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Author Topic: Obamacare.  (Read 29796 times)

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Offline Miss Philicia

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  • celebrity poster, faker & poser
Re: Obamacare.
« Reply #150 on: October 29, 2013, 09:40:12 AM »
Most of you don't know what a clusterfuck the Bush-era Medicare Part D was because you're not frail, feeble disability queens like myself. Suffice to say I was given so much incorrect information by case managers that I ended up paying $1,000 in premiums that I didn't need to, and then the state refused to refund the money. Live and learn I guess.

But hey, private corporations fuck up regularly too.
"I’ve slept with enough men to know that I’m not gay"

Offline mitch777

  • Member
  • Posts: 3,594
Re: Obamacare.
« Reply #151 on: October 29, 2013, 09:49:56 AM »
The ACA was a GOP idea for the most part prior to Obama becoming president. Most Democrats would have preferred a single payer system. The GOP continues to put politics before country by being as obstructive as possible. They are doing everything in their power to make the ACA fail. Government shutdown anyone? Pathetic.

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

I see Miss P. remembers (as I was typing this).
32 years hiv+ (oct. 2013) with a curtsy.

Offline Jeff G

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Re: Obamacare.
« Reply #152 on: October 29, 2013, 09:59:53 AM »
Most of you don't know what a clusterfuck the Bush-era Medicare Part D was because you're not frail, feeble disability queens like myself. Suffice to say I was given so much incorrect information by case managers that I ended up paying $1,000 in premiums that I didn't need to, and then the state refused to refund the money. Live and learn I guess.

But hey, private corporations fuck up regularly too.

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

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

If the opponents of the Affordable Care Act had to live on the average disability check and navigate the health care system for 6 months we would be having a totally different national conversation .   

Offline bocker3

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Re: Obamacare.
« Reply #153 on: October 29, 2013, 05:42:50 PM »
Wrong .

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

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

That made implementation much harder.
End Quote

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

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

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

Mike
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

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Re: Obamacare.
« Reply #154 on: October 29, 2013, 06:16:07 PM »
http://www.economist.com/news/united-states/21588390-big-threat-obamacare-not-republican-intransigence-white-houses-own

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

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

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

Then there is the issue of people in the private policy market getting dropped or forced to other policies with higher premiums, the whole "If you like your insurance policy you can keep it, nothing will change" is proving to be at the least a misleading message...

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

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



« Last Edit: October 29, 2013, 06:30:13 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
.

Offline mitch777

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Re: Obamacare.
« Reply #155 on: October 29, 2013, 06:45:03 PM »
http://www.economist.com/news/united-states/21588390-big-threat-obamacare-not-republican-intransigence-white-houses-own


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

All the more reason to go with a single payer system. Insurance companies are in business for profit. They are useless middlemen that DO NOT CARE. And on it goes... so sad.
32 years hiv+ (oct. 2013) with a curtsy.

Offline leatherman

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  • Google and HIV meds are Your Friends
Re: Obamacare.
« Reply #156 on: October 29, 2013, 07:10:34 PM »
to finance all the sickies (us)?
actually it's to finance themselves too. ;) Inevitably, by the time a person dies, nearly everyone has gone to the hospital at least once and nearly everyone has received some type of health care. It's only fair for everyone to take some personal responsibility and pay into the system that will, at some time, be caring for them. Going forward we'll see fewer and fewer 30 and 40 year olds going bankrupt and losing their homes because of the cost of health care covering accidents and illnesses destroying their financial lives.
leatherman (aka mIkIE)


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

Offline WillyWump

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  • Fall is in the air!
Re: Obamacare.
« Reply #157 on: October 29, 2013, 07:23:43 PM »
actually it's to finance themselves too. ;) Inevitably, by the time a person dies, nearly everyone has gone to the hospital at least once and nearly everyone has received some type of health care. It's only fair for everyone to take some personal responsibility and pay into the system that will, at some time, be caring for them. Going forward we'll see fewer and fewer 30 and 40 year olds going bankrupt and losing their homes because of the cost of health care covering accidents and illnesses destroying their financial lives.

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

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

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

I guess they can skate around until the penalties get stiff after a few years
« Last Edit: October 29, 2013, 07:26:22 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
.

Offline leatherman

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  • Google and HIV meds are Your Friends
Re: Obamacare.
« Reply #158 on: October 29, 2013, 08:03:23 PM »
We know they should, but will they?
healthy and unhealthy people who never wreck their vehicles (like myself who, as a courier, was wrecked into 14 times and went on to the IT guy for 3 different auto body repair shops), pay for car insurance all the time because it's the law.

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


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

Offline WillyWump

  • Member
  • Posts: 7,202
  • Fall is in the air!
Re: Obamacare.
« Reply #159 on: October 29, 2013, 08:10:44 PM »
healthy and unhealthy people who never wreck their vehicles (like myself who, as a courier, was wrecked into 14 times and went on to the IT guy for 3 different auto body repair shops), pay for car insurance all the time because it's the law.

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

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

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

If a 28yo doesn't get Obamacare insurance nothing happens except a $95 fine at the end of the year. Which is less than the cost of the monthly policy.
« Last Edit: October 29, 2013, 08:19:40 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
.

Offline leatherman

  • Member
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  • Google and HIV meds are Your Friends
Re: Obamacare.
« Reply #160 on: October 29, 2013, 10:29:08 PM »
If a 28yo doesn't get Obamacare insurance nothing happens except a $95 fine at the end of the year. Which is less than the cost of the monthly policy.
right - that minimal fine is how the Republicans worked (ie obstructed) to basically remove the individual mandate out of the equation (though that was their concern over many years).

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

Right now, as evidenced by the sign ins at the website, clearly a lot of people are looking at plans, and we can probably assume that a number of them will buy in. So the worry about paying for the ACA (which is also paid through a lot of other sources like re-appropriating the indigent care funds, ADAP, etc) is like much of the ACA a huge change and a work in progress.
leatherman (aka mIkIE)


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

Offline aaware72

  • Member
  • Posts: 226
Re: Obamacare.
« Reply #161 on: November 01, 2013, 04:07:50 AM »
"Yes, knowledge is power. Self-knowledge brings mastery of one's body."

Offline mitch777

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  • Posts: 3,594
32 years hiv+ (oct. 2013) with a curtsy.

Offline mitch777

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Re: Obamacare.
« Reply #163 on: November 01, 2013, 12:34:48 PM »
So I got fed up waiting for about 10 days to hear back from the broker. I called the Connecticut Healthcare Exchange last night at 7:45PM and was a bit surprised that someone was there to help.

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

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

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

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

I will keep you posted when I hear the details.

If this pans out I think that between Kenny and I, we might save as much as 15k per year... maybe even more! :)
32 years hiv+ (oct. 2013) with a curtsy.

Offline britchick

  • Member
  • Posts: 439
Re: Obamacare.
« Reply #164 on: November 01, 2013, 02:41:11 PM »
mitch777,

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

britchickx

Offline mitch777

  • Member
  • Posts: 3,594
Re: Obamacare.
« Reply #165 on: November 01, 2013, 03:02:53 PM »
Thanks Britchick! Me too.
32 years hiv+ (oct. 2013) with a curtsy.

Offline bocker3

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  • Posts: 3,422
  • You gotta enjoy life......
Re: Obamacare.
« Reply #166 on: November 01, 2013, 05:43:30 PM »
Hope this goes as it seems -- that would be a nice, tidy savings. 

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

Hugs,
M
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

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Re: Obamacare.
« Reply #167 on: November 01, 2013, 06:04:20 PM »
Hope this goes as it seems -- that would be a nice, tidy savings. 

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

Hugs,
M
There's a Presidential suite in New Orleans? ???
You're makin' that up. :)
m.
32 years hiv+ (oct. 2013) with a curtsy.

Offline a2z

  • Member
  • Posts: 193
Re: Obamacare.
« Reply #168 on: November 02, 2013, 04:35:19 AM »
my friends who work in IT tell me that the problem is people who are talented just don't bid on government contracts.

Begin rant.....

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

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

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

My blood pressure dropped a good 20 points :)
Dates are blood draw dates:
9/4/14: CD4 948, 37.9%, VL 150
5/23/14: CD4 895 --.-% VL UD - Truvada/Isentress
09/21/09: CD4 898 27.0% VL 120 - back on track, same meds.High level enzymes, but less so
06/15/09: CD4 478 21.8% VL 1150 - high liver enzymes... looks like I may not be resistant
05/22/09: Fixed insurance, resumed medicine
04/17/09: Ran out of medicine, could not resolve insurance problems
04/01/09: CD4 773 28% VL 120 - high liver enzymes
12/01/08: CD4 514 23% VL 630
10/17/08 started Reyataz, Norvir and Truvada. -- possibly minor neuropathy, but otherwise okay.
9/10/08: CD4 345 17%, VL > 78K
8/18/08: CD4 312 18%, VL > 60K (considering meds)
12/19/07: CD4 550 28% VL > 100K (no meds yet)
Diagnosed 10/23/07

Offline WillyWump

  • Member
  • Posts: 7,202
  • Fall is in the air!
Re: Obamacare.
« Reply #169 on: November 04, 2013, 05:49:53 PM »
This worries me, coupled with the fact that I cant find a plan with my current Doc "In-Network".

Top Us Hospitals Opt out of Obamacare..

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

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

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

Im becoming less enthusiastic about this and am finding more comfort in keeping my current plan although I can barely afford it. LOL
« Last Edit: November 04, 2013, 05:54:16 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
.

Offline mitch777

  • Member
  • Posts: 3,594
Re: Obamacare.
« Reply #170 on: November 04, 2013, 06:07:25 PM »
This worries me, coupled with the fact that I cant find a plan with my current Doc "In-Network".

Top Us Hospitals Opt out of Obamacare..

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

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

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

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

EDIT: I see. The max out of pocket goes up after looking into it. I still wonder if it would end up cheaper than your current plan. What a bummer!
« Last Edit: November 04, 2013, 06:23:17 PM by mitch777 »
32 years hiv+ (oct. 2013) with a curtsy.

Offline aaware72

  • Member
  • Posts: 226
Re: Obamacare.
« Reply #171 on: November 05, 2013, 10:32:20 AM »
This worries me, coupled with the fact that I cant find a plan with my current Doc "In-Network".

Top Us Hospitals Opt out of Obamacare..

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

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

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

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

This worries me too.  I live in NH and I travel to Boston to Mass General for my care.  I'm afraid that after all is said and done I will no longer be able to receive care here. 
"Yes, knowledge is power. Self-knowledge brings mastery of one's body."

Offline mecch

  • Member
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  • red pill? or blue pill?
Re: Obamacare.
« Reply #172 on: November 05, 2013, 02:10:32 PM »
Be careful of your sources, please. I find that linked article, disingenuous.
I went to the homepage of Watchdog, and read the first posted comment in the thread:

clydealan • 3 hours ago −
Watchdog.org is a project of The Franklin Center which was founded in 2009 with an initial sponsorship grant from the Sam Adams Alliance. According to the Columbia Journalism Review, in 2011, 95 percent of the Franklin Center’s revenues came from a charity called Donors Trust, whose top contributors were the Koch
brothers. If you are looking for an unbiased opinion move along. However, if twisted truth and Obama bashing is your fare you will enjoy this right wing leaning site.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Miss Philicia

  • Member
  • Posts: 24,225
  • celebrity poster, faker & poser
Re: Obamacare.
« Reply #173 on: November 05, 2013, 02:20:16 PM »
top contributors were the Koch

Now that's just plain sad behavior in a forum, Wilamina.
"I’ve slept with enough men to know that I’m not gay"

Offline SouthSam7

  • Member
  • Posts: 428
Re: Obamacare.
« Reply #174 on: November 05, 2013, 03:21:00 PM »
From The New York Times:

Under Health Care Act, Millions Eligible for Free Policies

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

http://www.nytimes.com/2013/11/04/business/under-health-care-act-millions-eligible-for-free-policies.html

Offline WillyWump

  • Member
  • Posts: 7,202
  • Fall is in the air!
Re: Obamacare.
« Reply #175 on: November 05, 2013, 04:56:51 PM »
Be careful of your sources, please. I find that linked article, disingenuous.


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

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

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

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

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

Anyways,

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

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

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

« Last Edit: November 05, 2013, 05:00:46 PM by WillyWump »
POZ since '08

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Offline mecch

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Re: Obamacare.
« Reply #176 on: November 05, 2013, 06:37:40 PM »
The CNN article was good enough.  It digs into the subject and covers matters that you are concerned about and gives the ups and downs, the micro and the macro.

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

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

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

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

Its a complex issue.   

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

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

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

Buck up and try it the fuck out, for crissakes...  Complain, explain, find solutions for the kinks, and black holes, but try to make it work.  Have to. At least for a few years. Because it is what it is.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline mecch

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Re: Obamacare.
« Reply #177 on: November 05, 2013, 06:45:59 PM »
But get this... and this is the cool part, which I've NEVER seen insurance companies do. They have a "rewards card" program whereby you get credits for certain things you to to improve your health. For example If you get an annual physical you get $150 credit, Flu shot is $25 credit, a health risk assesment is $50 credit, If I go to the gym twice a week I get a $20/mo credit, ..bascially if you do all these (and a few others) you can get up to $400 a year to apply towards your deductibles, prescription copays, etc... Pretty darn cool huh! :)
Hasn't that been happening for years already?

Freaking commie pinko Michelle Obama food nazi NSA/FDA spies in my refrigerator shit that is right there buddy.  Revolution! Freedom! justsayno to such German-smelling socialism. Eek god, it almost smells French even, like smelly god-damn socialist french cheese, that is.   Or worse, Scandinavian - those dirty sexual people. Dont like em.  Socialist fags the lot of em.  Freedom.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline bocker3

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Re: Obamacare.
« Reply #178 on: November 06, 2013, 05:57:58 PM »
Hasn't that been happening for years already?

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

WTF is this rant about???  I'm trying to connect this to the quoted post, but this makes absolutely no sense at all.   ::)
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Offline bocker3

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Re: Obamacare.
« Reply #179 on: November 06, 2013, 06:00:48 PM »
Obamacare is the law, has been approved by the Supreme Court, and another vote of support in the election of the Obama to his secord term. 

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

While I don't disagree with your larger point -- I find it amusing that all this cheerleading and lecturing about how we should "buck up" comes from a man who lives in Switzerland and isn't impacted by it. 
Wait, maybe "amusing" is the wrong word..........................
Atripla - Started 12/05
Reyataz/Norvir - Added 6/06
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Offline tednlou2

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Re: Obamacare.
« Reply #180 on: November 07, 2013, 01:36:58 AM »

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

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

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

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

Found this: 

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

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




Offline leatherman

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Re: Obamacare.
« Reply #181 on: November 07, 2013, 01:52:39 AM »
Of course, that didn't happen with this website.  With this being the president's signature achievement
except the website is NOT the signature achievement.

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

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

I am confused why the administration didn't do more education.
because that part of the plan (and the budget for it) was gutted by the Republicans in the compromise that finally allowed the law to get passed in both Houses.
leatherman (aka mIkIE)


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Offline tednlou2

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Re: Obamacare.
« Reply #182 on: November 07, 2013, 03:24:26 AM »
I realize the website is not the signature achievement, but you need people able to sign up.  And, we need young, healthy people, who will most likely use the Internet.  I should make it clear that I do think all this craziness about the website is overblown.  Having said that, I am surprised the president (or staff) weren't aware of these issues. 

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

If I'm incorrect about how these plans work with the deductibles, please advise.  The administration does need to start an education campaign.  There is so much misinformation out there, that even fairly educated people I know do not understand how these plans will work.  They think their employers are all going to drop them and throw them into the exchanges to thinking Medicare is being gutted to pay for this.  I realize this is all new and a huge change will take time.  I think a big mistake was both the president and Dems trying to never discuss the law, after it was passed.  They had this big achievement, but treated it like a huge family secret.  They did a good job explaining the preexisting condition part, no lifetime caps part, expanding Medicaid part, and staying on your parents insurance until 26, but haven't done a good job explaining how the plans work. 

Offline mitch777

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Re: Obamacare.
« Reply #183 on: November 07, 2013, 02:42:06 PM »
One thing to remember is that only about 14% of Americans will even need to buy insurance from the exchanges. Many of those (like me) were paying an enormous cost prior to Obamacare. The plans offered here in Connecticut would ALL save me money, even without the subsidy and even if I hit the max out of pocket each year. (assuming that I stay in network)

The young and healthy can choose a plan that suits them best. It still will be most likely far cheaper than they could get buying an individual plan outside of the exchanges, deductibles and all.
32 years hiv+ (oct. 2013) with a curtsy.

Offline mitch777

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Re: Obamacare.
« Reply #184 on: November 15, 2013, 04:42:40 PM »
Signed up! :)

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

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

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

Let's compare 2013 vs 2014:

2013

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

2014

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

Drum roll please....

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

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

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

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

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

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

I love Obamacare!

m

ps- I hope I understood the whole thing and no horrible unexpected surprises are coming our way. ::) :)
« Last Edit: November 15, 2013, 04:56:05 PM by mitch777 »
32 years hiv+ (oct. 2013) with a curtsy.

Offline Jeff G

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Re: Obamacare.
« Reply #185 on: November 15, 2013, 04:47:14 PM »
AMG is on Mitch this year guys !

Offline noregrets

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Re: Obamacare.
« Reply #186 on: November 15, 2013, 05:01:22 PM »
Here in VA I have 8 planes to choose from, 4 gold & 4 silver (no platinum & I'm not interested in the bronze).  All of the plans are reasonable priced & everything looks great until I dug deeper to see about prescription costs.  They only publish the first 3 "tiers" on the site (which  are anywhere from $5 - $20% depending on the tier).  Once I called (& had to speak to MANY different people before I could get a straight forward answer), Atripla is either a tier 4 or 5, meaning Id have to pay as much as 30% depending on the plan.  I have the co-pay assistance card, which helps tremendously, but I'd used to getting my Atripla for free (I have Cobra now & was hoping to let that go after the first of the year for a better plan).  Now I'm going to have to probably end up paying at least $100-$200 per month on top of approx $350/month for my plan. 

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

"Be who you are and say what you feel, because those who mind don't matter and those who matter don't mind." - Dr. Seuss

Diagnosed:  Dec. 15, 2011
Jan. 2012:  CD4 - 584, VL - 104,000
July 2012:  CD4 - 435, VL - 265,000
Sept. 2012:  CD4 - 252, VL - 307,000
Started Atripla:  Oct. 2, 2012
Nov. 2012: CD4 - 563, VL - 8,440
Jan. 2013: CD4 - 540, VL - 436
April 2013: CD4 - 369, VL - 109
July 2013: CD4 - 721, VL - Undetectable (finally!)
Nov. 2013: CD4 - 795, VL - 21
Mar. 2014: CD4 - 759, VL - Undetectable
July 2014: CD4 - 586, VL - Undetectable

Offline mitch777

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Re: Obamacare.
« Reply #187 on: November 15, 2013, 05:08:29 PM »
 

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

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

In any case, I still would rather see a single-payer system.
32 years hiv+ (oct. 2013) with a curtsy.

Offline noregrets

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Re: Obamacare.
« Reply #188 on: November 15, 2013, 05:18:35 PM »
You & me both.  A few months ago I applied for insurance through Aetna (just to see what my options were) & they refused me coverage.  After taking HOURS to go through the application I clicked "submit" & I got a big 'ole "eff you" in my email about 15 mintes later.

Again, it's expensive & I can "barely afford it but I'm just thankful to at least have access...which is something the insurance companies would flat out deny if they could get away with it.
Joey

"Be who you are and say what you feel, because those who mind don't matter and those who matter don't mind." - Dr. Seuss

Diagnosed:  Dec. 15, 2011
Jan. 2012:  CD4 - 584, VL - 104,000
July 2012:  CD4 - 435, VL - 265,000
Sept. 2012:  CD4 - 252, VL - 307,000
Started Atripla:  Oct. 2, 2012
Nov. 2012: CD4 - 563, VL - 8,440
Jan. 2013: CD4 - 540, VL - 436
April 2013: CD4 - 369, VL - 109
July 2013: CD4 - 721, VL - Undetectable (finally!)
Nov. 2013: CD4 - 795, VL - 21
Mar. 2014: CD4 - 759, VL - Undetectable
July 2014: CD4 - 586, VL - Undetectable

Offline mitch777

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Re: Obamacare.
« Reply #189 on: November 15, 2013, 05:35:54 PM »
Wishing you and everyone else the best.

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

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

All of the news coverage means diddly until one looks at the math and decides if it works out or doesn't. I would encourage everyone to speak to a knowledgeable broker and be prepared with a list of questions and concerns as well as clueing them in on your own healthcare expenses and needs.
32 years hiv+ (oct. 2013) with a curtsy.

Offline mitch777

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Re: Obamacare.
« Reply #190 on: November 15, 2013, 08:34:59 PM »
AMG is on Mitch this year guys !

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

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


 
32 years hiv+ (oct. 2013) with a curtsy.

Offline WillyWump

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Re: Obamacare.
« Reply #191 on: November 15, 2013, 09:22:22 PM »
Signed up! :)





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

Mitch thats great!!

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

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

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

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

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

-W
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 wolfter

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Re: Obamacare.
« Reply #192 on: November 15, 2013, 10:01:23 PM »

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


Since you've been waiting for more than the 2 year required wait, you should immediately receive medicare once you're approved for SSD.  Unless I'm not thinking correctly this late evening.
Complacency is the enemy.  ;)  Challenge yourself daily for maximum  return on investment.

Offline bmancanfly

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Re: Obamacare.
« Reply #193 on: November 16, 2013, 10:38:49 AM »
Mitch I'm glad you got such a good deal - excellent!

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

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

A couple of things I would point out. 

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

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

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

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

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





« Last Edit: November 16, 2013, 10:45:22 AM by bmancanfly »
"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

 Bertrand Russell

Offline SouthSam7

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Re: Obamacare.
« Reply #194 on: November 16, 2013, 11:14:22 AM »
And remember for the overwhelming majority of us, we could not get insurance AT ANY PRICE. I am flabbergasted that the insurance industry was allowed to pick and choose who to cover for all this time.

Offline mitch777

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Re: Obamacare.
« Reply #195 on: November 16, 2013, 11:38:35 AM »
Will,

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

Greg,

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

Bman,

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

Sam,
Bold inequity + $$$$$ = fatcats.
32 years hiv+ (oct. 2013) with a curtsy.

Offline Jeff G

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Offline buginme2

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Offline bmancanfly

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Re: Obamacare.
« Reply #198 on: November 21, 2013, 09:54:01 PM »
This is an interesting study.  It kind of contradicts all the media hysteria about all those people being killed I mean canceled by Obamacare. 

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

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

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

"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

 Bertrand Russell

Offline bocker3

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Re: Obamacare.
« Reply #199 on: November 22, 2013, 08:05:30 AM »
This is an interesting study.  It kind of contradicts all the media hysteria about all those people being killed I mean canceled by Obamacare. 

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

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

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

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

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

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

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

 


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