How Is Obamacare Working Out for You?

[Rupert Pupkin]

Originally Posted by GenuineRisk

I did some more googling, to try to see how this is the fault of the ACA, and I'm just not seeing it. If this plan predated 2010, which is when the ACA passed, and then continued until the start of this year, that means it was one that was grandfathered in, in which case it was Anthem's choice to stop offering it because it wasn't profitable enough for them. As someone on the political right, I am sure you understand and support their need to make a profit off of you. Anthem could have chosen to offer the plan for as long as they were not raising your premiums a lot, or making severe changes to the plan. If they cancelled the plan now, in 2015, it has nothing to do with the ACA and everything to do with it not being profitable, which they could have chosen to do before ACA, too. Currently, grandfathered plans are being honored through 2017, unless your state has elected to enforce the original 2015 deadline, which is your state's choice, not the ACA's.

If you got this plan after 2010, then it has nothing to do with the ACA because the regulations were already in place, and so it's always complied with the ACA.

As to the premiums, that's because in California, unlike many other states, health insurance companies do not have to get rate increases approved by a government regulator. So, insurance companies in California can raise their fees to whatever they want them to be, and trust in the free market to sort out if they're charging too much. Again, as a right-side guy, I'm sure you support and endorse this business model.

In fact, Proposition 45, which was on California's ballot last year, asked voters to approve appointed a regulator who would have to approve increases in health insurance premiums, and it was voted down, 60 percent to 40. Which way did you vote on it, Rupert? (the health insurance industry spend many millions of dollars to get it voted down).

I know this is long-winded, and not as agreeable as durr Obamacare sux durr, but that's the way it goes when you take time to look into an issue.

Do you know what Politifact.com called the biggest lie of the entire year? They called Obama's claim of "If you like your health care plan, you can keep it" as the biggest lie of the year. There is nothing for you to defend. It was a huge lie. You can try to spin and twist it any way you like, but it's not going to work. It was a total lie.

The plan I had did not meet the requirements of the ACA, so Anthem had to cancel the plan.

http://www.politifact.com/truth-o-me...-plan-keep-it/

[Pants II]

I can't talk about what I know regarding a particular state. Lets just say if they can keep it swept under the rug until 2017 it will be a miracle.

[Danzig]

Originally Posted by Rupert Pupkin

Do you know what Politifact.com called the biggest lie of the entire year? They called Obama's claim of "If you like your health care plan, you can keep it" as the biggest lie of the year. There is nothing for you to defend. It was a huge lie. You can try to spin and twist it any way you like, but it's not going to work. It was a total lie.

The plan I had did not meet the requirements of the ACA, so Anthem had to cancel the plan.

http://www.politifact.com/truth-o-me...-plan-keep-it/

no, they could have fixed the plan, made it match the minimum requirements.

[Rupert Pupkin]

Originally Posted by Danzig

no, they could have fixed the plan, made it match the minimum requirements.

If they fix a plan, it is still a new plan. When a plan is changed, it gets a new title and a new ID number. That is basically what they did. They changed all their plans to fit the minimum requirements.

I have been with Anthem for well over 15 years. Everything was alright until the last 5-6 years. Back in 2005 I was paying around $250 a month. I had about a $2,500 deductible. Starting in about 2008, they started raising the premium pretty much every year. It went up to $300, then $350, then $410, then $470, and finally $520 in about 2011 or 2012. I finally called them and said, "This is ridiculous. You keep raising my premiums by crazy amounts. I can't afford $520 a month. Don't you have a cheap plan with a really high deductible?"

It turns out they did. They gave me a plan with a $8,800 deductible that was only $210 a month. I was thrilled. But after the ACA passed, they switched me to another plan that was $320 a month this past year. Now this year they raised it to $367 a month. I think this might be the first year that it is an EPO. I didn't even realize it was an EPO until I went to the doctor a couple of weeks ago and they told me that I have an EPO, not a PPO, and they don't take EPOs. Then I called my internist's office to ask them if they take EPOs. They said, "No." So now I don't have any doctors that take my insurance.

[Sightseek]

Originally Posted by Rupert Pupkin

If they fix a plan, it is still a new plan. When a plan is changed, it gets a new title and a new ID number. That is basically what they did. They changed all their plans to fit the minimum requirements.

I have been with Anthem for well over 15 years. Everything was alright until the last 5-6 years. Back in 2005 I was paying around $250 a month. I had about a $2,500 deductible. Starting in about 2008, they started raising the premium pretty much every year. It went up to $300, then $350, then $410, then $470, and finally $520 in about 2011 or 2012. I finally called them and said, "This is ridiculous. You keep raising my premiums by crazy amounts. I can't afford $520 a month. Don't you have a cheap plan with a really high deductible?"

It turns out they did. They gave me a plan with a $8,800 deductible that was only $210 a month. I was thrilled. But after the ACA passed, they switched me to another plan that was $320 a month this past year. Now this year they raised it to $367 a month. I think this might be the first year that it is an EPO. I didn't even realize it was an EPO until I went to the doctor a couple of weeks ago and they told me that I have an EPO, not a PPO, and they don't take EPOs. Then I called my internist's office to ask them if they take EPOs. They said, "No." So now I don't have any doctors that take my insurance.

Well lucky for you, enrollment is still open and there ARE PPOs available.

[Rupert Pupkin]

Originally Posted by Sightseek

Well lucky for you, enrollment is still open and there ARE PPOs available.

I don't want to pay $600 a month. Does Anthem or any other company have a PPO that is affordable? I talked to Anthem on Wednesday and complained to them about my doctors not taking the EPO. The guy didn't mention anything to me about them having a PPO that I could switch to.

Switching to a PPO with a different company won't do me any good unless my doctors take the PPO. I know they take PPOs from Anthem. My internist's office told me that they take a company called Assurant. That could be an option but I don't know if I would want to switch to that if nobody else takes it. I don't know if Cedars takes Assurant.

[jms62]

Originally Posted by Rupert Pupkin

I don't want to pay $600 a month. Does Anthem or any other company have a PPO that is affordable? I talked to Anthem on Wednesday and complained to them about my doctors not taking the EPO. The guy didn't mention anything to me about them having a PPO that I could switch to.

Switching to a PPO with a different company won't do me any good unless my doctors take the PPO. I know they take PPOs from Anthem. My internist's office told me that they take a company called Assurant. That could be an option but I don't know if I would want to switch to that if nobody else takes it. I don't know if Cedars takes Assurant.

Then don't get old so you don't need to visit specialists. Really that simple Rupe. I really want to pay $125 that I paid when I was 25 years old but that doesn't seem in the cards. At least now your Health Care Provider won't boot you to the curb when you actually need them to start paying which may be sooner than later for you Rupe. So your rates started going up 5-6 years ago in 2008? You need to break out your calculator Rupe that was 7 years ago and while you have your calculator out you need to Google the ACA timeline and who was president in 2008. ACA was the fall guy for Healthcare CEO's making boatloads of money. This chart and the timeline clearly shows who the WINNERS are and include those politicians from BOTH parties whom they donated to in order to keep up this false war on ACA to keep those too lazy or not bright enough to see through the charade.


http://finance.yahoo.com/echarts?s=U...22linear%22%7D

[Rupert Pupkin]

Originally Posted by jms62

Then don't get old so you don't need to visit specialists. Really that simple Rupe. I really want to pay $125 that I paid when I was 25 years old but that doesn't seem in the cards. At least now your Health Care Provider won't boot you to the curb when you actually need them to start paying which may be sooner than later for you Rupe. So your rates started going up 5-6 years ago in 2008? You need to break out your calculator Rupe that was 7 years ago and while you have your calculator out you need to Google the ACA timeline and who was president in 2008. ACA was the fall guy for Healthcare CEO's making boatloads of money. This chart and the timeline clearly shows who the WINNERS are and include those politicians from BOTH parties whom they donated to in order to keep up this false war on ACA to keep those too lazy or not bright enough to see through the charade.


http://finance.yahoo.com/echarts?s=U...22linear%22%7D

I'm not claiming that the system was great before. For a while my rates were getting raised by 15-20% a year well before Obamacare. That should be illegal for them to raise a person's rates that dramatically. I was foolish at the time not to do my homework. I actually paid $520 a month for that final year of my old policy before finally calling Anthem and asking if they had something cheaper. The reason I didn't call them sooner was because I had always heard that Anthem's prices were very competitive and very reasonable and I just assumed that $520 a month was the going rate at the time. I was actually shocked when I found out I could get a policy with them for $210 a month.

Anyway, my whole point is not that the system was great before. My point was simply that that Obama totally mislead people about what was going to happen under ACA. He never said that rates would go way up in many states and that many people would not only not get to keep their doctors, they would also have to get new plans. I finally had a plan that I was happy with, that was only $210 a month and almost all my doctors were taking it. Now I have a plan that is $367 a month that none of my doctors take.

I'm not claiming that ACA is bad for everyone. It is actually very good for some people and there are certain things that I like about it. But I think it was totally wrong the way we were lied to about it. Obama should have told us the good and the bad and then let people decide whether they would support it or not. It would have never passed had he been totally honest about it.

As I said before, I don't think the old system was great. I think reform was needed. But I think the ACA went way too far and has had very negative consequences for a lot of people. It has obviously helped some people too.

[Sightseek]

Originally Posted by Rupert Pupkin

I don't want to pay $600 a month. Does Anthem or any other company have a PPO that is affordable? I talked to Anthem on Wednesday and complained to them about my doctors not taking the EPO. The guy didn't mention anything to me about them having a PPO that I could switch to.

Switching to a PPO with a different company won't do me any good unless my doctors take the PPO. I know they take PPOs from Anthem. My internist's office told me that they take a company called Assurant. That could be an option but I don't know if I would want to switch to that if nobody else takes it. I don't know if Cedars takes Assurant.

There is this lovely thing called the internet that will reveal these answers to you. If I can do it, while still recovering from my accident and neurosurgery, surely you can.

[GenuineRisk]

Originally Posted by Rupert Pupkin

It turns out they did. They gave me a plan with a $8,800 deductible that was only $210 a month. I was thrilled. But after the ACA passed, they switched me to another plan that was $320 a month this past year. Now this year they raised it to $367 a month. I think this might be the first year that it is an EPO. I didn't even realize it was an EPO until I went to the doctor a couple of weeks ago and they told me that I have an EPO, not a PPO, and they don't take EPOs. Then I called my internist's office to ask them if they take EPOs. They said, "No." So now I don't have any doctors that take my insurance.

Sweet Jesus. Do you have any idea what a crappy plan you were buying from them? An almost $9,000 deductible per year? Was there a lifetime cap on it after that? The reason many of these low-premium, high deductible plans were ended is because they were TERRIBLE. They were the Yugos of the health care industry (to show my age).

Rupert, none of us are getting any younger. At this point you should be on your knees, thanking the ACA for requiring young, healthy people to get insurance, because that's what brings the rates down on older folks. The ACA is what will keep health insurance even possible for you.

You honestly think Anthem wants you as a customer? Please. They want young non-smoking men in their 20s. That's it. No olds, no people with chronic conditions and no women who have an annoying habit of getting pregnant and having expensive babies. THEY DO NOT WANT PEOPLE WHO ACTUALLY NEED HEALTH CARE.

You didn't answer my early question- how did you vote on Prop 45, which would have made it illegal to arbitrarily raise health care premiums by 15 or 20 percent? How did you vote on it?

[GenuineRisk]

Post that does have something to do with the thread-

Here's an example of why the low-cost, high deductible plans are bad, Rupert. I'll use an example from myself this summer, so apologies if it's TMI.

I had miscarriage this year that came on very suddenly and very severely. I called the midwife who had delivered my son, and who was, I thought, going to see me through this very much-wanted pregnancy, to ask what to do and she said the bleeding was bad enough that I needed to go to the ER.

My husband has good, employer provided health insurance, so I was aware our copayment for the trip would be something like $50 (in fact it was $100, which I wasn't thrilled about when I paid, but it's still not going to break us). So, fifteen minutes later, once my best friend had raced over to watch our son and once I was fairly certain I wasn't going to pass out in the taxi (I was getting a bit woozy at that point), we headed to the nearest hospital.

If I'd had one of these low-cost, high deductible plans that are no longer legal under the ACA, my mind would have gone to the cost of an ER visit ($500 just to get into the room, then add on everything they might have to do- D&C, the thingy they put in in case I lost too much blood and needed electrolytes or a transfusion, blah blah blah) and I'm looking at least a few thousand dollars, all of which I'd be responsible for, and which we didn't have, and I might have decided to stay at home in my bathroom and hope for the best. And I might have bled out and died on my bathroom floor and my son might have grown up telling the story of how his mom died from a miscarriage.

But, because I knew I had coverage, I went to the ER, they took care of me, and sent me home the same night to grieve the loss of a pregnancy, which sucked to be sure, but is nothing compared to a child grieving the loss of a mother.

Those catastrophic plans forced people suddenly confronted with a health crisis to choose between their physical health and their financial health. It's good they're gone.

[dellinger63]

Originally Posted by GenuineRisk

Rupert, none of us are getting any younger. At this point you should be on your knees, thanking the ACA for requiring young, healthy people to get insurance, because that's what brings the rates down on older folks. The ACA is what will keep health insurance even possible for you.

Making young, healthy people and healthy people in general pay more than their fair share is what is keeping this afloat. Especially when young healthy people are no longer able to purchase inexpensive, catastrophic policies that were completely adequate w/o being subjected to the 1% and growing fine imposed for not having what the government considers proper insurance.

What's next? Requiring all citizens with driver's licenses to carry comprehensive, low deductible auto insurance regardless of the condition of one's vehicle or whether one even owns a vehicle, so those who are bad drivers and those with tickets and DUI's can be supplemented to purchase the same?

'Free Choice Hypocrites!'

[GenuineRisk]

Originally Posted by dellinger63

Making young, healthy people and healthy people in general pay more than their fair share is what is keeping this afloat. Especially when young healthy people are no longer able to purchase inexpensive, catastrophic policies that were completely adequate w/o being subjected to the 1% and growing fine imposed for not having what the government considers proper insurance.

Completely adequate until they get leukemia or cancer or Crohn's Disease and then the government has to pay for them because no health insurance company wants customers with chronic illness. My formerly healthy, non-smoking mother died of breast cancer at 35, Dell. If my father had not had health insurance through his job her death would have bankrupted us.

Yes, people who don't use insurance having insurance is what makes insurance work. That's why insurance companies don't want to insure people in flood zones and the government has to do it.

The problem is that we view health care as an insurance product at all. But as the defeat of Prop 45 showed, health insurance companies see great value in keeping the status quo as unchanged as possible, and they'll spend a lot of money to that end.

[Danzig]

Originally Posted by GenuineRisk

Completely adequate until they get leukemia or cancer or Crohn's Disease and then the government has to pay for them because no health insurance company wants customers with chronic illness. My formerly healthy, non-smoking mother died of breast cancer at 35, Dell. If my father had not had health insurance through his job her death would have bankrupted us.

Yes, people who don't use insurance having insurance is what makes insurance work. That's why insurance companies don't want to insure people in flood zones and the government has to do it.

The problem is that we view health care as an insurance product at all. But as the defeat of Prop 45 showed, health insurance companies see great value in keeping the status quo as unchanged as possible, and they'll spend a lot of money to that end.

as for flood insurance....yeah, that's separate so that the majority of us who don't choose to live in flood zones don't have to help pay for those that do.

people like to compare health to other insurance, but it's really not comparable.
one can choose not to drive a car, or to not drive drunk, they can be good drivers so they get good rates.
health is a crap shoot for the most part. non smokers get lung cancer, people who eat well get diabetes, or crohns, or colon cancer, etc.
as long as health insurance is handled for profit, it's going to remain a mess.

when one is a bad driver with multiple violations, one has to buy high risk auto insurance which is costly. obviously health insurance can't be handled the same way.

[Rupert Pupkin]

Originally Posted by GenuineRisk

Sweet Jesus. Do you have any idea what a crappy plan you were buying from them? An almost $9,000 deductible per year? Was there a lifetime cap on it after that? The reason many of these low-premium, high deductible plans were ended is because they were TERRIBLE. They were the Yugos of the health care industry (to show my age).

Rupert, none of us are getting any younger. At this point you should be on your knees, thanking the ACA for requiring young, healthy people to get insurance, because that's what brings the rates down on older folks. The ACA is what will keep health insurance even possible for you.

You honestly think Anthem wants you as a customer? Please. They want young non-smoking men in their 20s. That's it. No olds, no people with chronic conditions and no women who have an annoying habit of getting pregnant and having expensive babies. THEY DO NOT WANT PEOPLE WHO ACTUALLY NEED HEALTH CARE.

You didn't answer my early question- how did you vote on Prop 45, which would have made it illegal to arbitrarily raise health care premiums by 15 or 20 percent? How did you vote on it?

I'm sorry about your miscarriage. That is a shame.

I don't remember Prop 45 at all. I usually remember most propositions. I would think I would have had to vote yes on it. How could anyone be in favor of insurance companies raising rates by huge amounts? Are you sure that there wasn't more to the proposition? I don't know how a proposition like that could have lost. Although the prop about labeling GMO food lost, so it shows you that the voters can easily be fooled by tons of misleading advertisements by one side.

With regard to having a really high deductible and a low premium, I think that is the way to go for a really healthy person. For me, the point of insurance is to insure against a catastrophic illness. My medical bills are extremely low. I take good care of myself. I eat right and exercise daily. Even though I'm in my 40s, my blood pressure is 105 over 70. I certainly don't want to pay $4,500 a year for insurance when my medical bills are typically less than $1,000 a year.

With regards to what you were saying in another post about an emergency room visit, if I have a cheap deductible I am saving close to $2,000 a year. When my monthly premium dropped from $520 a month to $210 a month, I was saving $3,600 a year. So over just a 3 year period, I was going to save almost $10,000. I would have no problem spending $2,000 on an emergency room visit once every 5-10 years. I would much rather do that than spend an extra $2,000-$3,000 a year on premiums.

[GenuineRisk]

Originally Posted by Rupert Pupkin

I'm sorry about your miscarriage. That is a shame.

I don't remember Prop 45 at all. I usually remember most propositions. I would think I would have had to vote yes on it. How could anyone be in favor of insurance companies raising rates by huge amounts? Are you sure that there wasn't more to the proposition? I don't know how a proposition like that could have lost. Although the prop about labeling GMO food lost, so it shows you that the voters can easily be fooled by tons of misleading advertisements by one side.

With regard to having a really high deductible and a low premium, I think that is the way to go for a really healthy person. For me, the point of insurance is to insure against a catastrophic illness. My medical bills are extremely low. I take good care of myself. I eat right and exercise daily. Even though I'm in my 40s, my blood pressure is 105 over 70. I certainly don't want to pay $4,500 a year for insurance when my medical bills are typically less than $1,000 a year.

With regards to what you were saying in another post about an emergency room visit, if I have a cheap deductible I am saving close to $2,000 a year. When my monthly premium dropped from $520 a month to $210 a month, I was saving $3,600 a year. So over just a 3 year period, I was going to save almost $10,000. I would have no problem spending $2,000 on an emergency room visit once every 5-10 years. I would much rather do that than spend an extra $2,000-$3,000 a year on premiums.

Thank you for your kind words.

http://ballotpedia.org/California_Pr...itiative_(2014)

Anthem was one of the top 5 donors working to defeat it (contributed $250,000 towards campaigning against it) but didn't spend nearly as much as Kaiser and Wellpoint, which spent over $18 million. Each.

Propositions like that lose because people are influenced by advertising. Look at how much money grifters have made off of charter schools, which do no better than public schools and in many cases, do worse. And yet they are still being served up as the solution to education (when in fact the real issue is poverty, of course). It takes a lot of time and effort to be well informed on an issue, and most people have neither the time nor the inclination, though they still do get to vote on them.

As to your example of money saved, that's a fine idea if a person has the disposable income to put into a savings account that is reserved only for health care and if that person suffers illness or injury that is not more expensive than the money saved. For an example, here is the cost of a broken leg, which an active, 20 something might suffer while riding a bike, or crossing the street.

http://health.costhelper.com/broken-leg.html

Now, at the low end, three years of saving in your premiums would not have been enough to cover the cost of a broken leg that needed setting. And of course, the lifetime cap can become an issue if there is long term physical therapy needed. Did yours have a lifetime cap?

So many things can go wrong with the human body. I have a friend, in (she thought) great health, who, while volunteering at a riding stable, had a locker fall on her, breaking her neck. In treating the neck, they found she had a tumor growing there, which (oh, the irony!) likely would have killed her if she hadn't had a locker fall on her and break her neck. Tests also revealed she has multiple myeloma. While the combination of the broken bones in her spine and the tumor have resulted in her no longer being able to shake her head side to side (and, at this point, drive, or ride, or work sitting at a desk), she has, after a year, gone into remission. So now they can finally address the physical therapy for her neck, although she still must go through several more rounds of chemo.

How much of this would your old policy have covered?

A friend from high school had a double lung transplant 4 years ago- she has idiopathic pulmonary fibrosis, which killed her father in his 30s. Her medical costs are now well into seven figures. But she was unaware she had a problem until her 30s, when she started having trouble breathing- hell, she ran track in high school, and her siblings are fine. As her father died of it, you'd better believe that was considered a pre-existing condition. What was your plan like about pre-existing conditions?

It's excellent that you take good care of yourself, but a huge part of health, especially where things like cancer are concerned, is just luck (with, as Dell often points out, the exception of lung cancer, though I had a professor who died of it and had never smoked in his life). You've been lucky so far, and here's to hoping that you continue to be lucky and enjoy good health into old age. But life doesn't owe you anything, and as infuriated as you are now about your premiums, I would wager it's better coverage overall than what you had before.

And hey, if your health is that good, then one doctor is pretty much like another at this point and if you have to switch, it's no big deal. I had to switch a lot in my 20s and early 30s when I was buying my own insurance. If it's that you happen to just personally like certain doctors over others (which is natural), then that just falls into, well, sucks to be middle class; the rich get to have nice things the rest of us don't.

[dellinger63]

Fantastic program for those trying to kick the cigarette habit

http://www.latimes.com/world/middlee...212-story.html

[GenuineRisk]

Edited to remove. Post didn't actually have anything to do with the thread.