# Two basic Obamacare GQs **URL:** \ **Category:** Factual Questions\ **Created:** [November 22, 2013, 2:47pm UTC](https://boards.straightdope.com/t/two-basic-obamacare-gqs/674517 "2013-11-22T14:47:56Z")\ **Posts on this page:** 5\ **Page:** 2
**Author:** ![Terr](https://avatars.discourse-cdn.com/v4/letter/t/839c29/32.png) [@Terr](https://boards.straightdope.com/u/Terr)\ **Post date:** [November 29, 2013, 4:38am UTC](https://boards.straightdope.com/t/two-basic-obamacare-gqs/674517/21 "2013-11-29T04:38:23Z")
> [@BigT](#): > > Provide citations. Otherwise you are just making a political swipe. It’s a widely known fact. For example, if your old policy had a lifetime limit, no matter how high, it is not grandfathered in. No changes in the old policy, and it is invalid. > **[Affordable Health Care Act (ACA) Health Insurance Plans | Aetna CVS Health](https://www.aetna.com/aca-individual.html)** > > Get more than you expect from a health insurance company with Aetna CVS Health Affordable Care Act (ACA) individual & family Marketplace plans. Learn how quality Aetna coverage and the convenient care options of CVS come together to bring you... Lifetime dollar limits on essential health benefits are prohibited for plan years beginning September 23, 2010. This applies to all plans new and renewing on or after September 23, 2010, **including grandfathered plans.** > **[Rights & Protections](https://www.healthcare.gov/health-care-law-protections/)** > > Whether you need health coverage or have it already, the health care law offers rights and protections that make coverage fairer and easier to understand. Protections against lifetime limits on coverage apply to all health plans, **including grandfathered plans** , whether you get coverage through your employer or buy it yourself. or if you really prefer a government web site: [http://www.dol.gov/ebsa/pdf/grandfatherregtable.pdf](http://www.dol.gov/ebsa/pdf/grandfatherregtable.pdf) - dig around in there you will find it. ---
**Author:** ![FoieGrasIsEvil](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/foiegrasisevil/32/16638_2.png) [@FoieGrasIsEvil](https://boards.straightdope.com/u/FoieGrasIsEvil)\ **Post date:** [November 29, 2013, 4:50am UTC](https://boards.straightdope.com/t/two-basic-obamacare-gqs/674517/22 "2013-11-29T04:50:40Z")
I’m screwed. I was recently unemployed, and now I am under-employed and while my sons qualify for Medicaid, I do not because I now make over $500 a month. This whole thing is hard to understand and it’s bullshit. The law is crazy. I never imagined that my vote for Obama based solely on some type of UHC that would mimic what other Westernized nations have would be such a snafu. ---
**Author:** ![md2000](https://avatars.discourse-cdn.com/v4/letter/m/73ab20/32.png) [@md2000](https://boards.straightdope.com/u/md2000)\ **Post date:** [November 29, 2013, 1:33pm UTC](https://boards.straightdope.com/t/two-basic-obamacare-gqs/674517/23 "2013-11-29T13:33:20Z")
> [@What\_the](#): > > So basically you don’t know or don’t care to participate in the GQ. > > For anyone who does … > > If a premium increased by 35% is there any info available as to how much was the normal annual increase we’ve been seeing for years (maybe 25%?) and how much was due to Obamacare requirements (maybe 10%) … and then are there future requirements that can be expected to cause future increases? If so, how much (example: 1/3 of the requirements have kicked in so far so expect even bigger increases in the future). Well, since your response was equally fact-filled, let’s try this: [http://www.guttmacher.org/pubs/fb\_contr\_use.html](http://www.guttmacher.org/pubs/fb_contr_use.html) 43 million women who should use birth control - tallying the methods that look like they are doctor-prescribed - pill, IUD, ring, etc. - about 24% - so about 11 million out of a USA population of 330M - 3% of the population. I have no idea how much birth control costs (it’s usually covered by employer benefits in Canada, if you are lucky). Let’s say things are equally distributed - let’s say the proportion is higher because usually hose plans are for people more likely to be in child-bearing age, so I’ll make the number 10%. Let’s pretend birth control pills cost $100 a month or $1200/year, for 10% of the participants. That’s a $120 increase in premiums for single, or $10 a month. That’s what my back of the envelope tells me. Same back-of-the envelope calculation for any other issue. Lifetime maximum removed? How many people where you work are afflicted with cancer, need/have an organ transplant, or similar high-cost treatment each year? How many of those reach the maximum? Probably less than 1 in 100 employees each year. I hope your lifetime max was enough to finish the required chemo for cancer, it didn’t quit halfway through - or else why is the plan called insurance rather than “false hope”? This is the whole point of medical “insurance” - spread the load around, so the unlucky one does not lose their house, their life savings. etc. The failure of the states to expand Medicare is more a deliberate attempt by the state government to foil ACA, not a failure of the law itself. The cause is ideological and due to the state governments. Should you be surprised that problems occur if (a) some state governments actively are trying to frustrate the plan and (b) one party in congress frustrates any attempt to correct the issues arising from the law. One commentator said in programs like this there are plenty of issues, and typically in the past congress has passed amendments to clarify and correct these issues. It ain’t happening for this… is that Obama’s fault? FYI - Canada has an extremely simple system - each province’s plan, all covered procedures and doctor visits are paid for by one plan. However, it does not cover prescriptions (there’s a plan for that if you’re poor). There is no mandate for birth control. Prescription coverage is a sometime employer benefit for lucky employees, and whether birth control (or Viagra) is covered is up to the plan provider. Some don’t. ---
**Author:** ![What\_the](https://avatars.discourse-cdn.com/v4/letter/w/f4b2a3/32.png) [@What\_the](https://boards.straightdope.com/u/What_the)\ **Post date:** [November 29, 2013, 1:46pm UTC](https://boards.straightdope.com/t/two-basic-obamacare-gqs/674517/24 "2013-11-29T13:46:00Z")
> [@md2000](#): > > Well, since your response was equally fact-filled, let’s try this: I’m looking for facts …not trying to provide them. Your response seemed to be an effort to place blame. For anyone: Is the part of the law that requires coverage for more older children now fully implemented? Are those costs now built into the pricing of all “Family” coverages? My limited experience from quite a few years back is that the pricing of the plans that our company was looking at wasn’t based on how big the family was. There was only single and family… maybe one other in between for one parent families. ---
**Author:** ![md2000](https://avatars.discourse-cdn.com/v4/letter/m/73ab20/32.png) [@md2000](https://boards.straightdope.com/u/md2000)\ **Post date:** [November 29, 2013, 2:17pm UTC](https://boards.straightdope.com/t/two-basic-obamacare-gqs/674517/25 "2013-11-29T14:17:35Z")
Here’s another one, courtesy of Google… [http://www.hemophilia.org/docs/LifetimeLimitsReport.pdf](http://www.hemophilia.org/docs/LifetimeLimitsReport.pdf) > [@](#): > > About 55 percent of individuals with employer provided health insurance are subject to lifetime limits, or 91 million people in 2009. The proportion of individuals with employer coverage, who have no lifetime limits increased substantially between 2000 and 2007. > The most common lifetime limits are $1 million or $2 million. More than 20 percent of people covered by employer plans are subject to lifetime limits of $1 million; another 32 percent are subject to limits of $2 million or more. >  Employers that self-insure are more likely to have plans with lifetime limits. >  PwC estimates that in 2009 approximately 20,000 to 25,000 people are no longer covered by their employer-sponsored plans because of lifetime limits. > > Increasing lifetime limits from $1 million to $5 million would increase premiums, on average, by 0.6 percent to 0.8 percent (approximately $3 per month for typical single plan, $8 per month for family plan). > > Extending the limits from $5 million to $10 million would increase premiums on average by less than 0.1 percent. So around 1% increase or less… ? Sorry, I’m not seeing the impact of these rules as a driver of substantial cost increases. I presume the insurance companies are altruistic and have no interest in milking the change for its financial or political implications, and it’s just a coincidence that the replacement plans are more expensive… so I’m at a loss to explain the rash of plan cancellations. [Previous page](https://boards.straightdope.com/t/two-basic-obamacare-gqs/674517.md?page=1)