non political - anyone else screwed by healthcare marketplace?

Hooray for free breast pumps, we got one too. I'd rather go back to my $65 oh E36 M3 plan and have paid for the pump.

The whole problem with pre existing condition denial in my opinion is not the guy without insurance smoking up a storm, getting lung cancer and looking for someone else to pay. It's the person with insurance who got sick but paid their premiums, then they get a new job or their employer changes providers, then all the stuff that was covered by previous insurer for whatever that illness was is now denied by new insurer as pre existing condition. That's just flat out wrong.

Sine_Qua_Non wrote: This is going to be a ongoing nightmare

Worse than you can imagine

I still pay less, my deductibles went down and my out of pocket max is down. It could be confusing the situation as I did move from CT to WA recently and the cost structures of the two places are quite different.

In reply to Fueled by Caffeine:

You are seriously the only person that I know of who is paying less. We are paying a E36 M3 ton more for a much worse plan. I don't know of anyone who has insurance now that didn't before. I'm sure we hang out with entirely different people but I don't personally know a single person who is in a better position since this went into effect.

My wife works PT driving a school bus for the school district, she can no longer take extra runs because she can't exceed 30 hrs a week, even though she is insured through my employers policy.

IMO, the healthcare system was unsustainable and something needed to be done, but they managed to make it less sustainable while ignoring the biggest problems, and barely fixing a few of the peripheral issues .

Remember ; the opposite of progress is Congress.

Pre ex is no longer a problem, that's one big plus from the ACA. That's a good thing because it was quite possible, as noted earlier, for someone to get cancer etc, their company would change carriers and suddenly they were left out in the cold entirely.

I'm now in the position that if I lose my job and then have to do the ACA insurance I know they can't deny coverage for my cancer. I also have had to deal with non coverage of my daughter's asthma when I had to change insurance companies through circumstance beyond my control, the last time it cost me about $1000 out of pocket to keep her in meds so she could breathe; this was in addition to the premiums I was paying during the 'pre ex waiting period' for chronic disease. They can no longer do this to me or her.

So yeah this gets a little close and personal for me. Let the insurance companies squeal, there were enough people who died to keep their profit margins fat and shareholders happy that I don't really give a shi+.

ronholm wrote:

PubBurgers wrote: Maybe I spend too much time eating patchouli and farting rainbows but I don't see why health care should cost anyone any money whatsoever (taxes aside). How we as a species decided that profiting from healthcare took precedence over treating people boggles my mind. $14K is more money than I'll gross this year, I find it insane that health care is that expensive.

A doctors labor is not your right.

Why not? I'm not saying doctors should work for free but health care should absolutely be my and everyone's right. If I don't make enough money I'm not entitled to health care? That's messed up.

Lump me into the people who now have insurance due to the ACA. Thanks Obama.

News for y'all--

Many of the examples of pre-existing condition coverage cited were covered in previous legislation. As long as you maintained coverage moving from employer to employer or your employer changed providers you couldn't be denied coverage. The ACA allowed the previously uninsured or those with a gap due to unemployment to get coverage.

PubBurgers wrote:

ronholm wrote:

PubBurgers wrote: Maybe I spend too much time eating patchouli and farting rainbows but I don't see why health care should cost anyone any money whatsoever (taxes aside). How we as a species decided that profiting from healthcare took precedence over treating people boggles my mind. $14K is more money than I'll gross this year, I find it insane that health care is that expensive.

A doctors labor is not your right.

Why not?...

Ever heard of slavery?

Basil Exposition wrote: News for y'all-- Many of the examples of pre-existing condition coverage cited were covered in previous legislation. As long as you maintained coverage moving from employer to employer or your employer changed providers you couldn't be denied coverage. The ACA allowed the previously uninsured or those with a gap due to unemployment to get coverage.

but often if you were laid off, the time between jobs was such that you couldn't maintain coverage … finally get a job … add the waiting period for pre-ex.

Come on, get with the rest of the reasonably developed world, USA. It'll be fun. We have cookies.

GameboyRMH wrote: Come on, get with the rest of the reasonably developed world, USA. It'll be fun. We have cookies.

the american public as a whole loves cookies. it's our government as a whole that hates them. therefore no cookies for us.

Toyman01 wrote:

PubBurgers wrote:

ronholm wrote:

PubBurgers wrote: Maybe I spend too much time eating patchouli and farting rainbows but I don't see why health care should cost anyone any money whatsoever (taxes aside). How we as a species decided that profiting from healthcare took precedence over treating people boggles my mind. $14K is more money than I'll gross this year, I find it insane that health care is that expensive.

A doctors labor is not your right.

Why not?...

Ever heard of slavery?

It snowed last night. The people who plow my roads don't personally present me a bill but surely they get paid. I know taxes and socialism are two words that raise a lot of ire but when it comes to health care bring it on.

I could not afford health insurance before the ACA. Now I am being told to buy a policy that is even more expensive than the one I couldn't afford before. How does that make any sense? Good thing the penalty is cheaper than the the policy. Nice penalty by the way. "You're poor? you'll have to pay a penalty for that." Looks like the day my heart attack comes will be my last (and this stress is only making that day sooner).

All I can say is that I a glad that I don't have to deal with it. I have heard stories good and bad.

wbjones wrote:

Basil Exposition wrote: News for y'all-- Many of the examples of pre-existing condition coverage cited were covered in previous legislation. As long as you maintained coverage moving from employer to employer or your employer changed providers you couldn't be denied coverage. The ACA allowed the previously uninsured or those with a gap due to unemployment to get coverage.

but often if you were laid off, the time between jobs was such that you couldn't maintain coverage … finally get a job … add the waiting period for pre-ex.

That's exactly what happened to me. COBRA allows an employee to maintain their coverage but man that is EXPENSIVE. So I had to roll the dice. It happened twice; both times I had to wait six months before my daughter's asthma was covered.

Had I been diagnosed with this cancer during one of those periods, I'd have been in the same boat my dad was; his lung cancer was diagnosed in a gap between coverages meaning he would have to wait six months before any part was covered, given that his would have been a private plan, not employer based, he would have had a helluva time finding any sort of coverage at all. As it was, everything came out of his pocket.

Even with the ACA someone in my position with a preexisting condition is still in a very precarious spot; if for some reason I lose my job, when I go to apply somewhere else in order to get health insurance I have to disclose any preexisting conditions. It does not mean they are not covered but it does mean the company's premiums can go way up. That's enough reason for a possible employer to pass on hiring me, although there's no way in hell they'd ever admit that was the reason. If I lie on the application that's reason for dismissal.

So if I lose my job and thus my insurance, the ACA says I have to pay for some sort of coverage or pay a fine. If no one will hire me, it might actually be cheaper (and necessary) for me to just pay the damn fine and apply for Social Security disability and Medicaid, as much as I detest that idea.

Some observations I've had over the years.

The costs of health care have gotten so out of control: years ago I had an exchange student develop strep throat. She had her own antibiotics but I wasn't comfortable letting her start taking them without a diagnosis so off to the ER we went. She was seen for 15 seconds (the PA on duty peered in her mouth as she said AAAH. He confirmed that it was strep and agreed that the antibiotics she already had were sufficient. The price for this massive care? $800!!!!

Another story. At one point in my life I was in nursing school and during a pediatrics class the prof was telling us about an extreme form of hemophilia. Apparently the treatment for this particular variation cost $125,000 A MONTH! My hand went up to ask who paid for this. "Their insurance" I was told. But nearly all insurance companies cap individuals lifetime benefits at a million dollars, so I noted that to said instructor. "The government pays then" I was told. Ummmm, do you get that the government doesn't create money they simply take tax dollars and redistribute them. Same as insurance companies collecting premiums, building huge skyscrapers, paying their executives exhorbitant salaries, and then paying for the sickly ones after a long fight and several denials.

I don't know the answer but the problem as it stands now is really broken.

PubBurgers wrote:

ronholm wrote:

PubBurgers wrote: Maybe I spend too much time eating patchouli and farting rainbows but I don't see why health care should cost anyone any money whatsoever (taxes aside). How we as a species decided that profiting from healthcare took precedence over treating people boggles my mind. $14K is more money than I'll gross this year, I find it insane that health care is that expensive.

A doctors labor is not your right.

Why not? I'm not saying doctors should work for free but health care should absolutely be my and everyone's right. If I don't make enough money I'm not entitled to health care? That's messed up. Lump me into the people who now have insurance due to the ACA. Thanks Obama.

I cannot disagree more.

I'd like to know how much the Duggars are paying now.

GameboyRMH wrote: Come on, get with the rest of the reasonably developed world, USA. It'll be fun. We have cookies.

Why would we want that, your cookies taste like rocks sprinkled with excrement.

Regarding pre-existing conditions...

The "I could get screwed if I change jobs" argument is one I haven't heard before, and certainly has validity. But it could have been solved in ways that made a lot more sense. Some simple stopgap proposals.

I've had COBRA. It was a LOT cheaper than ACA.

Here's the problem...

A pre-existing allowance as it now stands ALSO allows people to avoid buying insurance until they have a problem. "Hello, insurance company. My house is on fire, and I'd like to buy fire insurance".

I am doing it RIGHT NOW.

I have 7 in my family. We are all pretty healthy (none of us have ever had a hospital visit or a broken bone). I am EXACTLY the kind of participant the ACA needs to to make the whole thing work.

But I can't. ACA is WAAY out of my budget, and I am left with the choice to have insurance, or food for my kids.

It's a pretty simple math problem. The fines are low enough that I have to choose to pay them, because there is no way the insurance thing is gonna happen. I live in one of the 10 poorest areas in the country, and the ACA insurances rates are the 2nd highest nationwide.

Besides, if any of us ever gets sick, I can go out and buy insurance. It's downright unAmerican, isn't it?

As more healthy people learn that they can't be refused, more will drop their current over-priced policies and roll the dice, like me. This will force prices higher. Rinse, repeat.

So, the system is designed to undermine itself. As more healthy people make the choices they need to and leave the system, prices will be forced higher, which will force more healthy people to leave.

Rich people don't need insurance. Poor people didn't need it before ACA, and could probably do without again if they had to (they'll just go back to the emergency room).

The people who ultimately get screwed are the middle class people who really need insurance.

It's just common sense.

Well... you can buy insurance through the Exchanges if you're willing to wait a few months for them to pull their heads out of their asses and figure out how to insurance.

Swank Force One wrote: Well... you can buy insurance through the Exchanges if you're willing to wait a few months for them to pull their heads out of their asses and figure out how to insurance.

I attempted to last year. Too expensive. We'll see this year.

SVreX wrote:

Swank Force One wrote: Well... you can buy insurance through the Exchanges if you're willing to wait a few months for them to pull their heads out of their asses and figure out how to insurance.

I attempted to last year. Too expensive. We'll see this year.

Oh sure, i wasn't passing judgement or anything on you.

I was just making the point that with how poorly this is all run, i wouldn't count on getting insurance in anything remotely resembling a timely manner if someone DOES get sick.

In reply to Swank Force One:

Gotcha.