Affordable Care Act (aka Obamacare) - Who's In?

In My Humble Opinion
1

OK gang, time’s coming: As of October 1st, open enrollment starts (at least in those states which are participating).

Show of Hands!

If you want to know if your state is in play, see Healthcare Marketplace.

Since my current insurance (with its $6000 deductible) is taking a bit over 20% of my income, you can bet I’m going to be at the head of the line.

I bought my insurance in the mid 90-s (while I was in my 40’s) because of a cancer scare (good reason!).
About the time I developed Osteoarthritis and the premiums start to grow exponentially, I tried to get another policy. One company agent asked if I had insurance, and then told me:
“Don’t ever let anything happen to that insurance”. Good advice, as it turned out, when my kidneys started to misfire.

So, how many are planning on signing up during this first open enrollment.

Sorry, I am not an expert on eligibility, and can’t answer all your questions, but:
For those worried about the penalty for not being insured:
I am on SS Disability, and get Medicare Part A free. If you have “Medicare” or Medicaid, you have insurance.

And the cost for the cheapest ACA plan is $0.00 for those below poverty level, if I am reading the tables (for CA, at least) correctly.

The Federal contribution in is the form of a direct tax credit, paid to the insurance company at the time the premium is due - you will NOT need to front the money and be re-reimbursed at tax time.

The policies are written be real, established insurance companies - they submit bids for a standard policy to the State Exchanges, which select which companies get the business. California is divided into regions, with some companies in these counties, others in other. Some of this is because they have selected regional companies. Don’t know if that is the only reason.

Why the Mickey Mouse of using States to hire the same insurance companies which are the problem?
The art of the possible. There is enough resistance to national health care in this country - for the Fed to actually put the insurance companies out of business (anybody hear of Medicare or Medicaid?) was not going to get enacted, nor was it going to fly without allowing the Red states to be Red States and not allow their residents access to the program.

2

I work with small businesses and owner only companies will no longer qualify for group coverage. Since they make up a large part of customer base, they’ll be moving to individual.

3

Grad school covers my insurance 100%. My wife just started a job at a small business which provides health care at a reasonable cost. I think her employer is going to benefit from shopping on the exchange.

She was considering a few job offers that didn’t come with health insurance. I never figured out how the hell the exchange and subsidies work for families where on person gets (very) affordable employee insurance, but the other does not. I suspect that’s going to be a huge issue in the next year or two.

4

This poll is a bit confusing. According to a letter I got from my employer about the ACA, our employer-paid health plan meets the requirements of the ACA. So I need do nothing, and my disabled/dependent husband and I are “enrolled in Obamacare.” Also, my husband is on Medicare, so if I lose my insurance he’ll need to do nothing to be Obamacare compliant, while I’ll need to find individual coverage once COBRA runs out. So I chose the “I like what I have” option, that seemed the closest.

My husband had emergency brain surgery on 8/13 and was just released from the hospital yesterday. I got a pleasant surprise when I learned that his co-pay for the hospital stay is waived due to his being covered under both my employer’s plan and Medicare (we have Kaiser). For the last five or so years, we were told that Kaiser would not coordinate the plans because I worked for a small business and he was under 65. All I can think of is that perhaps this rule may have changed under the ACA, saving us roughly $4,000. (When I worked for a large employer and had Kaiser, the plans were combined and he never had a copay.)

5

Since my employer provides healthcare, I don’t need to sign up for Obamacare. My daughter just got a job that pays health care, so she won’t be needing it, either.

6

My 100% employer provided plan is non-compliant with Obamacare but I like it just fine. But as an American living abroad I am exempt from penalties for not having a compliant plan.

However I am job shopping back in the States now and this is just one more thing to add to the confusion. It may take some time for employers to come to a general consensus about spousal and child coverage and such. Until that shakes out it is hard to compare job offers.

7

I will be getting decent insurance from my new job at a very good rate that kicks in October 1. However, the rule that young adults can stay on their parents’ insurance until they turn 26 has already benefited me enormously. I got kicked off at the end of the month following my 22nd birthday, then ACA passed a few months later and I was put back on. My new insurance will kick in the week before I turn 26.

8

If I was still on my previous two employer’s plans, I would be begging them to drop coverage so that I could be covered by a subsidized exchange plan. They sucked donkey balls. Having done the math on the subsidy and the plans, I would be much better off through the exchange.

However, the plan for my new job* isn’t bad. It’s an HSA, which largely means “you fucking pay everything until you hit the (large) deductible”, but since I don’t have a lot of non-prescription medical expenses, it doesn’t bother me. My prescriptions, on the other hand, are dirt cheap through the plan. Metformin for $0.74 cents a month, a box of test strips for $2.06!

  • Which pays beyond the subsidy range.
9

My current plan through work is pretty decent and covers me and my family. My work is actually one of the companies implementing Obamacare. I work in government programs, developing products that meet government requirements. It has been interesting seeing it from both sides - as a company putting the exchanges into place according to regulation and sub-regulatory guidance and as a healthcare consumer. Because Medicare and Medicaid plans re-set every year, January 1st is typically our busiest day of the year (lots of data monitoring, fingers crossed for new claims methodology, etc.); this year is going to be the biggest year ever.

10

Hmmm…

After all that “it will be the end of this country” and “we can’t trust the government to do heath care” Q: did any of those people think about how Medicare works? For a Medicare patient to parrot the “keep the government out of my insurance!” line was surreal.
A search of this board brings up many arguments.

After all that, we have just 1 voicing political/philosophical objections.

And the subject seems to not be of interest to even those who argued one way or the other.

People is strange…

11

Hell yeah I’m in. Been waiting for this for ages!

12

This is the big threat to the viability of the program - and why current insurance is so expensive - very few buy insurance when they don’t foresee needing it, and then buying it just in time to submit claims.
I didn’t end up needing it for the cancer, but, withing 2 years, I was in the ER after massive hemorrhaging - ICU with the nice, soft-spoken “Is there anyone you wish to have present” young man - type ICU. The EMT (I just gave her my wallet for ID) said something along the lines - “good thing you have insurance”.

I saw the bill on that - $54K for a stay which lasted less than 24 hours (I got a transfusion and walked home after a not-so-wonderful sleep).
The insurance company hasn’t made money on me - thank you Blue Shield of CA.

It’s also the reason why Medicare enrollment is limited to certain times or conditions - if you want to wait until you’re already sick, the bill is on you until enrollment comes around again

As expensive as it is now, I don’t want to see what happens to rates when they can no longer exclude any pre-existings - those sickies are going to shoot their costs up.

13

You mean an HDHP (high deductible healthcare plan) which qualifies you to have an HSA (healthcare savings account). That’s what I have through my employer and they cover the plan cost plus contribute about 65% of the annual deductible to my HSA. As a single, my deductible is $2600 and I think family coverage is double that. My current healthcare expenses are pretty negligible, so it works out well for me. I basically wind up with coverage and money in the bank.

It’s a considerable expense to my employer, who is very anti-Obamacare. It will be interesting to see what changes we see in the near future at my company.

14

This is the one I want to watch - how many employees? What is the demographics?

The situation is going to hit home as that group enters middle (and past) age.

15

My husband and I are covered under my job’s insurance. The company switched carriers a couple of years ago, so now we’re bearing the brunt of everything, including what I consider to be an insanely high deductible. Thankfully we’re both healthy, but I’m very glad it’s there.

OTOH when the changes go through, I can see companies within my industry switching around their scheduling to make sure most people won’t qualify for the company’s health plan.

16

I just looked at the linked page again - the pull-down list now has all states and territories.

The territories aren’t covered - the message is: See your local government for healthcare options.
For States which are sitting it out (mostly to try to scuttle it), the message is:
You will be shopping for health coverage here (the Federal Exchange)

For States which have their own exchanges, the message changes to:
You will be shopping at the (state name) Exchange, (exchangename). and the bar below becomes a button labelled “Go to (exchangename” and becomes a link.

Now you can find out if your state is playing or sitting it out while the House keeps trying to kill it.
Didn’t the Speaker, after the 2012 election state that “Obamacare is the law of the land”?

17

When I was a child my mother worked a few hours a week at a low-price department store, whose owner made a point of supporting the Minimum Wage (another thing the GOP tried desperately to kill).
Only problem was that he never allowed his clerks to work 40 hours, and was thus exempt - Minimum Wage was something his competitors had to pay, not him.
Big surprise he was all for it.

Please don’t count on being healthy - that cancer scare (I’m one of the few men with a lumpectomy scar) happened at age 45.
The hemorrhaging could hit anyone - it was a stomach ulcer that was completely asymptomatic until there was a bloody mess coming out of both ends in the middle of the night.

18

After the initial enrollment period, Obamacare goes to quarterly enrollment just like Medicare, so what you fear can’t happen. I’m on my phone right now, so cutting and pasting cites is a pain, but I will post them later.

Oh, and I’m in. I have been without health insurance since 2010 because of high rates due to pre-existing conditions. My rates should be about a third of what I have quoted in the individual market.

19

I would be in but live in Texas with our [BLEEP] of a governor.

I probably would have stayed on my employer’s health insurance plan BUT since my job is going south fast, I probably won’t have that too much longer. I have pre-existing conditions and haven’t been able to afford my own personal policy for many years. I used to have my own personal policy but finally couldn’t afford it any longer and had to go with whatever my employer offered at the time.

Medicaid is not an option in this state because you have to be disabled (I think) or have a child under age 10 or 12 or something like that, otherwise you don’t qualify. Mr. Brilliant (Rick Perry) didn’t want to expand Medicaid.

So my understanding is that if I do lose my job, I won’t have anything under Obamacare because I won’t be able to afford anything (job loss and all) and don’t qualify for Medicaid since this is Texas.

20

Residents of States that have chosen not to form their own exchanges are still going to be able to get exchange plans through the Federal exchange. I think it appears you’re aware of that, but the way you are phrasing your posts in regard to the “opt-out” States is confusing to me so just thought I’d mention this.

The States that have opted out of the Medicaid expansion, that is something their residents will genuinely miss out on versus other States. But opting out of forming your own State exchange just means the Federal government operates the exchange for your citizens.