Quantcast

Subscribe to:
POZ magazine
Newsletters
Join POZ: Facebook MySpace Twitter Pinterest
Tumblr Google+ Flickr Instagram
POZ Personals
Sign In / Join
Username:
Password:
Welcome, Guest. Please login or register.
October 22, 2014, 10:39:48 AM

Login with username, password and session length


Members
Stats
  • Total Posts: 643045
  • Total Topics: 48929
  • Online Today: 213
  • Online Ever: 585
  • (January 07, 2014, 02:31:47 PM)
Users Online

Welcome


Welcome to the POZ/AIDSmeds Community Forums, a round-the-clock discussion area for people with HIV/AIDS, their friends/family/caregivers, and others concerned about HIV/AIDS.  Click on the links below to browse our various forums; scroll down for a glance at the most recent posts; or join in the conversation yourself by registering on the left side of this page.

Privacy Warning:  Please realize that these forums are open to all, and are fully searchable via Google and other search engines. If you are HIV positive and disclose this in our forums, then it is almost the same thing as telling the whole world (or at least the World Wide Web). If this concerns you, then do not use a username or avatar that are self-identifying in any way. We do not allow the deletion of anything you post in these forums, so think before you post.

  • The information shared in these forums, by moderators and members, is designed to complement, not replace, the relationship between an individual and his/her own physician.

  • All members of these forums are, by default, not considered to be licensed medical providers. If otherwise, users must clearly define themselves as such.

  • Forums members must behave at all times with respect and honesty. Posting guidelines, including time-out and banning policies, have been established by the moderators of these forums. Click here for “Am I Infected?” posting guidelines. Click here for posting guidelines pertaining to all other POZ/AIDSmeds community forums.

  • We ask all forums members to provide references for health/medical/scientific information they provide, when it is not a personal experience being discussed. Please provide hyperlinks with full URLs or full citations of published works not available via the Internet. Additionally, all forums members must post information which are true and correct to their knowledge.

  • Product advertisement—including links; banners; editorial content; and clinical trial, study or survey participation—is strictly prohibited by forums members unless permission has been secured from POZ.

To change forums navigation language settings, click here (members only), Register now

Para cambiar sus preferencias de los foros en español, haz clic aquí (sólo miembros), Regístrate ahora

Finished Reading This? You can collapse this or any other box on this page by clicking the symbol in each box.

Author Topic: Obamacare.  (Read 29507 times)

0 Members and 1 Guest are viewing this topic.

Offline mitch777

  • Member
  • Posts: 3,582
Obamacare.
« on: September 25, 2013, 05:05:24 PM »
Heads up! The countdown for enrollment is 5 days away!

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

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

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

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

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

Guess we will see how it plays out across the country.
31 years hiv+ (oct. 2013) with a curtsy.

Offline tednlou2

  • Member
  • Posts: 4,979
Re: Obamacare.
« Reply #1 on: September 25, 2013, 05:17:12 PM »
I was just reading this article about some aspects of it. 

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

Offline mitch777

  • Member
  • Posts: 3,582
Re: Obamacare.
« Reply #2 on: September 25, 2013, 05:22:08 PM »
I was just reading this article about some aspects of it. 

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

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

I plan on checking every aspect out. Costs and limitations.
31 years hiv+ (oct. 2013) with a curtsy.

Offline thunter34

  • Member
  • Posts: 7,314
  • His name is Carl.
Re: Obamacare.
« Reply #3 on: September 25, 2013, 05:23:24 PM »
I'm on ADAP and not even considering enrolling right away.  GA hasn't even figured out what they are going to do regarding ADAP and the ACA - hell...GA hasn't even agreed to get on board with the ACA in general.
AIDS isn't for sissies.

Online Jeff G

  • Administrator
  • Member
  • Posts: 12,137
  • How am I doing Beren ?
Re: Obamacare.
« Reply #4 on: September 25, 2013, 05:29:21 PM »
We need some kind of formula that regulates profitable corporation's preventing them from cutting workers hours to 30 hours or less simply to sidestep the insurance requirement .

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

Offline Miss Philicia

  • Member
  • Posts: 24,209
  • celebrity poster, faker & poser
Re: Obamacare.
« Reply #5 on: September 25, 2013, 05:31:49 PM »
I honestly have no idea if this will even affect my coverage. Our lame-o Rethuglican governor didn't even make up his mind until two weeks ago whether our state would participate. Fortunately his poll numbers are so bad we will be having a Democrat for governor come the 2014 election.
"I’ve slept with enough men to know that I’m not gay"

Offline mecch

  • Member
  • Posts: 11,913
  • red pill? or blue pill?
Re: Obamacare.
« Reply #6 on: September 25, 2013, 05:38:27 PM »
I thought EVERY state must participate, but its a question of who foots the bill, for the moment.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Online buginme2

  • Member
  • Posts: 3,121
Re: Obamacare.
« Reply #7 on: September 25, 2013, 05:39:35 PM »
I really wonder what's going to happen to the people on ADAP and Ryan White.

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

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

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

« Last Edit: September 25, 2013, 05:42:34 PM by buginme2 »

Online buginme2

  • Member
  • Posts: 3,121
Re: Obamacare.
« Reply #8 on: September 25, 2013, 05:41:25 PM »
I thought EVERY state must participate, but its a question of who foots the bill, for the moment.

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

I think

Edited:changed Medicare to caid. Autocorrect
« Last Edit: September 25, 2013, 05:50:20 PM by buginme2 »

Offline mitch777

  • Member
  • Posts: 3,582
Re: Obamacare.
« Reply #9 on: September 25, 2013, 05:42:19 PM »
We need some kind of formula that regulates profitable corporation's preventing them from cutting workers hours to 30 hours or less simply to sidestep the insurance requirement .

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

It's sad isn't it?

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

A silver lining. :)

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

Sad to see people who live in Republican stronghold states suffer from the elected idiots who are cold hearted when it comes to what most people in this country face. :(
31 years hiv+ (oct. 2013) with a curtsy.

Offline mitch777

  • Member
  • Posts: 3,582
Re: Obamacare.
« Reply #10 on: September 25, 2013, 05:45:10 PM »
I really wonder what's going to happen to the people on ADAP and Ryan White.

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

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

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

I have insurance and am also on ADAP. I think this might vary from state to state.
Dunno.
31 years hiv+ (oct. 2013) with a curtsy.

Offline mitch777

  • Member
  • Posts: 3,582
Re: Obamacare.
« Reply #11 on: September 25, 2013, 05:48:53 PM »
The law expanded Medicare coverage to cover those people who can't afford insurance.  The Supreme Court said states didn't have to participate in this so some states are not expanding their Medicare.  This will leave a pretty big group of low income people without insurance or state assistance.

I think

I think you are right. Once again it is the Republican controlled states that will suffer from ignorant and cold hearted politicians. Sad.
31 years hiv+ (oct. 2013) with a curtsy.

Offline phildinftlaudy

  • Member
  • Posts: 2,965
  • sweet Ann what you think babe...
Re: Obamacare.
« Reply #12 on: September 25, 2013, 05:53:15 PM »
It's already beginning to have an impact (although I can't gauge whether it will be good or bad) on the coverage I have with my employer....

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

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

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

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

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

Online Jeff G

  • Administrator
  • Member
  • Posts: 12,137
  • How am I doing Beren ?
Re: Obamacare.
« Reply #13 on: September 25, 2013, 05:56:58 PM »
The insurance and health care lobby will put tremendous pressure on any governor who try's to opt out of excepting federal funding . Healthcare reform may not have been something these lobby's wanted to see happen but now that its law they will be there to collect the hundreds of millions of dollars coming in to each state .

Lots of work and tweaks has to be done to make the new law work for consumers , I just hope that conservatives are not able to defund it before people have the chance to see its going to be of benefit . 

Offline mitch777

  • Member
  • Posts: 3,582
Re: Obamacare.
« Reply #14 on: September 25, 2013, 06:18:14 PM »
@Phil- complicated isn't it? ???
@ Jeff- I think it's too late. It won't be defunded before taking effect. :)
31 years hiv+ (oct. 2013) with a curtsy.

Offline BT65

  • Global Moderator
  • Member
  • Posts: 9,974
Re: Obamacare.
« Reply #15 on: September 25, 2013, 07:03:51 PM »
Well, Hoosierville's idiot governor (Pence) is not expanding Medicaid. 

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

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

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

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

It's so detailed it gives me a headache.  If you read this far, you're doing better than I would do.
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Offline mitch777

  • Member
  • Posts: 3,582
Re: Obamacare.
« Reply #16 on: September 25, 2013, 07:29:58 PM »
I read that far. Thanks for the details Betty. I really hope this helps most of your clients. Government details.  ::)
I applaud you for your efforts!!!
31 years hiv+ (oct. 2013) with a curtsy.

Offline phildinftlaudy

  • Member
  • Posts: 2,965
  • sweet Ann what you think babe...
Re: Obamacare.
« Reply #17 on: September 25, 2013, 09:03:45 PM »
@Phil- complicated isn't it? ???
@ Jeff- I think it's too late. It won't be defunded before taking effect. :)

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

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

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

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

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 tednlou2

  • Member
  • Posts: 4,979
Re: Obamacare.
« Reply #18 on: September 25, 2013, 11:35:36 PM »
I would suggest picking up a copy of the November edition of Consumer Reports.  I know, November?  October isn't even here yet.  I got mine in the mail today.  They gave me more info so far, than I've learned over the last few years.  You may be able to find some articles on their website.  They've also set up an exclusive website at

healthlawhelper.org

Some of the highlights:

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

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

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

If you buy your own insurance or don't have any, the marketplace is designed for people like you.  Investigate whether you qualify for income-based assistance with your premiums, lower out-of-pocket costs, or free or almost free Medicaid.  You can still buy private insurance outside the marketplace, but you can qualify for and receive financial assistance only within the marketplace.  This help will come in the form of a tax credit that you can use right away to lower your premium.  Lower-income households will also receive help with out-of-pocket costs.  For details, download our free brochure at consumerreports.org/healthtaxcredit."

Offline tednlou2

  • Member
  • Posts: 4,979
Re: Obamacare.
« Reply #19 on: September 25, 2013, 11:39:14 PM »
Sorry for the bad phone pic.  You will obviously have to zoom in.



Offline BT65

  • Global Moderator
  • Member
  • Posts: 9,974
Re: Obamacare.
« Reply #20 on: September 26, 2013, 04:18:01 AM »
We were told, at the training in Indy, that some states not expanding Medicaid at this time, may in the future.  We were told they are looking at states like Arkansas, who apparently is writing something like their own version of Medicaid expansion?  Something like that.

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

I think universal health coverage is needed also.   I'm sure it will take a while to iron out all the kinks, just as with any new program.  We got an e-mail at work from a lawyer who works at NASTAD with links in it.  I will look at that later today, and try to post the links we were provided with for more info for people.  Nothing like getting it straight from the source.
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Offline BT65

  • Global Moderator
  • Member
  • Posts: 9,974
Re: Obamacare.
« Reply #21 on: September 26, 2013, 04:33:56 AM »
http://kff.org/interactive/subsidy-calculator/

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

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


From the e-mail:

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


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

I wish I knew how to post a power point we got e-mailed to us from the above person (Amy Killelea) that really explains things.  But, alas, I do not know how and have been trying for the last 20 minutes lol.  I don't know if the above helps anyone, hopefully it does.
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Offline mitch777

  • Member
  • Posts: 3,582
Re: Obamacare.
« Reply #22 on: September 26, 2013, 08:44:10 AM »
I would suggest picking up a copy of the November edition of Consumer Reports.  I know, November?  October isn't even here yet.  I got mine in the mail today.  They gave me more info so far, than I've learned over the last few years.  You may be able to find some articles on their website.  They've also set up an exclusive website at

healthlawhelper.org

Some of the highlights:

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


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

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

* The percentage penalty is imposed on gross household income over the federal income tax filing threshold. Certain people may not be subject to a penalty, such as those whose gaps in coverage are less than a continuous three month period in a single year. In addition, the penalty may be subject to a cap.
31 years hiv+ (oct. 2013) with a curtsy.

Offline tednlou2

  • Member
  • Posts: 4,979
Re: Obamacare.
« Reply #23 on: September 27, 2013, 03:15:30 PM »
I plugged in a family income of $30k in KY with 2 non-smoking adults and 2 kids.  I checked no employer insurance.  The premium was $600 a year with possible tax credits.  KY is going along with the Medicaid expansion, so the kids could probably go on that.  Our Governor just told people to get out of the way, and that the people of KY need this terribly.


http://www.npr.org/blogs/health/2013/09/26/226456791/how-much-will-obamacare-cost-me-try-our-calculator?utm_content=socialflow&utm_campaign=nprfacebook&utm_source=npr&utm_medium=facebook

Offline J.R.E.

  • Member
  • Posts: 7,213
  • Joined Dec-2003 Living positive, since 1985.
Re: Obamacare.
« Reply #24 on: September 27, 2013, 05:35:22 PM »


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

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

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


I so despise this guy this criminal governor...


Ray >:(
Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 12.5mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


 In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started my first  HAART regimen  on October 24th,03.

 As of 8/2514,  t-cells are at 402, Viral load <40

 Current % is at 11%

  
 62 years young.

Offline J.R.E.

  • Member
  • Posts: 7,213
  • Joined Dec-2003 Living positive, since 1985.
Re: Obamacare.
« Reply #25 on: September 27, 2013, 05:58:53 PM »

A little more to add on my post above:

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

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


 Florida Counties To Defy State Ban On Obamacare Navigators



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

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

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

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

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

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

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

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

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

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

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

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

"In states like Florida that seem determined to sabotage reform," wrote the New York Times editorial board, "the uninsured may have a very hard time getting the coverage they need and deserve."
Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 12.5mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


 In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started my first  HAART regimen  on October 24th,03.

 As of 8/2514,  t-cells are at 402, Viral load <40

 Current % is at 11%

  
 62 years young.

Offline bocker3

  • Member
  • Posts: 3,415
  • You gotta enjoy life......
Re: Obamacare.
« Reply #26 on: September 27, 2013, 06:14:04 PM »
It's already beginning to have an impact (although I can't gauge whether it will be good or bad) on the coverage I have with my employer....

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

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

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

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

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

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

Mike
Atripla - Started 12/05
Reyataz/Norvir - Added 6/06
Labs - Pre-Meds
Sep05 T=350/25% VL98,559
Nov05 288/18%  47,564
Current Labs
May2013 691/31% <20

Offline mitch777

  • Member
  • Posts: 3,582
Re: Obamacare.
« Reply #27 on: September 27, 2013, 06:30:52 PM »
I read in the Hartford Courant today that Connecticut is Health Exchange Costs are the 4th highest in the nation. I guess it goes along being the 4th highest in medical costs but the only states that seem to be charging more are Alaska, Mississippi, and Wyoming. Other factors must be in play.

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

Ray, pathetic and disgusting!!!  >:( The repubs WANT to see this fail at any cost. So sad they will be disappointed. :)
31 years hiv+ (oct. 2013) with a curtsy.

Online buginme2

  • Member
  • Posts: 3,121
Re: Obamacare.
« Reply #28 on: September 27, 2013, 06:37:52 PM »
I went onto the Washington state website.

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

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

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

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

Online buginme2

  • Member
  • Posts: 3,121
Re: Obamacare.
« Reply #29 on: September 27, 2013, 06:39:24 PM »


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

It's appalling


I can't wait for this to take effect, finally. If I lose my job or quit I don't have to worry about losing my healthcare .... I have thought and worried about that since, well, since October 2010
« Last Edit: September 27, 2013, 06:41:45 PM by buginme2 »

Online Jeff G

  • Administrator
  • Member
  • Posts: 12,137
  • How am I doing Beren ?
Re: Obamacare.
« Reply #30 on: September 27, 2013, 07:08:48 PM »
The one question that hits me like a punch in the gut is when a new member of this forum who just found out they have HIV ask us how am I going to get treatment or says that they do not have insurance , how do I get my meds .

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

Offline mitch777

  • Member
  • Posts: 3,582
Re: Obamacare.
« Reply #31 on: September 27, 2013, 07:29:25 PM »
The one question that hits me like a punch in the gut is when a new member of this forum who just found out they have HIV ask us how am I going to get treatment or says that they do not have insurance , how do I get my meds .

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

me too and I hope this turns out to be the answer.
31 years hiv+ (oct. 2013) with a curtsy.

Offline RobbyR

  • Member
  • Posts: 333
Re: Obamacare.
« Reply #32 on: September 27, 2013, 07:32:11 PM »
I have partial insurance and am on Ryan White it has been a lifesaver for me literally. I live in Kentucky, a very very red state. My insurance pays a portion of my doctor visits & co-pays, while Ryan White enables me to get my essential medications that otherwise would be totally unaffordable even with my insurance. In fact I only use Ryan White when it comes to my HIV meds, everything else goes on my insurance or I pay a minimal co-pay out of pocket. I don't know much about nor have I been following the Obamacare debate or the legislation. I just hope it keeps the status quo in my state for people who can have partial insurance like I do, & also utilize Ryan White. And maybe makes it easier for people who do work & need affordable healthcare especially people with HIV who need chronic care.

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

It's very disturbing how the Republicans always seem to want to deny hardworking people access to good healthcare. It's not surprising given their track record, but they always talk a big game about babies yet seems people who are already here on the planet they could care less about unless they are billionaires & can buy any insurance they want. Pretty nasty if you ask me. A quote I read somewhere online sums it up best..Most Republicans are pro-life..if you're a fetus that is!
« Last Edit: September 27, 2013, 07:34:52 PM by RobbyR »
Started Atripla August, 2010.

Offline WillyWump

  • Member
  • Posts: 7,196
  • Fall is in the air!
Re: Obamacare.
« Reply #33 on: September 27, 2013, 10:19:20 PM »

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

I went onto the Washington state website.

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

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

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

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


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

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

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

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

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


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

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

Edited to add: I guess I should stop panicking and just wait 3 days to find out  ;)
« Last Edit: September 27, 2013, 10:38:24 PM by WillyWump »
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
.

Online buginme2

  • Member
  • Posts: 3,121
Re: Obamacare.
« Reply #34 on: September 27, 2013, 10:33:11 PM »
From my understanding there will be bronze, silver, gold, and platinum plans.

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

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

Of course each state may vary

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

One thing that hasn't been discuss much.  With all these new people getting insured there may be an increase in the number of people going to the doctor.  That would make it harder to get an appointment etc. 

Offline tednlou2

  • Member
  • Posts: 4,979
Re: Obamacare.
« Reply #35 on: September 27, 2013, 11:03:41 PM »
I read in the Hartford Courant today that Connecticut is Health Exchange Costs are the 4th highest in the nation. I guess it goes along being the 4th highest in medical costs but the only states that seem to be charging more are Alaska, Mississippi, and Wyoming. Other factors must be in play.

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

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

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

About longer wait times at docs due to more patients, will we see a supply and demand thing happen?  Will those interested in medicine be given incentives to be various types of docs, by giving more scholarships or forgiving loan debt? 

Offline phildinftlaudy

  • Member
  • Posts: 2,965
  • sweet Ann what you think babe...
Re: Obamacare.
« Reply #36 on: September 28, 2013, 01:47:14 AM »
Check this out - I do not think you can have both a HSA and FSA.  However, you should be able to contribute pre-tax into your HSA (above the $750 from your employer).  Sid has this high-deductible plan and that is the info that I have pulled out go it.  The benefit of an HSA over FSA, you do not have the user it or lose it aspect.  You can add up to some max (can't remember the amount) and roll it over year to year AND it accrues interest.

Mike

Hi Mike:
Ours is an HRA - only the employer can contribute, but we are still allowed to have a separate FSA - which the employee contributes to exclusively... I will be using it to make up the difference between my employer funded HRA and the deductible portion I will have to pay out of pocket.  It should work out okay....
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 BT65

  • Global Moderator
  • Member
  • Posts: 9,974
Re: Obamacare.
« Reply #37 on: September 28, 2013, 05:48:49 AM »
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Offline tednlou2

  • Member
  • Posts: 4,979
Re: Obamacare.
« Reply #38 on: September 28, 2013, 05:35:35 PM »
Nice cartoon explaining The Affordable Care Act, or Obamacare.  Lots of info in this cartoon.

http://www.upworthy.com/the-simplest-explanation-of-obamacare-ever?g=4&c=huf1

Offline mecch

  • Member
  • Posts: 11,913
  • red pill? or blue pill?
Re: Obamacare.
« Reply #39 on: September 28, 2013, 06:07:45 PM »
I hope dems keep their nerve though the shut down.  And god forbid if both houses cave somewhat and send some shitty alteration to Obama to sign, I hope he keep his nerve and vetoes it...   Enough is enough.  This is excruciating to watch... Such childishness.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline mitch777

  • Member
  • Posts: 3,582
Re: Obamacare.
« Reply #40 on: September 28, 2013, 06:54:19 PM »
I hope dems keep their nerve though the shut down.  And god forbid if both houses cave somewhat and send some shitty alteration to Obama to sign, I hope he keep his nerve and vetoes it...   Enough is enough.  This is excruciating to watch... Such childishness.
Don't worry. Ain't gonna happen. The government might shut down for a day or 2. Who knows, but the Senate and Obama are not budging.
Childish AND costly.
31 years hiv+ (oct. 2013) with a curtsy.

Offline mecch

  • Member
  • Posts: 11,913
  • red pill? or blue pill?
Re: Obamacare.
« Reply #41 on: September 28, 2013, 07:19:56 PM »
Especially stomach turning is Ted Cruz.  And the widely held belief (self-fulling? truism?) that no publicity is bad publicity.  Its the Miley Cyrus school of win.  Act like a complete idiot and it makes you Presidential candidate material.  Princeton - Harvard and champion debater, he's so freaking cynical I want to vomit at his lowbrow mugging to the peanut gallery.  And that speech!  Geezuz..... 
“From each, according to his ability; to each, according to his need” 1875 K Marx

Online buginme2

  • Member
  • Posts: 3,121
Re: Obamacare.
« Reply #42 on: September 28, 2013, 07:59:37 PM »
Don't worry. Ain't gonna happen.

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


Especially stomach turning is Ted Cruz. 

Even more stomachs turning was I read today that the state of Texas has the highest percentage of uninsured residents in the US.  How can a senator from a state with the highest rate of uninsured people act this way. I can't wrap my brain around it.

Offline J.R.E.

  • Member
  • Posts: 7,213
  • Joined Dec-2003 Living positive, since 1985.
Re: Obamacare.
« Reply #43 on: September 28, 2013, 08:43:34 PM »
Probably not, but I'm a little scared.  I saw earlier today that they were going to compromise and delay Obamacare a year.  I cringed but didn't see the whole story.




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

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


Ray

Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 12.5mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


 In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started my first  HAART regimen  on October 24th,03.

 As of 8/2514,  t-cells are at 402, Viral load <40

 Current % is at 11%

  
 62 years young.

Offline WillyWump

  • Member
  • Posts: 7,196
  • Fall is in the air!
Re: Obamacare.
« Reply #44 on: September 29, 2013, 09:17:24 AM »
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 bocker3

  • Member
  • Posts: 3,415
  • You gotta enjoy life......
Re: Obamacare.
« Reply #45 on: September 29, 2013, 10:36:05 AM »
Hi Mike:
Ours is an HRA - only the employer can contribute, but we are still allowed to have a separate FSA - which the employee contributes to exclusively... I will be using it to make up the difference between my employer funded HRA and the deductible portion I will have to pay out of pocket.  It should work out okay....

Oops - saw HRA, read HSA!
Atripla - Started 12/05
Reyataz/Norvir - Added 6/06
Labs - Pre-Meds
Sep05 T=350/25% VL98,559
Nov05 288/18%  47,564
Current Labs
May2013 691/31% <20

Offline WillyWump

  • Member
  • Posts: 7,196
  • Fall is in the air!
Re: Obamacare.
« Reply #46 on: October 01, 2013, 10:21:54 AM »
Anybody get any quotes yet?

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


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


« Last Edit: October 01, 2013, 10:26:42 AM by WillyWump »
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
.

Online buginme2

  • Member
  • Posts: 3,121
Re: Obamacare.
« Reply #47 on: October 01, 2013, 11:10:44 AM »
I just read that the websites are getting so much traffic they are having a hard time processing.  let us know how it goes.

Online Jeff G

  • Administrator
  • Member
  • Posts: 12,137
  • How am I doing Beren ?
Re: Obamacare.
« Reply #48 on: October 01, 2013, 11:14:36 AM »
Tee Hee . Its going to be almost impossible to defund the affordable care act now that its being accessed .

This is the reason the conservatards where having a cow last night trying to delay this from happening today .

Online leatherman

  • Member
  • Posts: 6,272
  • Google and HIV meds are Your Friends
Re: Obamacare.
« Reply #49 on: October 01, 2013, 11:33:53 AM »
I would suggest that anyone here actually interested in the Marketplace Exchange Insurance policies - WAIT! Not because I don't approve of "obamacare" but because you have until January before it even goes into effect.

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

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


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

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

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


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

 


Terms of Membership for these forums
 

© 2014 Smart + Strong. All Rights Reserved.   terms of use and your privacy
Smart + Strong® is a registered trademark of CDM Publishing, LLC.