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Author Topic: New Health Plan Questions  (Read 9364 times)

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Offline wow1969

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New Health Plan Questions
« on: March 21, 2010, 04:36:53 PM »
Does anyone understand how the new Health Plan will affect us pozzies?

Offline Esquare

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Re: New Health Plan Questions
« Reply #1 on: March 21, 2010, 05:48:11 PM »
For us it should be all positives.

Offline WillyWump

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  • your ramblings bore Yamaguchi Kitteh
Re: New Health Plan Questions
« Reply #2 on: March 21, 2010, 06:03:22 PM »
I have absolutely no idea how it will effect us or anyone else for that matter. I tried following it for awhile but with all the changes over the past months Ive lost track.
POZ since '08

Last Labs-
6/3/14 CD4- 736, UD 34%
6/25/13 CD4- 1036, UD,
2/4/13, CD4 - 489, UD, 28%

Current Meds: Prezista/Epzicom/ Norvir
.

Offline Dachshund

  • Member
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Re: New Health Plan Questions
« Reply #3 on: March 21, 2010, 06:15:05 PM »
It's rather simple. Most of the provisions in the bill won't take effect until 2014. However, in six months insurance companies can no longer deny insurance to children with a preexisting condition, and unisured adults with a preexisting condition will have access to an exchange that will provide coverage until the bill is in full effect. That would be me.

Offline Miss Philicia

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Re: New Health Plan Questions
« Reply #4 on: March 21, 2010, 06:18:18 PM »
I would assume that since this means the implementation of death panels and since pozzies are a net drag on our new socialist economy we'll all get sent to the gallows.
"Iíve slept with enough men to know that Iím not gay"

Offline Matty the Damned

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Re: New Health Plan Questions
« Reply #5 on: March 21, 2010, 06:19:29 PM »
I would assume that since this means the implementation of death panels and since pozzies are a net drag on our new socialist economy we'll all get sent to the gallows.

Firing squads not gallows. We socialists prefer firing squads to the rope.

MtD

Offline Dachshund

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Re: New Health Plan Questions
« Reply #6 on: March 21, 2010, 06:24:06 PM »
Watch Cspan you tired bitches, it's quite the spectacle. We have the votes. The tea baggers called Barney Frank a fag and Congressman John Lewis a nigger. This is your leaner and meaner Republican Party.

Offline Miss Philicia

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Re: New Health Plan Questions
« Reply #7 on: March 21, 2010, 06:26:31 PM »
Watch Cspan you tired bitches, it's quite the spectacle. We have the votes. The tea baggers called Barney Frank a fag and Congressman John Lewis a nigger. This is your leaner and meaner Republican Party.

Calm down missy... didn't you hear that Rep. King (R-Iowa) state that what they said was OK because he doesn't feel safe walking in a black neighborhood?
"Iíve slept with enough men to know that Iím not gay"

Offline phildinftlaudy

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  • sweet Ann what you think babe...
Re: New Health Plan Questions
« Reply #8 on: March 21, 2010, 06:32:36 PM »
It is interesting to watch the debate on tv - at least some of it - as you get to see the true colors of some people.

The elimination of the preexisting condition clause the most insurances have is going to be a great thing.  I remember when I started one of my previous jobs and they had that clause - good thing I was still eligible for Ryan White and had my VA benefits to fall back on otherwise I would have been screwed.  What I wonder is, even if the pre-existing clause is gone - how much will the insurance companies try to charge to provide insurance to those with pre-existing conditions -- they might not be able to exclude - but can they make it cost prohibitive?
September 13, 2008 - diagnosed +
Labs:
Date    CD4    %   VL     Date  CD4  %   VL
10/08  636    35  510   9/09 473  38 2900  12/4/09 Atripla
12/09  540    30    60   
12/10  740    41  <48   
8/11    667    36  <20  
03/12  1,041  42  <20
05/12  1,241  47  <20
08/12   780    37  <20
11/12   549    35  <20
02/12  1,102  42  <20
11/12   549    35  <20

Offline Matty the Damned

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Re: New Health Plan Questions
« Reply #9 on: March 21, 2010, 06:54:53 PM »
Alternatively you can enjoy the splenetic rantings of the lunar right over at Freepersville.

My favourite comment at the moment is from armed retard Flintsliver7 who observes:

If this were 1776 the revolution wouldíve started a long time ago.

Oh yeah.  :)

MtD

Offline Assurbanipal

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Re: New Health Plan Questions
« Reply #10 on: March 21, 2010, 07:34:32 PM »
There's a lot of different ways that HIV+ people get access to care now. 

Some people are employed with employer coverage -- for them the bill means that they don't have to worry about health care coverage as much if they lose their jobs or change employers.

Others are on Medicare -- with the "donut hole" that means there is a big cost of drugs each year if ADAP does not pick it up.  The bill gradually closes the donut hole which should be very helpful for those not on ADAP and serve to relieve some of the pressure on ADAP budgets (potentially fewer people on ADAP waiting lists).

For a lot of younger people (under age 26), they may now be able to get coverage under their parents policies.

It's not going to be paradise ...  But it should be better..
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline azprince

  • Member
  • Posts: 153
Re: New Health Plan Questions
« Reply #11 on: March 21, 2010, 07:43:46 PM »
Assur,
I have few questions please! If I have a maximum limit  on the pharmacy benefits under my current insurance , does this mean that immediately I will be able to keep my insurance pay for my Meds or this clause will not be implemented right away?
I have to admit : the good thing is that from now on;  I have no option but to succeed , still its ok to worry :))

Offline Inchlingblue

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Re: New Health Plan Questions
« Reply #12 on: March 21, 2010, 07:52:44 PM »
  unisured adults with a preexisting condition will have access to an exchange that will provide coverage until the bill is in full effect. 

Are you sure about this? I hope it's accurate but I haven't seen this provision and I'm following this pretty closely.

Offline adhoc

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  • Posts: 28
Re: New Health Plan Questions
« Reply #13 on: March 21, 2010, 09:32:08 PM »
HA  :D The  tea party guys are going to Searchlight! That is the kind of place they need to be! There is nothing there. Its between Las Vegas and Laughlin. It has alot of trailers and one tiny casino and a couple of non working mines. A great place to make a statement on a out of the way state highway and not in a large metro area. Not saying that the people that live there aren't OK but Searchlight is literally "outthere". Back to the subject at hand, If it passes, for everyone here it will be good, especially for those who cant afford insurance or cant get it. For those who  depend on state or public supported programs its a matter of time before alot shut down. I think one in SC and a few in CA just closed down (correct me if I'm wrong I think I read about a couple here). It concerns me that the states are cutting these programs and cutting education like they are. Hopefully this passes as it will relieve a lot of worries for everyone. Also for me I have insurance, I bought it prior to my diagnosis and I will no longer have to be locked into my locale and will open up options for people who want to relocate as one of my concerns is leaving my current insurance and not being able to get it again if I have to move, especially in this economy with work the way it is. Just my two cents.
alea iacta est

Offline Dachshund

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Re: New Health Plan Questions
« Reply #14 on: March 21, 2010, 09:41:48 PM »
Are you sure about this? I hope it's accurate but I haven't seen this provision and I'm following this pretty closely.

I'm pretty sure. I know almost immediately children won't be denied insurance because of a preexisting condition. From my reading of the bill  uninsured adults with a preexisting condition will have access to an exchange (it's not comprehensive coverage) until the bill kicks in in 2014.

Offline Assurbanipal

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  • Taking a forums break, still see PM's
Re: New Health Plan Questions
« Reply #15 on: March 21, 2010, 10:05:21 PM »
I'm pretty sure. I know almost immediately children won't be denied insurance because of a preexisting condition. From my reading of the bill  uninsured adults with a preexisting condition will have access to an exchange (it's not comprehensive coverage) until the bill kicks in in 2014.

It's not "technically" an exchange, which may be why it did not ring a bell with Inchling.  Instead it is access to a high risk pool.

It was in the Senate bill, section 1101.  This summary of "immediate" changes says that people who have been denied coverage will have access to a high risk pool effective 90 days after enactment.  See item 12 http://docs.house.gov/energycommerce/IMMEDIATE_PROVISIONS.pdf
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline Assurbanipal

  • Member
  • Posts: 2,173
  • Taking a forums break, still see PM's
Re: New Health Plan Questions
« Reply #16 on: March 21, 2010, 10:09:38 PM »
Assur,
I have few questions please! If I have a maximum limit  on the pharmacy benefits under my current insurance , does this mean that immediately I will be able to keep my insurance pay for my Meds or this clause will not be implemented right away?

It is not clear how the annual limits will work under the bill.  The Senate bill prohibited lifetime limits and said annual limits had to be "reasonable" under guidance that applied to high deductible plans as issued by the IRS.  (Section 2711 of the Senate bill) Presumably this meant IRS (and Treasury) would issue regulations defining what was and was not reasonable.

But the reconciliation bill overrides this and says HHS will define what a "reasonable" annual limit will be,  The new limits are to be effective 6 months after the Bill is signed into law.  See section 8 in the link http://docs.house.gov/energycommerce/IMMEDIATE_PROVISIONS.pdf

So...sorry but it is too early to tell how that will work in any detail

A
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline Assurbanipal

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  • Taking a forums break, still see PM's
Re: New Health Plan Questions
« Reply #17 on: March 21, 2010, 10:14:09 PM »
I posted some of these links in a different thread -- but there is a lot of information available on the bill including timelines, section by section details, list of consumer protections etc.  at the following website for the Speaker of the House.

http://www.speaker.gov/newsroom/legislation?id=0361

Scroll down to see the various summaries.
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline Rev. Moon

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  • Smart ass faggot ©
Re: New Health Plan Questions
« Reply #18 on: March 21, 2010, 11:24:27 PM »
"I have tried hard--but life is difficult, and I am a very useless person. I can hardly be said to have an independent existence. I was just a screw or a cog in the great machine I called life, and when I dropped out of it I found I was of no use anywhere else."

Offline tednlou2

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Re: New Health Plan Questions
« Reply #19 on: March 21, 2010, 11:54:59 PM »
Are you sure about this? I hope it's accurate but I haven't seen this provision and I'm following this pretty closely.

I was watching ABC when they broke in right before 11pm EDT.  Diane Sawyer mentioned this part of the bill that would help adults with preexisting conditions until it takes full effect in 2014.  I had never heard of it either until she said it.  I also learned Medicaid will be greatly expanded.  Eventually, no one should ever have to go bankrupt, because they got sick.  As we all know, healthcare bills are the number one reason for bankruptcies. 

It is a very good start, but not perfect by any means.  Not to get too off topic, but it just amazes me how people who claim to be Christian would try to stop this.  Start an illegal war that costs over $2 Trillion--fine.  Try to help people, forget it. 

Offline WillyWump

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  • your ramblings bore Yamaguchi Kitteh
Re: New Health Plan Questions
« Reply #20 on: March 22, 2010, 12:28:57 AM »
It's not "technically" an exchange, which may be why it did not ring a bell with Inchling.  Instead it is access to a high risk pool.

It was in the Senate bill, section 1101.  This summary of "immediate" changes says that people who have been denied coverage will have access to a high risk pool effective 90 days after enactment.  See item 12 http://docs.house.gov/energycommerce/IMMEDIATE_PROVISIONS.pdf

"12.
IMMEDIATE HELP FOR THE UNINSURED UNTIL EXCHANGE IS AVAILABLE (INTERIM HIGH‐RISK POOL)óProvides immediate access to insurance for Americans who are uninsured because of a pre‐existing condition ‐ through a temporary high‐risk pool. Effective 90 days after enactment."


Is there any indication anywhere as to what it might cost to enter the "high risk pool"? If it's cost prohibitive, then it does no good. If the govt is paying for it, How?
POZ since '08

Last Labs-
6/3/14 CD4- 736, UD 34%
6/25/13 CD4- 1036, UD,
2/4/13, CD4 - 489, UD, 28%

Current Meds: Prezista/Epzicom/ Norvir
.

Offline tednlou2

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Re: New Health Plan Questions
« Reply #21 on: March 22, 2010, 01:02:18 AM »
I was reading a question to a doc on thebody.  This just reinforces why we need healthcare reform.  This guy is stopping meds waiting for COBRA.  First, I don't see how anyone unemployed can afford COBRA.  You have to pay your share plus what your employer's share was.  I would think being out of work he would qualify for ADAP.  Then again, we've been talking about all the waiting lists for that.  It is just sad people have to make decisions like this.  Below is the Q&A:

suspending meds for 30 days till COBRA updates
Mar 21, 2010

I found out that I was HIV+ in Nov. 2008. Around that time I had a vl=81400 and CD4=118. I suspect that I had been unknowingly infected for some 8-10 years or so. Anyway, after receiving my diagnosis in 11/08, I soon began meds in 02/09. I was lucky enough to be a participant in a clinical study involving Isentress and Atazanvir (2 pills each, twice daily). At the start of my treatment my vl=97900 and CD4=138. In less than 2 months, my vl became undetectable and my CD4 rose to 194 (213 was highest achieved). The study was originally supposed to last for 2 years; but was unfortunately discontinued after 1 year of treatment. Last results: vl=UD, CD4=167.

Around the same time, I lost my job and am waiting to begin COBRA so that I might start paying for my meds. I found out today, that it takes approx. 30 days for Cobra to kick in, and I only have 1 weeks worth of current trial meds available before leaving the study. My doctor has written me new Rx's for Isentress and Truvada. I also have an appoinment with a social case worker to assist me in obtaining financial help going forward. I understand that I will have to pay out-of-pocket (full retail) for my new scripts for at least the first month (total $2300). I simply do not have this considering I'm currently unemployed.

Question: Considering my history, current vl and CD4, how terrible would it be if I simply stopped taking any meds until my insurance was re-instated (approx. 1-month)?

I have done some research and feel that I would be ok in regards to developing resistance. However, I'm not sure considering my CD4 is still < 200. I haven't spoken to my HIV specialist about this idea yet; but plan to do so this week. Any suggestions?

Thanks for all you do. This site is invaluable.

 
 
 
Advertisement
 
     Response from Dr. Holodniy

I can certainly understand the financial squeeze on you regarding your meds. Although it is not the optimal decision, stopping for 30 days is unlikely to affect any future HIV med regimens being able to get you back to undetectable and I agree, development of resistance would be unlikely. A couple of things to point out. First, make sure you at least are taking bactrim or septra once daily to protect you from serious opportunistic infections. That should be relatively cheap to continue. Second, you may suffer from a viral load rebound syndrome, where you might develop flu like symptoms or fever after discontinuing HIV meds.

 

Offline Assurbanipal

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  • Posts: 2,173
  • Taking a forums break, still see PM's
Re: New Health Plan Questions
« Reply #22 on: March 22, 2010, 07:29:49 AM »
"12.
IMMEDIATE HELP FOR THE UNINSURED UNTIL EXCHANGE IS AVAILABLE (INTERIM HIGH‐RISK POOL)óProvides immediate access to insurance for Americans who are uninsured because of a pre‐existing condition ‐ through a temporary high‐risk pool. Effective 90 days after enactment."


Is there any indication anywhere as to what it might cost to enter the "high risk pool"? If it's cost prohibitive, then it does no good. If the govt is paying for it, How?

The Senate bill (Section 1101) sets aside $5 billion to subsidize the high risk pools.  The policies have a wider range of vairation based on age (4 to 1) and a lower mandated benefit value (65%) than the policies in the exchanges and there is no explicit discussion of subsidies based on ability to pay. 

But it is expected that most of these high risk pools will be set up by the States, which may provide some subsidies as well.  So ... too soon to tell, and affordability will probably vary by State.
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline Inchlingblue

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Re: New Health Plan Questions
« Reply #23 on: March 22, 2010, 10:35:17 AM »
Thanks to everyone who provided additional info. about these pools. I wasn't aware of them. It sounds great as long as they aren't prohibitively expensive.

Offline randym431

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Re: New Health Plan Questions
« Reply #24 on: March 22, 2010, 08:43:25 PM »
Rep. King (R-Iowa) is one nasty person. He's said a lot worse. This must have been one of his more sane days.  :o

As to 2014, hey kiddies... Keep the democrats in power and they will likely tweak this starting point to a much earlier date. It only gets better " IF  " democrats remain in control, for us non 100mill yearly salary folks that don't happen to own a 20 million home on the beach in Florida. Yes Im talking about those rich self serving radio show hosts and former presidential candidate losers. Oh.. and that creepy lady that can see Russia from her house.   8)

Offline Jody

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Re: New Health Plan Questions
« Reply #25 on: March 22, 2010, 09:47:50 PM »
I was glad to see this pass of course, but being a bit of a worry wort I fear the individual states could try to water it down with Republicans behind the effort to do so.  A tax break for Exxon-Mobil is their only platform it seems.  History tells us that back in the 1930's the same kind of hateful folks blasted Social Security for the elderly and disabled as "communism".  The sons of guns (yes!) threw the same term around back in the 1960's when Medicare came into existence.  They can't debate so they shout slurs at otherwise decent people, it is a weakness and folks should see through it.  I'm not perfect to be sure but I strive daily to be a better person than those ultra-conservatives and their angry minions, or since they like to throw around the commie term maybe we can just call them Fascists, but a name game serves no purpose.

Anyway this Tea Party movement is a bit frightening, you wonder what classless and dangerous things they're capable of if heaven forbid we dip into a major recession or even a Depression.  Some of them are certainly the types who will first burn books, then people.  Really!!!  

Jody
« Last Edit: March 22, 2010, 09:54:03 PM by Jody »
"Wake up to find out that you are the eyes of the world".
 "Try to discover that you are the song that the morning brings."

Grateful Dead

Offline decayingsinner

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Re: New Health Plan Questions
« Reply #26 on: March 22, 2010, 10:24:19 PM »
Glad to hear about this but man these Republics make me more furious by the second.

Offline Assurbanipal

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Re: New Health Plan Questions
« Reply #27 on: March 23, 2010, 01:26:42 PM »
A couple more good things in the bill :

1) Some states only allow children and their parents and the dsabled onto Medicaid.  Single individuals who are not disabled can't get onto Medicaid in those states.  The Bill will expand Medicaid to cover people who can still work in all states whether or not they are "single", up to 133% of the poverty threshold. (This one generated some heated discussion in the Forums last year)

2) The bill prevents states from cutting back existing Medicaid eligibility provisions, effective on enactment.  So States that already allow poor working single people into Medicaid cannot balance their state budget by kicking people out as of this morning when the President signed the Bill.
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline LordBerners

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Re: New Health Plan Questions
« Reply #28 on: March 23, 2010, 01:44:18 PM »
1) Some states only allow children and their parents and the dsabled onto Medicaid.  Single individuals who are not disabled can't get onto Medicaid in those states.  The Bill will expand Medicaid to cover people who can still work in all states whether or not they are "single", up to 133% of the poverty threshold. (This one generated some heated discussion in the Forums last year)

Yes!  This is the provision that I found most likely to benefit me - I'm likely to have little or no income if I go back to the US, and this seems to mean that I would get Medicaid. 

I have two questions: first when does this provision kick in?  Presumably 2014?  And secondly, would that mean that a person getting Medicaid under those terms would get their hiv medicines from Medicaid instead of ADAP?  I wonder if Medicaid covers all meds..
Please, just call me Berners.. or Baron.

Offline Assurbanipal

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Re: New Health Plan Questions
« Reply #29 on: March 23, 2010, 02:03:37 PM »
Yes!  This is the provision that I found most likely to benefit me - I'm likely to have little or no income if I go back to the US, and this seems to mean that I would get Medicaid. 

I have two questions: first when does this provision kick in?  Presumably 2014?  And secondly, would that mean that a person getting Medicaid under those terms would get their hiv medicines from Medicaid instead of ADAP?  I wonder if Medicaid covers all meds..

States that choose to expand Medicaid will get some federal support in 2010.  But the requirement to expand Medicaid to cover all non-elderly under 133% of the poverty line s a 2014 provision.

But States are currently all over the place in what they offer.  You really need to talk to someone knowledgeable in the State you intend to move to and see what it offers.

You may find this chart at the Kaiser Family foundation State Health Facts page helpful in seeing which states recently allowed people on ADAP into Medicaid.  For the US as a whole, 11% of people receiving ADAP were on Medicaid but that is an average of a lot of States with 0% and some States with as much as 60% covered (Maine)
http://www.statehealthfacts.org/comparetable.jsp?ind=542&cat=11
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline Inchlingblue

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Re: New Health Plan Questions
« Reply #30 on: March 23, 2010, 03:06:54 PM »
A friend of mine who has HIV lives in AZ and he gets Medicaid (they call it AHCCCS). It covers all his meds and doctor appointments, it's basically comprehensive health insurance.

The thing is the current governor, a conservative Replublican, because Obama "stole" the previous liberal lesbian by offering her a job so she had to resign (Janet Napolitano), now intends to drop coverage to children who are eligible for the CHIP program (the only state considering this) as well as to many "single" adults on AHCCCS in order to balance the budget.
« Last Edit: March 23, 2010, 04:23:19 PM by Inchlingblue »

Offline wow1969

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Re: New Health Plan Questions
« Reply #31 on: March 23, 2010, 10:02:08 PM »
Thanks for the responses .. I think I'm still confused .. UGH

Offline justaguy

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Re: New Health Plan Questions
« Reply #32 on: March 23, 2010, 10:38:34 PM »
I have a HIV+ friend who has pretty bad insurance through work, but good income (just over $100k per year) and we've debated this thing until blue in the face.  His meds are only covered 50% through his work policy, so he's paying somewhere around $900 a month for meds out of pocket (after tax).  He and I hoped this bill would help his situation, since he could then go out and apply for a separate new policy to help cover the meds, outside of work.  But according to him the clause forcing coverage of pre-existing conditions doesn't set a limit on how much they can charge, so they could charge as much as $2,000 a month for coverage for him, so it would be pointless to do that.  Also, it changes levels of Flexible Spending Accounts, to lower numbers ($2,500), which hurts him since that's what he uses to pay his $900 per month, and also raises the medical expense deduction for income taxes from 7.5 to 9.5%, which also hurts him since he won't quite meet that if paying $900 a month.  Is this true?  He is pretty irate about it.  I can't find that it will change anything for me, but from what I'm reading, I have a so-called "Cadillac plan", and I'm worried about increased tax burden for that?  I do like the protections (exchanges, etc) it creates if we pozzies were to lose our jobs, or if we wanted to start our own businesses, but then again, my state already had a high-risk pool that I could have qualified for, so I have to wonder how redundant that is?
Estimated infection: 3/2008
Tested HIV positive: 3/31/2009
CD4 136/unknown %/VL 150,000: 4/6/2009
Started Atripla 4/17/2009
CD4 255/19%/VL 409 5/27/2009
CD4 247/??/VL 161 6/27/2009
CD4 257/21%/VL 60 7/22/2009
CD4 352/22%/VL Undetectable 10/21/2009
CD4 490/27%/VL Undetectable 2/15/2010
CD4 397/?/VL Undetectable 7/2/2010

Offline Inchlingblue

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Re: New Health Plan Questions
« Reply #33 on: March 24, 2010, 12:05:24 AM »
I have a HIV+ friend who has pretty bad insurance through work, but good income (just over $100k per year) and we've debated this thing until blue in the face.  His meds are only covered 50% through his work policy, so he's paying somewhere around $900 a month for meds out of pocket (after tax). 

Not to hijack the thread but you should tell your friend about co-pay assistance programs. I have two big co-pays until I meet the deductibles at the beginning of the year and Truvada and Isentress co-pay programs covered $600. for both January and February for a total of $1200.

LINK:

http://positivelyaware.com/2009/09_02/13th_annual_hiv_drug_guide.shtml

Offline RapidRod

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Re: New Health Plan Questions
« Reply #34 on: March 24, 2010, 04:16:19 PM »
It's rather simple. Most of the provisions in the bill won't take effect until 2014. However, in six months insurance companies can no longer deny insurance to children with a preexisting condition, and unisured adults with a preexisting condition will have access to an exchange that will provide coverage until the bill is in full effect. That would be me.
Wrong because they didn't read the bill and voted on it children will not get the preexisting condition care until 2014 like adults. Same with closing the loop hole in medicare and medication price reduction. They were in a rush to pass a bill that now it has to be changed and revoted on.

Offline Assurbanipal

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Re: New Health Plan Questions
« Reply #35 on: March 24, 2010, 06:00:13 PM »
Wrong because they didn't read the bill and voted on it children will not get the preexisting condition care until 2014 like adults. Same with closing the loop hole in medicare and medication price reduction. They were in a rush to pass a bill that now it has to be changed and revoted on.

Rapidrod
Dachshund appears to be referring to the two bills as a package:
- the Senate version of health care reform which the House passed and the President signed
- the additional changes agreed to by the House and Senate leadership which were set forth as a separate bill and have passed the House and are now being debated in the Senate. 

The suggestion that the second bill is needed because the first Bill had not been adequately read and vetted is just not true -- not to say that typo's and poorly phrased bits won't need to be fixed in the future (almost every big bill has several sets of "technical corrections "  its a routine part of the political process) -- but these are about additional policy changes on top of those in the Senate bill which form a package in the minds of the Democratic leadership.
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline Assurbanipal

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Re: New Health Plan Questions
« Reply #36 on: March 24, 2010, 06:58:13 PM »
I have a HIV+ friend who has pretty bad insurance through work, but good income (just over $100k per year) and we've debated this thing until blue in the face.  His meds are only covered 50% through his work policy, so he's paying somewhere around $900 a month for meds out of pocket (after tax).  He and I hoped this bill would help his situation, since he could then go out and apply for a separate new policy to help cover the meds, outside of work.  But according to him the clause forcing coverage of preexisting conditions doesn't set a limit on how much they can charge, so they could charge as much as $2,000 a month for coverage for him, so it would be pointless to do that.  Also, it changes levels of Flexible Spending Accounts, to lower numbers ($2,500), which hurts him since that's what he uses to pay his $900 per month, and also raises the medical expense deduction for income taxes from 7.5 to 9.5%, which also hurts him since he won't quite meet that if paying $900 a month.  Is this true?  He is pretty irate about it.  I can't find that it will change anything for me, but from what I'm reading, I have a so-called "Cadillac plan", and I'm worried about increased tax burden for that?  I do like the protections (exchanges, etc) it creates if we pozzies were to lose our jobs, or if we wanted to start our own businesses, but then again, my state already had a high-risk pool that I could have qualified for, so I have to wonder how redundant that is?

Justaguy

In a Nyquil/Norvir haze I typed up and lost a long response this morning (Note -- just because Sudafed mixes ok with Norvir does not mean Nyquil does  :) )  Sorry

On your friend's issues:
1) If he has coverage now it is not clear that he would even be able to participate in the high risk pools.  They are intended as a stopgap measure until 2014 for people who can't get coverage at all -- not for people who have coverage but don't like it.  As a stop gap for people who are really in desperate straits they are not expected to be as affordable or as protective as the long term solution.  That said, the bill does set aside $5billion to try to help keep the cost of these policies relatively affordable.  But comparing his current coverage to what he sees in the risk pools is, well ...

2) There has been a thread of discussion running through the whole healthcare debate that it is somehow almost unpatriotic to suggest that America does not have the best health care.  All this stuff about some Canadian official having an operation in the US is hauled out to say that because he was able to pay for the best that American health care could offer, so can all Americans.  Yes, some parts of American health care are superb, but in total the quality and access to health care in America is less even.  In round numbers about 30 million people don't have health insurance at all, and about 20,000 or so of them die each year because they don't.  And about 60 million people have health care insurance that is so cheap and riddled with holes that when they actually need it a sizable fraction of them go bankrupt -- about a third of all bankruptices in this country are due to bad health insurance that doesn't pay for squat (and another third of bankruptices are due to people not having adequate disability income insurance). 

The health care reform is mainly about bringing these 90 million people's benefits up.  It sounds like your friend's policy might be one of the rotten ones, or it might be just a bit better.  If it is one of the rotten ones, he will benefit from reforms that will make his employer fix some of the worst flaws -- for instance by not allowing lifetime caps or unreasonable annual caps on benefits.  If it is marginally above a rotten policy, (only "lousy"   :P)  then the legal changes may not directly affect his policy.  And giving up the employer subsidy and buying a decent policy from the exchanges is probably not going to be a good financial move. 

So, is he out of luck? 

Well... probably not.  The policies in the exchange will be out there for everyone to see, and employer health plans that are clearly inferior are going to stick out.  Employers with those lousy policies will see a lot of pressure from employees in hiring and the potential for bad news media coverage.  So there will be a lot of pressure on those employers to upgrade their plans to be at least as good as the exchanges or to cancel their plans and give their employees the money to shop for a plan.  So eventually, you can see the exchange plans as providing a competitive floor on health plans -- employees won't want to settle for less.

3) Your friend is right about the health spending account limit decreasing.  The limit on deducting health expenses actually goes up to 10% of income not 9.5% -- but that is in 2013.



As far as your concerns about the Cadillac tax -- 2018 is a long time from now, and health plans usually change a lot over any 5 year period.  The chance that you would still be working there and that no changes would have happened to the plan by then are probably pretty small.  And if you should change jobs you will have a lot of additional protections under the new law.  So, you need to balance the long term risks vs opportunities for yourself and also look at the long term added protections for 90 million of your fellow citizens.



Finally, when Social Security was first enacted it was amended quite frequently to deal with unintended consequences, add improvements etc.  The same is likely here.  But first we had to have something to improve.

A
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline RapidRod

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Re: New Health Plan Questions
« Reply #37 on: March 24, 2010, 07:21:46 PM »
Rapidrod
Dachshund appears to be referring to the two bills as a package:
- the Senate version of health care reform which the House passed and the President signed
- the additional changes agreed to by the House and Senate leadership which were set forth as a separate bill and have passed the House and are now being debated in the Senate. 

The suggestion that the second bill is needed because the first Bill had not been adequately read and vetted is just not true -- not to say that typo's and poorly phrased bits won't need to be fixed in the future (almost every big bill has several sets of "technical corrections "  its a routine part of the political process) -- but these are about additional policy changes on top of those in the Senate bill which form a package in the minds of the Democratic leadership.
I'm talking about the Healthcare Bill that was just signed into law on tuesday, that Obama claimed that would take care of preexisting conditions for children in 60 days after his signature. Well it is not going to happen in 60 days.

Offline Assurbanipal

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Re: New Health Plan Questions
« Reply #38 on: March 24, 2010, 09:41:43 PM »
I'm talking about the Healthcare Bill that was just signed into law on tuesday, that Obama claimed that would take care of preexisting conditions for children in 60 days after his signature. Well it is not going to happen in 60 days.

The President actually referred to the package of both bills.  He said:

"In a few moments, when I sign this bill, all of the overheated rhetoric over reform will finally confront the reality of reform. (Applause.) And while the Senate still has the last round of improvements to make on this historic legislation --

Audience Member: Yes.

President Obama: -- and these are improvements I'm confident they will make swiftly -- "

Read the VP's and President's signing speeches here http://www.nytimes.com/2010/03/24/us/politics/24health-text.html?pagewanted=2

Yes We Did!

5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline Inchlingblue

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Re: New Health Plan Questions
« Reply #39 on: March 24, 2010, 09:53:29 PM »
I think Rod is referring to something about the language being vague re: children with pre-existing conditions but HHS intends to fix this in the next 30 days.

LINK:

http://www.fiercehealthcare.com/story/health-reform-currently-leaves-kids-coverage-incomplete/2010-03-24

Offline Assurbanipal

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Re: New Health Plan Questions
« Reply #40 on: March 24, 2010, 09:59:59 PM »
I think Rod is referring to something about the language being vague re: children with pre-existing conditions but HHS intends to fix this in the next 30 days.

LINK:

http://www.fiercehealthcare.com/story/health-reform-currently-leaves-kids-coverage-incomplete/2010-03-24

Spin, Inchling and don't fall for it.

If the Secretary can specify it by regs under the law and does, it is IN the law.


5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline RapidRod

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Re: New Health Plan Questions
« Reply #41 on: March 24, 2010, 10:05:09 PM »
Assurbanipal, here is the link so that you will know what you are talking about.  

http://www.google.com/hostednews/ap/article/ALeqM5jYnajhWrPEXihcCrpRNfUKN7rN-AD9EKTKIG0

They screwed the bill up and no one caught it until today.
« Last Edit: March 24, 2010, 10:08:12 PM by RapidRod »

Offline Inchlingblue

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Re: New Health Plan Questions
« Reply #42 on: March 24, 2010, 10:51:20 PM »

If the Secretary can specify it by regs under the law and does, it is IN the law.


I agree.

Offline tednlou2

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Re: New Health Plan Questions
« Reply #43 on: March 25, 2010, 12:04:28 AM »
Wrong because they didn't read the bill and voted on it children will not get the preexisting condition care until 2014 like adults. Same with closing the loop hole in medicare and medication price reduction. They were in a rush to pass a bill that now it has to be changed and revoted on.

On the evening news tonight, the Obama Administration said their lawyers are looking at this and believe it can be corrected without having to be voted on again.  This is what they are saying at least.  We'll see.

Offline Assurbanipal

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Re: New Health Plan Questions
« Reply #44 on: March 25, 2010, 07:07:29 AM »
After 25 years of closely following new federal legislation:

- 1000+ page bills are not uncommon, no matter who controls Congress
- There are always a few issues where someone will look back and wonder if they phrased something correctly
- Usually it is fixable by regulations
- Sometimes it requires "technical corrections"  You will find pages of them at the back of other bills (part of the reason 1000+ page bills are not uncommon)

It is only the hyper-politicized nature of the debate that brings "issues" like these out and where cynical,  faux populist legislators, analysts or reporters try to pretend they are new or have any meaning.
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline Dachshund

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Re: New Health Plan Questions
« Reply #45 on: March 25, 2010, 08:02:00 AM »
I know Roddles is just gleeful hoping that children with preexisting conditions might somehow derail this bill. Don't worry Ro-Ro you're going to be able to keep you're socialist, government run healthcare that the tax payers pay for. However, the technical, parliamentarian rules that sent the bill back to the house will be corrected and the bill will be passed. No matter what the folks at Fox tell you.


Offline RapidRod

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Re: New Health Plan Questions
« Reply #46 on: March 25, 2010, 09:05:53 AM »
I know Roddles is just gleeful hoping that children with preexisting conditions might somehow derail this bill. Don't worry Ro-Ro you're going to be able to keep you're socialist, government run healthcare that the tax payers pay for. However, the technical, parliamentarian rules that sent the bill back to the house will be corrected and the bill will be passed. No matter what the folks at Fox tell you.


Again someday I want to meet you personally and thank you for taking care of mine and several other million people's healthcare.

Offline Miss Philicia

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Re: New Health Plan Questions
« Reply #47 on: March 25, 2010, 09:15:18 AM »
I know Roddles is just gleeful hoping that children with preexisting conditions might somehow derail this bill. Don't worry Ro-Ro you're going to be able to keep you're socialist, government run healthcare that the tax payers pay for. However, the technical, parliamentarian rules that sent the bill back to the house will be corrected and the bill will be passed. No matter what the folks at Fox tell you.



He claimed all of this was dead in the water six months ago anyway.  Not like he's ever, ever right about anything of a political nature, but whatever.
"Iíve slept with enough men to know that Iím not gay"

Offline Dachshund

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Re: New Health Plan Questions
« Reply #48 on: March 25, 2010, 10:31:52 AM »
Again someday I want to meet you personally and thank you for taking care of mine and several other million people's healthcare.

Don't waste your bus fare comrade, your sincere online "thanks" is all I need. Spend that money on a tractor pull. It's on me! :-*

Offline RapidRod

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Re: New Health Plan Questions
« Reply #49 on: March 25, 2010, 12:08:25 PM »
Don't waste your bus fare comrade, your sincere online "thanks" is all I need. Spend that money on a tractor pull. It's on me! :-*
Nah, that just doesn't seem like it's personal enough. And for your friend the bill didn't get passed back then and it's not over with yet.

Offline Jeff G

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Re: New Health Plan Questions
« Reply #50 on: March 25, 2010, 12:24:54 PM »
Hopefully they will stick the public option in there before they send it back .

Offline Hellraiser

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Re: New Health Plan Questions
« Reply #51 on: March 25, 2010, 12:27:49 PM »
I'm confused by all of this.  Is someone who is on medicare against socialized medicine?

Offline Dachshund

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Re: New Health Plan Questions
« Reply #52 on: March 25, 2010, 12:41:44 PM »
Nah, that just doesn't seem like it's personal enough. And for your friend the bill didn't get passed back then and it's not over with yet.

Put on your best dress Mary, we'll have a tea party. ;D Oh, and you're welcome.

Offline Dachshund

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Re: New Health Plan Questions
« Reply #53 on: March 25, 2010, 02:48:47 PM »
Senate just passed reconciliation 56-43 and the bill returns to the house to be voted on around 7:00 pm. Healthcare here we come!

Offline Jeff G

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Re: New Health Plan Questions
« Reply #54 on: March 25, 2010, 03:03:12 PM »
Put on your best dress Mary, we'll have a tea party. ;D Oh, and you're welcome.


I do hope you are talking about a proper Tea party . Those Tea Bagging Republicans have turned something wholesome like a hot hairy nut sack dangling in my upturned face into something ghastly . 

Offline Miss Philicia

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Re: New Health Plan Questions
« Reply #55 on: March 25, 2010, 03:07:35 PM »
It's dead in the water I tell ya!  N'obama is a miserable failure, as is Pelosi!
"Iíve slept with enough men to know that Iím not gay"

Offline azprince

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Re: New Health Plan Questions
« Reply #56 on: March 25, 2010, 03:24:31 PM »
It's dead in the water I tell ya!  N'obama is a miserable failure, as is Pelosi!
I smell tea bags  ;D
I have to admit : the good thing is that from now on;  I have no option but to succeed , still its ok to worry :))

Offline Miss Philicia

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Re: New Health Plan Questions
« Reply #57 on: March 25, 2010, 03:35:10 PM »
I smell tea bags  ;D

You're soaking in it, Madge!
"Iíve slept with enough men to know that Iím not gay"

Offline Miss Philicia

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Re: New Health Plan Questions
« Reply #58 on: March 25, 2010, 09:07:23 PM »
MSNBC BREAKING NEWS: Reconciliation just passed in the house 220-207

This legislation is now complete.
"Iíve slept with enough men to know that Iím not gay"

Offline Assurbanipal

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Re: New Health Plan Questions
« Reply #59 on: March 25, 2010, 10:01:07 PM »
This legislation is now complete.

NAWwww

This legislation is now ready to be signed into law and set the floor for  vast ongoingimprovements in access to health care for all Americans!  With this legislation as a base we have taken a solid first step.

And here's to many more!
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline metekrop

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Re: New Health Plan Questions
« Reply #60 on: March 26, 2010, 03:01:27 PM »
Most of the provisions in the bill won't take effect until 2014.

What do you mean?  Should people keep on dying up to the year 2014.  It will be effected in the coming 10 - 15 days.  It is the question of servival.
Diag on Dec 8, 2000, CD 440 VL 44K, No Meds
Dec/08 - Feb/09 CD< 50 & VL >500k hosp'z.
St. Atripla - July/09 CD 179, VL 197k
Oct/09 CD 300 VL UD Chol 267
Mar/10 CD 468 UD, Ch 220
Aug/10 CD 460 UD, Ch 195
Dec/10 CD 492 UD, Ch 172
Mar/11 CD 636 UD, Ch 201
Aug/11 CD 530 UD, Ch 98
Jan/12 cd 616 UD, ch 189
Jul/12 CD 640 UD, Ch ?
Dec/12 CD 669 Ud, Ch 125
May/7 CD711 Ud, Ch?
Nov/ 22 663 UD, Ch,
April 17 CD 797, UD

Offline Florida69

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Re: New Health Plan Questions
« Reply #61 on: March 26, 2010, 03:14:06 PM »
I thought this was pretty informative.... made sense to me..

http://www.cnn.com/2010/HEALTH/03/24/health.care.viewer.faqs/index.html?hpt=C1



CNN) -- With the passage of the health care reform bill, CNN has been flooded with viewer questions about specifics of the measure and how their lives may be affected. In response, we're providing answers here, based on our reporting research, that address some of the issues you're raising most often. Got another question? E-mail us at healthcare@cnn.com.

Question: Would you please check and report on this "doctors fix" part of the bill? Is it a part of this new bill, and if so, did the [Congressional Budget Office] score it against the deficit? I heard that it will be part of this bill and that it wasn't scored by the CBO, and if it had been scored that the CBO would have shown this to add to the deficit. I want what is in this bill, but I'm concerned that the country can't or won't be able to afford it down the road. Asking you to keep them honest!

Answer: The "doctors fix" (which would eliminate years of scheduled pay cuts for Medicare doctors) is not in the final health care plan. It was in the House bill but was dropped when Democrats decided to move forward with the Senate version instead. Your deficit concerns are still appropriate, though. Doctors' groups expect a separate bill dealing with this issue, and Democrats passed language in their "pay-go" measure allowing them to borrow money to pay for the "doc fix." It will be hundreds of billions of dollars.

Question: Health care for all is a necessity, and it's a noble goal, but the current process leaves much to be desired. By many estimates, there are 48 million without insurance. This plan covers 32 million. What happens to the remaining 16 million? They will still need and get health care, somewhere. They can not be turned away by hospitals under the Emergency Medical Treatment and Active Labor Act, passed by the same elected people who are now saying that these people are not eligible to be covered under health care reform.

Answer: You're right, the health bill is forecast to bring health insurance to 32 million more Americans than now (by 2019). But your second number may be off. The Congressional Budget office thinks that by 2019, there will be 23 million people without health insurance (instead of 16). What happens to them? A significant amount of them will be illegal/undocumented immigrants who, under the Senate bill, cannot buy insurance in the main market, even with their own money. You are right that this group may raise further health care questions.
Go here, page 7, for more information.

Question: If this is going to help us get cheap insurance, why do we have to wait four years? We will be broke because the insurance companies will raise all of our rates.

Answer: The health care plan sets up a high-risk pool for people who can't get or have high-cost insurance now (for various reasons) and who can't wait for the plan to fully kick in. The idea is to significantly cut costs for groups that face the highest rates and most trouble getting insurance. But it's temporary, lasting only until the broader reforms start in 2014.

Question: The Constitution says the federal government is not supposed to meddle in state business. If a state opts not to accept this health care bill, can the feds force me as an individual to get insurance?

Answer: No one may have the answer to this question yet. Attorneys general from 14 states are preparing to sue the federal government precisely over this issue. Those states are Alabama, Colorado, Florida, Idaho, Louisiana, Michigan, Nebraska, Pennsylvania, South Carolina, South Dakota, Texas, Utah, Virginia and Washington.

Question: Could you give me an outline showing a timeline or date grid explaining what laws take effect on what dates? My wife has a pre-existing condition, and we pay a huge amount for her coverage. I'm wondering how soon we can apply for coverage from another company and not get rejected. Time is running out on us -- financially.

Answer: Many parts of the bill go into effect at different times. The new insurance "exchanges" and individual mandate, for example, start in 2014. And unfortunately for you, insurers can continue to exclude or charge higher rates for adults because of pre-existing conditions until 2014. There is some potential help for your family, though. This bill sets up a "high-risk" pool for people like your wife who have difficulty getting reasonably-priced (or any) health insurance. That should be set up in coming months. Start by calling the Department of Health and Human Services. And here's a timeline outlining when measures will come into effect.

Question: Can you explain whether the elimination of lifetime caps under the new health care bill applies to existing policy-holders as well as new insurance sign-ups?

Answer: Yes, within six months, the private insurance plans will have to stop some practices, such as setting lifetime limits on coverage and canceling policy-holders who get sick, on all new policies and current policies.

Question: I have been watching all of the debating. I still cannot figure out, what does this mean to me? I'm an unemployed 56-year-old. Lost my health care. Cannot afford COBRA. Now, what is there for me? I have a daughter in college. My insurance company refused to pay for therapy on my knees, calling it pre-existing. My unemployment just ran out. Now what?

Answer: When the insurance exchange opens, as required by the health care bill, people who are self-employed or whose employers don't offer coverage can purchase a plan. If you lost a job, you could get insurance through this new marketplace. Also, once this exchange opens, private insurers will no longer be able to turn away people with medical problems or charge them more. Individuals would be required to purchase coverage or face a fine of up to $695 or 2.5 percent of income, whichever is greater, starting in 2016. The plan includes a hardship exemption for poorer Americans. Exemptions will be granted for financial hardship, those for whom the lowest-cost option exceeds 8 percent of an individual's income and those with incomes below the tax filing threshold (in 2009, the threshold for taxpayers under age 65 was $9,350 for singles and $18,700 for couples).

Question: What happens to the cost of insurance to the company that is providing the insurance to the employee? Is there a set amount or percentage of the total premium that the employer is required to pay? Will it change the mix that already exists between employer and employee responsibility?

Answer: By no later than 2014, states will have to set up Small Business Health Options Programs, or SHOP exchanges, in which small businesses will be able to pool together to buy insurance. Small businesses are defined as those with no more than 100 employees, though states have the option of limiting pools to companies with 50 or fewer employees through 2016; companies that grow beyond the size limit will also be grandfathered in. But until the SHOP exchanges are set up, there will be a tax break for small businesses that goes into effect right away: Tax credits of 35 percent to 50 percent of premiums will be available to small businesses that offer coverage.

Question: I am living with HIV and cannot get health care coverage. If this reform passes, how long before I am able to get coverage?

Answer: By 2014, that there would be no discrimination based on pre-existing conditions. You could not be denied based on an infection or some sort of pre-existing illness. That's four years away, though.

Question: What will happen when there are not enough doctors to oblige all the patients?

Last year, the American Academy of Family Physicians predicted a shortfall of 40,000 primary care doctors, and that was before the signing of the health care bill. That will put another 32 million people into the system -- with a promise of free preventive care -- and insurance to pay for regular doctor visits. Some physicians have expressed concern about this. Patients could see increased wait times, as in Massachusetts, where since "RomneyCare" went into effect, residents wait an 10 extra days to see the doctor. But others say the bill will help create more community health centers, so primary care can happen at these centers instead of expensive emergency rooms

Question: Isn't defensive medicine a big factor leading to overtreatment both at the beginning and at the end of life?

Answer: A recent Gallup Poll found that nine in 10 doctors admit having practiced defensive medicine at some time during their career. Some estimates put the cost at hundreds of billions of dollars in a year. If you look at all the lawsuits, there are about a million people who claim some sort of harm in any given year. But only about 11,000 lawsuits are actually paid out. Medical malpractice represents really only about 2 percent of the health care budget.

Question: Is there anything in the bill about rationing health care?

Answer: No one is using the term "rationing" as part of the bill. But there is a term called comparative effectiveness. And that's this idea that we figure out what works in medicine and make sure to pay for those things. This also means that there are a lot of things being done right now where there's not scientific proof that it works and maybe those things won't get paid any more. Some people call that rationing. Other people say, look, rationing exists under the current system. It's just that the insurance companies are essentially rationing by denying payment or dropping people off their coverage.

Question: I recently had to go to the ER for a rash. I had a $100 co-pay. If the new health care bill passes, would the co-pays for ER visits go down?

Answer: Not necessarily. In 2014, you will be able to buy a standardized health plan through a state-based exchange, with tiers of benefit packages available, if you do not have insurance through your employer, Medicare or Medicaid. You will be able to choose whether you want a plan with a higher premium and lower cost-sharing or a lower premium and higher cost-sharing. It will be very clear what the responsibilities will be for co-pays. Also, through the exchanges, there will be two multistate private plans under contract with the federal government, one of which must be nonprofit. But none of this means that your co-pays for ER visits will necessarily go down.

Question: I am on a Blue Cross Blue Shield PPO plan where I pay $252 now. It has been increasing every year, and I may have been to the doctor probably once or twice a year for physical. I do not smoke and am in perfect health, but every year for some reason, my they keep raising my insurance costs. With the new reform, are they going to have some checks and balance on these companies, who before did not have to answer to anyone? Or can I change my insurance to a government-run cheaper insurance?

Answer: Beginning in 2011, companies that spend more than a specified portion of premiums on administrative costs and profits must give a rebate to enrollees. In other words, large insurance companies will need to give rebates if they spend less than 85 percent of money from enrollees on medical costs. In the individual market, that figure is 80 percent. Also, the health care exchanges could reject premium increases that insurers propose if they think they are too high.

In 2014, on the individual market, you can buy your own insurance through the exchanges if you do not have health insurance through your employer, or through Medicare or Medicaid. These exchanges are supposed to provide plans that are as good as employer-based plans, which generally have good benefits. If you do have employer-based coverage, however, and don't spend more than 9.5 percent of your income on premiums and the plan covers at least 60 percent of medical costs, you are not eligible for premium subsidies. But if your employer-based coverage does not meet this standard, you will be able to get insurance through the exchange, and your employer is required to pay a penalty.

Question: Over 30 million couples suffer from infertility in the United States. Most insurers will not cover this problem. Will the new bill finally address this as a significant health problem?

Answer: There is nothing in the bill regarding this issue. One benefit is that insurance companies cannot deny coverage to couples who suffer from infertility because it was deemed a pre-existing condition. However, in terms of covering infertility treatments or in-vitro fertilization, none of that is made mandatory under the bill for insurance companies.

Question: Is there any provision for a part-time employee getting health insurance from their employer under the new health care bill?

Answer: It's not in the employer responsibility provision to offer health insurance to their part-time employees under the new law.

However, employers who have more than 50 full-time employees are required by 2014 to offer coverage to employees or pay a $2,000 penalty per employee after their first 30 if at least one of their employees receives a tax credit.

Nothing in the world can take the place of Persistence. Talent will not; nothing is more common than unsuccessful men with talent. Genius will not; unrewarded genius is almost a proverb. Education will not; the world is full of educated derelicts. Persistence and determination alone are omnipotent. The slogan 'Press On' has solved and always will solve the problems of the human race.
Calvin Coolidge

Offline Inchlingblue

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Re: New Health Plan Questions
« Reply #62 on: March 26, 2010, 05:03:53 PM »

Question: I am living with HIV and cannot get health care coverage. If this reform passes, how long before I am able to get coverage?

Answer: By 2014, that there would be no discrimination based on pre-existing conditions. You could not be denied based on an infection or some sort of pre-existing illness. That's four years away, though.
 

I wonder why they did not mention the high risk pools for this person? Isn't that an option for someone with HIV without insurance?

Offline ATorrez

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Re: New Health Plan Questions
« Reply #63 on: March 26, 2010, 05:25:47 PM »
Not all states have high risk plans. A few years ago, I was planning to move to Nevada and I was unable to secure a job before moving there. I looked to see if they had a high risk plan in the event I couldn't find a job before getting out, but they didn't have one.

I ended up not moving, because there just are not that many jobs out in Nevada in my field. I could have moved to Utah, but I can't stand Mormons.
Piss off a democrat: Take responsibility for your life and your actions.

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Offline Inchlingblue

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Re: New Health Plan Questions
« Reply #64 on: March 26, 2010, 05:27:32 PM »
Not all states have high risk plans. A few years ago, I was planning to move to Nevada and I was unable to secure a job before moving there. I looked to see if they had a high risk plan in the event I couldn't find a job before getting out, but they didn't have one.

I ended up not moving, because there just are not that many jobs out in Nevada in my field. I could have moved to Utah, but I can't stand Mormons.

The high-risk pools  (or "exchanges") that I'm referring to are part of the new legislation. Supposedly they will go into effect within the first year and be open to those with pre-existing conditions. It's explained above, in Florida69's post with the CNN reporting.

Offline Assurbanipal

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Re: New Health Plan Questions
« Reply #65 on: March 26, 2010, 05:30:00 PM »
I wonder why they did not mention the high risk pools for this person? Isn't that an option for someone with HIV without insurance?
A lot of it is pretty iffy .  
 - They talk about the State AG suits without mentitoning the 16th Amendment
- They don't mention the training programs (and the recent decision by Medicare to pay more to the types of docs we need the most and less to those in oversupply) when they talk about access to docs

It's CNN -- they don't do detail well

But yes, HIV is a preexisting condition and if you were denied coverage you are eligible for the high risk pools.  And maybe they think they covered it with this one

Question: Could you give me an outline showing a timeline or date grid explaining what laws take effect on what dates? My wife has a pre-existing condition, and we pay a huge amount for her coverage. I'm wondering how soon we can apply for coverage from another company and not get rejected. Time is running out on us -- financially.

Answer: Many parts of the bill go into effect at different times. The new insurance "exchanges" and individual mandate, for example, start in 2014. And unfortunately for you, insurers can continue to exclude or charge higher rates for adults because of pre-existing conditions until 2014. There is some potential help for your family, though. This bill sets up a "high-risk" pool for people like your wife who have difficulty getting reasonably-priced (or any) health insurance. That should be set up in coming months. Start by calling the Department of Health and Human Services. And here's a timeline outlining when measures will come into effect.
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline madbrain

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Re: New Health Plan Questions
« Reply #66 on: March 26, 2010, 08:22:23 PM »

Offline Inchlingblue

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Re: New Health Plan Questions
« Reply #67 on: March 26, 2010, 08:43:12 PM »
"Applicants must be U.S. citizens who are not covered by another form of insurance, have been denied coverage due to a pre-existing condition and have been without health care coverage for at least six months."

That's a crock, in six months someone with HIV and no meds can die. Same goes for anyone with any other life threatening illness. Why do they make people have to jump through hoops? It should be enough that a person has a condition, period. But no, they make you wait six months and they make you apply for insurance and be denied before you even qualify.

Does it cross anyone's mind to try and make life just a little easier for a person with a serious condition such as HIV or cancer or diabetes or whatever? NO, God forbid, let's make them wait six months and make sure they show proof that they've applied for other insurance, maybe by then they'll be dead and we won't have to deal with them at all!

I have to vent.

Offline madbrain

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Re: New Health Plan Questions
« Reply #68 on: March 26, 2010, 08:51:15 PM »
"Applicants must be U.S. citizens who are not covered by another form of insurance, have been denied coverage due to a pre-existing condition and have been without health care coverage for at least six months."

That's a crock, in six months someone with HIV and no meds can die. Same goes for anyone with any other life threatening illness. Why do they make people have to jump through hoops? It should be enough that a person has a condition, period. But no, they make you wait six months and they make you apply for insurance and be denied before you even qualify.

I think you could remain on ADAP during the 6 months period since it isn't health insurance. But if you are ineligible for it and without any coverage, then you are screwed.

Quote
Does it cross anyone's mind to try and make life just a little easier for a person with a serious condition such as HIV or cancer or diabetes or whatever? NO, God forbid, let's make them wait six months and make sure they show proof that they've applied for other insurance, maybe by then they'll be dead and we won't have to deal with them at all!

I have to vent.

I think previous iterations of the health care bill would have done that. But now you have to wait until 2014 to be guaranteed coverage. And yes, it sucks. But it's still better than what we have now. Provided it doesn't get repealed by then.


Offline Inchlingblue

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Re: New Health Plan Questions
« Reply #69 on: March 26, 2010, 09:40:43 PM »
Provided it doesn't get repealed by then.

The President would have to sign the repeal and, as long as it's Obama or a Democrat in the White House, they would veto it so it's unlikely to happen for a while.

I do hope they improve upon it. This other provision in the high risk pools can make it prohibitive for many, 65% of costs (if they stick to that minimum) is pretty shabby:

The plan must cover at least 65 percent of participantsí health costs and follow annual out-of-pocket limits set in the bill.

Offline ATorrez

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Re: New Health Plan Questions
« Reply #70 on: March 26, 2010, 09:45:29 PM »
Actually, no, the President does not need to sign a repeal. If there are enough people in the House and Senate to support something they can override a Presidential veto.

And I hope to high hell, we (the Republicans) take back power and obliterate this bill. I can't think of anything short of a cure for HIV that would make me happier.
Piss off a democrat: Take responsibility for your life and your actions.

"When Marxist dictators shoot their way into power in Central America, the San Francisco Democrats don't blame the guerrillas and their Soviet allies. They blame United States policies of 100 years ago. But then they always blame America first." -Jeanne Kirkpatrick

Offline Inchlingblue

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Re: New Health Plan Questions
« Reply #71 on: March 26, 2010, 09:54:01 PM »
Actually, no, the President does not need to sign a repeal. If there are enough people in the House and Senate to support something they can override a Presidential veto.

And I hope to high hell, we (the Republicans) take back power and obliterate this bill. I can't think of anything short of a cure for HIV that would make me happier.

You and RapidRod shouldn't get your hopes up.

Because itís highly doubtful that the GOP will convince any Democrats who supported the bill to change their votes, that means Republicans would need to win 40 House seats and 10 Senate seats in this fallís election to gain simple majorities to pass the bill. But to repeal some of the reforms ó like the individual insurance mandate ó they would need 60 votes in the Senate, meaning the GOP would have to gain 19 seats.

Even then, it wouldnít be signed into law because thereís no doubt President Obama would veto it. To override a veto, Republicans would need two-thirds of each house.

That means 67 senators and 290 House members. To achieve that goal, Republicans would need to gain 26 seats in the Senate and 112 in the House.


LINK:

http://www.pensitoreview.com/2010/03/26/to-repeal-health-care-law-gop-must-elect-26-new-senators-112-house-members/

One of the strangest and indescribable things I have seen and heard throughout this whole Health care debate is the new campaign slogan that Republicans have come up with that they are sure is going to be a winner and that is "Repeal and Replace." Their supporters are jumping up down with joy over this but there is on little thing that Republicans are not telling their supports and that is repealing a new law is extremely hard, it is even harder than just beating a filibuster. For Republicans to be able to repeal this legislation not only would they have to have a complete sweep in the election in November they would have convince several Democrats to vote with them, not only to get the 3/5ths vote necessary to repeal the law but the 2/3rds vote to over turn a veto by President Obama. But as President Obama said yesterday, if the Republicans want to run on that then they can go for it.

LINK:

http://www.mccookgazette.com/blogs/1460/entry/33975/
« Last Edit: March 26, 2010, 10:08:38 PM by Inchlingblue »

Offline phildinftlaudy

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Re: New Health Plan Questions
« Reply #72 on: March 26, 2010, 10:02:23 PM »
To paraphrase some words I read in a thread earlier today "it is beyond my scope of imagination" why anyone would want the health reform bill overturned and remain with the status quo - which was more than 37 million with no insurance and people being only one medical bill away from bankruptcy - it is really beyond my scope of imagination particularly how anyone who is HIV+ (if they are actually HIV+) would want this bill repealed.  Maybe anyone who thinks this way is one of the elite -- God help the person if they ever suffer a downturn in their economic status and find themself in need of medical care, insurance or any other type of government assistance. 
September 13, 2008 - diagnosed +
Labs:
Date    CD4    %   VL     Date  CD4  %   VL
10/08  636    35  510   9/09 473  38 2900  12/4/09 Atripla
12/09  540    30    60   
12/10  740    41  <48   
8/11    667    36  <20  
03/12  1,041  42  <20
05/12  1,241  47  <20
08/12   780    37  <20
11/12   549    35  <20
02/12  1,102  42  <20
11/12   549    35  <20

Offline madbrain

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Re: New Health Plan Questions
« Reply #73 on: March 26, 2010, 10:32:28 PM »
Around the same time, I lost my job and am waiting to begin COBRA so that I might start paying for my meds. I found out today, that it takes approx. 30 days for Cobra to kick in, and I only have 1 weeks worth of current trial meds available before leaving the study.

Insurance companies are required to provide uninterrupted coverage. It should not take 30 days, even if their records are not updated. When I left my job last year and the coverage was stopped, Kaiser made me sign a paper saying that I would be financially responsible for charges if they were not covered by insurance. I paid the copays just as before. I got some bills in the mail soon after. But when I finally got to pay the COBRA premium, coverage was retroactive to my termination date and all those bills were cancelled.

Offline madbrain

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Re: New Health Plan Questions
« Reply #74 on: March 26, 2010, 10:41:05 PM »
But according to him the clause forcing coverage of pre-existing conditions doesn't set a limit on how much they can charge, so they could charge as much as $2,000 a month for coverage for him, so it would be pointless to do that.

That's incorrect, the bill also prevents insurance companies from charging higher premiums based on those pre-existing conditions. Otherwise, there would be no point - companies would accept you and then charge you for the full cost of your meds and indeed, there would be no point. I think only tobacco usage and age are allowed to be considered in the premium.

Quote
Also, it changes levels of Flexible Spending Accounts, to lower numbers ($2,500), which hurts him since that's what he uses to pay his $900 per month, and also raises the medical expense deduction for income taxes from 7.5 to 9.5%, which also hurts him since he won't quite meet that if paying $900 a month.  

The bill sets maximum out-of-pocket annual expenses for all insurance plans in 2014. That limit will be less than $900/month. So his costs will go way down.

Quote
Is this true?  He is pretty irate about it.  I can't find that it will change anything for me, but from what I'm reading, I have a so-called "Cadillac plan", and I'm worried about increased tax burden for that?  I do like the protections (exchanges, etc) it creates if we pozzies were to lose our jobs, or if we wanted to start our own businesses, but then again, my state already had a high-risk pool that I could have qualified for, so I have to wonder how redundant that is?

Some of those state high-risk pools are pretty bad. For example the California plan has annual limits of $75k and lifetime of $750k . If you get your meds through them, it can eat into those limits. Any hospitalization on top of that probably would still leave you with lots of bills. And of course once you hit the lifetime cap, it's over.

Offline RapidRod

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Re: New Health Plan Questions
« Reply #75 on: March 26, 2010, 10:41:33 PM »
You and RapidRod shouldn't get your hopes up.

Because itís highly doubtful that the GOP will convince any Democrats who supported the bill to change their votes, that means Republicans would need to win 40 House seats and 10 Senate seats in this fallís election to gain simple majorities to pass the bill. But to repeal some of the reforms ó like the individual insurance mandate ó they would need 60 votes in the Senate, meaning the GOP would have to gain 19 seats.

Even then, it wouldnít be signed into law because thereís no doubt President Obama would veto it. To override a veto, Republicans would need two-thirds of each house.

That means 67 senators and 290 House members. To achieve that goal, Republicans would need to gain 26 seats in the Senate and 112 in the House.


LINK:

http://www.pensitoreview.com/2010/03/26/to-repeal-health-care-law-gop-must-elect-26-new-senators-112-house-members/

One of the strangest and indescribable things I have seen and heard throughout this whole Health care debate is the new campaign slogan that Republicans have come up with that they are sure is going to be a winner and that is "Repeal and Replace." Their supporters are jumping up down with joy over this but there is on little thing that Republicans are not telling their supports and that is repealing a new law is extremely hard, it is even harder than just beating a filibuster. For Republicans to be able to repeal this legislation not only would they have to have a complete sweep in the election in November they would have convince several Democrats to vote with them, not only to get the 3/5ths vote necessary to repeal the law but the 2/3rds vote to over turn a veto by President Obama. But as President Obama said yesterday, if the Republicans want to run on that then they can go for it.

LINK:

http://www.mccookgazette.com/blogs/1460/entry/33975/
Wrong, it could be independents.

Offline ATorrez

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Re: New Health Plan Questions
« Reply #76 on: March 26, 2010, 10:51:32 PM »
That's incorrect, the bill also prevents insurance companies from charging higher premiums based on those pre-existing conditions.


Actually, you're only partially correct. Rates are "pooled", usually. So just because they can't raise YOUR rates because a pre-existing condition does NOT mean they can't do it to the entire pool.
Piss off a democrat: Take responsibility for your life and your actions.

"When Marxist dictators shoot their way into power in Central America, the San Francisco Democrats don't blame the guerrillas and their Soviet allies. They blame United States policies of 100 years ago. But then they always blame America first." -Jeanne Kirkpatrick

Offline skeebo1969

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Re: New Health Plan Questions
« Reply #77 on: March 26, 2010, 10:56:24 PM »
why anyone would want the health reform bill overturned and remain with the status quo - which was more than 37 million with no insurance and people being only one medical bill away from bankruptcy - it is really beyond my scope of imagination particularly how anyone who is HIV+ (if they are actually HIV+) would want this bill repealed.  Maybe anyone who thinks this way is one of the elite -- God help the person if they ever suffer a downturn in their economic status and find themself in need of medical care, insurance or any other type of government assistance. 

I agree.
I despise the song Love is in the Air, you should too.

Offline Miss Philicia

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Re: New Health Plan Questions
« Reply #78 on: March 26, 2010, 11:04:19 PM »
The idea that Republicans will retake any part of Congress when their white trash supporters are running around the country vandalizing property is simply absurd.  There will be no repeal.  Ever.
"Iíve slept with enough men to know that Iím not gay"

Offline ATorrez

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Re: New Health Plan Questions
« Reply #79 on: March 26, 2010, 11:06:47 PM »
To paraphrase some words I read in a thread earlier today "it is beyond my scope of imagination" why anyone would want the health reform bill overturned and remain with the status quo - which was more than 37 million with no insurance and people being only one medical bill away from bankruptcy - it is really beyond my scope of imagination particularly how anyone who is HIV+ (if they are actually HIV+) would want this bill repealed.  Maybe anyone who thinks this way is one of the elite -- God help the person if they ever suffer a downturn in their economic status and find themself in need of medical care, insurance or any other type of government assistance.  

I am against it because I don't believe in government handouts. I believe in people going out and getting a job and supporting themselves. This country would not be in debt if we weren't always giving away free shit. Our public schools have done a huge diservice to our children by teaching them that they are owed stuff just because they're alive. They're not.

Being HIV+ makes me feel this way even more. When I was diagnosed I made a vow that I would never die of AIDS. I will die of my own hand before I die of AIDS. I made a promise to myself that I was always going to work hard and be a productive citizen. I made a promise that no one would take away my dignity.

Do I struggle? Hell yes. I am depressed a lot of the time, but I keep pushing myself. I have to wake up at 5 a.m. some days to be in class by 6, other days I have to be up at 4 a.m. to be at the hospital an hour away from me at 5:30 a.m. for clinical rotations. And it's hard, and I bitch and moan and I cry about it, but I still do it anyway. There are so many people in such worse situations who are able to get their ass out of bed and go to work.

I'd love to sit around and collect "free" stuff from the government, but I have too much pride to do that. No one gives me a fucking dime for anything, everything I have it bought and paid for by myself and it belongs to me and whomever I wish to share it with.

When I graduate from the anaesthesiology programme next year I expect my income to go from the $65,000 a year it is now to $130,000 a year. Why is anyone else entitled to a portion of that? I have been in college since I was 17 years old working my ass off. I don't care if you or anyone else thinks I am greedy. I worked hard for it and it's mine, get your own.
« Last Edit: March 26, 2010, 11:10:43 PM by ATorrez »
Piss off a democrat: Take responsibility for your life and your actions.

"When Marxist dictators shoot their way into power in Central America, the San Francisco Democrats don't blame the guerrillas and their Soviet allies. They blame United States policies of 100 years ago. But then they always blame America first." -Jeanne Kirkpatrick

Offline phildinftlaudy

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Re: New Health Plan Questions
« Reply #80 on: March 26, 2010, 11:23:54 PM »
ATorrez - since you are always so quick to point out when people are not correct, let me say you are incorrect -- no one has ever died from AIDS - they might die from an OI, but not AIDS
Next - this country had a surplus, until a Republican President used false information to put us into severe debt and left the financial industry to run amuck
Most people who receive SSDI, SSI, Medicare, etc have paid taxes
Even if one has only paid sales tax, they have contributed
And FYI - most higher education is subsidized by the governement - whether it be student loans or other support of colleges/universities that comes from the government
I also wake up and go to work everyday (40 hours a week) and do private consulting another 40 hours or so a month
I'm glad I believe in karma to a degee and many times the words we speak and beliefs will come back to bite us --
On another note, I had to look up the definition of the word molest today and found that as a verb one of its meanings (American Heritage) is to annoy --- the opinions of some people make me feel molested --
September 13, 2008 - diagnosed +
Labs:
Date    CD4    %   VL     Date  CD4  %   VL
10/08  636    35  510   9/09 473  38 2900  12/4/09 Atripla
12/09  540    30    60   
12/10  740    41  <48   
8/11    667    36  <20  
03/12  1,041  42  <20
05/12  1,241  47  <20
08/12   780    37  <20
11/12   549    35  <20
02/12  1,102  42  <20
11/12   549    35  <20

Offline Joe K

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Re: New Health Plan Questions
« Reply #81 on: March 26, 2010, 11:24:31 PM »
I'd love to sit around and collect "free" stuff from the government, but I have too much pride to do that. No one gives me a fucking dime for anything, everything I have it bought and paid for by myself and it belongs to me and whomever I wish to share it with.

When I graduate from the anaesthesiology programme next year I expect my income to go from the $65,000 a year it is now to $130,000 a year. Why is anyone else entitled to a portion of that? I have been in college since I was 17 years old working my ass off. I don't care if you or anyone else thinks I am greedy. I worked hard for it and it's mine, get your own.

Surely you have anti-freeze in your veins, because your comments are some of the most inhumane I have ever heard. I am so happy for you that you can work. I on the other hand, cannot, through no fault of my own. I worked for 35 years and paid my taxes and now I need some help... because I cannot work. For you to insinuate, especially on an AIDS website, that people with disabilities are lazy and sit around taking government handouts, is possibly the vilest thing I have ever heard. Lucky for you, most people are not heartless, so if you get disabled by AIDS, unlike you, we won't be suggesting that you be thrown to the wolves.

Offline skeebo1969

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Re: New Health Plan Questions
« Reply #82 on: March 26, 2010, 11:29:46 PM »


  I think it's time.
I despise the song Love is in the Air, you should too.

Offline Inchlingblue

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Re: New Health Plan Questions
« Reply #83 on: March 26, 2010, 11:31:55 PM »

  I think it's time.

LOL

That's very cryptic.

Time for what, skeebo?


Offline ATorrez

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Re: New Health Plan Questions
« Reply #84 on: March 26, 2010, 11:34:14 PM »
It's not through no fault of your own.

Most of us, including myself, contracted HIV through unprotected sex or drug use. I began having unprotected sex with older men when I was only 18 and a few years later I was HIV+. Who's fault is that? MINE. So if I get sick and die it's my fault, not anyone else's. Now if you were disabled due to, let's say, Multiple Sclerosis or something, I would have more sympathy. There is nothing one can do to cause themselves to have Multiple Sclerosis.

On the other hand, I cause my own disease and there is no one to blame but myself. Why should the tax payers have to shoulder that burden? They shouldn't. I believe in personal responsibility, which is why I advocate for people taking care of themselves.

I realise to many this may be a bitter pill to swallow, but that's because for decades we've been told that we are "victims" and that nothing is our fault, blah blah blah. That's bullshit. No one forced me to take raw dick up my ass. No one held a gun to my head and told me to do it.

Everyone has choices, and you must live with the consequences of your choices.
Piss off a democrat: Take responsibility for your life and your actions.

"When Marxist dictators shoot their way into power in Central America, the San Francisco Democrats don't blame the guerrillas and their Soviet allies. They blame United States policies of 100 years ago. But then they always blame America first." -Jeanne Kirkpatrick

Offline skeebo1969

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Re: New Health Plan Questions
« Reply #85 on: March 26, 2010, 11:35:28 PM »
LOL

That's very cryptic.

Time for what, skeebo?



Dunno, time to bite my tongue!!  My wife and I  are tax payers.  Home paid for, as is both our cars....  And we are sinking further into debt because of our medical bills.

« Last Edit: March 26, 2010, 11:38:38 PM by skeebo1969 »
I despise the song Love is in the Air, you should too.

Offline Joe K

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Re: New Health Plan Questions
« Reply #86 on: March 26, 2010, 11:42:14 PM »
It's not through no fault of your own.

Everyone has choices, and you must live with the consequences of your choices.

Since you don't know how I got infected, you can't just make blanket statements and expect anyone to take them as fact. I've been reading your posts and your views are just more of the Republican hate-everyone-but-white-guys crap, they have been peddling for years. Speech like yours, while protected, is nothing more than hate speech repackaged. Hatred and violence are the language of the heartless. I thank the universe, everyday, that there just are not that many people, like you, who have such hatred for everyone and I know that karma, has a few lessons in store, for you. Over and out.

Offline WillyWump

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Re: New Health Plan Questions
« Reply #87 on: March 26, 2010, 11:42:51 PM »
Why should the tax payers have to shoulder that burden? They shouldn't.



This is the UNITED STATES!! Not some third world country. WE take care of those that need assistance and need help!! This is one of the things that make us the greatest nation on this planet! Wake up!

Are you advocating that we cut all govt funded programs helping the needy? Helping those with HIV?
POZ since '08

Last Labs-
6/3/14 CD4- 736, UD 34%
6/25/13 CD4- 1036, UD,
2/4/13, CD4 - 489, UD, 28%

Current Meds: Prezista/Epzicom/ Norvir
.

Offline ATorrez

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Re: New Health Plan Questions
« Reply #88 on: March 26, 2010, 11:43:14 PM »

Next - this country had a surplus, until a Republican President used false information to put us into severe debt and left the financial industry to run amuck

Do you think the President operates in a vacuum?

When Clinton was President he had a Republican House and Senate. If it wasn't for them the welfare reforms would have never gone through. Thank you, Republicans.

Under Bush, there was a Democratic House and Senate for the majority of his time in office.

I have heard all of that anti-Bush BS before. I was not a fan of Bush. But there were democratic senators and congressman who voted in favour of the war in Iraq and Afgahnistan. I know you said he lied, but I haven't seen any credible source of information say that. The government chose to go to war based on the information they had, democrats regret that CHOICE and they choose to BLAME someone else, as they usually do.
Piss off a democrat: Take responsibility for your life and your actions.

"When Marxist dictators shoot their way into power in Central America, the San Francisco Democrats don't blame the guerrillas and their Soviet allies. They blame United States policies of 100 years ago. But then they always blame America first." -Jeanne Kirkpatrick

Offline ATorrez

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Re: New Health Plan Questions
« Reply #89 on: March 26, 2010, 11:44:49 PM »
Since you don't know how I got infected, you can't just make blanket statements and expect anyone to take them as fact. I've been reading your posts and your views are just more of the Republican hate-everyone-but-white-guys crap, they have been peddling for years. Speech like yours, while protected, is nothing more than hate speech repackaged. Hatred and violence are the language of the heartless. I thank the universe, everyday, that there just are not that many people, like you, who have such hatred for everyone and I know that karma, has a few lessons in store, for you. Over and out.

I am hispanic/latino. Thanks for judging me though. It seems you are as guilty of making faulty assumptions as you claim I am.
Piss off a democrat: Take responsibility for your life and your actions.

"When Marxist dictators shoot their way into power in Central America, the San Francisco Democrats don't blame the guerrillas and their Soviet allies. They blame United States policies of 100 years ago. But then they always blame America first." -Jeanne Kirkpatrick

Offline Joe K

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Re: New Health Plan Questions
« Reply #90 on: March 26, 2010, 11:48:12 PM »
I am hispanic/latino. Thanks for judging me though. It seems you are as guilty of making faulty assumptions as you claim I am.
I was judging no one. Please reread what I wrote, I said your speech was "like" Republican ... not you personally.

Offline leatherman

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Re: New Health Plan Questions
« Reply #91 on: March 26, 2010, 11:49:04 PM »
no one has ever died from AIDS - they might die from an OI, but not AIDS
that's really just petty semantics there. ;) Plenty of people have died from AIDS. Of course, it's been PCP or non-hodgkins lymphoma or toxoplasmosis; but it's been because the HIV has developed into AIDS. Without "teh AIDS", there wouldn't be the deaths.

Saying that millions throughout the world have died of AIDS is totally correct, as AIDS was the underlying condition, and the actually OI was just another symptom from having a destroyed immune system.
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline ATorrez

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Re: New Health Plan Questions
« Reply #92 on: March 26, 2010, 11:49:18 PM »
This is one of the things that make us the greatest nation on this planet! Wake up!

Are you advocating that we cut all govt funded programs helping the needy? Helping those with HIV?

I don't think, in my entire, short, life I have ever heard a democrat say something positive about America. I think I might cry.

And yes, we should cut most services. Most people are poor because of choice they have made. They have had children out of wedlock that they couldn't afford to take care of. I  grew up with this girl who was afforded all the riches and options in the world, but she blew it. She got pregnant and 16 and kept pumping out babies until she was 20. She has 5 kids and is living in the housing projects. All of the children's fathers have walked out on her and she's all alone with these kids.

She is in that position because of her CHOICES. No one made her get pregnant. She could have had an abortion or gotten on birth control, but she didn't. And now she has to suffer the consequences.
Piss off a democrat: Take responsibility for your life and your actions.

"When Marxist dictators shoot their way into power in Central America, the San Francisco Democrats don't blame the guerrillas and their Soviet allies. They blame United States policies of 100 years ago. But then they always blame America first." -Jeanne Kirkpatrick

Offline ATorrez

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Re: New Health Plan Questions
« Reply #93 on: March 26, 2010, 11:52:51 PM »
I still don't see how telling people to go out and get a job is hateful/racist/homophobic or whatever. I don't hate anyone. I want to see people better themselves and you can't do that on your couch living on welfare or disability.

If I can do it, so can you.

Didn't you learn anything in grade school? "You can do anything you put your mind to"? Isn't that the canard they are teaching our kids today?
Piss off a democrat: Take responsibility for your life and your actions.

"When Marxist dictators shoot their way into power in Central America, the San Francisco Democrats don't blame the guerrillas and their Soviet allies. They blame United States policies of 100 years ago. But then they always blame America first." -Jeanne Kirkpatrick

Offline phildinftlaudy

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Re: New Health Plan Questions
« Reply #94 on: March 26, 2010, 11:53:13 PM »
As I lay down to sleep tonight -- I will pray many things -- one of them may be for those who come on these forums with one purpose -- to inflame and incite -- get the timeout or the ban.  Space on these forums wouldn't allow me to list all of the credible sources that show the misiformation and lies that were used to justify the Iraq war.  I can only pray that I have an anethesiologist who may not be filled with so much hate filled rhetoric that they might just put a patient at risk (particularly if they view the patient as someone who is sitting around collecting a government handout).  Long live health care reform, sing it from the mountain tops - long live health care reform   LA LA LA LA LA - we won (can't stand a sore loser)
September 13, 2008 - diagnosed +
Labs:
Date    CD4    %   VL     Date  CD4  %   VL
10/08  636    35  510   9/09 473  38 2900  12/4/09 Atripla
12/09  540    30    60   
12/10  740    41  <48   
8/11    667    36  <20  
03/12  1,041  42  <20
05/12  1,241  47  <20
08/12   780    37  <20
11/12   549    35  <20
02/12  1,102  42  <20
11/12   549    35  <20

Offline Miss Philicia

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Re: New Health Plan Questions
« Reply #95 on: March 26, 2010, 11:53:41 PM »
Ain't passin' the sniff test.
"Iíve slept with enough men to know that Iím not gay"

Offline Ann

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Re: New Health Plan Questions
« Reply #96 on: March 26, 2010, 11:54:38 PM »
ATorres,

If you cannot see how much offence (or more likely you CAN and you're loving it) you're causing to members of these forums, then maybe it's time for you to find another forum to post in. I'm sure they'd love you at Free Republic.

I'm giving you that seven day time out I warned you about earlier today to give you time to think about how you talk to people here. If you come back with more of the same after your time out, you'll probably find yourself permanently banned.

I'm also locking this derailed thread.

Ann
Condoms are a girl's best friend

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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

 


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