
Title: Re: Obamacare.
Post by: Jeff G on October 02, 2013, 12:17:45 pm
hope this is helpful.
https://www.healthcare.gov/glossary/out-of-pocket-maximum-limit/

I saw that. Frightful. ::)

That helps heaps . Thanks .
Title: Re: Obamacare.
Post by: mitch777 on October 02, 2013, 06:43:03 pm
I was able to get connected today and while our options are MUCH more expensive here than most of the country I am still very encouraged.

My situation is rather complicated. ADAP, pending SSDI appeal, meds, future likelihood of further needs, etc., etc.

Tried to find out who to talk to in person about all of my questions but there was a glitch in the system to provide me with a connection. Will keep trying but it looks like both Kenny and I will end up saving many thousands of dollars.

When I get this all figured out I will certainly be posting the results.

Tea party.... suck it!!! :)
Title: Re: Obamacare.
Post by: WillyWump on October 02, 2013, 08:11:01 pm
I'm still waiting :(

But to be fair this is the longest stretch Ive been on today which is only about 10 mins so far.

I hope I can save some money. Yeah all the base rates sound good, but I need to see the specifics, Out-of-pocket, etc..

Edited to add: after 25 minutes it let me in to create my account. Then said "account unable to be created check back later". Ill try again tomorrow.
Title: Re: Obamacare.
Post by: mitch777 on October 02, 2013, 09:38:27 pm
I'm still waiting :(

But to be fair this is the longest stretch Ive been on today which is only about 10 mins so far.

I hope I can save some money. Yeah all the base rates sound good, but I need to see the specifics, Out-of-pocket, etc..

Edited to add: after 25 minutes it let me in to create my account. Then said "account unable to be created check back later". Ill try again tomorrow.
Hang in dear. I hope this works out for you and if it does I hope you will give credit to Obamacare and not to the ACA.  :)
Title: Re: Obamacare.
Post by: tednlou2 on October 02, 2013, 10:38:37 pm
This is a look at plans for Colorado.  It does cover ER and prescriptions.  Of course, depending on the plan, you may have higher deductibles. 

http://www.nbcnews.com/id/3032619/ns/NBCNightlyNews/
Title: Re: Obamacare.
Post by: tednlou2 on October 02, 2013, 10:55:08 pm
Oh, I saw this on the Today Show.  They ran numbers for Connecticut.  A family of four making $50,000 a year could get Silver coverage for $178 a month.  Their deductibles would max out at $5,000 and their out-of-pocket costs would max out at $10,400 per year. 

Ok, that premium is very affordable.  That deductible is high.  But, I've read not all services are necessarily subject to deductibles.  I would like to know more about that.  Do you have to pay $5,000 out-of-pocket, before insurance pays doc visits and prescriptions?  That's steep.  Is that what this means?  It would be great for a serious illness, where you rack up tens of thousands of dollars in bills.  $178 a month is affordable, if it ensures you don't go bankrupt over a costly hospitalization, surgery, or serious health issue. 

http://www.today.com/id/49063771/ns/today-video/

 
Title: Re: Obamacare.
Post by: aaware72 on October 03, 2013, 02:19:17 pm
I really wonder what's going to happen to the people on ADAP and Ryan White.

The law requires that everyone buys insurance and if you don't then you will be charged a fine.  So, if your on ADAP that would mean you don't have insurance.  So will you be forced to buy insurance effectively removing you from ADAP coverage?

Most states will be expanding Medicaid coverage to include people who are now on ADAP which would be beneficially for them since Medicaid would cover more than just HIV related issues. 

But what happens if your in one of the states that threw up their middle finger to the Feds?

I am currently on NHCARES aka as "ADAP/Ryan White" in my state.  I'm on a transitional health care plan funded on the federal level and it will expire at the end of the years.   My ASO in conjunction with the NHCARES will help me find a new health care plans and will pay any premium or copay as long I a continue to qualify for the program.  Also today I got a notice that they are raising the qualification level to 400 percent of the poverty level effective right now.  That raises the income level for a single person from 34,470$ to 45,960$ and a married couple from 46,530$ to 62,040$.  Not sure if this is a change on the federal level or just on the state level here.  Just learning how all this actual works.

I have also be asked to join a committee with the Health and Human Services in my state.  I'm told it is a requirement for the state to receive federal funding and they have now opened these committees up to people living with HIV.  Anyway I'll be attending a meeting on November 15Th and there will be a presentation on the Affordable Heath Care Law and what it mean to people living with HIV.  I hopping to gain a better understanding and I share any information that I may get. 

**added**
I'm in a state that has yet to decide if it will expand Medicaid
Title: Re: Obamacare.
Post by: tednlou2 on October 03, 2013, 02:54:46 pm
Here's an article and map of where the poorest Americans live, which are mainly in the red states not expanding Medicaid. 

http://www.nytimes.com/interactive/2013/10/02/us/uninsured-americans-map.html?_r=1&
Title: Re: Obamacare.
Post by: mecch on October 03, 2013, 06:49:37 pm
Here's an article and map of where the poorest Americans live, which are mainly in the red states not expanding Medicaid. 

http://www.nytimes.com/interactive/2013/10/02/us/uninsured-americans-map.html?_r=1&

That is no news...   This is a culture war, been building for years and years...   One of the leftist talk show (Bill Maher? ) presented a series during the last Presidential election cycle, on health care, welfare, etc, in poor areas of the south. It was extremely sobering...   All about the idea of entitlement and also the grossly underserved....  People have been brainwashed or squashed so low and marginal, they don't realise what a scandalous lot in life this is, for a rich country.  And then other people pointing fingers....  And the prediction that some states will face the future and win, delivering a better society, and some are on a fast road to poverty, ill health, misery and insecurity. Some states will be banana republics resembling third world countries.  Others will be more like scandanavia. 
Title: Re: Obamacare.
Post by: mecch on October 03, 2013, 07:02:05 pm
Those revolting, depressing "people's testimony" ads in the beginning of Romney's campaign.   "I work two jobs, have no savings, have no health insurance, my kids have no future, my cars a wreck and my teeth are falling out. But I don't complain and I don't think my government owes me anything. That's what makes me a GOOD AMERICAN.  Any contrary thought is immoral, atheistic, communism. " 
Title: Re: Obamacare.
Post by: buginme2 on October 04, 2013, 02:30:20 am
I was able to get on the state healthcare exchange site today and priced out some insurance for info purposes (still have employer healthcare so just did this for the info)

40yo male making $40,000 per year

Lowest cost Bronze plan was $212 per month.  $5000 deductible. HSA plan.

Silver plan was $280 per month.  $1500 deductible.  $20 office visit Copay and 100% coverage once deductible and Copay is paid.  $10 Copay for generic prescriptions and 60% coverage for name brand prescriptions. 

Best plan I could find is $404 per month. $500 deductible.  $30 office visit Copay.  Covered at 100% once Copay is paid.  Prescriptions are included at 100% with no Copay (wow). 

There were 38 plans to choose from these are just three of the options. 



Title: Re: Obamacare.
Post by: WillyWump on October 04, 2013, 08:10:38 am
:( Still nothing.

Title: Re: Obamacare.
Post by: mitch777 on October 04, 2013, 10:32:22 am
:( Still nothing.
Call Ted Cruz and complain. :)
Title: Re: Obamacare.
Post by: WillyWump on October 04, 2013, 10:48:56 am
Call Ted Cruz and complain. :)

Um k. 'Cause I'm sure it's his fault that the site is being swamped and or glitchy

Been on the "wait here" page for 1 hour, but it finally flashed up and said "In a hurry? You might be able to apply faster at our Marketplace call center. Call 1-800-318-2596 to talk with one of our trained representatives about applying over the phone."

On hold now, but getting excited.

Title: Re: Obamacare.
Post by: mitch777 on October 04, 2013, 11:00:27 am
Um k. 'Cause I'm sure it's his fault that the site is being swamped and or glitchy

Been on the "wait here" page for 1 hour, but it finally flashed up and said "In a hurry? You might be able to apply faster at our Marketplace call center. Call 1-800-318-2596 to talk with one of our trained representatives about applying over the phone."

On hold now, but getting excited.
good luck! :)
Title: Re: Obamacare.
Post by: WillyWump on October 04, 2013, 11:12:27 am
I talked to Paul (who sounds sexy btw), I told him I am not sure I wish to sign up yet but wanted to get some quotes. He told me I would have to do that on the website (which is what I figured he would say).

Ill try again later.

-W
Title: Re: Obamacare.
Post by: Miss Philicia on October 04, 2013, 12:50:33 pm
Here's an article and map of where the poorest Americans live, which are mainly in the red states not expanding Medicaid. 

http://www.nytimes.com/interactive/2013/10/02/us/uninsured-americans-map.html?_r=1&

Shorter version: Texas Sucks
Title: Re: Obamacare.
Post by: tednlou2 on October 04, 2013, 03:31:34 pm
Kentucky has gotten national attention, for how we are one of a couple red states fully implementing the law with the Medicaid expansion.  And, how enrollment has gone smoothly.  It is interesting how some believe there are 2 options-- a regular healthcare benefit and "Obamacare."  Jimmy Kimmel interviewed people on the street to ask whether they preferred the Affordable Care Act plan or Obamacare.  Many said they wanted no part of Obamacare, but liked the Affordable Care Act plans.  Yes, those are small samples, but I think this thinking is common.

With Pennsylvania, I thought they were just not expanding Medicaid, but it seems they also didn't set up the exchanges, leaving it to the federal govt to do??  And, I heard many think marriage equality has a good chance of becoming reality there soon.  Does the governor have sole discretion on whether to implement the healthcare law?  Or, did the legislature have to vote on it? 

http://m.dailykos.com/story/2013/10/03/1243855/-Kentucky-s-success-makes-a-mockery-of-GOP-Obamacare-foes
Title: Re: Obamacare.
Post by: Jeff G on October 04, 2013, 03:46:30 pm
I kinda wish all the sates let the feds set up the exchanges , that way it will be easier morph to it into a single payer system if they are all managed and regulated by the feds and not state by state , if that time ever comes . 

I know this is a huge leap of imagination from what's really going on but just saying .
Title: Re: Obamacare.
Post by: mikeyb39 on October 04, 2013, 04:27:46 pm
Anybody have any idea what the drug plans on these exchanges are like for hiv medications. I was just looking at united health care plans from their site, they show most hiv drugs in tier 4 which shows 25% coinsurance. That would seem expensive for 3 medications when looking at 1000 per month for each drug
Title: Re: Obamacare.
Post by: mitch777 on October 04, 2013, 04:58:30 pm
Anybody have any idea what the drug plans on these exchanges are like for hiv medications. I was just looking at united health care plans from their site, they show most hiv drugs in tier 4 which shows 25% coinsurance. That would seem expensive for 3 medications when looking at 1000 per month for each drug

I just checked several plans offered in CT and it seems they are all over the map. I was able to find one with no coinsurance for tier 4 drugs.
I think all of the benefits across the board are going to vary state by state, insurance co. by insurance co.
I don't know how ADAP works in other states but here in CT you can have insurance and still have ADAP. ADAP covers any co-pays that the primary insurance company doesn't.
Title: Re: Obamacare.
Post by: Miss Philicia on October 04, 2013, 05:14:37 pm
ADAP, by law, must be "payer of last resort" so I suppose they could have ADAP pick up whatever isn't covered in these exchange thingies. If any particular state doesn't do that then it just means the state you live in sucks and you should move.
Title: Re: Obamacare.
Post by: leatherman on October 04, 2013, 05:47:41 pm
I think all of the benefits across the board are going to vary state by state, insurance co. by insurance co.
I don't know how ADAP works in other states but here in CT you can have insurance and still have ADAP. ADAP covers any co-pays that the primary insurance company doesn't.

all insurance plans, under ACA, must contain the 10 "essential health benefits" https://www.healthcare.gov/glossary/essential-health-benefits/ ; but of course those are at varying amounts based on the insurer and the plan premium.

It's always been possible to have insurance and ADAP (if you are financial eligible). Often ADAP is then able to just pay a premium or a co-pay amount and not have to fund a patient's entire medication bill.

ADAP monies will eventually (in the future) be funneled into the ACA and Medicaid Expansion programs; as will indigent funds paid to hospitals to cover those who cannot afford to pay. This is why the "defunding" arguement of the Republicans is so crazy. Most of the ACA is actually already paid for by funds that were spent elsewhere. All these monies which were funding people's healthcare will just be put into a different account and will still fund people's healthcare.

But in the meantime, as payer of last resort, ADAP will become a wrap-around program, filling in the gaps (co-pays, premiums, emergencies, etc) as people get insurance or get onto the Expansion program. Of course, in the states that didn't accept Medicaid Expansion, ADAP will very much be needed in the next few years to pay for a LOT of health care.

For those people having a hard time finding an appropriate plan, you should contact your case manager to get in touch with a Navigator. There are people funded in every state to help clients navigate through the Marketplace. These Navigators have been trained and (should) have evaluated the plans available in your state and should be able to point consumers to the plans that would be best for HIV positive clients.

I kinda wish all the sates let the feds set up the exchanges , that way it will be easier morph to it into a single payer system if they are all managed and regulated by the feds and not state by state
there's a problem with this idea though. In states that have not accepted medicaid expansion or created their own marketplace, consumers will only have federally approved plans available to them. For example, people in both North and South Carolina, neither one which accepted ME or a state-run Marketplace, only have access to Federal plans - plans based on averages across all the states. This means consumers in these two states will be paying more because none of the plans have been tailored to either state. If the plans had been tailored, they would have cost less as our costs here are less than in some other states.
Title: Re: Obamacare.
Post by: GoForIt on October 04, 2013, 05:54:14 pm
Has anyone from Florida been able to log in and see any plans?  I have been trying since it opened and can't get logged in.
Title: Re: Obamacare.
Post by: tednlou2 on October 04, 2013, 05:54:49 pm
Leatherman, I was just about to post this, when I saw your post.  I think you answered my last question.

At my HIV doc, I stopped in to say hello to my old ADAP coordinator.  When I was dx'd, I had to sign up for it, but never used it and then took myself off the rolls when I got insurance.

Anyway, I overheard him telling someone on Medicare getting the "extra help" that if he ever makes above the limits for the extra help, they would take over and pay the deductibles, premiums, etc.  Volunteers of America runs ADAP here.

This got me wondering whether they would help pay the premiums, deductibles, and co-pays, for those getting insurance through the new exchanges.  I was on my way out, when I heard the part about paying the Medicare premiums, so I didn't get to ask him.  I will have to ask next time I'm there for my flu jab. 
Title: Re: Obamacare.
Post by: WillyWump on October 04, 2013, 06:25:57 pm
Has anyone from Florida been able to log in and see any plans?  I have been trying since it opened and can't get logged in.

Same in Texas, although I am going to do a marathon  "try again" session tonight. Starting.....NOW (I figure everyone is out drinking so that should clear up the site.
Title: Re: Obamacare.
Post by: bocker3 on October 04, 2013, 07:40:45 pm
Same in Texas, although I am going to do a marathon  "try again" session tonight. Starting.....NOW (I figure everyone is out drinking so that should clear up the site.

I Blame the Governors of Texas and Florida..........
Title: Re: Obamacare.
Post by: WillyWump on October 04, 2013, 07:50:10 pm
After an hour and 30 minutes I advanced from the "wait here" page to the "create account" page....and after creating account (twice) I get this...

Please note that two or more answers to the security questions cannot be the same. You must provide distinct answers to the chosen security questions.

this is the SAME FUCKING glitch I was getting on day 1. that they supposedly fixed.

Incredible. are there any competent programmers at Healthcare.Gov?

Even my bareback porn sites have a better sign up process than this.  ::)





Title: Re: Obamacare.
Post by: Jeff G on October 04, 2013, 08:05:40 pm
Please note that two or more answers to the security questions cannot be the same. You must provide distinct answers to the chosen security questions.


Have you tried using " power bottom " for only one of the questions ?
Title: Re: Obamacare.
Post by: bocker3 on October 04, 2013, 10:50:36 pm
After an hour and 30 minutes I advanced from the "wait here" page to the "create account" page....and after creating account (twice) I get this...

Please note that two or more answers to the security questions cannot be the same. You must provide distinct answers to the chosen security questions.

this is the SAME FUCKING glitch I was getting on day 1. that they supposedly fixed.

Incredible. are there any competent programmers at Healthcare.Gov?

Even my bareback porn sites have a better sign up process than this.  ::)

They have all been furloughed while Cruz tries to kill the ACA.
Title: Re: Obamacare.
Post by: WillyWump on October 05, 2013, 07:44:16 am
Have you tried using " power bottom " for only one of the questions ?

Ahhh! ok.

Ps- It's 6:30 saturday morning, SURELY the traffic is down and they've fixed the glitch. Here I go! ;)

Edited to Add: Holy Crap! I'm in! I was able to create an account! ...but of course after that I get  "Downstream Error" and the whole process comes to a screeching stop. LOL

Title: Re: Obamacare.
Post by: Habersham on October 05, 2013, 08:11:01 am
It's a shame they couldn't have a soft opening. It's like Christmas Eve and even Nordstrom's website has problems then.

However, I have friends in both New Jersey and Georgia who were able to obtain policies that were less expensive than their current ones with NO co-pay for RX's.

NPR just said the website will be closed during off peak hours this weekend while they tweak it.  Imagine that.......
Title: Re: Obamacare.
Post by: J.R.E. on October 05, 2013, 06:09:40 pm
I was able to get on the state healthcare exchange site today and priced out some insurance for info purposes (still have employer healthcare so just did this for the info)




Best plan I could find is $404 per month. $500 deductible.  $30 office visit Copay.  Covered at 100% once Copay is paid.  Prescriptions are included at 100% with no Copay (wow). 

There were 38 plans to choose from these are just three of the options.

My partner Ed, likes that price of $404.00 per month, and what this offers. Although he currently has private insurance through AARP Aetna, he's going to look into this. He also received a letter a while back, stating that if he decides to go through the exchanges, he would not be permitted back into the AARP Aetna private insurance plan.  :-\  ( not sure what that's about ) , but that's what the letter stated.

He currently pays about 445.00 a month for a plan that is no where as good as this one. And he knows that age (62) and location ( Florida) could very well change this pricing, but he's going to check it anyway.

Thanks for that info bug----Ray
Title: Re: Obamacare.
Post by: J.R.E. on October 06, 2013, 08:53:31 am
  He also received a letter a while back, stating that if he decides to go through the exchanges, he would not be permitted back into the AARP Aetna private insurance plan.  :-\  ( not sure what that's about ) , but that's what the letter stated.



This is exactly what the letter stated, as far as not allowing Ed back into the Aetna coverage, should he decide on the exchanges.

"Please keep in mind, if you cancel your current coverage, you will not be able to purchase another AARP Essential Premier Health insurance plan. "  As a result  of the many health coverage options and policies available under the ACA, AARP will not be co-branding a 50-64 ( age) health insurance product in the 2014 Exchance marketplace."   

=================================

So in other words,.. he's "Grandfathered into his current plan. Just wanted to clarify why he would not be allowed back into his current plan, should he decide to change.

Ray


Ray
Title: Re: Obamacare.
Post by: mikeyb39 on October 06, 2013, 03:38:21 pm
well this morning I was able to get registered and was making my way thru the system fine, then got to the screen where to view eligibility and send info If wanted Medicaid and couldn't get past that screen to view the options.

I was able to speak to someone on the chat and she said there are still some glitches they are working every evening and to give it few more days
Title: Re: Obamacare.
Post by: OneTampa on October 07, 2013, 11:21:29 pm
Web site page view froze and could not continue. Will try again later.
Title: Re: Obamacare.
Post by: aaware72 on October 08, 2013, 10:14:24 am
I came across this article this morning.  A new donut hole!  I know in my state they have not decide weather or not Medicaid will be expanded...

"An important issue that is highlighted from the first few days of enrollment is the number of individuals who will continue to be uninsured. Because several states have refused to expand Medicaid beginning in January 2014, millions of lower-income Americans with incomes at or below 133% of the federal poverty level, including many with HIV, will not have access to affordable health coverage. These individuals are trapped in what many are referring to as the new “donut hole”—which describes individuals who are too poor to qualify for premium subsidies, but too “wealthy” to qualify for Medicaid in their state."

http://salsa3.salsalabs.com/o/50464/t/0/blastContent.jsp?email_blast_KEY=1260948
Title: Re: Obamacare.
Post by: leatherman on October 08, 2013, 01:33:52 pm
A new donut hole!
this is why many have still been advocating for ADAP to remain funded.

IF every state was to fully implement the ACA, people would have access to insurance or the Medicaid Expansion program, and wouldn't need ADAP funding. In actuality, ADAP and indigent funds to hospitals is funding that is scheduled to be appropriated into the ACA. That's why the defunding notion is sorta ridiculous. Much of the ACA is already paid for by this kind of consolidation of services.

However, since quite a few states are not accepting ME, ADAP is very much needed to fill in this horrible gap. Because of the eligibility requirements, Medicaid expansion would have greatly helped many HIV positive people have easy, affordable, guaranteed access to the thing they need they most - medications. ADAP has to be renewed usually every 6 months, while ME or ACA insurance would be much more permanent.
Title: Re: Obamacare.
Post by: WillyWump on October 08, 2013, 09:33:03 pm
well this morning I was able to get registered and was making my way thru the system fine, then got to the screen where to view eligibility and send info If wanted Medicaid and couldn't get past that screen to view the options.

I actually got stuck at that same spot but I get the "Downstream error" also again.

I'm done. I'm tired of spending an hour each day trying to log in. I'll wait a week or so, maybe they will find some competent people to program by then.
Title: Re: Obamacare.
Post by: tednlou2 on October 10, 2013, 02:06:06 pm
I really wish the administration would have done better at explaining how the law works, and how the plans work.  I'm just now learning how it works, as are most.

The big complaint I see are the high deductibles.  Is it correct that if you have a plan with a $5,000 deductible, then you have to pay $5,000 out-of-pocket, before your plan covers doctor visits, ER visits, meds, etc?  If so, that's steep.  I know that is how deductibles work, but wasn't sure whether there are benefits to reduce/help with that.  Most would never spend that much for your everyday medical needs.  It would only help for a major illness, so you don't end up with $50,000 to $100,000 in bills, which is great.  That is really great and would help many stay out of bankruptcy.   
Title: Re: Obamacare.
Post by: buginme2 on October 10, 2013, 02:59:08 pm
Yes that's how deductibles work.

However all the plans offered are not with a $5000 deductible.  As I mentioned in my previous thread I went to my states exchange website and for a 40 year old single male non smoker there were 38 different plans to choose from with deductibles ranging from $5000 down to $500.

There didn't seem to be any difference between these new plans and what people have had historically.  There's really no difference except maybe these cover more.

Title: Re: Obamacare.
Post by: Schnauzer on October 10, 2013, 04:36:16 pm

The big complaint I see are the high deductibles.  Is it correct that if you have a plan with a $5,000 deductible, then you have to pay $5,000 out-of-pocket, before your plan covers doctor visits, ER visits, meds, etc? 

I have a $2500 deductible on my employer-offered plan, but office visits, lab work, and prescriptions meds are all co-pay so they are not part of the deductible.  The deductible kicks in if I'm hospitalized or have some sort of out-patient surgery.  There is also "out-of-pocket" expense which is another important factor to look at.

Health insurance policies are -at least to me- unbelievably puzzling.  I suppose the best thing is to call the insurer and hope that you get a representative that can answer your questions. Then call back again to see if get the same answer.
Title: Re: Obamacare.
Post by: leatherman on October 10, 2013, 05:35:27 pm
I suppose the best thing is to call the insurer and hope that you get a representative that can answer your questions. Then call back again to see if get the same answer.
or call your ASO, find out who the navigators are in your area (the federal gov't covers these navigators and their training, so there are navigators even in the red states that didn't accept Medicaid Expansion). These navigators may not be associated with your ASO, so you might have to check around.

You may even want to check on whether your ASO or some other agency has done the hard part of evaluating and rating insurance policies just for pozzies. My statewide Task Force paid for navigation training for a large group of case managers from across the state (HIV and other illnesses) and has hired a special team to evaluate all the plans on the Federal Marketplace (SC didn't want to help at all with the ACA, so we're stuck with national not local plans) to determine which of these plans might deliver better access to health care for HIV positive people in our state.

Maybe someone in your state has already produced a report or is in the process of evaluating plans and could better help an HIV+ person with getting the best policy. That's just another reason an HIV+ person should be waiting till later in this period to sign up. Give your case managers and advocates the time to do the work figuring out the list of plans that would best help you ;)
Title: Re: Obamacare.
Post by: mikeyb39 on October 10, 2013, 06:00:13 pm
My employer had a 2000 deductible but that didnt include prescription meds, I just had to pay 200 deductible then it went down to regular copays
Title: Re: Obamacare.
Post by: leatherman on October 16, 2013, 09:46:36 pm
Seven Alternatives To HealthCare.gov, Obamacare's Glitchy Website

1. State-run exchanges ...
2. Paper applications and the telephone ...
3. Navigators and other in-person assistance ...
4. State Medicaid offices ...
5. Health insurance companies ...
6. Web-based insurance brokers ...
7. Insurance agents and brokers ...

http://www.huffingtonpost.com/2013/10/16/alternatives-healthcare-gov-obamacare-website_n_4109749.html
Title: Re: Obamacare.
Post by: buginme2 on October 17, 2013, 11:34:10 am
I heard on the radio this morning that the state of Washington has signed up 25,000 -people so far for insurance under Obamacare.  Now we have our own state website that actually works unlike the federal site but I think those are prettygood numbers for just fifteen days from a small/medium sized state.

Any updates on the federal site, is it working yet?

Title: Re: Obamacare.
Post by: WillyWump on October 17, 2013, 01:23:53 pm
I heard on the radio this morning that the state of Washington has signed up 25,000 -people so far for insurance under Obamacare.  Now we have our own state website that actually works unlike the federal site but I think those are prettygood numbers for just fifteen days from a small/medium sized state.

Any updates on the federal site, is it working yet?

It would be nice to see numbers on the Fed part.

Im going to try again tonight and see if it's gotten any better. I hear the glitches are few now.

-W
Title: Re: Obamacare.
Post by: bocker3 on October 17, 2013, 05:41:08 pm
It would be nice to see numbers on the Fed part.


Why?  To help it get better or to show how awful it's been??  Didn't you just express, in another thread, dismay at the President focusing on the bad instead of talking about how we would band together and tackle the work in front of us?

I'd rather see that they have brought in some experts to fix the website.  The numbers will be bad -- we know that, but what are we doing to fix it??  We can't go back and undo the past.

M
Title: Re: Obamacare.
Post by: mitch777 on October 17, 2013, 06:21:24 pm
It seems to me that the fed might have not had the best people in charge to develop the website.  That being said, the states that CHOSE to not bother getting involved and create their own Health Exchange have themselves to blame. If you are in one of these states I would suggest you look no farther than your own Governor.

It's a massive program. It will take time.

I called today to find out who would be the best person to speak with in regard to my own situation. I was referred to a local broker. I explained my health issues and concerns and she didn't know all of the answers yet. She seemed competent and would get back to me via phone or email when she was able to get my questions answered from the state. She admitted that it takes awhile. I already know that the ACA will save us loads of money but I want to be sure to choose the right plan for us. I have time to wait for the answers.
Title: Re: Obamacare.
Post by: mecch on October 17, 2013, 06:30:56 pm
by the way, is Affordable Care actually called Obamacare on anything official related to it?  We might all work towards avoiding this term.
It seems to push so many buttons in a very negative way, for people who don't like Obama, or don't like the idea of something labeled as anti-freedom, anti-American, immoral, communistic, etc.
On the otherhand, if fans of Obamacare want to use the term, as a way of HONORING Obama for this great act of his Presidency and his leadership and contribution to Americans, present and future, then I guess I'm all for that.
Title: Re: Obamacare.
Post by: mitch777 on October 17, 2013, 07:14:18 pm
by the way, is Affordable Care actually called Obamacare on anything official related to it?

No, and Obama already said in a prior speech that the Repubs won't be referring to it as such when they realize that it works and people like it. "Heh heh." (oops, the heh heh sounded like Bush but for some reason it comes off better when Obama does it. Less evil and more funny)
Title: Re: Obamacare.
Post by: WillyWump on October 17, 2013, 08:33:20 pm
Why?  To help it get better or to show how awful it's been??  Didn't you just express, in another thread, dismay at the President focusing on the bad instead of talking about how we would band together and tackle the work in front of us?

 The numbers will be bad -- we know that, but what are we doing to fix it??  We can't go back and undo the past.

M

Did I say I expected the numbers to be bad? (or did you just do that).

I think the numbers from WA are GREAT, matter of fact I saw 35k on the news. Why wouldn't I think large Fed numbers wouldnt be GREAT?

But yes, please continue to interpret my thoughts for me. You are doing a stellar job ::)

Title: Re: Obamacare.
Post by: bocker3 on October 17, 2013, 09:46:38 pm
Did I say I expected the numbers to be bad? (or did you just do that).

I think the numbers from WA are GREAT, matter of fact I saw 35k on the news. Why wouldn't I think large Fed numbers wouldnt be GREAT?

But yes, please continue to interpret my thoughts for me. You are doing a stellar job ::)

Darling....  EVERYONE expects the Fed numbers to be bad.....  No one is able to register.  The website is, as you have been reporting.....  Frustrating and not letting you through.  Unless I missed where you succeeded

 :-*

M
Title: Re: Obamacare.
Post by: WillyWump on October 17, 2013, 10:28:15 pm
Darling....  EVERYONE expects the Fed numbers to be bad.....  No one is able to register.  The website is, as you have been reporting.....  Frustrating and not letting you through.  Unless I missed where you succeeded

 :-*

M

I'm not sure what any of this has to do with "Didn't you just express, in another thread, dismay at the President focusing on the bad instead ". But Okies.

Anywho, I just talked to Sarah at Healthcare.Gov after not being able to get in again tonight, and she says I should probably create a new username and password. Will try that tomorrow.
Title: Re: Obamacare.
Post by: noregrets on October 21, 2013, 03:16:01 am
I still can't get into the Healthcare.org website & sign up, but in the meantime I was at least finally able to get a look at the plans that are going to be available and what each one will be offering.

http://www.valuepenguin.com

I already have insurance now (crazy expensive Cobra) and my anxiety level has been pretty high over the past few weeks as I try to log on each day to see what I might be eligible for on Jan 1st.  I still can't sign up but at least I have a better idea now!

Title: Re: Obamacare.
Post by: Dachshund on October 21, 2013, 03:36:06 am
I'm in, signed up and ready to go on Jan 1. After walking on egg shells the last twelve years without insurance, i am so grateful to have health insurance. i qualified for a bit of a subsidy which will help cover the costs.
Title: Re: Obamacare.
Post by: mitch777 on October 21, 2013, 09:42:20 am
I'm in, signed up and ready to go on Jan 1. After walking on egg shells the last twelve years without insurance, i am so grateful to have health insurance. i qualified for a bit of a subsidy which will help cover the costs.

Great to hear Dach. I'm expecting the same.
Title: Re: Obamacare.
Post by: buginme2 on October 21, 2013, 02:45:42 pm
I'm in, signed up and ready to go on Jan 1. After walking on egg shells the last twelve years without insurance, i am so grateful to have health insurance. i qualified for a bit of a subsidy which will help cover the costs.

Congratulations.  I'm very happy to hear after twelve years without insurance you will no be covered.  THAT is awesome!!
Title: Re: Obamacare.
Post by: buginme2 on October 21, 2013, 02:47:02 pm
Side note: as someone who at times is so far left/liberal I walk in circles, Kathleen Sebelius needs to be pulled in front of congress for a congressional hearing. 
Title: Re: Obamacare.
Post by: Habersham on October 21, 2013, 03:59:24 pm
my friends who work in IT tell me that the problem is people who are talented just don't bid on government contracts.

It's the same people over and over who design all the government sites. It's a very specialized thing to go through the bidding process and they never pick the most expensive bid. Experienced designers can make more money in the private sector.
Title: Re: Obamacare.
Post by: Theyer on October 22, 2013, 09:39:20 am
In the UK we have perfected the art off wasting millions on IT systems that end up scrapped millions and millions . You name it and a service will have spent money on a scrapped IT system , Fire Service, Ambulance , Police  , Health , Local Gov National GOV and on and on . IN fact I am wondering if there is a public service that has not employed IT with nothing but frayed nerves at the end off it all.
Title: Re: Obamacare.
Post by: Miss Philicia on October 22, 2013, 09:45:54 am
Meanwhile the latest hipster trend is to sit at outdoor cafes and/or park benches and use a vintage typewriter.
Title: Re: Obamacare.
Post by: WillyWump on October 22, 2013, 07:08:33 pm
Meanwhile the latest hipster trend is to sit at outdoor cafes and/or park benches and use a vintage typewriter.

Lawl. LOVE this^


I still can't get into the Healthcare.org website & sign up, but in the meantime I was at least finally able to get a look at the plans that are going to be available and what each one will be offering.

http://www.valuepenguin.com

I already have insurance now (crazy expensive Cobra) and my anxiety level has been pretty high over the past few weeks as I try to log on each day to see what I might be eligible for on Jan 1st.  I still can't sign up but at least I have a better idea now!



THANK YOU for that link Noregrets. This is really what i've been trying to see. Now can they get those ValuePenquin people to DC stat to put the website together. ::)

According to the link, I can get a Policy for $690 which is about $300 less than what I am paying now for Adult+child. It shows a 20% copay which again is less that what I pay now. But the deductable field says Info not available (weird). I think someone said all deducs are maxed out at $6k? Still no info on scrips. But hopefully when I get let into healthcare.gov ill see all the specifics

This is progress. I think ill set up a meeting with my doc and see what they think about me switching and which policy they will work best with.





Title: Re: Obamacare.
Post by: mitch777 on October 22, 2013, 07:14:11 pm
Not sure if this might help but have you tried calling the number to get your questions answered?
Title: Re: Obamacare.
Post by: WillyWump on October 22, 2013, 07:18:53 pm
Not sure if this might help but have you tried calling the number to get your questions answered?

Yes, twice. The first time I called he said I would need to go to website to "compare" policies. The second time, which was a complaint about the "downstream error", I didnt ask about quotes cause I want to be able to see them in front of me and compare them, which ValuePenquin does really good. I just couldn't see myself trying to write down quotes and all info for 6 different policies from someone I could barely understand.

But I may try it again now that Ive narrowed down the policy
Title: Re: Obamacare.
Post by: mitch777 on October 22, 2013, 07:22:24 pm
frustrating but it sounds like this might work out well for you. still waiting to hear back from the broker here. it doesn't sound like they know what they are doing either.
Title: Re: Obamacare.
Post by: WillyWump on October 22, 2013, 07:30:58 pm
frustrating

Ohhh My bad!

I didnt click far enough in. It has all info right there for me....It says my scrips would be $100 for "preferred brand" and $150 for "non-preferred brand",  so thats $300-$450/month. Of course generic is $25 but that doesnt help me with teh AIDS drugs.

LOTS of good info in there. Each policy is different of course in regards to scrips and copays, so I actually have alot of number crunching to do as there are 22 plans under Silver alone.

Title: Re: Obamacare.
Post by: buginme2 on October 22, 2013, 08:25:43 pm
have you figured out a deductible? 6 thousand sounds like a lot.  I didn't see any over five thousand and that was for bronze plans.  I was finding 2 to 5 hundred for gold  plans and one thousand for silver.
Title: Re: Obamacare.
Post by: WillyWump on October 23, 2013, 07:09:53 pm
have you figured out a deductible? 6 thousand sounds like a lot.  I didn't see any over five thousand and that was for bronze plans.  I was finding 2 to 5 hundred for gold  plans and one thousand for silver.

They are ranging from $2k to $6350 for Silver. In addition Some of the plans have prescrip deducs of $1000-$3000.

I'm actually overwhelmed by all the info, and I havent even gotten to platinum or Gold or Bronze yet

-W
Title: Re: Obamacare.
Post by: bocker3 on October 23, 2013, 09:15:18 pm
They are ranging from $2k to $6350 for Silver. In addition Some of the plans have prescrip deducs of $1000-$3000.

I'm actually overwhelmed by all the info, and I havent even gotten to platinum or Gold or Bronze yet

-W

Are those numbers deductibles, or max out of pocket?? 

I have not looked into this at all, i am assuming that my employer plan is cheaper.

M
Title: Re: Obamacare.
Post by: Habersham on October 23, 2013, 09:33:54 pm
If you are HIV poz and pay for your own meds, prescription co-pays are the easiest way to sort. Look for the lowest co-pays and then compare other features.

The silver and bronze plans aren't even worth looking at. They are for people with no medical conditions.
Title: Re: Obamacare.
Post by: WillyWump on October 24, 2013, 09:38:10 am
Are those numbers deductibles, or max out of pocket?? 


Deductibles, although the high figure of $6350 I apparently got from the MOOP field...

so as a correction, the deducs i'm seeing are $2k-5k

I'm certain there are lower deducs as Buggy states, I just haven't gotten to them yet.


I have not looked into this at all, i am assuming that my employer plan is cheaper.


Oh no doubt. But go into Valuepenguin and click around and see.

If you are HIV poz and pay for your own meds, prescription co-pays are the easiest way to sort. Look for the lowest co-pays and then compare other features.

The silver and bronze plans aren't even worth looking at. They are for people with no medical conditions.

yes, valid point


As an aside, another problem I came across is the In Network/Out of Network Physicians. One plan I was keying on as a good fit did not show my current doc as "in network", further...there were no ID docs "In Network" in San Antonio. So that plan payed zero for out of network physicians.



Title: Re: Obamacare.
Post by: Dachshund on October 24, 2013, 10:16:38 am
Deductibles, although the high figure of $6350 I apparently got from the MOOP field...

so as a correction, the deducs i'm seeing are $2k-5k

I'm certain there are lower deducs as Buggy states, I just haven't gotten to them yet.

Oh no doubt. But go into Valuepenguin and click around and see.

yes, valid point


As an aside, another problem I came across is the In Network/Out of Network Physicians. One plan I was keying on as a good fit did not show my current doc as "in network", further...there were no ID docs "In Network" in San Antonio. So that plan payed zero for out of network physicians.

I don't know what providers are offered in Texas but Blue Cross offers the most plans here in TN. I narrowed it down to three of their plans and was still confused by what they covered. After talking to some very helpful people at Blue Cross I have a better understanding. First, the deductible has to be met (including meds) on all of Blue Cross policies. Check the maximum out of pocket listed on the policy because the vary wildly. I will probably go with a higher deductible that follows with a 0% copay after the deductible is met because after paying for my meds for a month I will meet the deductible. It's gonna hurt that first month but then I won't be paying anything out of pocket after that. Call the provider if you have questions and they might be able to help.
Title: Re: Obamacare.
Post by: WillyWump on October 27, 2013, 11:09:20 am
LAWL!

http://www.dailymotion.com/video/x16h6cv_how-to-sign-up-for-obamacare-kathleen-sebelius-snl-10-26-13_people

..."Blue Cross Blue Balls"  ;D
Title: Re: Obamacare.
Post by: intaglio on October 27, 2013, 02:47:31 pm
I didnt click far enough in. It has all info right there for me....It says my scrips would be $100 for "preferred brand" and $150 for "non-preferred brand",  so thats $300-$450/month. Of course generic is $25 but that doesnt help me with teh AIDS drugs.

Don't forget that most pharmaceutical companies have their own copay assistance programs. My current monthly BC-BS copay of $305 is reduced to $5 by copay assistance programs.

The copays these programs provide shouldn't be the reason you use to choose your healthcare package. They could influence whether or not you go with a package that has a bit higher out-of-pocket costs for prescriptions.
Title: Re: Obamacare.
Post by: Jeff G on October 29, 2013, 07:01:55 am
This an interesting opinion piece on why the roll out hasn't been a smooth one .

http://www.cnn.com/2013/10/28/opinion/carroll-gop-obamacare-hypocrisy/index.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+rss%2Fcnn_topstories+%28RSS%3A+Top+Stories%29
Title: Re: Obamacare.
Post by: bocker3 on October 29, 2013, 07:51:02 am
This an interesting opinion piece on why the roll out hasn't been a smooth one .

http://www.cnn.com/2013/10/28/opinion/carroll-gop-obamacare-hypocrisy/index.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+rss%2Fcnn_topstories+%28RSS%3A+Top+Stories%29

While it is an interesting article, it doesn't really have much to do with the website rollout issues.  The money denied by the Republicans was for educating the public (a much needed action), but the website issues seem to stem from a complete lack of understanding on how these things work.  Last minute change requests to the developers - no real end to end testing that included VOLUME of users, decisions to insists that all must create an account before even browsing, etc, etc.  Anyone who has spent any time near IT development projects can tell you that these are a recipe for failure.  I have not read anywhere that money was behind the website issues.  This one is, I'm afraid, mainly the fault of the Administration -- piss poor project management.  A little blame to all the states who refused to set up exchanges, but from what I read that wasn't the real driver behind this fiasco, just a bit of a contributing factor.

Mike
Title: Re: Obamacare.
Post by: Jeff G on October 29, 2013, 08:14:25 am
While it is an interesting article, it doesn't really have much to do with the website rollout issues.  The money denied by the Republicans was for educating the public (a much needed action), but the website issues seem to stem from a complete lack of understanding on how these things work.  Last minute change requests to the developers - no real end to end testing that included VOLUME of users, decisions to insists that all must create an account before even browsing, etc, etc.  Anyone who has spent any time near IT development projects can tell you that these are a recipe for failure.  I have not read anywhere that money was behind the website issues.  This one is, I'm afraid, mainly the fault of the Administration -- piss poor project management.  A little blame to all the states who refused to set up exchanges, but from what I read that wasn't the real driver behind this fiasco, just a bit of a contributing factor.

Mike

Wrong .

Quote form link .
Federal legislators aren't the only ones to blame. Let's remember that original versions of the bill called for one big national exchange. This would have been much easier to implement. But conservatives declared that insurance should be left to the states and kept out of the hands of the federal government. So as a compromise (yes, those did occur), exchanges were made state-based instead of national.

As a precaution, the law stipulated that if states failed to do their duty and enact exchanges, the federal government would step in and pick up the slack. This was to prevent obstructionism from killing the law. Surprisingly, it was many of the same conservative states that demanded local control that refused to implement state-based exchanges, leaving the federal government to do it for them.

That made implementation much harder.
End Quote

All of the red states that refused to set up exchanges did contribute to the website not being ready in time . All of these states except for a couple have GOP governors and it accounts for about half of the country . Its clearly caused problems .

I'm not giving a pass to the Obama administration because its a fact this roll-out could have been handled a lot better and they are ultimately the ones that are responsible .       
Title: Re: Obamacare.
Post by: Miss Philicia on October 29, 2013, 09:40:12 am
Most of you don't know what a clusterfuck the Bush-era Medicare Part D was because you're not frail, feeble disability queens like myself. Suffice to say I was given so much incorrect information by case managers that I ended up paying $1,000 in premiums that I didn't need to, and then the state refused to refund the money. Live and learn I guess.

But hey, private corporations fuck up regularly too.
Title: Re: Obamacare.
Post by: mitch777 on October 29, 2013, 09:49:56 am
The ACA was a GOP idea for the most part prior to Obama becoming president. Most Democrats would have preferred a single payer system. The GOP continues to put politics before country by being as obstructive as possible. They are doing everything in their power to make the ACA fail. Government shutdown anyone? Pathetic.

The unfunded Medicare Part D rollout didn't go so well in the beginning either under Bush. Computer glitches, delays, and confusion. Sure, there was criticism but the obstructionism that we are seeing today didn't happen. Hmmm...

I see Miss P. remembers (as I was typing this).
Title: Re: Obamacare.
Post by: Jeff G on October 29, 2013, 09:59:53 am
Most of you don't know what a clusterfuck the Bush-era Medicare Part D was because you're not frail, feeble disability queens like myself. Suffice to say I was given so much incorrect information by case managers that I ended up paying $1,000 in premiums that I didn't need to, and then the state refused to refund the money. Live and learn I guess.

But hey, private corporations fuck up regularly too.

It was a cluster fuck wasn't it . I was rolled off adap into part D and it wasn't a smooth transition . The benefits of part D eventually outweighed the negatives in my personal situation . I was able to treat my depression and metabolic conditions and get access to treatments I badly needed but simply could not afford before part D .

I still had trouble paying for my copay's and remember once having to leave the pharmacy without my meds because I couldn't afford the $2.60 copay for a generic .

If the opponents of the Affordable Care Act had to live on the average disability check and navigate the health care system for 6 months we would be having a totally different national conversation .   
Title: Re: Obamacare.
Post by: bocker3 on October 29, 2013, 05:42:50 pm
Wrong .

Quote form link .
Federal legislators aren't the only ones to blame. Let's remember that original versions of the bill called for one big national exchange. This would have been much easier to implement. But conservatives declared that insurance should be left to the states and kept out of the hands of the federal government. So as a compromise (yes, those did occur), exchanges were made state-based instead of national.

As a precaution, the law stipulated that if states failed to do their duty and enact exchanges, the federal government would step in and pick up the slack. This was to prevent obstructionism from killing the law. Surprisingly, it was many of the same conservative states that demanded local control that refused to implement state-based exchanges, leaving the federal government to do it for them.

That made implementation much harder.
End Quote

All of the red states that refused to set up exchanges did contribute to the website not being ready in time . All of these states except for a couple have GOP governors and it accounts for about half of the country . Its clearly caused problems .

I'm not giving a pass to the Obama administration because its a fact this roll-out could have been handled a lot better and they are ultimately the ones that are responsible .     

I don't think I'm wrong at all --
I agree with you -- the states made things much more difficult.  However, from what I've read and saw from the development folks, this was destined to be screwed up - no matter the make up of states.  I've been involved in a number of large scale IT development efforts -- it never goes well if things are done in silo's.  It never goes well when requirements change constantly (especially at the last minute) -- this is where adding additional states probably had the biggest impact, and it NEVER, EVER goes well if you don't do a proper end to end test with a good amount of "volume" hitting the system.
Most big companies have had large IT efforts go off like this did -- they rarely get the press that healthcare.gov did and they almost never get their mistakes used as political fodder.  Hopefully, this can get fixed quickly and then the press will move on, because right now, their need for headlines (and the republicans need for anything to help them derail this) are branding an IT snafu as Obamacare rollout.  the fiasco wasn't with the rollout of the ACA, it was with the (non)functionality of the website.

Mike
Title: Re: Obamacare.
Post by: WillyWump on October 29, 2013, 06:16:07 pm
http://www.economist.com/news/united-states/21588390-big-threat-obamacare-not-republican-intransigence-white-houses-own

Look Whoever's fault it is Obama and his minions will spin out of it somehow...It's the repubs, It's Bush, It's too much traffic, It was the shutdown, I wasnt aware, no one told me but I am holding them responsible... Obama is an amazing orator and is very persuasive. Trust me, this rollout problem will pass. Sure the Obama admin will take some bruises but it's politics.

The admin can easily delay the deadlines to get everything up and running, dont know if they will, but there is an out for them.

I'm starting to worry about other things down the road now...I already had questions about "in network vs out of network" and several policies offered in my area, that I liked, not using my doc (the largest HIV provider in south Texas) and today I find this..
Obamacare Doctors limited http://www.cnn.com/2013/10/29/health/obamacare-doctors-limited/index.html?hpt=hp_t2

Then there is the issue of people in the private policy market getting dropped or forced to other policies with higher premiums, the whole "If you like your insurance policy you can keep it, nothing will change" is proving to be  at the least a misleading message... (http://thehill.com/blogs/healthwatch/health-reform-implementation/331223-hoyer-dems-knew-some-patients-would-lose-insurance-plans-under-obamacare)

Luckily I have had my policy since before 2010, and have had no significant user initiated changes to the policy so I am supposed to be grandfathered in and will be allowed to keep my policy, which doesn't meet ACA standards but has kept me alive and in HIV meds, If I chose too. so I still feel safe in that I can stay on my current policy if the ACA turns out it wont work for me. But I worry about the others.

And of course I've always been worried about paying for the ACA. Who are all these healthy 27-32yo that don't have employer provided insurance and will suddenly shell out a couple hundred dollars a month to buy a policy to finance all the sickies (us)?...But in the end we've spent worse money on lesser things so I'm actually becoming more at peace with this part of it.



Title: Re: Obamacare.
Post by: mitch777 on October 29, 2013, 06:45:03 pm
http://www.economist.com/news/united-states/21588390-big-threat-obamacare-not-republican-intransigence-white-houses-own


I'm starting to worry about other things down the road now...I already had questions about "in network vs out of network" and several policies offered in my area, that I liked, not using my doc (the largest HIV provider in south Texas) and today I find this..
Obamacare Doctors limited http://www.cnn.com/2013/10/29/health/obamacare-doctors-limited/index.html?hpt=hp_t2

All the more reason to go with a single payer system. Insurance companies are in business for profit. They are useless middlemen that DO NOT CARE. And on it goes... so sad.
Title: Re: Obamacare.
Post by: leatherman on October 29, 2013, 07:10:34 pm
to finance all the sickies (us)?
actually it's to finance themselves too. ;) Inevitably, by the time a person dies, nearly everyone has gone to the hospital at least once and nearly everyone has received some type of health care. It's only fair for everyone to take some personal responsibility and pay into the system that will, at some time, be caring for them. Going forward we'll see fewer and fewer 30 and 40 year olds going bankrupt and losing their homes because of the cost of health care covering accidents and illnesses destroying their financial lives.
Title: Re: Obamacare.
Post by: WillyWump on October 29, 2013, 07:23:43 pm
actually it's to finance themselves too. ;) Inevitably, by the time a person dies, nearly everyone has gone to the hospital at least once and nearly everyone has received some type of health care. It's only fair for everyone to take some personal responsibility and pay into the system that will, at some time, be caring for them. Going forward we'll see fewer and fewer 30 and 40 year olds going bankrupt and losing their homes because of the cost of health care covering accidents and illnesses destroying their financial lives.

No, I get that. And that sells very well and actually you sound like Obama in front of a TV camera, its all very nice and you make me want to cast a vote for you.

But reality abounds and is a charismatic speaker going to make a healthy 28 year, who has never had a policy before, suddenly spend a few hundred bucks a month and buy a policy? We know they should, but will they?

Maybe they will. I just hate having to "hope" they will.

I guess they can skate around until the penalties get stiff after a few years
Title: Re: Obamacare.
Post by: leatherman on October 29, 2013, 08:03:23 pm
We know they should, but will they?
healthy and unhealthy people who never wreck their vehicles (like myself who, as a courier, was wrecked into 14 times and went on to the IT guy for 3 different auto body repair shops), pay for car insurance all the time because it's the law.

There's actually much less of a chance for a person being in an accident and needing car insurance than there is the greater chance of a person needing hospital care at some point in their lives. I've never understood why all the small-government crowd doesn't decry auto insurance when the vast majority of people never file a claim against their car insurance policy.
Title: Re: Obamacare.
Post by: WillyWump on October 29, 2013, 08:10:44 pm
healthy and unhealthy people who never wreck their vehicles (like myself who, as a courier, was wrecked into 14 times and went on to the IT guy for 3 different auto body repair shops), pay for car insurance all the time because it's the law.

There's actually much less of a chance for a person being in an accident and needing car insurance than there is the greater chance of a person needing hospital care at some point in their lives. I've never understood why all the small-government crowd doesn't decry auto insurance when the vast majority of people never file a claim against their car insurance policy.

You clearly are not getting my point. ..believe it or not this is a concern of even the Admin, getting young and healthy to sign up.

Auto insurance and ACA are 2 different things. If you get pulled over in San Antonio without auto Insurance they tow your car right there and then, and you walk. You pay about $500 to get your car out, in the minimum.  Now just a few years ago there was only a small fine for not having auto insurance IF YOU GOT CAUGHT, they gave you a ticket and sent you on your way. Alot of people didnt have auto insurance...including the guy that totalled my car with me in it even though there was a law saying you had to have it.

If a 28yo doesn't get Obamacare insurance nothing happens except a $95 fine at the end of the year. Which is less than the cost of the monthly policy.
Title: Re: Obamacare.
Post by: leatherman on October 29, 2013, 10:29:08 pm
If a 28yo doesn't get Obamacare insurance nothing happens except a $95 fine at the end of the year. Which is less than the cost of the monthly policy.
right - that minimal fine is how the Republicans worked (ie obstructed) to basically remove the individual mandate out of the equation (though that was their concern over many years).

I understand that right now there is this glaring problem - and that's why I write, email and call my Representative (Mick Mulvaney) to ask him to quit grandstanding with his letter to Sec. Sebilus and actually get to work fixing and patching up the problematic areas of this law. I think as time goes by (I mean the ACA policies buy in period isn't even over for the year and none of the plans have gone into effect), issues like getting everyone to buy in will be corrected.

Right now, as evidenced by the sign ins at the website, clearly a lot of people are looking at plans, and we can probably assume that a number of them will buy in. So the worry about paying for the ACA (which is also paid through a lot of other sources like re-appropriating the indigent care funds, ADAP, etc) is like much of the ACA a huge change and a work in progress.
Title: Re: Obamacare.
Post by: aaware72 on November 01, 2013, 04:07:50 am
I came across this article.

http://www.usatoday.com/story/news/nation/2013/10/28/how-the-aca-will-affect-people-with-hiv-and-aids/3285897/
Title: Re: Obamacare.
Post by: mitch777 on November 01, 2013, 12:16:20 pm
I came across this article.

http://www.usatoday.com/story/news/nation/2013/10/28/how-the-aca-will-affect-people-with-hiv-and-aids/3285897/

Interesting. Thanks for the post.
Title: Re: Obamacare.
Post by: mitch777 on November 01, 2013, 12:34:48 pm
So I got fed up waiting for about 10 days to hear back from the broker. I called the Connecticut Healthcare Exchange last night at 7:45PM and was a bit surprised that someone was there to help.

Anyway, I got the names of a couple more brokers before she said that she would also put in a message for one of their "in-house" brokers to give my a call. (I didn't know that the state even had in-house brokers.)

Forward to this morning at 9 AM...
I get a call from the in-house broker! I explained my health/insurance needs and she could not have been more kind and helpful. :) She has been in the business for many years and was still shocked to hear what I am currently paying.

She is convinced that the plans offered in the exchange will be just as good if not better as far as coverage at a fraction of the price! Yay! Maybe even 75% cheaper!
She is checking on a few things and says she will call me back later today.

I hope my bubble doesn't burst as I really am in the need for doing the monkey dance.

I will keep you posted when I hear the details.

If this pans out I think that between Kenny and I, we might save as much as 15k per year... maybe even more! :)
Title: Re: Obamacare.
Post by: britchick on November 01, 2013, 02:41:11 pm
mitch777,

I hope that you get good news soon re your health insurance.

britchickx
Title: Re: Obamacare.
Post by: mitch777 on November 01, 2013, 03:02:53 pm
Thanks Britchick! Me too.
Title: Re: Obamacare.
Post by: bocker3 on November 01, 2013, 05:43:30 pm
Hope this goes as it seems -- that would be a nice, tidy savings. 

You and Keneisha can rent the Presidential suite in New Orleans and our Meet and Greet location will be solved!!   ;)

Hugs,
M
Title: Re: Obamacare.
Post by: mitch777 on November 01, 2013, 06:04:20 pm
Hope this goes as it seems -- that would be a nice, tidy savings. 

You and Keneisha can rent the Presidential suite in New Orleans and our Meet and Greet location will be solved!!   ;)

Hugs,
M
There's a Presidential suite in New Orleans? ???
You're makin' that up. :)
m.
Title: Re: Obamacare.
Post by: a2z on November 02, 2013, 04:35:19 am
my friends who work in IT tell me that the problem is people who are talented just don't bid on government contracts.

Begin rant.....

I work in IT, and actually I spent most of 2012 working on a government health-care related site.  It was a hellish experience.

Sadly, nothing that is happening right now is surprising.  It's a thing of when you have a firm deadline to build something, and not enough time to build it right, much less test it right or people willing to fund the infrastructure needed.  Why?  Because they are in a hurry and they think fixing the bugs later is cheaper.  It's not. 

I spent most of 2012 telling someone "Hey, I told you this would happen." time and time again.  They asked me to stay around and help them through their third deadline extension.  I decided to spend time at another employer instead.

My blood pressure dropped a good 20 points :)
Title: Re: Obamacare.
Post by: WillyWump on November 04, 2013, 05:49:53 pm
This worries me, coupled with the fact that I cant find a plan with my current Doc "In-Network".

Top Us Hospitals Opt out of Obamacare..

http://watchdog.org/114137/top-hospitals-opt-out-of-obamacare/

The gist of it was that some hospitals are only accepting a couple plans that are on the Exchange, so if previously your private policy, like mine, allowed you to go to any hospital you may not have that option under ACA. This just doesnt sound right...what am I not understanding here.

Even though my doc is under University Health System, I prefer to go to Methodist Hospital ER for emergencies. I guess I should now call Methodist and see which plans they will be taking, and then get with my doc and see which plans they will be taking, and hope I can find a plan that has them both.

Im becoming less enthusiastic about this and am finding more comfort in keeping my current plan although I can barely afford it. LOL
Title: Re: Obamacare.
Post by: mitch777 on November 04, 2013, 06:07:25 pm
This worries me, coupled with the fact that I cant find a plan with my current Doc "In-Network".

Top Us Hospitals Opt out of Obamacare..

http://watchdog.org/114137/top-hospitals-opt-out-of-obamacare/

The gist of it was that some hospitals are only accepting a couple plans that are on the Exchange, so if previously your private policy, like mine, allowed you to go to any hospital you may not have that option under ACA. This just doesnt sound right...what am I not understanding here.

Even though my doc is under University Health System, I prefer to go to Methodist Hospital ER for emergencies. I guess I should now call Methodist and see which plans they will be taking, and then get with my doc and see which plans they will be taking, and hope I can find a plan that has them both.

Im becoming less enthusiastic about this and am finding more comfort in keeping my current plan although I can barely afford it. LOL
Will,
While that is very discouraging I wonder if it really matters one way or another if you know you will be hitting the max out-of-pocket level anyway. Maybe I'm wrong here?
Keep going to your out of network docs. What difference would it make once you hit that threshold. ??

EDIT: I see. The max out of pocket goes up after looking into it. I still wonder if it would end up cheaper than your current plan. What a bummer!
Title: Re: Obamacare.
Post by: aaware72 on November 05, 2013, 10:32:20 am
This worries me, coupled with the fact that I cant find a plan with my current Doc "In-Network".

Top Us Hospitals Opt out of Obamacare..

http://watchdog.org/114137/top-hospitals-opt-out-of-obamacare/

The gist of it was that some hospitals are only accepting a couple plans that are on the Exchange, so if previously your private policy, like mine, allowed you to go to any hospital you may not have that option under ACA. This just doesnt sound right...what am I not understanding here.

Even though my doc is under University Health System, I prefer to go to Methodist Hospital ER for emergencies. I guess I should now call Methodist and see which plans they will be taking, and then get with my doc and see which plans they will be taking, and hope I can find a plan that has them both.

Im becoming less enthusiastic about this and am finding more comfort in keeping my current plan although I can barely afford it. LOL

This worries me too.  I live in NH and I travel to Boston to Mass General for my care.  I'm afraid that after all is said and done I will no longer be able to receive care here. 
Title: Re: Obamacare.
Post by: mecch on November 05, 2013, 02:10:32 pm
Be careful of your sources, please. I find that linked article, disingenuous.
I went to the homepage of Watchdog, and read the first posted comment in the thread:

clydealan • 3 hours ago −
Watchdog.org is a project of The Franklin Center which was founded in 2009 with an initial sponsorship grant from the Sam Adams Alliance. According to the Columbia Journalism Review, in 2011, 95 percent of the Franklin Center’s revenues came from a charity called Donors Trust, whose top contributors were the Koch
brothers. If you are looking for an unbiased opinion move along. However, if twisted truth and Obama bashing is your fare you will enjoy this right wing leaning site.
Title: Re: Obamacare.
Post by: Miss Philicia on November 05, 2013, 02:20:16 pm
top contributors were the Koch

Now that's just plain sad behavior in a forum, Wilamina.
Title: Re: Obamacare.
Post by: SouthSam7 on November 05, 2013, 03:21:00 pm
From The New York Times:

Under Health Care Act, Millions Eligible for Free Policies

Federal subsidies will pay the entire monthly cost of some plans being offered in the online marketplaces, a surprising figure that has not gotten much attention, in part because the zero-premium plans come with serious trade-offs.

http://www.nytimes.com/2013/11/04/business/under-health-care-act-millions-eligible-for-free-policies.html
Title: Re: Obamacare.
Post by: WillyWump on November 05, 2013, 04:56:51 pm
Be careful of your sources, please. I find that linked article, disingenuous.


My bad Mecch. I should know better than to post such things here in Liberal-ville...

How's this http://www.cnn.com/2013/10/29/health/obamacare-doctors-limited/

Not sure if NYpost is allowed but...http://nypost.com/2013/10/17/hospitals-reject-six-obamacare-plans/

Now that's just plain sad behavior in a forum, Wilamina.

No Trollina, what's sad behavior is you texting me to say "Mecch just called you out in Obamacare thread..." while I was deep in my Walmart shopping trying to find my favorite pickled Okra.

Anyways,

...I have a call in to my Docs benefit rep to see what policies they are accepting from ACA, she hasnt called back yet.

Sooo,  I called an insurance company on a plan that I really liked, Superior Health, to inquire as to whether my Doc and preferred hospital was In-Network or not (out of network is not covered at all). He didn't have the info available but will be calling me back in a couple days, when healthcare.gov site comes up....Which didn't make ANY sense as I was talking to the actual insurance company, Superior Health. Grrr. Wouldnt they have provider info on their own policies? Then I blew his mind when I told him I needed to make sure the policy covered specific docs and hospitals in Austin for my son.

But get this... and this is the cool part, which I've NEVER seen insurance companies do. They have a "rewards card" program whereby you get credits for certain things you to to improve your health. For example If you get an annual physical you get $150 credit, Flu shot is $25 credit, a health risk assesment is $50 credit, If I go to the gym twice a week I get a $20/mo credit, ..bascially if you do all these (and a few others) you can get up to $400 a year to apply towards your deductibles, prescription copays, etc... Pretty darn cool huh! :)

Title: Re: Obamacare.
Post by: mecch on November 05, 2013, 06:37:40 pm
The CNN article was good enough.  It digs into the subject and covers matters that you are concerned about and gives the ups and downs, the micro and the macro.

I see that Affordable Care is going to be a process, not all settled beforehand, and that people who currently buy individually are going to see changes and yeah these network are restricting.  I also am not sure this is the entire fault of Affordable Care. It seems like an argument between capitalistic doctors, capitalistic hospitals, and capitalistic insurance companies.  For example the situation explained in the CNN article about the local hospital in Concord NH.  Which for the moment holds the IMPOSSIBLE position that it won't take any Affordable Care plans.  (And then the dirty detail that it seems all plans are in fact one sponsor - blue cross, blue shield.  So we see that these stakeholders are playing "who get stiffed".  "We're not going to shoulder the burden" - doctors, hospitals - trying to shift it to the insurance plan. "We're not going to budge" insurance plans saying we won't pay the price at this and that service provider.   

This war and shakeout is part of the process -- its all going to involve shakeout and compromise.  And that's because single payer wasn't chosen as the solution. 

You can't have EVERYTHING go your way... In America Freedomland who has the right to tell a for-profit hospital (or Doctor "my fee is non-negotiable" so and so) it has to see everyone?  Feedom. Market.  Win! Right?  Otherwise, (the solution to the above complaint - means every doctor/hospital has to see anyone with any insurance) --- critics of Obamacare will just complain again - freaking Socialism, thats what that is.  Especially the profit-making doctors and hospitals!!!  Hey they have the right...

I'm sure that Concord hospital has figured out that SOME local consumers are going to have the "premium" insurance plans - whether employee sponsored, or State Obamacare, or national networks, whatever, so that SOME local consumers are going to be able to go to the damned hospital. Otherwise they are shooting themselves in the foot...   

Its a complex issue.   

Its a massive, national change that is beginning and a LOT of adjustment is going to be necessary over time, as all the stakeholders stand their ground trying to get as much s possible and lose as little as possible.  And there is going to be a LOT of complaining.  So already there are thousands of Obamacare access success stories in the media and Obamacare horror stories as well.   

So do we really need the Koch brothers sponsored media outlets, and think tanks, goosing the process on this never ending propaganda campaign with the goal of destruction of Obamacare.  At least try to find stories in somewhat independent media sources and also media sources that include REPORTERS, and editors, etc. 

Obamacare is the law, has been approved by the Supreme Court, and another vote of support in the election of the Obama to his secord term. 

Buck up and try it the fuck out, for crissakes...  Complain, explain, find solutions for the kinks, and black holes, but try to make it work.  Have to. At least for a few years. Because it is what it is.
Title: Re: Obamacare.
Post by: mecch on November 05, 2013, 06:45:59 pm
But get this... and this is the cool part, which I've NEVER seen insurance companies do. They have a "rewards card" program whereby you get credits for certain things you to to improve your health. For example If you get an annual physical you get $150 credit, Flu shot is $25 credit, a health risk assesment is $50 credit, If I go to the gym twice a week I get a $20/mo credit, ..bascially if you do all these (and a few others) you can get up to $400 a year to apply towards your deductibles, prescription copays, etc... Pretty darn cool huh! :)
Hasn't that been happening for years already?

Freaking commie pinko Michelle Obama food nazi NSA/FDA spies in my refrigerator shit that is right there buddy.  Revolution! Freedom! justsayno to such German-smelling socialism. Eek god, it almost smells French even, like smelly god-damn socialist french cheese, that is.   Or worse, Scandinavian - those dirty sexual people. Dont like em.  Socialist fags the lot of em.  Freedom.
Title: Re: Obamacare.
Post by: bocker3 on November 06, 2013, 05:57:58 pm
Hasn't that been happening for years already?

Freaking commie pinko Michelle Obama food nazi NSA/FDA spies in my refrigerator shit that is right there buddy.  Revolution! Freedom! justsayno to such German-smelling socialism. Eek god, it almost smells French even, like smelly god-damn socialist french cheese, that is.   Or worse, Scandinavian - those dirty sexual people. Dont like em.  Socialist fags the lot of em.  Freedom.

WTF is this rant about???  I'm trying to connect this to the quoted post, but this makes absolutely no sense at all.   ::)
Title: Re: Obamacare.
Post by: bocker3 on November 06, 2013, 06:00:48 pm
Obamacare is the law, has been approved by the Supreme Court, and another vote of support in the election of the Obama to his secord term. 

Buck up and try it the fuck out, for crissakes...  Complain, explain, find solutions for the kinks, and black holes, but try to make it work.  Have to. At least for a few years. Because it is what it is.

While I don't disagree with your larger point -- I find it amusing that all this cheerleading and lecturing about how we should "buck up" comes from a man who lives in Switzerland and isn't impacted by it. 
Wait, maybe "amusing" is the wrong word..........................
Title: Re: Obamacare.
Post by: tednlou2 on November 07, 2013, 01:36:58 am

No Trollina, what's sad behavior is you texting me to say "Mecch just called you out in Obamacare thread..." while I was deep in my Walmart shopping....

Ok, tell us what she's said about the rest of us.   :o

With many websites, they would do beta testing.  Of course, that didn't happen with this website.  With this being the president's signature achievement, I would have thought he and others would have made sure the website and enrolling program was ready to go.  People have forgotten the shutdown and dems are seeing the damage in the polls.  I heard tonight that developers did a stress test a day before it went live and found that the site would only support ~11,000 users at one time.  Well, the media is taking up all those slots.  I am confused why the administration didn't do more education.  I just read there are plans that cover dental.  I had never heard that before. 

What is clear is that there is so much misinformation about how much people will actually have to pay.  I just read some can get help lowering their deductibles.  That is something I hadn't heard before either.  I was seeing these deductibles of $2,000 or more, before coverage would start.  That is a lot of money.  Is that out of the norm for most plans-- employer or private?  It is good if you have a very expensive illness, but not much good for going to the doc and getting a fairly inexpensive prescription or two filled each month.  It would seem the plans are basically good for a major illness or hospitalization, no?  And, that is where the big trouble comes from, from bankruptcies to tax payers picking up the tabs of non-insured going to the hospital.  I think ACA was really designed for catastrophic medical issues, which was needed. 

Found this: 

"If your income falls between 100 and 250% of the federal poverty level ($11,490 to $28,725 for an individual), you may be eligible for a Cost-Sharing Reduction subsidy, which can help lower your deductibles, copayments and coinsurance. In order to receive Cost-Sharing Reductions, you must purchase a Silver plan on the Marketplace. You will still have a variety of plans from which to choose, but it must be Silver to be able to take advantage of the Cost-Sharing Reduction subsidy."

http://www.forbes.com/sites/investopedia/2013/10/01/how-to-choose-between-bronze-silver-gold-and-platinum-health-insurance-plans/



Title: Re: Obamacare.
Post by: leatherman on November 07, 2013, 01:52:39 am
Of course, that didn't happen with this website.  With this being the president's signature achievement
except the website is NOT the signature achievement.

it's just a piece of the puzzle. medicaid expansion is running in many states, the medical loss ratio is in effect and people are receiving refunds, children are covered till 26, no pre-existing condition limitations.

so one problematic website does not negate his signature achievement in the least. the signature achievement is the whole ACA Law that was passed and approved by the SCOTUS
I think ACA was really designed for catastrophic medical issues, which was needed. 
nope. the ACA was designed with the 10 essential health care benefits (which is why some junk plans are being canceled) with a heavy emphasis on preventative services in both insurance policies and in medicaid expansion.

I am confused why the administration didn't do more education.
because that part of the plan (and the budget for it) was gutted by the Republicans in the compromise that finally allowed the law to get passed in both Houses.
Title: Re: Obamacare.
Post by: tednlou2 on November 07, 2013, 03:24:26 am
I realize the website is not the signature achievement, but you need people able to sign up.  And, we need young, healthy people, who will most likely use the Internet.  I should make it clear that I do think all this craziness about the website is overblown.  Having said that, I am surprised the president (or staff) weren't aware of these issues. 

I should also make it clear that I realize ACA is much more than these plans.  The law has been a godsend to those with preexisting conditions, to those canceled, to those with caps, and the list goes on.  I was specifically talking about these plans.  I see these deductibles of $2,000 or more.  Unless you can qualify for assistance to lower that, then many will not pay out that much to have their insurance kick in, as I understand it.  When I said it was mainly for those with major illnesses or hospitalizations, I meant the plans seem more geared for those who do spend more than $2,000 to $5,000 out of pocket, to extremely large medical bills--except people will be able to get preventative health screenings.  For the average younger person, they will not spend that much out of pocket.  But, they will have coverage in the event of some accident or illness and they won't have huge debt and won't be a burden on ER's and hospitals. 

If I'm incorrect about how these plans work with the deductibles, please advise.  The administration does need to start an education campaign.  There is so much misinformation out there, that even fairly educated people I know do not understand how these plans will work.  They think their employers are all going to drop them and throw them into the exchanges to thinking Medicare is being gutted to pay for this.  I realize this is all new and a huge change will take time.  I think a big mistake was both the president and Dems trying to never discuss the law, after it was passed.  They had this big achievement, but treated it like a huge family secret.  They did a good job explaining the preexisting condition part, no lifetime caps part, expanding Medicaid part, and staying on your parents insurance until 26, but haven't done a good job explaining how the plans work. 
Title: Re: Obamacare.
Post by: mitch777 on November 07, 2013, 02:42:06 pm
One thing to remember is that only about 14% of Americans will even need to buy insurance from the exchanges. Many of those (like me) were paying an enormous cost prior to Obamacare. The plans offered here in Connecticut would ALL save me money, even without the subsidy and even if I hit the max out of pocket each year. (assuming that I stay in network)

The young and healthy can choose a plan that suits them best. It still will be most likely far cheaper than they could get buying an individual plan outside of the exchanges, deductibles and all.
Title: Re: Obamacare.
Post by: mitch777 on November 15, 2013, 04:42:40 pm
Signed up! :)

After spending over 2 hours with a State of Connecticut broker I found plans for Kenny and me.

My plan is an Anthem Gold HMO. (no platinum plans offered here)
ALL of my doctors are participating in this plan.
Premium after tax credit is $225.00/month.
Deductible is $1500.
Max out of pocket is $3000.

Kenny went with a silver plan and with his tax credit it will cost $266.00/month.

Let's compare 2013 vs 2014:

2013

Total premium costs annually for both of us:  $24,000.
Out of pocket costs annually for both of us:  $4,000.
------------------------------------------------------------------
TOTAL:  $28,000 frigging dollars!

2014

Total premium costs annually for both of us:  $6900.
Out of pocket costs annually for both of us:  $4000.
(estimated- $3000. max for me because of the plan and $1000. for Kenny)
-------------------------------------------------------------------------------------
TOTAL:  $10,900.

Drum roll please....

Total savings:  A whopping $17,100. !!!

Now, there are some factors that I'm still not sure how they will affect the bottom line.
 
I'm not sure how ADAP plays into this for starters.

My bigger concern is that when I get my disability back-pay check (thinking optimistically here) and also get my monthly checks, will those amounts be considered as income in their entirety? If so, I would no longer be eligible for the tax credit and I would have to add another $5000. to my premium cost annually.

Anyway, even the worst case scenario is MUCH better than what we currently had no choice but to accept.

I think many of you won't have the same figures to compare as we were paying through the nose to begin with but I wanted everyone to know how brutal the current system was for a self-employed small business guy.

edited to add: It's no wonder why small businesses struggle to survive.

I love Obamacare!

m

ps- I hope I understood the whole thing and no horrible unexpected surprises are coming our way. ::) :)
Title: Re: Obamacare.
Post by: Jeff G on November 15, 2013, 04:47:14 pm
AMG is on Mitch this year guys !
Title: Re: Obamacare.
Post by: noregrets on November 15, 2013, 05:01:22 pm
Here in VA I have 8 planes to choose from, 4 gold & 4 silver (no platinum & I'm not interested in the bronze).  All of the plans are reasonable priced & everything looks great until I dug deeper to see about prescription costs.  They only publish the first 3 "tiers" on the site (which  are anywhere from $5 - $20% depending on the tier).  Once I called (& had to speak to MANY different people before I could get a straight forward answer), Atripla is either a tier 4 or 5, meaning Id have to pay as much as 30% depending on the plan.  I have the co-pay assistance card, which helps tremendously, but I'd used to getting my Atripla for free (I have Cobra now & was hoping to let that go after the first of the year for a better plan).  Now I'm going to have to probably end up paying at least $100-$200 per month on top of approx $350/month for my plan. 

It's much better than not having insurance, but here in VA the options aren't as great as in other places.
Title: Re: Obamacare.
Post by: mitch777 on November 15, 2013, 05:08:29 pm
 

It's much better than not having insurance, but here in VA the options aren't as great as in other places.

That's what gets my blood boiling. I'm not sure if the politicians are to blame or the insurance companies for this kind of inequity.

In any case, I still would rather see a single-payer system.
Title: Re: Obamacare.
Post by: noregrets on November 15, 2013, 05:18:35 pm
You & me both.  A few months ago I applied for insurance through Aetna (just to see what my options were) & they refused me coverage.  After taking HOURS to go through the application I clicked "submit" & I got a big 'ole "eff you" in my email about 15 mintes later.

Again, it's expensive & I can "barely afford it but I'm just thankful to at least have access...which is something the insurance companies would flat out deny if they could get away with it.
Title: Re: Obamacare.
Post by: mitch777 on November 15, 2013, 05:35:54 pm
Wishing you and everyone else the best.

The system still sucks, even with Obamacare, but for most it's a step in the right direction.

I hope many here find it an improvement over what was offered to us in the past and look forward to hearing from others once they sign up or not.

All of the news coverage means diddly until one looks at the math and decides if it works out or doesn't. I would encourage everyone to speak to a knowledgeable broker and be prepared with a list of questions and concerns as well as clueing them in on your own healthcare expenses and needs.
Title: Re: Obamacare.
Post by: mitch777 on November 15, 2013, 08:34:59 pm
AMG is on Mitch this year guys !

No problem at all!  :)  AMG 2014 in our back yard at Camp Mitchypoo. A tent will be provided. When I say a tent, I mean ONE. It might be a bit crowded but AMG is all about getting in touch.  Shower privileges will be provided, our sprinkler works great! :) Bathroom? A Dunkin' Donuts is a mere 5 blocks away across the bridge. Entertainment will be provided by Keniesha. (generous tips suggested)

Looking forward to all of your smiling faces. 
Hope you enjoy your stay. :)


 
Title: Re: Obamacare.
Post by: WillyWump on November 15, 2013, 09:22:22 pm
Signed up! :)





ps- I hope I understood the whole thing and no horrible unexpected surprises are coming our way. ::) :)

Mitch thats great!!

Are your docs and Hospitals "In Network" or OON?

That's the prob Im having. And at least half the plans Ive seen have OON as "not covered" at all instead of a higher percentage.  :(

The insurance company never called me back about ^this. My doc called me back and get this... They are still finalizing the plans they will accept! How can they still be doing that?

So given all this I've basically given up for now. Especially since Obama stepped up and took ownership of his lie, and said he would allow us to keep our policy if we are cancelled. (Im not cancelled but at least I can sleep a bit easier now if they DO cancel me ;))

I know it will all work out somehow, someway at some point.

-W
Title: Re: Obamacare.
Post by: wolfter on November 15, 2013, 10:01:23 pm

My bigger concern is that when I get my disability back-pay check (thinking optimistically here) and also get my monthly checks, will those amounts be considered as income in their entirety? If so, I would no longer be eligible for the tax credit and I would have to add another $5000. to my premium cost annually.


Since you've been waiting for more than the 2 year required wait, you should immediately receive medicare once you're approved for SSD.  Unless I'm not thinking correctly this late evening.
Title: Re: Obamacare.
Post by: bmancanfly on November 16, 2013, 10:38:49 am
Mitch I'm glad you got such a good deal - excellent!

I get my insurance through my partners employer and they are in the process of downsizing so I've been shopping around myself -just in case.  I've been really surprised at what good coverage is available at reasonable prices.  And I'm in my 50's.  I'll be able to maintain the same level of coverage I have now through my partners employer group plan (a Fortune 500 company). 

I am a licensed insurance agent,  although I am no longer active in that line of work.
When shopping around for insurance it has been shocking how uninformed some of the people are that I get on the phone.  I mean really shocking.

A couple of things I would point out. 

Never completely trust the info that you get from these people on the phone.

A lot of them are claiming that the policy terms are dictated by the ACA when in fact they are just the marketing decisions that that insurance company made on how they want to structure their policies.  If you go to another carrier their policies may be completely different.   The insurance company you're talking to isn't going to tell you that.    Shop around!!

Sometimes insurance companies have a percentage copay on drugs (say 30%) but also have a max out of pocket dollar amount that the insured has to pay per 'script.   I have been amazed at how often the agents that I've talked to on the phone don't point out that distinction - or are unaware of it.  This varies by state and by company.  Your mileage may vary.

Finally,  I'm getting a little tired of this Obama lied bullshit.  I worked in the insurance industry for may years.  These companies are laughing til they piss themselves right now.  They got to cancel all these policies that they most likely wanted to cancel anyway (the individual market had about a 50% annual cancellation/nonrenewal rate before the ACA) and now they can blame it on the ACA.  What a scam.   

Why isn't anyone in the news media asking why these companies were selling policies (post 2010) and not informing their customers that they were non-compliant policies that wouldn't be renewable?





Title: Re: Obamacare.
Post by: SouthSam7 on November 16, 2013, 11:14:22 am
And remember for the overwhelming majority of us, we could not get insurance AT ANY PRICE. I am flabbergasted that the insurance industry was allowed to pick and choose who to cover for all this time.
Title: Re: Obamacare.
Post by: mitch777 on November 16, 2013, 11:38:35 am
Will,

Thanks. Yes my docs and hospital are all in network. Sorry to hear that the plans in Texas have such a limited network. And your doc just deciding now?  ::) Hope you find a plan eventually that at covers your needs and is less expensive than your current one. I still think it might be possible but maybe not. Hope to hear more when you finally are able to get the answers you need.

Greg,

I have heard of both starting dates (date of application/ date of determination) used as far as when one would become eligible for Medicare. I hope you are right! I need to dig into this further. Maybe JR would know? It will make a huge difference.

Bman,

Thanks. Looks like you have good options. Glad to hear it!
Your advice is great and yes, it seems like some of these agents don't even know what they are selling. ::)
I too am getting tired of the BS. There will be some people who pay more but only a tiny fraction of those who will be paying less and many will be getting a better policy to boot. Many of the old plans were "junk". A minimum standard was needed.
Repeating myself yet again, a single payer system would prevent the med coverage issue and the in/out of network issue. Our current system is unsustainable and much more inequitable. I think it's just a matter of time.

Sam,
Bold inequity + $$$$$ = fatcats.
Title: Re: Obamacare.
Post by: Jeff G on November 17, 2013, 10:36:57 am
Could this be true ? http://www.examiner.com/article/right-wing-cyber-attacks-on-healthcare-gov-website-confirmed?cid=db_articles
Title: Re: Obamacare.
Post by: buginme2 on November 18, 2013, 08:57:17 pm
How we got Obamacare to work

http://www.washingtonpost.com/opinions/how-we-got-obamacare-to-work/2013/11/17/3f2532bc-4e42-11e3-be6b-d3d28122e6d4_story.html
Title: Re: Obamacare.
Post by: bmancanfly on November 21, 2013, 09:54:01 pm
This is an interesting study.  It kind of contradicts all the media hysteria about all those people being killed I mean canceled by Obamacare. 

Turns out it's really only about six tenths of one percent of the population.

"The group of people who would retain individual market coverage and not be income-eligible for financial help to purchase new plans turns out to be quite small, making up just 0.6 percent of all non-elderly U.S. residents "

http://www.familiesusa.org/ACA-individual-market/

Title: Re: Obamacare.
Post by: bocker3 on November 22, 2013, 08:05:30 am
This is an interesting study.  It kind of contradicts all the media hysteria about all those people being killed I mean canceled by Obamacare. 

Turns out it's really only about six tenths of one percent of the population.

"The group of people who would retain individual market coverage and not be income-eligible for financial help to purchase new plans turns out to be quite small, making up just 0.6 percent of all non-elderly U.S. residents "

http://www.familiesusa.org/ACA-individual-market/

Interesting point, but it IS a big deal to the hundreds of thousands (or millions) of folks that make up that 06%.
Look at it this way -- there is always lamenting on here (and justly so) around folks on ADAP waiting lists -- what is the percentage of the US population there??

My point -- it is just as easy to try and minimize an impact with statistics as it is to overblow it.  Using words like "it affects JUST xxxxx" or "ONLY xxxx" doesn't take into account the actual individuals.

in this instance Obama really screwed up, IMO.  He clearly stated you could keep your current insurance "period" and you can't.  Just wait until the media starts on his promise that, "you will be able to keep your current doctor"..............................

Mike
Title: Re: Obamacare.
Post by: bmancanfly on November 22, 2013, 10:10:41 am
The ADAP comparison falls flat.  People on ADAP waiting lists have no access to coverage at all

The .6% are not going to be disenfranchised from coverage,  they are just going to have to pay more for it.  They will all get better coverage,  in a better functioning market,  but at a higher price.  Previously, they were benefiting from the exclusion, from the market,  of people with pre-existing conditions.  A situation which,  at any time,  they could find themselves in too.   If you eliminate all the sick people from the insurance pool,  of course premiums will be lower. 

I'm not saying,  nor are the authors of this study saying,  nor have I heard anyone else say,  that the changes for these people are not important - especially to them.  But this group has received wall to wall coverage,  especially in right wing media,  aided and abetted by the lazy "main-stream" media to the exclusion of all the positives taking place.  A little proportionality would be nice.

The functioning of the insurance market has been made dramatically better for everyone.   99.4% of all the people in this country will pay the same or less.  No one with a pre-existing condition can ever be denied coverage again.  No annual caps,  no lifetime caps,  etc.  etc.

Talk about broken promises all you want.  This seems like an excellent outcome to me.

P.S.  Medicare for all !!
Title: Re: Obamacare.
Post by: bmancanfly on November 22, 2013, 10:19:51 am
Another little tidbit excerpted from the study linked above;

"under the ACA, at least 80 percent of premiums must now pay for health care. If a plan falls short of that standard, it must refund the difference to consumers. This requirement, which began in 2011, has already reduced premiums by an average of 7.5 percent for consumers in the individual market."

^^^^^that's all consumers.
Title: Re: Obamacare.
Post by: leatherman on November 22, 2013, 10:29:02 am
Another little tidbit excerpted from the study linked above;
it's called "medical loss ratio" ;)

some people have already been receiving refund checks from their insurance companies because of this provision.

for anyone receiving notices of insurance premium increases, just remember since the ACA already requires your insurance to maintain the medical loss ratio, your insurance is rising because of your greedy insurance company not "Obamacare". To those people, I recommend checking the marketplace for a new insurer. The free market has been and will continue to weed out some of these greedier insurance companies.
Title: Re: Obamacare.
Post by: bocker3 on November 22, 2013, 05:29:37 pm
The ADAP comparison falls flat.  People on ADAP waiting lists have no access to coverage at all

The .6% are not going to be disenfranchised from coverage,  they are just going to have to pay more for it.  They will all get better coverage,  in a better functioning market,  but at a higher price.  Previously, they were benefiting from the exclusion, from the market,  of people with pre-existing conditions.  A situation which,  at any time,  they could find themselves in too.   If you eliminate all the sick people from the insurance pool,  of course premiums will be lower. 

I'm not saying,  nor are the authors of this study saying,  nor have I heard anyone else say,  that the changes for these people are not important - especially to them.  But this group has received wall to wall coverage,  especially in right wing media,  aided and abetted by the lazy "main-stream" media to the exclusion of all the positives taking place.  A little proportionality would be nice.

The functioning of the insurance market has been made dramatically better for everyone.   99.4% of all the people in this country will pay the same or less.  No one with a pre-existing condition can ever be denied coverage again.  No annual caps,  no lifetime caps,  etc.  etc.

Talk about broken promises all you want.  This seems like an excellent outcome to me.

P.S.  Medicare for all !!

You missed my point entirely! 

I wasn't disputing that the media has blown this bigger than it really is, but you are doing just the opposite -- minimizing the impact to hundreds of thousands (or millions) that it does impact.  Hyperbole goes both ways.
I used the ADAP example to point out that the impact to something is very large to the individuals affected. even if it is miniscule to the overall population.  You, unfortunately, tried to tie this to coverage -- I wasn't talking about coverage or insurance, per se -- I was talking about overblowing and underplaying impact in anything.

Mike
Title: Re: Obamacare.
Post by: bmancanfly on November 22, 2013, 06:03:04 pm
I didn't miss your point,  I just disagree with it.

The comparison between ADAP wait lists and some people getting better coverage but having to pay more for it is not a valid comparison.

And you missed the point that all of those people who will be paying more will be buying into a greatly improved market situation - even for them.   They are getting something for those additional dollars.  That's virtually never reported or discussed.  There is a value add for the extra cost.  They're not being punished.





Title: Re: Obamacare.
Post by: mitch777 on November 22, 2013, 06:32:01 pm
They're not being punished.

Exactly. A major change in our standard of healthcare may cost some a bit more.... with better benefits. It comes with the territory in a similar fashion that any changes in the tax code has it's implications.

If I were better off financially and had to pay more for health insurance for the good of our society as a whole I would be happy to do so.

We need to have a more fair and equitable system and the ACA is heading in that direction regardless if .06% are forced to pay a bit more.

Are there problems that still need tweeking? Yup, but this "concern" about the .06% paying more has been hyped beyond belief. The GOP is grasping for anything they can do to prevent moving forward in a positive way. Sad.
Title: Re: Obamacare.
Post by: WillyWump on November 22, 2013, 06:36:59 pm
Kinda what has been chapping my behind the last few weeks, is how Obama and his minions say that these plans are "junk" and most people don't realize how bad they are and that when you get sick they drop you and don't cover you. Greedy insurance companies and all.

Although for the most part they are backing off that mantra, at least a bit now.

Yes I realize there are some bad policies out there, but one size does not fit all. No one hears about the great policies.

But someone telling me that my private policy is junk and I don't realize how bad it is rather offensive to me. I've had my policy since before I was HIV+, My policy has kept me in HIV meds, and alive for 5 years. I was in the ICU for 5 days at one point.. and guess what, they covered it. Yes, Ive taken alot of premium increases over the years, and it is very expensive, but they've never dropped me, and Im alive. We have a mutually beneficial relationship, I send them money each month, they give me the ability to receive medical attention. I would be HIGHLY upset if they dropped me, I realize the letter could come any day and quite frankly have lost sleep over it a couple nights.

and yes, I am trying to look for policies in the exchange, but it's not as easy as you would think, and with things changing daily I'm kinda sitting on the sidelines for now.

I found myself Jealous of Mitchypoo and his success :P

Title: Re: Obamacare.
Post by: mitch777 on November 22, 2013, 07:07:09 pm
Well, you unfortunately might not have as much success as I did for a variety of reasons. That's why it needs tweeking.

The fact that insurance companies can still decide who is in network seems to be your major issue and understandably so. Tweek needed. There are so many awful reasons why this may never happen. The biggest one is that insurance companies need to be profitable, hence the need for Medicare for all.

I'm still willing to bet that you will make out ok. Not ideal, but ok.

Maybe your current policy complies with the ACA. Why don't you just call your insurance company instead of losing sleep? At least you will have an answer if your policy is subject to cancelation.

I'm pulling for you Will. :)
Title: Re: Obamacare.
Post by: WillyWump on November 22, 2013, 07:38:41 pm

Maybe your current policy complies with the ACA. Why don't you just call your insurance company instead of losing sleep? At least you will have an answer if your policy is subject to cancelation.

I'm pulling for you Will. :)

Thanks Mitch.

Mine  is substandard because I don't have Maternity coverage. I wonder If I could just add that for a small fee? I'm grandfathered since I had it prior to the ACA law, but I am still nervous of the dreaded "letter"  :P

I'm actually afraid to call them for fear it will rock the boat. LOL

Title: Re: Obamacare.
Post by: Jeff G on November 22, 2013, 07:42:01 pm
I guess the people that are forced to make an inconvenient but rarely a more costly switch in insurance will have to make up their own mind if that sacrifice is worth making to insure that many will have access to insurance and decent healthcare for the first time in the history of this country . That's not the way it was sold to us but what its coming down to .   
Title: Re: Obamacare.
Post by: WillyWump on November 22, 2013, 07:51:26 pm
I guess the people that are forced to make an inconvenient but rarely a more costly switch in insurance will have to make up their own mind if that sacrifice is worth making to insure that many will have access to insurance and decent healthcare for the first time in the history of this country . That's not the way it was sold to us but what its coming down to .   

I suppose I am an ass for complaining.
Title: Re: Obamacare.
Post by: Jeff G on November 22, 2013, 07:55:03 pm
I suppose I am an ass for complaining.


Wow , that was easy LOL . 
Title: Re: Obamacare.
Post by: mitch777 on November 22, 2013, 08:02:13 pm


I'm actually afraid to call them for fear it will rock the boat. LOL

You laugh (in jest) but fear is a huge problem with our existing system when it comes to insurance companies. It shouldn't be this way.
Title: Re: Obamacare.
Post by: WillyWump on November 22, 2013, 08:11:27 pm
You laugh (in jest) but fear is a huge problem with our existing system when it comes to insurance companies. It shouldn't be this way.

I was never afraid to call them before Oct 1st.
Title: Re: Obamacare.
Post by: bocker3 on November 23, 2013, 12:10:12 am
I didn't miss your point,  I just disagree with it.

The comparison between ADAP wait lists and some people getting better coverage but having to pay more for it is not a valid comparison.

And you missed the point that all of those people who will be paying more will be buying into a greatly improved market situation - even for them.   They are getting something for those additional dollars.  That's virtually never reported or discussed.  There is a value add for the extra cost.  They're not being punished.

No dear,  you missed my point.  My point is not really about Obamacare, it is about reading whatever your preconceived idea is into stats.  You are not reading my posts to understand, you are simply reading to reply how I am wrong and you are right.
You see, I agree (for the most part) with your Obmacare point, but not with your take on the stats.

I know probably beyond your comprehension, but I tried.  Or perhaps you simply being obtuse
Title: Re: Obamacare.
Post by: Jeff G on November 23, 2013, 06:39:39 am
No dear,  you missed my point.  My point is not really about Obamacare, it is about reading whatever your preconceived idea is into stats.  You are not reading my posts to understand, you are simply reading to reply how I am wrong and you are right.
You see, I agree (for the most part) with your Obmacare point, but not with your take on the stats.

I know probably beyond your comprehension, but I tried.  Or perhaps you simply being obtuse

That's a little harsh don't you think we should be able to talk about these things without using insulting language or condescending to one another . 
Title: Re: Obamacare.
Post by: bocker3 on November 23, 2013, 11:16:10 am
That's a little harsh don't you think we should be able to talk about these things without using insulting language or condescending to one another .

You are right -- I had a bad day at work yesterday (I will never get used to the prospect of firing someone).

My apologies for going a little over the edge.

M
Title: Re: Obamacare.
Post by: Jeff G on November 23, 2013, 11:25:21 am
You are right -- I had a bad day at work yesterday (I will never get used to the prospect of firing someone).

My apologies for going a little over the edge.

M

Thanks for understanding my point of view . We all have bad days and I hope today is a better one for you .
Title: Re: Obamacare.
Post by: aaware72 on November 23, 2013, 11:38:42 am
Kinda what has been chapping my behind the last few weeks, is how Obama and his minions say that these plans are "junk" and most people don't realize how bad they are and that when you get sick they drop you and don't cover you. Greedy insurance companies and all.

Although for the most part they are backing off that mantra, at least a bit now.

Yes I realize there are some bad policies out there, but one size does not fit all. No one hears about the great policies.

But someone telling me that my private policy is junk and I don't realize how bad it is rather offensive to me. I've had my policy since before I was HIV+, My policy has kept me in HIV meds, and alive for 5 years. I was in the ICU for 5 days at one point.. and guess what, they covered it. Yes, Ive taken alot of premium increases over the years, and it is very expensive, but they've never dropped me, and Im alive. We have a mutually beneficial relationship, I send them money each month, they give me the ability to receive medical attention. I would be HIGHLY upset if they dropped me, I realize the letter could come any day and quite frankly have lost sleep over it a couple nights.

and yes, I am trying to look for policies in the exchange, but it's not as easy as you would think, and with things changing daily I'm kinda sitting on the sidelines for now.

I found myself Jealous of Mitchypoo and his success :P

Well the "Junk Policy" are the one that do not include the new required min coverage.  So all policies that do not include Maternity or Pediatric coverage are being canceled as they are considered "Junk Policies"   So now there be a part of the population that will be required to carry this coverage and may never use it.

 
Title: Re: Obamacare.
Post by: Jeff G on November 23, 2013, 11:50:49 am
Well the "Junk Policy" are the one that do not include the new required min coverage.  So all policies that do not include Maternity or Pediatric coverage are being canceled as they are considered "Junk Policies"   So now there be a part of the population that will be required to carry this coverage and may never use it.

 

They are not junk , they just don't meet the minimum requirements set forth in the new law . 
Title: Re: Obamacare.
Post by: WillyWump on November 23, 2013, 11:57:20 am
Another reason to wait..

The government kicks you off your good policy tells you to go to website for better policy, then if you can get on at all  your personal info may not be safe.  (http://www.cnbc.com/id/101210663)

 ::)
Title: Re: Obamacare.
Post by: aaware72 on November 23, 2013, 12:12:29 pm
I currently have a PCIP plan that will expire at the end of the year.  This plan was paid for by Ryan White/ADAP on my behalf. 

I will going onto a plan through Assurant Health.  Which is a policy outside the exchange here in NH. 

In NH I can only buy a policy through Anthem BC/BS and my current doctor is outside the network and they do not cover my medication(Stirbild)

It's Bronze plan with 3,500$ over all deductible, 500$ Brand RX Drugs, and 50% copay on all services. 

The Ryan White/ADAP will cover my cost of the premium and all co-payments to services related to HIV.  So basically it's a good deal for ADAP as they only pay for a 500$ on my medication for the year, however any normal heath care items I will be forced to pay for 50 percent out of pocket.  They do cover all preventive care/screening/immunization at 100%   

Title: Re: Obamacare.
Post by: mitch777 on November 23, 2013, 02:45:44 pm
Well the "Junk Policy" are the one that do not include the new required min coverage.  So all policies that do not include Maternity or Pediatric coverage are being canceled as they are considered "Junk Policies"   So now there be a part of the population that will be required to carry this coverage and may never use it.

Paying for something and not getting anything from it happens in many areas not just with health insurance. Most of my property taxes go toward the school system. I have no children. It's all about helping our society as a whole. We HIV+ folks get MUCH more out of the system than we put in. 

I'm just grateful that the ACA plans don't charge the ridiculous premiums that I was stuck with for my entire life. It's a shame that some states don't have much competition and/or that the networks are so limited. It still needs work (or replacement with a single payer system).
Title: Re: Obamacare.
Post by: bmancanfly on November 24, 2013, 09:51:16 am
I typed something then changed my mind.

Willy,
From memory,  didn't you say that you earn too much to qualify for a subsidy on the exchange?

If so then why are you going through the exchange at all?  If you are not getting Medicaid or a subsidy then you shouldn't even need to use the exchange at all.

I may have your situation confused with someone else. 
Title: Re: Obamacare.
Post by: WillyWump on November 24, 2013, 05:53:43 pm
I typed something then changed my mind.

Willy,
From memory,  didn't you say that you earn too much to qualify for a subsidy on the exchange?

If so then why are you going through the exchange at all?  If you are not getting Medicaid or a subsidy then you shouldn't even need to use the exchange at all.

I may have your situation confused with someone else.

No subsidies for me.

I was looking to see If I could save any money, I am basically in the same situation as Mitch (he went from private policy to cheaper policy on exchange).

Currently I am "grandfathered in" on the private policy even though Obama considers it substandard. I'm also not kidding myself, I know that at some point my private policy will cease to exist and I will be forced on exchange.

-W
Title: Re: Obamacare.
Post by: bmancanfly on November 24, 2013, 10:11:55 pm
In your situation you don't need to use the exchange at all - unless you want to.  You certainly won't be forced too.

Currently, people who get Medicaid or a subsidy need to use the exchange,  but their options will be expanding soon too.

It seems to be a widely held belief that all people must use the exchange when in fact that is not the case.

Shopping on the exchange does make things easier.  Once you have found a policy you like you can choose to contact the insurance company directly.   If you have trouble setting up an account or have concerns about security,  or you're afraid that the gov't may implant a chip in your brain,    ;) don't use the website at all.
Title: Re: Obamacare.
Post by: Hellraiser on November 25, 2013, 02:19:47 am
No subsidies for me.

I was looking to see If I could save any money, I am basically in the same situation as Mitch (he went from private policy to cheaper policy on exchange).

Currently I am "grandfathered in" on the private policy even though Obama considers it substandard. I'm also not kidding myself, I know that at some point my private policy will cease to exist and I will be forced on exchange.

-W

Aren't you old enough to qualify for Medicare?
Title: Re: Obamacare.
Post by: Miss Philicia on November 25, 2013, 07:22:11 am
Aren't you old enough to qualify for Medicare?

Don't mock Medicare -- I swear it works better than both Obamacare AND private insurance.

ps: I have been oddly uninvolved in this political discussion.

::noted::
Title: Re: Obamacare.
Post by: Jeff G on November 25, 2013, 07:30:47 am
I have received the best of healthcare from medicare and I agree with Miss P . Its medicaid that makes me able to make ends meet though . Without the extra help I would rack up unsustainable proscription drug copay's and medical bills . 
Title: Re: Obamacare.
Post by: Miss Philicia on November 25, 2013, 07:38:31 am
I have received the best of healthcare from medicare and I agree with Miss P . Its medicaid that makes me able to make ends meet though . Without the extra help I would rack up unsustainable proscription drug copay's and medical bills . 

Yes, that too -- I have this program here called M.A.W.D. (Medical Assistance Benefits for Workers with Disabilities) which basically allows me to pay a monthly premium and have Medicaid as a secondary insurance so it picks up that pesky 20% of medical bills that Medicare doesn't pay. My premium is $98/month and my Medicare premium is $105 so I shell out $203/month for my health.

Medicare Part D pays for my prescriptions though, and I'm not even sure who pays for that premium but someone does -- I think it's the PA Dept. of Health. I have an annual deductible but I forget how much it is -- I end up paying some co-pays for the first two months of the year and then the rest of the year I pay nothing.
Title: Re: Obamacare.
Post by: Jeff G on November 25, 2013, 07:43:47 am
I damn near lost my extra help a few months back and I almost had a friggin heart attack . Without that help my house of cards would fall in short order . 
Title: Re: Obamacare.
Post by: mecch on November 25, 2013, 04:12:34 pm
It galls me the Republican pundits invited onto libtard shows like Bill Maher, and the extremely cynical, completely asinine GOP talking points they blather on about the wrongs of Affordable Care.  There are problems but the GOP offers no freaking alternative.
Thank god for independent thinkers like Dan Savage. I am not even a huge fan of his but at least he can make a counter jab at the GOP pundits and he isn't even for Affordable Care, being a purist, he supports single payer.
Its deplorable, the dumbass arguments, obstructionist tactics,  destroy destroy destroy cynicism of people who we KNOW can afford health care no matter the delivery system...  Jesus Christ and they go BLANK when confronted with the comparison charts of bang for the buck, American system versus other advanced industrialised democracies... Blank. Or obfuscation.  Because freedom.  Because American exceptionalism.   It is so freaking inhumane not to mention against all the tenants of every major religious morality I can think of.  Its fucking craven.

There, I had my screed.  Sorry.
Title: Re: Obamacare.
Post by: WillyWump on November 25, 2013, 08:49:22 pm
In your situation you don't need to use the exchange at all - unless you want to.  You certainly won't be forced too.


WAITWUT? You're telling me I can keep my policy?  ;)
Title: Re: Obamacare.
Post by: Jeff G on November 25, 2013, 08:57:08 pm
WAITWUT? You're telling me I can keep my policy?  ;)

You love you AARP policy don't you ?
Title: Re: Obamacare.
Post by: BT65 on November 26, 2013, 03:58:39 am
I have received the best of healthcare from medicare and I agree with Miss P . Its medicaid that makes me able to make ends meet though . Without the extra help I would rack up unsustainable proscription drug copay's and medical bills .

Agreed.  Like Miss P, I receive Medicaid for working disabled people, but in Indiana it's called MED Works.  I pay $107/month for it.  It pays the Medicare premiums, makes extra help possible, and picks up the 20% Medicare doesn't pay.  For my Medicare Part D plan, I pay $9/month, and the meds are all paid for.  So far.  So, I pay a total of $117/month for healthcare but the payoff is invaluable. 
Title: Re: Obamacare.
Post by: bmancanfly on November 26, 2013, 09:57:31 am
WAITWUT? You're telling me I can keep my policy?  ;)

I promise.   8)
Title: Re: Obamacare.
Post by: denb45 on November 26, 2013, 10:56:49 am
I have Medicare, but not Medicaid, nobody picks up my Medicare Premium of $110 a month, and get no extra-help, and cannot use Medicare Part D ( due to the donut-hole for HIV-MEDS  ::)

 Noboby picks up my non-HIV-Meds of $65 a month, however BCBS of New Mexico crave-out-program picks up my HIV-Meds and the 20% that Medicare doesn't pay, at my income-level ( I'm @ 155% of FPL)   :-[

this seem like I should at least qualify for more help, but unfortunately, I don't in New Mexico  :-\

also I cannot get ACA and don't qaulify for it  ???

however, I've applied for VA-benefits, and till waiting for the approval

I hope I get them, then as a category 5    I wouldn't have any co-pays for anything and all my meds would be free of charge  :D

so I'm keeping my fingers crossed that I do get some VA-benefits, they sure would help me out some  :-X

and would cover that $175 to $200 a month outta pocket expense, @ 155% of FPL  that's a lotta money  :-\

I could save for other things  ;)
Title: Re: Obamacare.
Post by: Jeff G on November 30, 2013, 11:31:04 am
This is an interesting chart . http://www.commonwealthfund.org/~/media/Files/Publications/In%20the%20Literature/2013/Nov/PDF_Schoen_2013_IHP_survey_chartpack_final.pd

Title: Re: Obamacare.
Post by: mitch777 on December 01, 2013, 10:23:35 am
This is an interesting chart . http://www.commonwealthfund.org/~/media/Files/Publications/In%20the%20Literature/2013/Nov/PDF_Schoen_2013_IHP_survey_chartpack_final.pd

Very interesting. Lots of myths busted. Sadly, learning from other countries doesn't seem to be our strong suit.
Title: Re: Obamacare.
Post by: buginme2 on December 01, 2013, 10:42:48 am
Last night was the deadline to get the Obamacare website fixed.  According to the LA Times they have "improved" the site now to were it is working 90% of the time!

http://www.latimes.com/nation/politics/politicsnow/la-healthcare-gov-obamacare-website-working-deadline-20131201,0,4426410.story#axzz2mEp3Gw6Y

I heard on the local news that our state enrolled 100,000 people so far.  I wish the media would talk about the successes more than just the failures.  I think that's a huge amount.
Title: Re: Obamacare.
Post by: mitch777 on December 02, 2013, 03:18:24 pm
Last night was the deadline to get the Obamacare website fixed.  According to the LA Times they have "improved" the site now to were it is working 90% of the time!

http://www.latimes.com/nation/politics/politicsnow/la-healthcare-gov-obamacare-website-working-deadline-20131201,0,4426410.story#axzz2mEp3Gw6Y

I heard on the local news that our state enrolled 100,000 people so far.  I wish the media would talk about the successes more than just the failures.  I think that's a huge amount.

I'm sure Faux News will track down and report on the last person in the country to have an issue with the site and demand repeal. They will also focus on the very small minority of those who end up paying more even after the website is fixed. It's their job after all. ::)

The good news stories will FAR outweigh the bad news stories as more people sign up. I think Obamacare is here to stay for years to come. Next: A single payer system. Too optimistic? 
Title: Re: Obamacare.
Post by: mecch on December 02, 2013, 07:07:17 pm
Time to roll out the story, nationally, broadly, that many of the state exchanges are doing great?
Title: Re: Obamacare.
Post by: mecch on December 02, 2013, 07:14:35 pm
Very interesting. Lots of myths busted. Sadly, learning from other countries doesn't seem to be our strong suit.
Er. Socialism! Marxism! Because, Freedom!
Hillary learned all these lessons first year of her hubby's Presidency. She was laughed if not ramrodded off the Hill.  If I remember, she presented a model modified on the Swiss system. Cause its still pretty capitalist.  Regulated free market, you might say.  All the companies are still private here. Everybody must buy.  Every company must offer a basic, pretty comprehensive policy.  Noone can be refused a basic policy.  Very poor get subsidies to pay their premiums.   It's holding, but who knows what the future will bring...   
Title: Re: Obamacare.
Post by: mitch777 on December 02, 2013, 07:20:39 pm
Er. Socialism! Marxism! Because, Freedom!
Hillary learned all these lessons first year of her hubby's Presidency. She was laughed if not ramrodded off the Hill.  If I remember, she presented a model modified on the Swiss system. Cause its still pretty capitalist.  Regulated free market, you might say.  All the companies are still private here. Everybody must buy.  Every company must offer a basic, pretty comprehensive policy.  Noone can be refused a basic policy.  Very poor get subsidies to pay their premiums.   It's holding, but who knows what the future will bring...
So, is what you are saying is that the Swiss healthcare model is potentially failing?
Title: Re: Obamacare.
Post by: mecch on December 02, 2013, 07:51:23 pm
I don't know enough about it to say its failing or not. Insurance companies do occasionally belly up here. But there are lots of companies so maybe its bad management.  My guess is the day the present system becomes unreliable, the Federal government will fund another solution. 
The luxury of rich, functioning  European states... I think we don't have the military sink hole. 
I was just reading about the Metro North derailment. Many people griping about the poor state of American public transport, not to mention roads and bridges, etc. Comparing to some European utopia.
Yet I have heard Germany also faces a big burden because of delayed infrastructure investment.  Yeah, its better here, but these sorts of things - the so-called socialist benefits of advanced and mostly capitalist economies - they take constant constant tweaking and constant reinvestment...
Reunification cost a shit load. Then during the new crisis, the Germans have preached austerity and thus, yeah, better infrastructure was in place but overall, there are major challenges going forward.
Now Britain, trying to sort out how to pay for its top flight university system...
The key to me is that a country makes its social welfare commitments and does what is necessary to stick to them... 
Bush Jr. toured Europe, before the American financial collapse, on a propaganda tour telling heads of states the only model was the American model, and the social welfare states were unsustainable.   Then he delivered his epic catastrophe of the pure capitalist formula. 

 
Title: Re: Obamacare.
Post by: mecch on December 02, 2013, 07:59:48 pm
My students are getting 45k a year educations for about 1k a year out of their pockets or subsidies. (many do get subsidies but not all.)  But we are all paying for that in taxes.  The US states shouldn't have let their state university systems become unaffordable, in my opinion. 
Etc etc etc.
What can you cut, to pay for the things you consider essential, or necessary. Who (and what, since IMO corporations are not people) can you tax, to get the revenues necessary.  Not easy, right?
Title: Re: Obamacare.
Post by: mitch777 on December 02, 2013, 08:18:55 pm
I don't know enough about it to say its failing or not. Insurance companies do occasionally belly up here. But there are lots of companies so maybe its bad management.  My guess is the day the present system becomes unreliable, the Federal government will fund another solution. 
The luxury of rich, functioning  European states... I think we don't have the military sink hole. 
I was just reading about the Metro North derailment. Many people griping about the poor state of American public transport, not to mention roads and bridges, etc. Comparing to some European utopia.
Yet I have heard Germany also faces a big burden because of delayed infrastructure investment.  Yeah, its better here, but these sorts of things - the so-called socialist benefits of advanced and mostly capitalist economies - they take constant constant tweaking and constant reinvestment...
Reunification cost a shit load. Then during the new crisis, the Germans have preached austerity and thus, yeah, better infrastructure was in place but overall, there are major challenges going forward.
Now Britain, trying to sort out how to pay for its top flight university system...
The key to me is that a country makes its social welfare commitments and does what is necessary to stick to them... 
Bush Jr. toured Europe, before the American financial collapse, on a propaganda tour telling heads of states the only model was the American model, and the social welfare states were unsustainable.   Then he delivered his epic catastrophe of the pure capitalist formula. 

 
And my simple question begets a long and wonderful answer. I understood all of that but thank you for connecting the dots.

Capitalism has it's benefits and faults. So does any social path forward.... or not.

The bottom line is that we "Americans" (sorry, we "United States of America" folks) are pathetic when it comes to learning from other countries as far as what truly works when it comes to healthcare.

The stats speak for themselves. (see above y'all)

Compassion seems to be lacking here as well as the pure numbers of fiscal responsibility.

They CAN go hand in hand. The Republican's amongst us just DO NOT get it or worse yet are more concerned with their own "careers" and making the corporations who are "people too" their priority over us lowly citizens.

.....just another long reply to the never ending saga of the death panels we are all facing according to the idiots in power today.

*breathe in, breathe out* lol. :)
Title: Re: Obamacare.
Post by: bocker3 on December 02, 2013, 09:03:57 pm
Compassion seems to be lacking here as well as the pure numbers of fiscal responsibility.

They CAN go hand in hand. The Republican's amongst us just DO NOT get it or worse yet are more concerned with their own "careers" and making the corporations who are "people too" their priority over us lowly citizens.

Well -- that trait does not belong to Republicans alone.  Everyone knows that SS and Medicare need reforming, but the Democrats don't want to talk about it for it will impact their "careers" -- the AARP will be after them.  The problem rests not really with the pols -- it rests with us (yes, gerrymandering makes it far more difficult for us to remove the bad ones, but......... it can and has happened)

As for healthcare -- I think Obamacare is an absolutely necessary, but not anyway ideal, first step to where we must get -- Single Payer system.  It will take baby steps, unfortunately.  From what I am reading (and seeing first hand) is that Obamacare is going to give large companies an avenue to slowly exit the health insurance game -- that is how, I hope, we navigate from here to there.  There will be winners and losers along the way and I suspect the "groups" will change in each category over time, but we can't do it in a single leap, so we'll all have to grin and bear it.  My hope is that empathy and compassion is shown from both sides of the political spectrum.  Without that - that us vs. them only intensifies as "impacts" happen.  Neither side is pure evil, neither side is pure altruism -- both have good and not so good ideas.

yes -- I continue to be the "fence sitting" moderate in the middle.   ;) :D

M
Title: Re: Obamacare.
Post by: mitch777 on December 02, 2013, 09:19:12 pm
Well -- that trait does not belong to Republicans alone.  Everyone knows that SS and Medicare need reforming, but the Democrats don't want to talk about it for it will impact their "careers" -- the AARP will be after them.  The problem rests not really with the pols -- it rests with us (yes, gerrymandering makes it far more difficult for us to remove the bad ones, but......... it can and has happened)

As for healthcare -- I think Obamacare is an absolutely necessary, but not anyway ideal, first step to where we must get -- Single Payer system.  It will take baby steps, unfortunately.  From what I am reading (and seeing first hand) is that Obamacare is going to give large companies an avenue to slowly exit the health insurance game -- that is how, I hope, we navigate from here to there.  There will be winners and losers along the way and I suspect the "groups" will change in each category over time, but we can't do it in a single leap, so we'll all have to grin and bear it.  My hope is that empathy and compassion is shown from both sides of the political spectrum.  Without that - that us vs. them only intensifies as "impacts" happen.  Neither side is pure evil, neither side is pure altruism -- both have good and not so good ideas.

yes -- I continue to be the "fence sitting" moderate in the middle.   ;) :D

M
Hmm... I really hate getting into these discussions with you Mike. Your "moderate in the middle" stance is not moderate or in the middle as much as you think it is. You yourself are saying that a single payer system is what is best. Which political party is working toward that goal? It is certainly NOT the Republican party in this day.

Give me a list of ANY Republican in office. Is it 1 or 10? give me a break!

Yes Dems get influenced by AARP. So what. better than the greed factory of the healthcare industry.

Empathy and compassion from the Republicans? LOL. LOL.
Show me.
Title: Re: Obamacare.
Post by: bocker3 on December 02, 2013, 10:16:39 pm
Hmm... I really hate getting into these discussions with you Mike. Your "moderate in the middle" stance is not moderate or in the middle as much as you think it is. You yourself are saying that a single payer system is what is best. Which political party is working toward that goal? It is certainly NOT the Republican party in this day.

Give me a list of ANY Republican in office. Is it 1 or 10? give me a break!

Yes Dems get influenced by AARP. So what. better than the greed factory of the healthcare industry.

Empathy and compassion from the Republicans? LOL. LOL.
Show me.

You see -- you read only what you wanted to read in my post -- just enough to refute.  Again, as I've said many times to many folks, this is why our political situation is what it is today.
When I referred to "empathy and compassion" from both sides -- I wasn't speaking only of politicians, I was speaking of all of us.  Also -- people can have stupid ideas and yet be compassionate. 
Additionally -- why is the AARP power "better" than the healthcare industry??  Do you really think the powers at the AARP care about their members more than they do their own position and LARGE SALARIES?

You take my pointing out the hypocrisy of the left to mean that I support the right, when I support NEITHER.  And my thought process in the political realm may be in the minority on this forum but it is where a large chunk of Americans fall.

As for "who is working for a single payer system" -- the answer is simple -- almost no one.  If the Dems really wanted it -- we would have had it when they controlled Congress with 60 Senators back in 2009.  Ah yes, lobbyists do tend to throw money at the party in power and money does talk to both parties.

What I find more unfortunate is that you and I are far closer to each other on many topics than I am to the far right, but you seem only to focus on how we are different.  Even when we agree you use it as a way to denigrate my position.  Yes -- I think a Single Payer System is what we need, but there is not enough support on either side for it to happen. 
The one place we consistently differ is that I don't view the Republicans, in general, as evil -- though I haven't voted for one since I left New England.  I respect your position, but I just can't always let one-sided posts go by without giving my thoughts.  BTW -  William Weld, Claudine Schneider -- two Repubs with empathy and compassion who have gotten my votes in the past.  Even Christie has his moments -- like when he put politics on the back burner after Sandy and actually talked and thanked Obama for helping the victims in his state.  Not that I am a big Christie fan -- but he has shown empathy and compassion and deserves to get credit for it.  Olympia Snowe, Susan Collins also come to mind, I'm sure with time I can come up with more.

Anyway -- I'm sorry you don't like our political discussions -- I always find them interesting, I mean if people with differing views don't even like to discuss them, we'll never get anywhere, because I'm not always right -- but I'm not always wrong either.

Hugs,
Mike
Title: Re: Obamacare.
Post by: mitch777 on December 03, 2013, 01:26:04 am
You see -- you read only what you wanted to read in my post -- just enough to refute.
Condescending and untrue.

You take my pointing out the hypocrisy of the left to mean that I support the right, when I support NEITHER.  And my thought process in the political realm may be in the minority on this forum but it is where a large chunk of Americans fall.
Nope. I just do not believe that the "large chunk" of Americans are right. If that includes you that is your choice.
 
As for "who is working for a single payer system" -- the answer is simple -- almost no one.  If the Dems really wanted it -- we would have had it when they controlled Congress with 60 Senators back in 2009.  Ah yes, lobbyists do tend to throw money at the party in power and money does talk to both parties.
Filibuster ready. (was it #82 recently?)
 
What I find more unfortunate is that you and I are far closer to each other on many topics than I am to the far right, but you seem only to focus on how we are different.  Even when we agree you use it as a way to denigrate my position. 
I agree we are far closer to each others positions but you have the notion that compromise and being "in the middle" is a solution. Should we "compromise' on gay rights? Women's rights? Human "rights" ? Sometimes you just have to put the blame on who is trying to prevent progress and forward thinking from occurring and you keep talking compromise. Compromise is NOT always the solution. I know you believe this but I do not. That is where we differ and that has always been the focus of our discussions. I just wish that you could get beyond that concept but I'm not sure if you can. I know your heart is the right place but by naming 3 or 23 Republicans out of nearly 300 means little to me and more importantly it means little to those who suffer in the mean time. Compromise? With what?

 Yes -- I think a Single Payer System is what we need, but there is not enough support on either side for it to happen. 
The one place we consistently differ is that I don't view the Republicans, in general, as evil -- though I haven't voted for one since I left New England.  I respect your position, but I just can't always let one-sided posts go by without giving my thoughts.  BTW -  William Weld, Claudine Schneider -- two Repubs with empathy and compassion who have gotten my votes in the past.  Even Christie has his moments -- like when he put politics on the back burner after Sandy and actually talked and thanked Obama for helping the victims in his state.  Not that I am a big Christie fan -- but he has shown empathy and compassion and deserves to get credit for it.  Olympia Snowe, Susan Collins also come to mind, I'm sure with time I can come up with more.
If you are all for a single payer system which I believe you are I would only hope that some day soon you will see that, in general, the Republican party has been obstructing this concept for decades upon decades along with the previously mentioned rights of others. MUCH more vile (and yes, evil) lately without shame. It is not just a few but the vast majority of the GOP and it saddens me to even have to have this conversation with an HIV+ gay man in 2013.

Rosa Parks stood up against "mental midgets" and turned the tide for all of us. I'm just trying to do the same without defending the people who by all of their actions and deeds prevent human understanding and progress.

The so called "middle" is a place I could only be when rational thinking comes from both sides.

Should we have compromised or been in the middle when it came to fighting for our lives with the government no matter what political color the pushback was coming from? hmm....


Anyway -- I'm sorry you don't like our political discussions -- I always find them interesting, I mean if people with differing views don't even like to discuss them, we'll never get anywhere, because I'm not always right -- but I'm not always wrong either.

Hugs,
Mike
I'm sorry too. We both have similar beliefs in many ways as to what needs to happen but our ideas in how to get there are at opposite sides of the room and I don't think that will change.

I still think the world of you if it matters. If I didn't care about you I would not have spent this much time and effort to respond at this late hour.  :)

Hugs,
Mark
Title: Re: Obamacare.
Post by: leatherman on December 03, 2013, 07:10:31 am
I just do not believe that the "large chunk" of Americans are right.
according to data from 2002 - 2013:
72 million - Democrat
55 million - Republican
42 million - Independent

when you figure some of the Independents would side Democrat - clearly we a more blue nation
Title: Re: Obamacare.
Post by: bocker3 on December 03, 2013, 07:52:28 am
Mitch,

Your filibuster comment is an example of why I mentioned that you seem to be reading to refute (don't mean to be condescending at all) -- there was no threat of a filibuster back then -- there were 60 Dems in the Senate, right up until Ted Kennedy's death.

As for Compromise -- yes -- it is the path and has always been the path, in my opinion.  Your stance that compromise is a bad thing mimics the Tea Party and I know you are no fan of that group.  And yes -- compromise on Gay Rights is what has been happening -- do I wish we could just get to equality, yes I do, but it is not feasible.  Right now we can marry in 16 states -- that "compromise" is better than going for the holy grail and ending up with a US Constitutional Amendment banning it.

And to be clear -- you seem to be thinking that by not agreeing with your side that I am agreeing with the other -- I am not.  We once had a farther right person on here -- I forget his name now -- I had a couple of these conversations with him too. (although I had little respect for him, so didn't bother too much)

I do agree that the middle requires rational thinking -- from BOTH SIDES.  I know you think the left is much more rational than the right.  I'm not sure I agree -- there is heel digging on both.

Bottomline for me -- compromise get progress more than "purity", though there are times when one must hold fast to principle -- I do agree with that.

At any rate -- I agree with most of what you say -- we do just see different paths to get there.  By talking about it, hopefully we learn a little about why we think that way -- I'm not really looking to change your mind, just to help you see where I am coming from and I get to see where you are coming from.

Hugs----  :-*
Mike
according to data from 2002 - 2013:
72 million - Democrat
55 million - Republican
42 million - Independent

when you figure some of the Independents would side Democrat - clearly we a more blue nation
Moderates exist in all three groups -- so your conclusion is a little flawed -- there are "shades" of blue and "shades" of red.  Think Cruz vs. Collins -- very different shades of Red.  Baucus vs. Pelosi -- very different shades of blue.

Mike
Title: Re: Obamacare.
Post by: WillyWump on December 03, 2013, 07:18:31 pm
I just can't wait for  George P.  (https://www.google.com/search?q=george+p&client=firefox-a&hs=ENM&rls=org.mozilla:en-US:official&source=lnms&tbm=isch&sa=X&ei=2XOeUpGwJYbg2QWQ2IFQ&ved=0CAkQ_AUoAQ&biw=922&bih=583#facrc=_&imgdii=_&imgrc=nGm3w_-RlZBAqM%3A%3BUDKcXbF7VzwrKM%3Bhttp%253A%252F%252Fimg.timeinc.net%252Ftime%252Fphotoessays%252F2010%252F40under40%252Fgeorge_p_bush.jpg%3Bhttp%253A%252F%252Fcontent.time.com%252Ftime%252Fspecials%252Fpackages%252Farticle%252F0%252C28804%252C2023831_2023829_2025217%252C00.html%3B307%3B409) ( I call him gorgeous George) to come up the political ranks  :-*
Title: Re: Obamacare.
Post by: Atripla_User on December 05, 2013, 10:31:14 am
Well I finally got enrolled in a plan I think I can live with for $54.00 per month. I gave up on the healthcare website after days of BS in Oct. So if all the paperwork comes through and payment is made I should be good hopefully. I am scared to death to go without ADAP and Ryan White. But I guess its time to see what happens, those 5 hour waiting periods in the health clinic are getting gruesome.
Title: Re: Obamacare.
Post by: Hellraiser on December 09, 2013, 03:09:36 pm
I just can't wait for  George P.  (https://www.google.com/search?q=george+p&client=firefox-a&hs=ENM&rls=org.mozilla:en-US:official&source=lnms&tbm=isch&sa=X&ei=2XOeUpGwJYbg2QWQ2IFQ&ved=0CAkQ_AUoAQ&biw=922&bih=583#facrc=_&imgdii=_&imgrc=nGm3w_-RlZBAqM%3A%3BUDKcXbF7VzwrKM%3Bhttp%253A%252F%252Fimg.timeinc.net%252Ftime%252Fphotoessays%252F2010%252F40under40%252Fgeorge_p_bush.jpg%3Bhttp%253A%252F%252Fcontent.time.com%252Ftime%252Fspecials%252Fpackages%252Farticle%252F0%252C28804%252C2023831_2023829_2025217%252C00.html%3B307%3B409) ( I call him gorgeous George) to come up the political ranks  :-*

that is one unattractive kid.
Title: Re: Obamacare.
Post by: mecch on December 09, 2013, 03:29:11 pm
George P. and John Ellis are attractive enough brothers, IMO
http://nimg.sulekha.com/others/original700/john-ellis-bush-weds-2010-5-29-21-16-43.jpg
Title: Re: Obamacare.
Post by: Hellraiser on December 09, 2013, 07:18:08 pm
George P. and John Ellis are attractive enough brothers, IMO
http://nimg.sulekha.com/others/original700/john-ellis-bush-weds-2010-5-29-21-16-43.jpg

that kid looks like the cheshire cat had offspring with John Leguizamo

Edit: Also apparently Matt Lauer is his brother?
Title: Re: Obamacare.
Post by: mitch777 on December 09, 2013, 07:30:18 pm
um... topic please. :)
Title: Re: Obamacare.
Post by: mitch777 on December 09, 2013, 07:36:49 pm
Well I finally got enrolled in a plan I think I can live with for $54.00 per month. I gave up on the healthcare website after days of BS in Oct. So if all the paperwork comes through and payment is made I should be good hopefully. I am scared to death to go without ADAP and Ryan White. But I guess its time to see what happens, those 5 hour waiting periods in the health clinic are getting gruesome.

Thanks for the post! I hope others, many others in the months to come share their experiences good or bad.
Title: Re: Obamacare.
Post by: Cosmicdancer on December 11, 2013, 08:47:57 am
Here's a disconcerting article from the Washington Post about inadequate coverage of prescription drugs for people with HIV in many of the online insurance exchange plans.

AIDS advocates say drug coverage in some marketplace plans is inadequate

The nation’s new health-care law says insurers can’t turn anyone away, even people who are sick. But some companies, patient advocates say, have found a way to discourage the chronically ill from enrolling in their plans: offer drug coverage too skimpy for those with expensive conditions.

Some plans sold on the online insurance exchanges, for instance, don’t cover key medications for HIV, or they require patients to pay as much as 50 percent of the cost per prescription in co-insurance — sometimes more than $1,000 a month...

(Read the full article here)

http://www.washingtonpost.com/national/health-science/aids-advocates-say-drug-coverage-in-some-marketplace-plans-is-inadequate/2013/12/09/0fca0fd0-5d18-11e3-95c2-13623eb2b0e1_story.html
Title: Re: Obamacare.
Post by: Ann on December 11, 2013, 09:00:17 am

But some companies, patient advocates say, have found a way to discourage the chronically ill from enrolling in their plans: offer drug coverage too skimpy for those with expensive conditions.


Trust insurance companies to find ways of continuing to fuck people over. >:(
Title: Re: Obamacare.
Post by: gingin on December 13, 2013, 09:09:59 am
so frigging true!!!!!!!!!!!!
Title: Re: Obamacare.
Post by: Dachshund on December 13, 2013, 11:36:14 am
I'm sure this has been already mentioned, but I think it's worth repeating. I talked to my case manager this morning and since I qualify for Ryan White/ADAP they will pay my insurance premium and meds. I'm enrolled in a silver plan through Blue Cross. My premium is very affordable but the cost of my meds before I met my deductible would have been expensive. if you think you qualify you should really check this out.
Title: Re: Obamacare.
Post by: BT65 on December 13, 2013, 03:00:32 pm
I'm sure this has been already mentioned, but I think it's worth repeating. I talked to my case manager this morning and since I qualify for Ryan White/ADAP they will pay my insurance premium and meds. I'm enrolled in a silver plan through Blue Cross. My premium is very affordable but the cost of my meds before I met my deductible would have been expensive. if you think you qualify you should really check this out.

I believe that is a state by state issue.  When we went for the training in Indianapolis a couple months ago, we were told adap would not pay for the premiums, and if any of our clients who receive insurance through ISDH (state dept of health who administers adap), signs up through the insurance exchange, they would be dropped by the state's insurance.  Just want people to verify this through their own state program.
Title: Re: Obamacare.
Post by: Habersham on December 14, 2013, 03:52:33 am
Here's a disconcerting article from the Washington Post about inadequate coverage of prescription drugs for people with HIV in many of the online insurance exchange plans.

AIDS advocates say drug coverage in some marketplace plans is inadequate

The nation’s new health-care law says insurers can’t turn anyone away, even people who are sick. But some companies, patient advocates say, have found a way to discourage the chronically ill from enrolling in their plans: offer drug coverage too skimpy for those with expensive conditions.

Some plans sold on the online insurance exchanges, for instance, don’t cover key medications for HIV, or they require patients to pay as much as 50 percent of the cost per prescription in co-insurance — sometimes more than $1,000 a month...

(Read the full article here)

http://www.washingtonpost.com/national/health-science/aids-advocates-say-drug-coverage-in-some-marketplace-plans-is-inadequate/2013/12/09/0fca0fd0-5d18-11e3-95c2-13623eb2b0e1_story.html

Some Marketplace Plans Are Inadequate For Aids Drugs]

Hey All - I think this would be a better headline here. Not scary but informative. It's nothing new to be offered different tiers of coverage at different prices. I'm no fan of insurance companies but you have to make informed decisions and be familiar with the terms like "out of pocket costs", deductibles, drug tiers, co pays. None of these are were invented yesterday. If you are buying insurance for the first time get assistance. Speak to a couple of different insurance companies and write things down.

If you want the convenience of once a day dosing be prepared to pay for it. Sure it's more convenient. But if you can take two pills a day and save $300 a month you need to be able to weigh the pros and cons. From the little research I've done on The Affordable Care Act it looks like a person who is HIV should enroll in a Gold or Platinum plan unless they have a lot of cash in hand or other coverage. BUT - I'm not an advocate or YOU. Be familiar with all the terms and then make an informed decision.

I'm not looking to open a subthread here. Insurance is not a new product. It is an expensive one and for now we have to work within the parameters of the new law. Everyone needs it but needs to be sure they obtain the policy that best fits their needs.

Title: Re: Obamacare.
Post by: Ann on December 14, 2013, 07:37:42 am
I saw an e-card on someone's FaceBook page today that I thought was appropriate for this thread:

The Republican Party:

Where they believe guns don't kill people, but Americans having more access to healthcare does.


Says it all really. >:(
Title: Re: Obamacare.
Post by: mitch777 on December 14, 2013, 10:34:55 am
I saw an e-card on someone's FaceBook page today that I thought was appropriate for this thread:

The Republican Party:

Where they believe guns don't kill people, but Americans having more access to healthcare does.


Says it all really. >:(
http://politicalhumor.about.com/od/politicalcartoons/ig/Healthcare-Cartoons/Party-of-Tradition.1-2i.htm
Title: Re: Obamacare.
Post by: Ann on December 14, 2013, 11:07:15 am
http://politicalhumor.about.com/od/politicalcartoons/ig/Healthcare-Cartoons/Party-of-Tradition.1-2i.htm

This one's good too: http://politicalhumor.about.com/od/politicalcartoons/ig/Healthcare-Cartoons/GOP-Killing-Healthcare.0_aF.htm

And this: http://politicalhumor.about.com/od/politicalcartoons/ig/Healthcare-Cartoons/Health-Blockage.0yfv.htm

And... http://politicalhumor.about.com/od/politicalcartoons/ig/Healthcare-Cartoons/Death-Panels.0izo.htm

http://politicalhumor.about.com/od/politicalcartoons/ig/Healthcare-Cartoons/Healthcare-Liberal.htm

Title: Re: Obamacare.
Post by: mitch777 on December 14, 2013, 01:04:34 pm
This one's good too: http://politicalhumor.about.com/od/politicalcartoons/ig/Healthcare-Cartoons/GOP-Killing-Healthcare.0_aF.htm

And this: http://politicalhumor.about.com/od/politicalcartoons/ig/Healthcare-Cartoons/Health-Blockage.0yfv.htm

And... http://politicalhumor.about.com/od/politicalcartoons/ig/Healthcare-Cartoons/Death-Panels.0izo.htm

http://politicalhumor.about.com/od/politicalcartoons/ig/Healthcare-Cartoons/Healthcare-Liberal.htm

Oh Ann, there are SO many of these^ we could post and if we did I think it could rival the "youtube post of the day" thread.  ;)
Title: Re: Obamacare.
Post by: Miss Philicia on December 16, 2013, 10:44:19 am
omgomgomg Obamacare is just SOOOO doomed! (http://www.washingtonpost.com/blogs/wonkblog/wp/2013/12/16/wonkbook-insurers-will-spend-more-than-500-million-to-get-people-to-sign-up-for-obamacare/?tid=pm_business_pop)
Title: Re: Obamacare.
Post by: Jeff G on December 16, 2013, 10:54:38 am
omgomgomg Obamacare is just SOOOO doomed! (http://www.washingtonpost.com/blogs/wonkblog/wp/2013/12/16/wonkbook-insurers-will-spend-more-than-500-million-to-get-people-to-sign-up-for-obamacare/?tid=pm_business_pop)

Yep ... and all these red state governors who are standing in the way of the potential insurance consumer will start to feel the heat . 
Title: Re: Obamacare.
Post by: mitch777 on December 18, 2013, 06:14:27 pm
The deadline is looming to be covered by a new ACA plan by January 1st. Anybody have good or bad news to share?

( still wondering if Will found it beneficial. )
Title: Re: Obamacare.
Post by: BT65 on December 20, 2013, 07:45:07 pm
The deadline is looming to be covered by a new ACA plan by January 1st. Anybody have good or bad news to share?

( still wondering if Will found it beneficial. )

Well, heh, we have to get all our clients, who are currently on ichia (which will be phasing out), applied to the exchange when we get back to work.  I mean the first week, we have to have all applications to the state by 01/10/13.  The original plan was for the state to roll people into insurance, but since there are seven, with a shitload of different plans, we have to figure it out.  Not something I look forward to.
Title: Re: Obamacare.
Post by: mitch777 on December 20, 2013, 08:57:11 pm
Well, heh, we have to get all our clients, who are currently on ichia (which will be phasing out), applied to the exchange when we get back to work.  I mean the first week, we have to have all applications to the state by 01/10/13.  The original plan was for the state to roll people into insurance, but since there are seven, with a shitload of different plans, we have to figure it out.  Not something I look forward to.

I don't envy you Betty. It's a huge change in so many ways and the planning was not executed well. Once the dust settles I hope your clients benefit.
Title: Re: Obamacare.
Post by: mecch on December 23, 2013, 05:13:24 pm
So did you get your Obamacare heroin yet?
http://www.huffingtonpost.com/2013/12/21/obamacare-heroin_n_4485487.html?utm_hp_ref=mostpopular

Title: Re: Obamacare.
Post by: livingmmy9lives on December 30, 2013, 12:07:28 am
I have medicare. I can't afford to go to all of the specialists my doctor sends me to because of the 20% co-pay and my health is suffering because of it. I can't afford to buy a health plan. Is there any help for me? I make over the cutoff for medicaid. I applied for Medicaid "spend down" and I was denied but told if I rack up over $1014 IF medical bills I may be eligible for the "spend down".. Is there no other help?? The local ASO doesn't seem to be aware at all of any help I can get.
Title: Re: Obamacare.
Post by: Jeff G on December 30, 2013, 08:52:16 am
I have medicare. I can't afford to go to all of the specialists my doctor sends me to because of the 20% co-pay and my health is suffering because of it. I can't afford to buy a health plan. Is there any help for me? I make over the cutoff for medicaid. I applied for Medicaid "spend down" and I was denied but told if I rack up over $1014 IF medical bills I may be eligible for the "spend down".. Is there no other help?? The local ASO doesn't seem to be aware at all of any help I can get.

Some times a medical provider has programs or compassionate care programs that you can apply for that can drastically cut your doctor bills and sometimes eliminate them . When I was in chemo therapy and had Medicare only so the facility wrote off my 20 % , which was a considerable amount .   
Title: Re: Obamacare.
Post by: mitch777 on January 05, 2014, 06:08:01 pm
Well, I was signed up pretty early and paid the first months premium in early-mid December and have yet to get a new card or the policy from Anthem.

I've got a confirmation number after making the payment but not sure what to do when I need to fill a prescription or see a doctor.

Tried calling them last week and was on hold for 2 hours before I hung up.

hmmm...


PS- Wumpy, did you ever find a plan that worked for you? Anybody else have any luck?
Title: Re: Obamacare.
Post by: BT65 on January 06, 2014, 07:04:11 am
Anybody else have any luck?

Actually my best friend's daughter and son-in-law were able to get signed up for a plan (for the two of them, their children are on Medicaid), for $34/month; the daughter is the only one working, as the son-in-law just lost his job right before Christmas. 

Living,
Jeff is correct, many doctor's offices have a financial aid assistance that can help greatly with co-pays. Also, many doctors will write off what Medicare doesn't pay.  What about your meds?  Are they taken care of?
Title: Re: Obamacare.
Post by: Dachshund on January 06, 2014, 07:24:23 am
I guess I'm one of the really lucky ones. I was able to navigate the website and sign up for a plan I like through Blue Cross. I have been under Ryan White for the past ten years. I went in to talk to my case manager because I wanted to make sure I would be able to get my meds for December while waiting for my insurance coverage. Totally surprised to find out that the state of TN is going to pay for my insurance because I qualify for Ryan White. Premium, deductible, the whole nine yards. I know it varies state to state but I would advise anyone to check with their ASO or case manager to see what help is available. Thanks Obama!
Title: Re: Obamacare.
Post by: BT65 on January 07, 2014, 03:28:12 pm
I'm glad people are able to get signed up for this.  Here in Hoosierville, it's not that simple.

We had a webinar right before Christmas, letting us know there will be 7 (now they say eight) plans to choose from.  We were supposed to get a "widget" that would let us search by county of residence, doctor, meds etc.   We were supposed to get this widget last week.  As of today, nothing.  Also, we have been closed because of the weather and will be tomorrow.  For people's insurance to start 03/01, we needed to have the apps to Indiana State Dept of Health for final approval (they are paying everything for the clients), in two days (01/10). 

So, I have been working from home, calling clients because I also found out that we can also get apps for clients in by 03/10 for insurance to start 04/01.  In the meantime, we were told to contact the insurance carriers to find out if people's doctors/meds are covered.  So, I started with Anthem.  Talked to one of the agents.  She searched for the doctor's name I gave her, which many of our clients see.  She found his name, but told me he is not accepting plans through the exchange.  WTF?  Now what? 

Of course I can't talk to my boss and I bet she has no idea about this.  Not sure how this is going to play out.

In the meantime, when the insurance the clients are currently on (ichia) runs out, clients will be covered by adap/eip until the new insurance starts, or indefinitely.  This also covers vision and dental.  But, it does not cover emergency room visits or hospital stays.  But will cover everything else. 

I've been contacting clients, and one of them cussed me up and down as I was trying to explain "how" the insurance is going to change.  That's nice, I'm working from home, and he was screaming at me because we haven't been open and he has to work etc. etc. etc.   

I'M FRUSTRATED!

Edited to add:  Since the announced changes to the insurance, the head of the insurance department at Indiana State Dept of Health resigned; last week the head of the whole care coordination dept at ISDH resigned.  I think something is happening, just don't know what.
Title: Re: Obamacare.
Post by: mitch777 on January 07, 2014, 05:58:43 pm
I'm glad people are able to get signed up for this.  Here in Hoosierville, it's not that simple.

We had a webinar right before Christmas, letting us know there will be 7 (now they say eight) plans to choose from.  We were supposed to get a "widget" that would let us search by county of residence, doctor, meds etc.   We were supposed to get this widget last week.  As of today, nothing.  Also, we have been closed because of the weather and will be tomorrow.  For people's insurance to start 03/01, we needed to have the apps to Indiana State Dept of Health for final approval (they are paying everything for the clients), in two days (01/10). 

So, I have been working from home, calling clients because I also found out that we can also get apps for clients in by 03/10 for insurance to start 04/01.  In the meantime, we were told to contact the insurance carriers to find out if people's doctors/meds are covered.  So, I started with Anthem.  Talked to one of the agents.  She searched for the doctor's name I gave her, which many of our clients see.  She found his name, but told me he is not accepting plans through the exchange.  WTF?  Now what? 

Of course I can't talk to my boss and I bet she has no idea about this.  Not sure how this is going to play out.

In the meantime, when the insurance the clients are currently on (ichia) runs out, clients will be covered by adap/eip until the new insurance starts, or indefinitely.  This also covers vision and dental.  But, it does not cover emergency room visits or hospital stays.  But will cover everything else. 

I've been contacting clients, and one of them cussed me up and down as I was trying to explain "how" the insurance is going to change.  That's nice, I'm working from home, and he was screaming at me because we haven't been open and he has to work etc. etc. etc.   

I'M FRUSTRATED!

Edited to add:  Since the announced changes to the insurance, the head of the insurance department at Indiana State Dept of Health resigned; last week the head of the whole care coordination dept at ISDH resigned.  I think something is happening, just don't know what.

Betty,

I feel your frustration!!  :(

All I know is that it takes people like yourself to help those who are unable to navigate through the system. You really are making a difference. I hope you get thanked on a daily basis.
Title: Re: Obamacare.
Post by: BT65 on January 07, 2014, 06:54:24 pm
Thanks, Mitch.  I feel I need to get out.  I really feel it is getting to the point where they are trying to push people out of care.  Something weird is happening, and I don't know what it is.  But, I need to get out....

Sometimes I get thanked.  I'm not narcissistic, I don't believe I'm the glue holding the clients to the agency lol, but it's nice when a client thanks me. 
Title: Re: Obamacare.
Post by: Ann on January 08, 2014, 06:05:44 am

Sometimes I get thanked.  I'm not narcissistic, I don't believe I'm the glue holding the clients to the agency lol, but it's nice when a client thanks me. 


I bet you're the glue more often that you give yourself credit for. I was reading a study on how clients become lost to care recently and one of the factors listed was (particularly otherwise vulnerable) clients not feeling respected by, listened to or cared about by those handling their case. I don't remember which study had that little gem hidden in it, I read several.

I know you listen and I know you care, so who knows how many of your clients may have given up if faced with a case worker who obviously wasn't really listening and didn't really give a shit. We've all come up against people like that in the so-called "caring" professions and some people (clients) just can't cope with it.

As for the other stuff, it certainly sounds like the shit is going to hit the proverbial fan in Indiana with those resignations. Something is definitely amiss. Wonder if Obama knows what's going on in the Hoosier State? Maybe someone should drop him a line.....
Title: Re: Obamacare.
Post by: tednlou2 on March 02, 2014, 12:33:29 am
Article that says "Obamacare" is not so affordable for those with HIV.

http://www.poz.com/articles/unaffordable_care_401_25227.shtml
Title: Re: Obamacare.
Post by: bmancanfly on March 02, 2014, 09:49:03 am
That's an overly broad interpretation of what the articles actually says.

There are certainly some loopholes that need to be plugged.  But for the overwhelming majority of people with HIV the ACA is a godsend.  Including the 26,000 getting coverage through Medicaid expansion.

From the article;
First and overriding, health care reform as a whole, with all of its troubles and everything, is a huge step forward for folks with HIV,” she says. “And so now our work is to bring it home and do all the changes that need to happen in order to make it really work.”


Remember,   before the ACA it was virtually impossible for someone with HIV to get an individual policy,  let alone one at an "affordable" price.

HIV isn't cheap.  If you have an expensive chronic disease,  a bronze plan probably isn't going to work for you.

It's easy to foresee how the cost of meds is going to become,  if it isn't already, one of many factors in determining which meds to choose (i.e. soon to be generic Sustiva & Truvada can be just as effective as Atripla,  at a much lower cost).   Will treatment inexperienced patients,  with no resistance issues,  be started on something like Stribild ($28,000 annually) right off the bat,  when something much cheaper and just as effective will work for them?  Like it or not,  that may be the way things are heading.

 
Title: Re: Obamacare.
Post by: zach on March 02, 2014, 10:21:10 am

It's easy to foresee how the cost of meds is going to become,  if it isn't already, one of many factors in determining which meds to choose (i.e. soon to be generic Sustiva & Truvada can be just as effective as Atripla,  at a much lower cost).   Will treatment inexperienced patients,  with no resistance issues,  be started on something like Stribild ($28,000 annually) right off the bat,  when something much cheaper and just as effective will work for them?  Like it or not,  that may be the way things are heading.

i ask out of ignorance. is that a bad thing? much cheaper and just as effective, why not use it? i personally don't need to feel like i'm getting cavier when the kabob do just fine. all i want is my VL controlled.
Title: Re: Obamacare.
Post by: bmancanfly on March 02, 2014, 11:38:16 am
I'm not personally making a value judgment.  It's neither a good thing or a bad thing,  it's just a thing.

It does seem an inevitability that for-profit insurance companies will be moving toward a tiered system for HIV drugs as more and more drugs become available in generic form.

FWIW I am on Viramune which was approved in'95 (or '96?).  I have an undetectable VL and no side effects plus my copay with this drug is so low there was no motivation to switch to one of the newer meds with a higher copay.

Others,  for a multitude of reasons,  may make different choices.  But I think the days of putting everyone on the "latest and greatest" meds,  irrespective are cost,  are numbered.
Title: Re: Obamacare.
Post by: AusShep on March 02, 2014, 11:42:50 am
i ask out of ignorance. is that a bad thing? much cheaper and just as effective, why not use it? i personally don't need to feel like i'm getting cavier when the kabob do just fine. all i want is my VL controlled.

My doc also likes to follow this philosophy, but more because it leaves more options open in the future if you have failure of one regimen.  In addition to VL, drug resistance, and side effects, I'd add that keeping CD4 above 500 should be a goal as well, especially given the long term mortality numbers in the study below from both HIV and non-HIV causes for those who don't achieve CD4 recovery above 500 even with viral suppression.

http://www.aidsmap.com/A-low-CD4-cell-count-despite-viral-suppression-with-HIV-treatment-is-associated-with-a-big-increase-in-mortality-risk/page/2823458

Some of the OCA plans are crap for anyone with ongoing medical needs, really more akin to catastrophic coverage, bu at least with a $6,350 out of pocket max now.  But the reality for most OCA plans is that for HIV treatment you'll be hit either quickly, or by the end of the year, with the out of pocket limit, plus the plan costs for the year, about 10k in total for plans I've helped friends look into.  So without Ryan White, Fed assistance or medicade etc. it's still not affordable for many.  Compared to employer plans where many people may have to pay $100ish a month for Rx co-pays without mfg assistance, and the monthly cost may be 0 or low for the employee, there is still a way to go.

Title: Re: Obamacare.
Post by: zach on March 02, 2014, 02:14:33 pm
My doc also likes to follow this philosophy, but more because it leaves more options open in the future if you have failure of one regimen.  In addition to VL, drug resistance, and side effects, I'd add that keeping CD4 above 500 should be a goal as well, especially given the long term mortality numbers in the study below from both HIV and non-HIV causes for those who don't achieve CD4 recovery above 500 even with viral suppression.

http://www.aidsmap.com/A-low-CD4-cell-count-despite-viral-suppression-with-HIV-treatment-is-associated-with-a-big-increase-in-mortality-risk/page/2823458

is there a med that directly raises CD4? i thought meds only addressed VL, and everything else was a sweet little side effect of a rebuilding immune system
Title: Re: Obamacare.
Post by: buginme2 on March 02, 2014, 02:33:30 pm
is there a med that directly raises CD4?

No
Title: Re: Obamacare.
Post by: AusShep on March 02, 2014, 03:37:39 pm
No

Fuzeon, and some PIs, Kaletra for instance.

12% mortality over 5 years for those with CD4 < 200 vs. 2% of those with CD4 above 500, all of whom had complete viral suppression.  Last bit of the article below.  If my CD4 was < 500, I'd work on getting it up via Fuzeon, a PI, or anything else my doc could recommend.

Edit: removed junk, misread the initial comment from Zach that buginme2 was replying to
Title: Re: Obamacare.
Post by: zach on March 02, 2014, 03:50:33 pm
"FUZEON blocks HIV's ability to infect healthy CD4 cells. When used with other anti-HIV medicines, FUZEON can reduce the amount of HIV in the blood and increase the number of CD4 cells. This may keep your immune system healthy, so it can help fight infection."

"KALETRA is used with other anti-HIV-1 medicines to increase the chance of treatment response in people with human immunodeficiency virus (HIV-1) infection. KALETRA:
Blocks HIV-1 protease, a chemical that is needed for HIV-1 to multiply
Reduces the amount of HIV-1 in the blood
Increases the CD4 cell (immune cell) count in the blood"

both quotes taken directly from the manufacturer's websites. so is this an actual claim that these drugs raise CD4, or that by suppressing HIV replication, CD4 will as a byproduct of that, rise?
Title: Re: Obamacare.
Post by: AusShep on March 02, 2014, 03:54:43 pm
I've read on another site a guy had very long term suppressed CD4, never above 400 and mostly below 200, that got his up to mid 600s on Fuzeon.  I don't think he was a marketing plant.

I have access to a few Rx coverage plans, and all I've seen have Fuzeon as a pre auth, dispensing limit, speciality med (it's injected 2-3x a day via insulin syringe) no idea of the cost.

Edit: that's why I'd directly approach it with my doc.  I haven't researched Fuzeon studies directly.
Title: Re: Obamacare.
Post by: Miss Philicia on March 02, 2014, 04:24:25 pm
Jeesh, one guy's story on the internet really means a lot these days.

For what it's worth, my cd4 count shot up significantly when I went on Fuzeon and Prezista simultaneously, and my doctor had me wait to go on Fuzeon an extra year or more until I could get in a Prezista clinical study because he thought it would work better synergystically. I'm meaning from ~600 to ~900 fairly quickly.

ON THE OTHER HAND a friend of mine who started Fuzeon with much lower numbers of ~200 only had his go up by 50, so I would hesitate to make the claims that some are making below. It's possible, but far far from guaranteed.

ps: you inject Fuzeon twice daily, to three times. And unless you have documented multi-class resistance issues you're not going to get approved for Fuzeon. It costs something like $45,000 year alone.
Title: Re: Obamacare.
Post by: Dachshund on March 02, 2014, 04:52:07 pm
The only thing Kaletra raises is your trips to the bathroom.
Title: Re: Obamacare.
Post by: AusShep on March 02, 2014, 05:15:44 pm
Yeah, I agree Miss P, that's the problem with anecdotal evidence.  I did look at a couple of Fuzeon links out of curiosity, and what your friend saw seems more in line, but those studies were all with patients who still had detectable viral replication going on too and Fuzeon is used on top of PI/NRTIs.  Thanks for the cost info.

It would be nice to see some studies focusing on managing CD4s up in the cases of those with UD/low VL and poor CD4 counts.  The morbidity numbers based on all of cohorts involved in the earlier link could also be reinforced or not...
Title: Re: Obamacare.
Post by: tednlou2 on March 07, 2014, 01:19:23 am
From the L.A. Times-- Maybe they are no true Obamacare horror stories

http://www.latimes.com/business/hiltzik/la-fi-mh-obamacare-horror-stories-20140220,0,3801120.story#axzz2vFrMJalX
Title: Re: Obamacare.
Post by: mecch on March 07, 2014, 07:38:44 am
Colbert did  bit on the fake horror stories, including the actors performing Horror Story simulations, a few days ago, and had Patrick Stewart perform one.
http://www.colbertnation.com/the-colbert-report-videos/433405/march-03-2014/phony-obamacare-horror-stories---patrick-stewart
Title: Re: Obamacare.
Post by: tednlou2 on March 11, 2014, 02:18:59 pm
President Obama does a mock talk show interview with Zach Galifianakis, for Funny or Die.  So, Funny or Die? 

Does this kind of thing work?  I found myself FWDing through it.  Even though there were some funny lines, it still just seemed like one of those late night infomercials, where they pretend to be doing a real interview, but it is way too rehearsed.  I suppose even if younger folks roll their eyes, it may still get them to think about signing up. 

http://www.upworthy.com/president-obama-burns-a-rude-celebrity-and-then-teaches-him-how-to-get-it-treated?c=ufb1
Title: Re: Obamacare.
Post by: Dan0 on March 11, 2014, 02:40:28 pm
Funny you should mention this...I just saw this over at JoeMyGod (http://www:joemygod.com)

(http://i57.tinypic.com/102v0wh.jpg)
Title: Re: Obamacare.
Post by: mitch777 on April 17, 2014, 06:30:59 pm
Obama announced today in a press conference that 8 million people have signed up and 35% of those were under 35 years old.

Seems like it's working as planned. Now if the Republicans could finally admit it they could focus their energy on fixing any flaws and attend to more important issues facing our country but I know that won't happen before November. Hell, I bet they vote to repeal the ACA another few times in the coming months. So sad.

He also mentioned in his PC that the Governors who didn't allow Medicaid expansion are denying another 5 million people healthcare purely for political reasons. Obvious to me but the people that live in these states are the only ones with the power to vote them out. I wish them the best.
Title: Re: Obamacare.
Post by: mecch on April 17, 2014, 06:56:01 pm
Rachel Maddow reported this week (?) that the Republicans voted a minor fix for Obama Care, very very quietly.
Title: Re: Obamacare.
Post by: mitch777 on April 17, 2014, 07:35:08 pm
Rachel Maddow reported this week (?) that the Republicans voted a minor fix for Obama Care, very very quietly.

Details? Or was it SO quiet that it will never be heard?

Edited to add:
Or does the "minor" fix come at the cost of another social program. Sorry, I'm jaded.
Title: Re: Obamacare.
Post by: leatherman on April 18, 2014, 12:09:24 am
Details?

Edited to add:
Or does the "minor" fix come at the cost of another social program. Sorry, I'm jaded.
Color yourself Jade. :(

"At the urging of business organizations, House Republicans quietly secured a recent change to Obamacare to expand coverage choices
....
No member of the House GOP leadership has publicly hailed the fix, which was tucked, at Republicans’ request, into legislation preventing a cut in payments to doctors who treat Medicare patients."
http://freakoutnation.com/2014/04/06/house-republicans-quietly-support-a-change-in-obamacare-to-expand-coverage/

Rachel's vid:
https://www.youtube.com/watch?v=KwWX80RBA8s
Title: Re: Obamacare.
Post by: mitch777 on April 18, 2014, 03:33:54 pm
Color yourself Jade. :(

"At the urging of business organizations, House Republicans quietly secured a recent change to Obamacare to expand coverage choices
....
No member of the House GOP leadership has publicly hailed the fix, which was tucked, at Republicans’ request, into legislation preventing a cut in payments to doctors who treat Medicare patients."
http://freakoutnation.com/2014/04/06/house-republicans-quietly-support-a-change-in-obamacare-to-expand-coverage/

Rachel's vid:
https://www.youtube.com/watch?v=KwWX80RBA8s

Interesting. Reform due to pressure from the business community. Why bury it? (rhetorical question)
Title: Re: Obamacare.
Post by: BT65 on April 19, 2014, 04:52:25 pm
He also mentioned in his PC that the Governors who didn't allow Medicaid expansion are denying another 5 million people healthcare purely for political reasons. Obvious to me but the people that live in these states are the only ones with the power to vote them out. I wish them the best.

I live in one of those states and I can tell you that Indiana is pretty conservative.  Pretty typical Nascar fans, beer-drinking, gun-toting rednecks.  Not that everyone who likes one of those activities is a redneck. But typically, well, they are.

I wish these people would realize they're being screwed.  But, they don't.  You would think with Indiana University (IUSB), Notre Dame, and St Mary's, it would be more liberal.  And they do have liberal groups on these campuses and do lots of community service.  But, you are correct M, they need to vote these fuckers out.  Too many people being untreated.  I just talked to one today whose shoulder is dislocated.  She cannot get it fixed due to no health coverage.  MADDENING!
Title: Re: Obamacare.
Post by: mitch777 on April 19, 2014, 06:06:31 pm
I live in one of those states and I can tell you that Indiana is pretty conservative.  Pretty typical Nascar fans, beer-drinking, gun-toting rednecks.  Not that everyone who likes one of those activities is a redneck. But typically, well, they are.

I wish these people would realize they're being screwed.  But, they don't.  You would think with Indiana University (IUSB), Notre Dame, and St Mary's, it would be more liberal.  And they do have liberal groups on these campuses and do lots of community service.  But, you are correct M, they need to vote these fuckers out.  Too many people being untreated.  I just talked to one today whose shoulder is dislocated.  She cannot get it fixed due to no health coverage.  MADDENING!

It IS maddening. I hear reports from MNSBC (ya, I know, liberal media) that it is estimated 17,000 people will die this year in the states that refused to expand Medicaid. Wonder what "death squad" Michelle Bachman has to say about that. Wait... I don't want to know.

I'm sure your story is repeated countless times over across those states. I honestly think it's all about education. A tough job ahead.
Title: Re: Obamacare.
Post by: mecch on April 19, 2014, 07:44:34 pm
I have a question. The oft touted 8,000,000 people on "Obama Care" first year out. Is there a breakdown yet how many people signed up for state run and how many to the national?  How many people from states that didn't expand Medicaid, signed up for national plans?
Isn't there a way to fund the poor who might have been eligible for state medicaid, had it been offered, to next year somehow get enough funds to buy plans on the national exchange? 
I realise its a nation with state powers and independence. But it maybe not be constructive or realistic to expect the banana-republic 3rd world mentality states to put their legislatures in order. 
Its seems like a long slow slide to destitution and in 20 years there will be failed States peppering the country.  At that point, its going to be even more expensive to fix and that means one or two decades of people suffering, with poor country standards of living, in one of the so-called "richest countries in the world".   
Title: Re: Obamacare.
Post by: buginme2 on April 19, 2014, 08:50:54 pm
I have a question. The oft touted 8,000,000 people on "Obama Care" first year out. Is there a breakdown yet how many people signed up for state run and how many to the national?  How many people from states that didn't expand Medicaid, signed up for national plans?
Isn't there a way to fund the poor who might have been eligible for state medicaid, had it been offered, to next year somehow get enough funds to buy plans on the national exchange? 


What do you mean by how many people signed up for state run versus national?

I thought the 8 million were people who signed up for private insurance on the exchanges.  I don't think it includes people who signed up for Medicaid.  But I could be wrong.

In states that didn't expand Medicaid the poor are still offered subsidies to purchase insurance, but if you still can't afford it your shit out of luck.

I have a friend who got on Medicaid with the expansion.  She hasn't been to a doctor in years.  She got coverage on the exchange through Medicaid, she got a phone call two days later from a medical clinic in her neighborhood to set up an appointment, was seen two weeks later.  Was amazing how quick and easy it was.

Title: Re: Obamacare.
Post by: leatherman on April 19, 2014, 11:42:01 pm
In states that didn't expand Medicaid the poor are still offered subsidies to purchase insurance, but if you still can't afford it your shit out of luck.
not quite. if you're so poor that you would have been eligible for Medicaid Expansion,  then you are too poor to qualify for any subsidies from get-go. Subsidies are for people who are not quite as poor and make too much to qualify for ME in the first place.

Quote
If you make less than about $11,490 a year as a single person or about $23,550 for a family of 4, you may not qualify for lower costs for private insurance based on your income. You may be eligible for Medicaid, even without the expansion, based on your state’s existing rules. But if you aren’t, you won’t qualify for either of the affordability options under the health care law.
https://www.healthcare.gov/what-if-my-state-is-not-expanding-medicaid/
Title: Re: Obamacare.
Post by: leatherman on April 19, 2014, 11:42:51 pm
How many people from states that didn't expand Medicaid, signed up for national plans?
Medicaid Expansion and getting insurance through the exchanges (either state- or federal-administered, and with or without subsidies) are different issues.

Isn't there a way to fund the poor who might have been eligible for state medicaid, had it been offered, to next year somehow get enough funds to buy plans on the national exchange?
SC has started up it's own program to help the poor - the Healthy Outcomes Plan. Instead of using the federal tax dollars that could have come back to our state through ME, our Governor tasked the Director of Health and Human Services (tony keck) to create a whole other plan, funded by SC, to fill in the gap.

Quote
TONY KECK: My fear is, in the states where there’s Medicaid expansion that hospitals and doctors and other health care providers take the path of least resistance, which is instead of going and finding the people who need the most help, they take the healthy folks who just come on into their door, easy dollars, easy to treat. And it’s not really solving the big problems that a state like South Carolina needs to focus on.

MARY JO BROOKS: Keck has launched a pilot program that he thinks could do just that. It’s called the Healthy Outcomes Plan, and it’s really a series of 40 different experiments, each one developed by hospitals in the state to reach out to uninsured people who are chronic users of their emergency rooms
http://www.pbs.org/newshour/bb/in-a-state-without-medicaid-expansion-uninsured-south-carolinians-mind-the-gap/

the problem with Keck's plan (besides the huge cost to SC w/o any federal reimbursement) is, as the SC HIV Task Force pointed out in our one-on-one meeting with Mr. Keck, is that the hospitals which he believed would reach out to the poor and disenfranchised have sat on the funds and reached out to no one. Millions of dollars earmarked for health care for those who would have received ME are sitting idle in hospital bank accounts - while the dozen ASOs in SC could have used those funds to treat financially poor PLWH.

Its seems like a long slow slide to destitution and in 20 years there will be failed States peppering the country.  At that point, its going to be even more expensive to fix and that means one or two decades of people suffering, with poor country standards of living, in one of the so-called "richest countries in the world".   
I would venture to say that we're already in that slide you mention and that 20-yrs could be wishful thinking. SC, Mississippi and Alabama (for example) with their low quality education issues, high STI rates, high teen pregnancy, poor overall health, poor access to health care, poverty.....well with all those issues and more, some states are already on the verge of failing right now.
Title: Re: Obamacare.
Post by: mecch on April 20, 2014, 05:57:43 am
Medicaid Expansion and getting insurance through the exchanges (either state- or federal-administered, and with or without subsidies) are different issues.
SC has started up it's own program to help the poor - the Healthy Outcomes Plan. Instead of using the federal tax dollars that could have come back to our state through ME, our Governor tasked the Director of Health and Human Services (tony keck) to create a whole other plan, funded by SC, to fill in the gap.
http://www.pbs.org/newshour/bb/in-a-state-without-medicaid-expansion-uninsured-south-carolinians-mind-the-gap/

the problem with Keck's plan (besides the huge cost to SC w/o any federal reimbursement) is, as the SC HIV Task Force pointed out in our one-on-one meeting with Mr. Keck, is that the hospitals which he believed would reach out to the poor and disenfranchised have sat on the funds and reached out to no one. Millions of dollars earmarked for health care for those who would have received ME are sitting idle in hospital bank accounts - while the dozen ASOs in SC could have used those funds to treat financially poor PLWH.
I would venture to say that we're already in that slide you mention and that 20-yrs could be wishful thinking. SC, Mississippi and Alabama (for example) with their low quality education issues, high STI rates, high teen pregnancy, poor overall health, poor access to health care, poverty.....well with all those issues and more, some states are already on the verge of failing right now.

First of all,yes,I understood that the exchanges and medicaid are two different issues.  I was asking is there a way to reach these US citizens who won't get qualified within state for medicaid and don't have the funds to pay for their state exchanges.


Maybe a mega foundation needs to step in.  After all, that suits the Randian/Victorian politics of charity being the recourse for "poor cases". 

If I understand correctly, the idea of government paying for a social safety net such as healthcare is too big a leap of consciousness for these state legislatures.  Even if it wasn't going to be their own state monies......lts the world view that the poor don't deserve government "handouts".   So would they be OK with say, a Clinton or Gates or Rockefeller foundation handout?
Title: Re: Obamacare.
Post by: zach on April 20, 2014, 06:36:44 am
leather specifically, but anyone that has knowledge. how difficult is it to move to another state with programs like adap and ryan white? i understand the difference in federal and state funding and administering, but have no experience with it.

say from georgia to north carolina? (out of the fire, into the pan i know). would i be making it more difficult for myself to access healthcare in north carolina than i have now in georgia? would ryan white and/or adap be affected? access to medicaid?

i know you live in south carolina, but i think the south is generally roughly equivalent in its hateful politics. i have noticed before you seem very knowledgeable in the healthcare access. is this something you're politically or professionally involved in? i do want to thank you for educating me now and in the past. i've lurked on most of these threads, but am starting to feel more politically motivated in this area
Title: Re: Obamacare.
Post by: leatherman on April 20, 2014, 11:08:16 am
how difficult is it to move to another state with programs like adap and ryan white? i understand the difference in federal and state funding and administering, but have no experience with it.

say from georgia to north carolina? (out of the fire, into the pan i know). would i be making it more difficult for myself to access healthcare in north carolina than i have now in georgia? would ryan white and/or adap be affected? access to medicaid?
everytime I read of someone moving to another state the first thing I warn them to do is check on the availability of services. Every state has different eligibility requirements and different services. Not too long ago, several states even had waiting lists for ADAP so if you moved there and needed ADAP, you would simply not have it - nor have any meds. Right now, no one using ADAP should be moving to Utah, because they currently have a waiting list. Also, Medicaid, because it is another federally-funded state-administered program, pays differently in different states. (SNAP benefits are different too but that's another story).

One other thing to consider when moving between states is the time-lag of applying and being approved in the new state. Some people have found the paperwork change to be smooth and easy, and others have had to battle the bureaucracy. A pozzie changing states needs to make sure they have enough "backup meds" to weather through the changeover in a worse case scenario.

Looking back, I had more services and higher benefits in Ohio than I do in SC. The only saving grace for where I live in SC is that there is an ASO here (Catawba Care) which fills in the gaps and pays for a lot of services for it's clients (we are part of the Charlotte metro area and are the only SC county that receives NC ADAP and CDC for the clients we care for who cross the the state line). Yet even with this ASO, it still took the state of SC 3 long months to get everything transferred properly for my case and benefits.

i have noticed before you seem very knowledgeable in the healthcare access. is this something you're politically or professionally involved in? i do want to thank you for educating me now and in the past. i've lurked on most of these threads, but am starting to feel more politically motivated in this area
When I moved back to SC, I attended an ADAP funding rally and realized that 20 yrs earlier I had been at a rally in Cleveland - both times advocating for meds. In 1990, I was advocating for the development of meds; and in 2010, I was advocating for access to meds. It seemed not much has changed, except the meds were finally working for me, so I began volunteering for my ASO doing prevention/education work. for the last 3 yrs, I've been the Communications Chair for the volunteer SC HIV Task Force (http://schtf.com).

The Task Force was formed in 2006 when 4 people died in SC while they were on the ADAP waiting list. We had another Waiting list in 2010 and one person died. Thankfully, we have been able to persuade enough State Legislators to fund ADAP and they agreed to 4 yrs worth of recurring funding. (we have just about a yr and a half left before we'll have to be advocating for ADAP again). Over the last 2-3 years we've been advocating for Medicaid Expansion (and hence why I know all I do, and more than I wanted to know LOL, about the ACA, the exchanges, and ME  ;) ).

We're working towards becoming a stand-alone non-profit this year, and I've got my fingers crossed because I want to the be not just the first Exe Director of the independent Task Force; but I want to be the first HIV+ person leading the Task Force. (I think it's going to be very important to grab this leadership spot as the ASOs in my state are having to follow the money and turn into Community Health Centers expanding to serve more than just HIV+ people. As HIV is recognized more and more as a "chronic" illness, our fight for resources is changing. but that really is another story for another time)
Title: Re: Obamacare.
Post by: mitch777 on October 08, 2014, 04:26:12 pm
I know the ACA has had it's problems but this latest attempt to squash it without any replacement (once again) by the repubs will piss millions off. Kinda makes me smile in a way. It's funny how they describe the liberals as "elite" but seem to have no idea how elite they are themselves.

I'm STILL wondering if Wumpy ever found a policy through the ACA that was beneficial for him. Not picking on you if your listening, just wondering.

I have another link to post but granny doesn't seem to know how to post 2 links in one thread yet. lol.

http://thinkprogress.org/health/2014/10/08/3577518/republicans-threaten-another-shutdown-over-obamacare/
Title: Re: Obamacare.
Post by: mitch777 on October 08, 2014, 04:31:23 pm
Looks like we hiv+ folks are a huge portion of enrollees in Obamacare. No surprise to me. Not to mention Medicaid expansion, at least in the states that have more compassionate politicians.
http://mobile.nytimes.com/2014/10/08/business/health-law-drug-plans-are-given-a-check-up-.html?referrer&_r=0
Title: Re: Obamacare.
Post by: tednlou2 on October 12, 2014, 12:50:50 am
Interesting that HIV patients are making up such a huge number. 

I continue to hope for a Medicare-For-All system, btw.  Did the CBO ever do a study on the effect of that?  It would seem Medicare would have huge buying power, if allowed to negotiate drug prices-- even with the current Medicare beneficiaries and much more so, if opened to millions more. 
Title: Re: Obamacare.
Post by: buginme2 on October 12, 2014, 01:01:47 am
Ya if Medicare were allowed to negotiate drug prices, that would be huge.
Title: Re: Obamacare.
Post by: AusShep on October 12, 2014, 02:32:00 pm
Interesting that HIV patients are making up such a huge number. 

The numbers are misleading.  It's based on number of Rx's, not enrolees.  If it were the number enrolled, it would more than the total HIV population of the US.  Also, based on the expense to the insurance companies it isn't nearly as far off from the employer plans.