She’s cutting premiums 23% with Obamacare. Want proof? Here you go

Lots of folks remember the appalling breach of congressional comity and protocol when Republican Representative Joe Wilson (R-SC) shouted “You lie!” at President Obama during a joint address to Congress about health care reform in September, 2009.  (In fact, Joe Wilson was the one who lied.)

Wilson came to mind the other day after I posted an account of my experiences — and eventual success — in obtaining health insurance through the Healthcare.gov (aka Obamacare) website.

In my story, I noted how the Affordable Care Act permitted me to buy a high-risk plan for people with pre-existing conditions to hold me over until the actual Obamacare exchanges kicked into gear on January 1, 2014. Before that, I had no insurance at all due to – get this – the fact that I have hay fever allergies and migraines. That was enough to disqualify me from ever getting health insurance again.

becca-health-insurance-rejection

And finally, I recounted how with my new Obamacare exchange plan, my premiums were about to go down by 23% or a little over $100/month. A drop from about $479 a month to $371.

Then a curious thing happened.

Despite my including tons of detail, at least a few of the visiting trolls flat out accused me of lying.

Here’s your stinking proof

Not only was I accused of lying about my plan, premium, and benefits, one contended that my $371 premium absolutely had to include subsidies. It doesn’t.

Another claimed that I didn’t put premium comparison amounts anywhere in my post, so that somehow, again, proved that I was a liar.

So, here’s the proof of the premium and the fact that I’m not getting a subsidy (my application ID number has been removed to prevent further trollage). Note the $371 price tag, and the $0 in subsidies:

My Healthcare.gov plan summary page

My Healthcare.gov plan summary page – for realsies.

Not good enough? Okay, here’s my acceptance letter for my new ACA plan (address and marketplace ID removed, also cropped the info for where to mail or submit my payment):

My health plan acceptance letter -- $371 monthly premium, no tax credit subsidy

My health plan acceptance letter — $371 monthly premium, no tax credit subsidy

To be honest, come April 15, 2015, if business isn’t as good as I hope it will be in 2014, I might even qualify for a tax credit. So I’d be saving even more than $100.

Get ready for some Healthcare.gov wonkishness

The accusations of outright falsehood and sockpuppetry took me aback. Not that I gave them any credence, but surprised (I know) that there are people out there so set in their beliefs, that they absolutely won’t consider new information. I know there have been studies on this, how too many partisans prefer to reinforce what they already believe, and simply are not open to information contradicting their pre-conceptions.

Our own Jon Green has written about some of these:

Information consumers tend to seek out information that confirms what they already know; when that information is readily available we are able to tell ourselves that we are right, over and over again, and each successive piece of information further solidifies our particular set of neural networks (this is why priming “Democrat” with “bad” will have different effects on different people).

We like being right, we don’t like being wrong; and this is true beyond our conscious evaluations of correct and incorrect. One study showed that levels of testosterone in male voters were affected by whether or not their candidate won. As the New York Times reported:

…the male McCain voters “felt significantly more controlled, submissive, unhappy and unpleasant.” The testosterone effect was “as if they directly engaged head-to-head in a contest for dominance” and lost, one researcher told a reporter when the study was published in 2009. The men who voted for Obama fared better. The researchers speculated that there might be an Obama baby boom.

Politics is more than an individual pursuit. With high stakes and clearly-defined opponents, we place a high premium on being on the winning team, both in arguments and in elections. By arming ourselves with “correct” information and rejecting “incorrect” information, our political attitudes are socialized, or solidified, over time.

I could understand such a doubting attitude if I were posting about generalities, opinions, or projections as to future events. And we had some healthy debate in the comments, including with and among AMERICAblog regulars who don’t always agree with me — which I’m totally cool about. A variety of viewpoints is why I keep coming back.

But I was providing numbers — hard data. I was telling people exactly how much money I was going to save, to the dollar – and they thought I’d just made it up out of thin air.

Now let’s look at some other “lying” states

So I thought to myself, ‘Okay, let’s go get some more hard numbers and proof.’ Just for the heck of it. Fortunately, one of the things I was able to do with my Healthcare.gov login was to go back and view all of the plans available to me — a 50 year old non-smoking woman, living in a middle county in New Mexico. (Not all exchanges allow a difference based on smoker or not, such as DC for example.)

I went back to the plan browsing area of Healthcare.gov and looked at some additional plans. Here’s the least expensive silver plan I was offered:

Healthcare-gov - NM - silver plan 1And here’s the least expensive Bronze-level plan, again using my own eligibility as a benchmark.

Healthcare-gov - NM - bronze plan 1

Pretty cheap, huh? (By the way, both of those plans are eligible for a tax free Healthcare Spending Account (HSA) to help offset the deductible.) I also checked what a Silver-level plan would cost with my new provider, Lovelace Health Plan, and it would’ve been around $325 a month. Platinum plans from the same provider ran from $419 to $505.

Now I do know that health insurance in my state and part of the country is less expensive than elsewhere, so I decided the next thing to do was to log out and just start seeing what kinds of numbers I could find for generic coverage in other states, using Healthcare.gov’s browsing function. I picked several at semi-random. (I mainly chose GOP-controlled states because they’re the ones that don’t have their own exchanges.)

So I went first to my old home state, Pennsylvania. Because I wasn’t really signed in, the summary information is far more bare-bones, but I could still get numbers using my own stats — self, 50 or older. (Over 50 years old significantly increases premium costs, by the way.)

Here are the first three plans listed under Silver in Pennsylvania:

Healthcare-gov - PA 50 silver

Gold plans for me in Pennsylvania (Allegheny county) ranged from $288 to $400/month.

Well after that, it only made sense to go whole hog and start checking those other states. I’m not going to embed graphics for these because it would be far too many, so I’ll summarize the results (I lie!), and anybody with a lick of curiosity or doubt can go find them for themselves.

In each case I tried to pick the same county for each go.

Self only, 50 or older (Silver)

Arkansas = $367-$545
Florida = $490-$627
Montana = $358-$391
Ohio = $302-$447
South Carolina = $394-$443
North Dakota = $400-$439
Texas = $332-$443

Self and spouse (Silver)

Arkansas = $587-$623
Florida = $702-$898
Montana = $512-$560
Ohio = $432-$642
South Carolina = $536-$633
North Dakota = $572-$627
Texas = $476-$634

Self, spouse and kids (Silver)

Arkansas = $813-$991
Florida = $779-$934
Montana = $708-$774
Ohio = $599-$887
South Carolina = $780-$879
North Dakota = $792-$896
Texas = $659-$879

There are some fairly obvious outliers there. Florida insurance is quite expensive, for example. However, it’s worth noting I wasn’t asked any of the questions which could reduce overall premium amounts, other than age and that only when I picked just myself. As soon as I went for self+spouse or family coverage, there were no other questions besides location. The ‘family’ selection also did not ask how many kids.

With a subsidy, those premiums are even better

You might be thinking, ‘How’s a family of four in Little Rock, Arkansas (for example) going to come up with that kind of scratch for a family policy?’

That is just way too much, more than $800 a month for health insurance. Especially for a family of modest means.

I’m glad you asked, because I decided to make use of another tool: The Kaiser Family Foundation subsidy calculator. Going to the Census.gov website for Arkansas data, I determined that median family income is just over $40k/year. So I filled out the calculator for a family with two kids under 20, two adults age 30, living near Little Rock.

Healthcare-gov - Arkansas subsidy calc1Lo and behold. Guess what? This hypothetical Arkansas family qualifies for a premium subsidy. A big one.

Healthcare-gov - Arkansas subsidy calc2

In case you can’t quite make out the numbers, it estimates a Silver level plan’s premium would cost about $10,177 a year, or $848/month — which is right in line with Healthcare.gov’s numbers ($813-991/mo). Because the family is at 170% of the Federal poverty level, they’re eligible for $8,212 a year in subsidy help, leaving them on the hook for just $1,965 a year, or $163 a month.

Let me repeat that: A Little Rock, Arkansas family of four earning that state’s median income of $40,000 a year could get a Silver level health insurance plan for $163 a month.

And as if that isn’t enough, the coverage calculator says there’s a chance that family’s two kids would be eligible for the Children’s Health Insurance Program (CHIP) or Medicaid. (Full Medicaid coverage in Arkansas would kick in at an income of $32,400 or lower, since they’re one of the Medicaid expansion states.)

Actually, you lie

It seems to me we’re dealing with two problems here: One is people utterly unwilling to accept facts and hard data. And possibly also those who’ve decided they already know what the facts are, and are either unwilling or unable to find that information for themselves. (The latter half of that — unable to find — is entirely on HHS, and the urgent need to make the Healthcare.gov website fully operational ASAP.  And, as John has noted, the actual prices and policies need to be easily accessible to everyone – no passwords, no accounts, just let people browse plans effortlessly.)

I would suggest for those who are at all persuadable or on the fence, especially if Healthcare.gov is still difficult to manage, go check out that Kaiser premium subsidy calculator. If nothing else, and particularly for people of modest means, it might allay some unnecessary fears.  And at least peak their curiosity to go explore the actual plans and actual prices before just writing the entire thing off.

And it might just help us all identify who the real liars actually are.


Published professional writer and poet, Becca had a three decade career in technical writing and consulting before selling off most of her possessions in 2006 to go live at an ashram in India for 3 years. She loves literature (especially science fiction), technology and science, progressive politics, cool electronic gadgets, and perfecting Hatch green chile recipes. Fortunately for this last, Becca and her wife currently live in New Mexico. @BeccaMorn

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  • Robin Pejsa

    I am unemployed and need to keep health care to deal with my wife’s health problems. My premiums are going from $688 to $941. My insurer also insinuated that if they do not enroll enough younger, healthier people to offset the influx of formerly uninsured older folks (older, like me) premiums will rise rapidly to adjust for additional care related expenses.

  • Mark Cohen

    Posting against your own posts so I won’t see it and respond will not work. I will find and respond to your continued posting of false information. EVERYONE should take note of his attempt to keep his responses out there unchallenged by hiding the ball. Does this seem like the efforts of someone who is posting true and correct information? No, clearly not.

    The ACA plan that I referred you to cost in the $400-$500 range, NOT in the $300s, so you are STILL looking at plans with the cheaper rates WELL below your current premium in the $600s, which is stupid. Given the extensive range of meds you CLAIM to be on and the fact that you CLAIM to need specialists, you would clearly be served better by the plans with premiums closer to what you are currently paying. I just checked and several of the plans in the $400 to $500 range INCLUDE Norton Healthcare. So, again, problem solved by being a better shopper (or by not trying to pass off false information as the truth).

  • Mark Cohen

    Nice. That is the best you come up with after 11 days? Simple fact is that I looked up your available plans, you picked the ABSOLUTE worse plan for your medical conditions and then try to post from here to Timbuktu claiming FALSELY that the ACA raised your insurance costs exorbitantly. When the issue was, you picked a piss poor plan given your health situation. My personal opinion? I think you are just a shill making up a fake ACA horror story and running with it. Calling you a careless shopper was giving you the benefit of the doubt, which your continued posts call more and more into question.

  • GregoryC

    I did research the Anthem plan you suggested. There was a good rate of $383.85 per month but Anthem has changed their network for 2014 and will no longer include Norton Healthcare (which has 40% market share in Louisville, KY) where my two primary doctors are located. I’d have to change doctors to apply for that coverage.

  • GregoryC

    Careless shopper? As of December 19, 2013, the Obama White House and HHS Secretary Sebelius will allow a ‘hardship exemption’ for those whose health plans have been canceled and who believe current health insurance plans ‘are unaffordable’. Those folks can now be exempted from the ‘individual mandate’ to obtain qualified health coverage. Are all these millions of Americans bad shoppers too? Send a note to the Obama White House that they’re enabling bad shopping.

  • Mark Cohen

    Greg, your are not lying when you specify that the Kentucky Health Cooperative quotes a silver plan for a 51 year old with the variables you have relayed. Where you are lying is when you try to pretend that this ONE silver plan is the only one available to you on the site. I visited the site and as posted above, there are SEVERAL other silver plans and ALL of them would be better for someone in the situation you claim to be in than the plan you pretend is the only plan quoted to you. It isn’t the only plan quoted and anyone can go and verify this themselves. It IS the plan with the LOWEST premium of all the silver plans offered. As the plan with the lowest premium, it is a plan better suited to someone who is relatively healthy and doesn’t expect to utilize medical facilities too often. To choose this lowest premium plan ($285/mo premium) and compare it to your current ($615/mo premium) plan is completely dishonest. I initially gave you the benefit of the doubt and assumed you might be just a very careless shopper. However, as anyone who reads through your posting history can tell, your story started 16 days ago on one version and has morphed into something entirely different now. It isn’t a personal attack on you to expose your lie for what it is. It is research and reporting the facts. I’ll not allow you to go about on these sites spreading yet another false ACA horror story without providing people the facts that they can judge for themselves.

  • GregoryC

    True, Considering that 75% of the nation lives paycheck to paycheck, many people are one crisis away from homelessness, bankruptcy.

  • GregoryC

    Agreed.

  • GregoryC

    My story is not BS. Kentucky Health Cooperative, Silver plan for 51 year old at my income level quotes a premium cost of ~$312 month. $2500 deductible (including $500 Rx) and $6350 MOOP limit for an individual (limit set by PPACA). The drug I take has a retail cost of $2,000 per month at Walgreens. The health plan requires a 35% coinsurance, per month, for this drug, until the MOOP limit has been reached. Specialist copay of $50 per visit. $20 copay for generic (but usually generics are priced at retail cost, so if the drug cost less, the pharmacy charges less – I take gemfibrozil 600 mg BID now which cost me $10.07 month, lower than my current generic co-pay). You need to stop your personal attacks at this website and Bill Moyers. I’m only relaying my own experience, I’m not trying to change anyone’s mind. Please, by all means, do the research on whatever exchange is available to you, federal or state, and find what works best for you. My drug costs will be considerably higher next year. My current premium is $618 month but Kentucky Health Cooperative quotes a considerable savings per month, but I can’t win if the drug and laboratory costs are higher because those costs are my highest costs.

  • Mark Cohen

    Greg, your story is complete BS. I
    just chose a KY silver plan for a 51 year old male making 100K per
    year to see what you are going on about. Instead of shopping for the best insurance for your particular situation, you chose to look at the plan with the lowest montly premium.
    Well OF COURSE taking a dramatically lower premium is going to raise the
    costs of all coverage used. People who are healthier, will choose a plan with lower premiums in exchange for higher costs should they get sick. You on the other hand with chronic health condition need to choose a plan that maximizes your needed beneifits at the lowest cost. You are currently paying $600/mo and
    trying to compare that coverage with a plan that is listed at
    $285.55/month. However, compare with some of the other plans costing in
    the $400-500/month range and you find $3600 MOOP, no specialist copays,
    combined med/drug deductible of $3000, $40 copay brand name, $15 copay
    generic, and a 0% coinsurance after you hit your deductible for
    specialty drugs. Which plan am I talking about? Anthem Blue Access PPO.

    So, you really need to shop smarter given your particular
    situation before coming on the boards and ranting about how the ACA
    raised your rates (that is assuming this is really your situation and
    you aren’t just another rightwinger trying to make a persuasive horror
    story about the ACA out of thin air). So, if you are telling the truth,
    then you need to do a better job looking at the plans before you
    complain. If you aren’t, then shame on you for trying to scare folks
    with yet another false ACA horror story.

  • Phrederica

    My premiums are going from 2012 $1045 per month to 2013 $675 per month (with NO government subsidy). Since my old premium was going up about $100 per year, my expected 2013 premium under the old plan is about $1145 per month, giving me approximately a $470 per month savings for slightly better coverage.

  • GregoryC

    I have a chronic health condition and I am currently paying $617.72 per month, premium, for Kentucky’s high-risk pool for people with pre-existing conditions. I have the Anthem Blue Access PPO. Under ACA, my premium drops to $311.39 month for a Silver plan, Kentucky Health Cooperative, but that is the end of the cost savings. The deductible increases from $1,000 to $2,500, the MOOP limit increases from $2,500 to $6,350. My copayment for specialists increases from $10 for an office visit to $50. My laboratory costs increase from $0 to 35% coinsurance. My biggest cost increase is prescription drug costs. I currently pay $30 month for a brand name drug that has no generic equivalent. The current wholesale cost for this drug is $2,039.43 per month at Walgreen’s. At a 35% coinsurance under ACA, my monthly cost increases to $713.80. Quite an increase! ACA allows discrimination of those with chronic health conditions by shifting costs to patients attempting to pay for prescribed medications. Under ACA, my costs increase considerably. My annual cost now, premiums plus prescriptions monthly, averages $7,892.64. Under ACA that increases to a minimum of $10,086.68. Unaffordable.

  • lynchie

    We had a Dem governor he was just as corrupt as the current Repub. The problem is few people in politics are there to represent the electorate. They are owned by the 1% and there is little we can do. Dems go ape shit when we talk about a 3rd party and trot out Gore losing to Bush. But Gore couldn’t even win his own state.

  • Sharon McDonald

    What you all have to do in PA is elect a Governor, etc that is/are Democrats. We in Virginia did it and now we expect that we will now participate. If Virginia can do it certainly PA can.

  • Kathy Schermerhorn

    lol can’t say anything bad about her cost for obamacare so run your mouth about Benghazi. Typical Tea Sharty. They obviously missed the 60 minutes 60 second apology for lying. So karmanot, what do you know about the 13 Embassies bombed during Bush’s admin? And what do you know about Bush being a convicted war criminal who can’t leave the country, and can’t even apologize for it? What do you think of the Obama admin having to apologize over and over again to the world for what Bush did before anyone will listen to us?

  • Whitewitch

    I will not vote for Hillary – many will not. She is a Corporate, wealthy woman with no concern for us. She served on Wal Mart’s board – the most evil of corporations and she does not believe in unions.

    How about if we all vote for a real Democrat and not a Republican (as in republican pre-Reagan). Bernie Sanders or perhaps Elizabeth Warren.

    If you are a WH paid poster – please give the President my regards and let him know I am sorely disappointed with the ACA and said that he betrayed those who worked so hard to get him elected.

  • Whitewitch

    And where does one get get the 6,000 when they need a knee replacement? Bankruptcy? Know how long it took me to pay of my double mastectomy – 3 years…lost my home, my credit rating. I did finally pay it off AND THAT was with insurance.

    EDITED to add – imagine what I would have owed if I had opted to have them reconstructed…imagine a world where a woman has no breasts and loses everything else as well.

    Single payor is the only answer….not empowering/enriching corporations on the backs of the ill. That is my point, my only point.

  • Nancy L. Rattign

    A $6,000 deductible is fairly common with other, less comprehensive policies, that already exist. Some even had $10,000 deductibles and gave the insured almost no real coverage. That is exactly why single provider would be the most economical and best overall way to go for everyone. Healthy people likely won’t come close meeting the deductible, so it’s no big deal. However, if you have heart surgery, joint replacements or other expensive in hospital stays, $6K is a drop in the bucket when we routinely go over $100K for hospital procedures. Having children and not having excellent insurance is a HUGE mistake. You have to protect them and the breadwinners.

  • Nancy L. Rattign

    I’m sure that Hillary will work very hard on it. After all, she also tried to get universal health care through.

  • MyKarmaRanOverYourDogma

    As I explained in another reply above, the gov’t pays for the deductibles and OOPs somewhat, depending on what plan you get. You do not know the subsidy until you complete the application. It varies for everyone depending on where you live, even from county to county here in Fla. The gov’t kicks in up to 93% or more for some folks on both deductibles/oops and premiums if you get the silver plan. AND you have the choice of using all, some or none of the subsidy. AND if you don’t use it all you get it back on your taxes later! #ThanksPresidentObama! However, I chose the platinum plan because the deducible was quite reasonable ($850) and the OOP was doable for us, $2500. But I wouldn’t want to pay more than 10%! The silver is like 60%-40%…40% of a large hospital bill is an awful lot to deal with…

  • MyKarmaRanOverYourDogma

    Do not blame the President for what the GOP has done. Do you think he would have used the GOPs own plan if he had a chance in hell of passing single payer? II think he thought they would cooperate if it was their own plan, but he didn’t count on the racism and hatred they have for him and the rest of us.

    The problem with this world is NOT THE DEMOCRATS, LEAST of all President Obama! HE isn’t the one who shut down the gov’t over a hissy fit, or held 40+ votes against something that stands to save this country a shitload of money, or cost us all that they have doing these things in trying to overturn a sitting president, like the traitors they are. Rmoney did not win, and thank GOD.

    At least President Obama got us this. AND he left a door open so states can expand to TRUE single payer if they wish, while STILL USING THE ACA funding. NOW it is up to the various states. VERMONT HAS ALREADY DONE IT. <3 http://www.occupydemocrats.com/vermont-makes-promise-people-video/

  • MyKarmaRanOverYourDogma

    I am in Florida. I do qualify for subsidies, although Fl has not expanded Medicaid. I have researched the plans available to me extensively and my criteria was dental and vision. Out of the over hundred plans I have available, only two have that, one is gold and one is platinium. The difference with the subsidies is that the gov’t is trying to persuade everyone to go silver, which they pay more of the subsidy money for, even paying some of the deductible and OOP. However, the platinum plan makes the most sense for us. Two adults, over 50, vision and dental and only 10% co-pay, all my doctors are on the plan, BC/BS, btw, GREAT company, for less than three hundred a month. $850 Deductible and $2,500 OOP. Can’t get much better than that! We were paying TRIPLE that for substandard, inferior healthcare that covered NOTHING. I am so thrilled with the ACA! It’s a good first step and hopefully ALL will go for single payer once we get the rethugs out…Make sure you note that Vermont is going for it NOW. http://www.occupydemocrats.com/vermont-makes-promise-people-video/ SO HAPPY! Now I know I won’t bankrupt my family when I get my gall bladder out next year :)

  • MyKarmaRanOverYourDogma

    Single payer is coming. Vermont will be the first. :) “The ACA provided states with federal funds to institute a Medicaid expansion. The states chose to expand the program also were able to set up their own state exchanges, which were relatively free from the problems the federal site had. Vermont decided to take it a step further by setting up their very own single payer system.

    The slogan of the program: Everybody in, nobody out.

    The program will be fully operational by 2017, and will be funded through Medicare, Medicaid, federal money for the ACA given to Vermont, and a slight increase in taxes. In exchange, there will be no more premiums, deductibles, copay’s, hospital bills or anything else aimed at making insurance companies a profit. Further, all hospitals and healthcare providers will now be nonprofit.”
    http://www.occupydemocrats.com/vermont-makes-promise-people-video/

  • MyKarmaRanOverYourDogma

    I know it was a made up debacle that you idiots can’t let go of because Obama has done nothing wrong. No dick pix, no extramarital affairs…you are grasping at straws, over and over, from the IRS made up crap to this bullshit, which is the most you can come up with, and is not the President’s fault.

    Funny how you never ever mentioned the hundreds of folks that died in embassy attacks under the shrub’s watch. OR the fact that a large part of the problem with Benghazi was the asshole RethugliCONs (what a surprise) who cut funding for embassy security right before the attacks that you idiots try to blame Obama for. NEVER EVER HEAR ABOUT THAT DO WE?

    Now, what the hell do you know about it? Precious little, I bet. https://www.facebook.com/photo.php?fbid=677326435622558&set=a.115013885187152.12534.114270361928171&type=1

  • Badgerite

    Me too.

  • Whitewitch

    Thank you so much for all the information Badgerite – Now I see why they have Navigators to help people way complicated to figure out. I am happy that I have insurance through my employer…I am worried about others I guess…and hoping for Single Payor someday…

    EDITED

  • Badgerite
  • Badgerite

    Someone making $44,000 who does not get adequate insurance through their employer, would be required to handle the premiums themselves. But for people of a lower income, there is some help with deductibles.
    Here is a link about that very topic.
    http://www.kaiserhealthnews.org/features/insuring-your-health/2013/070913-michelle-andrews-on-cost-sharing-subsidies.aspx

  • http://www.rebeccamorn.com/mind BeccaM

    Depending on the specific plan, there are often a number of things not subject to the deductible, and as you said, some are required to be free. Benefits I can get in my plan before the deductible:

    – Prescription benefits (the usual discounts, but my out-of-pocket maximum is $2k/year; after that, ‘scrips are free)

    – Routine doctor and specialist visits ($10 or $25 co-pay)
    – Hearing aids (free, not that I need ‘em, yet)
    – Basic emergency room admission ($250; in-patient subject to deductible and co-insurance though)
    – Asthma, heart disease, diabetes, or pregnancy health programs (I could see that 2nd one coming into my life at some point… family history and all)

    – Accupuncture or chiropractic care — 20 visits a year each, flat rate of $25 a visit
    – Mental health outpatient visits, $25 each, no limit
    – And if I had a kid, they’d be eligible for free vision care and eyeglasses

    These benefits aren’t always the case in every plan, and among the reasons I chose this one over the others. At my age, I need to be able to go in at need and tell the doc, “Y’know, this mole looks funny” — and not be thinking, ‘Crap, this visit would cost a couple hundred bucks and it’s probably just a stupid pimple-cyst, I’ll let it go…’

    However, some of the lower cost plans have no pre-deductible benefits other than ‘scrips and preventive visits. That ain’t right either.

  • http://adgitadiaries.com/ karmanot

    pppffftttt

  • runfastandwin

    Yeah, too bad McCain didn’t win, then we’d have got single payer!

  • http://adgitadiaries.com/ karmanot

    Bows in sublime recognition. >>>>>>>> :-)

  • timncguy

    Under the ACA an annual check-up with your doctor and preventive care has NO deductible and NO co-pay.

  • Whitewitch

    Ditto Karmanot…I will never recover financially from my double mastectomy…as if loosing one’s breasts is not enough….eh? Maybe our next President will be able to follow through.

  • http://www.rebeccamorn.com/mind BeccaM

    My own wish is that the public option and drug importation hadn’t been traded away before the bill drafting even began.

  • http://adgitadiaries.com/ karmanot

    We love ya Mods!

  • http://www.rebeccamorn.com/mind BeccaM

    What do I know about Benghazi?

    EVERYTHING. I’m the motherf*ckin’ Oracle, sugar.

    Have a cookie.

  • http://adgitadiaries.com/ karmanot

    You are right, but an affordable plan is only the beginning. Once activated, what about the cost controls.

  • http://adgitadiaries.com/ karmanot

    Those of us who are older have gone through hell over medical affairs. I was dropped from BSBC because of acid indigestion. I went through years of suffering over that, because at the time the medication was not over the counter and extremely expensive. I lost my entire life savings a few years ago at the ER, two months before Medicare kicked in. I was thrilled during the first primary when Obama was promising single payer and sold out to a neo-liberal insurance scheme. I will never forgive him.

  • Whitewitch

    Thanks Badgerite – I am fortunate and for now have insurance through my employer. What I fear is for those who don’t qualify for a subsidy, because they make say $44,000 – which sounds like a lot of money, but isn’t – and the premiums for the barebones through ACA are $200-300 per month with a $6,000 deductible. How does anyone afford that?

  • Badgerite

    Well, to be honest I haven’t applied yet and the first level of information does not tell you details such as deductibles which I think is a major oversight. But if you have a family of 4 and you make under $94,000 per year, you do qualify for the tax subsidies and they are quite generous. In order to not qualify for subsidies you would need to make as an individual over $44,000 per year. That is an individual. As I said, for a family of 4 they would need to make more than $94,000 per year. You have to be doing reasonably well NOT to qualify for the subsidies and the subsidies actually make the premiums something akin to what you would pay as a Medicare Premium. Maybe a little bit more. There is the option of an individual waiver for reasons of economic hardship but I really don’t know what that would entail.

    But I also know that there are different levels of coverage available all the way from 70-90% and various plans have different deductibles. It is one of the things you would shop around in the exchange for. There is more than one level of coverage or one level of deductible available. Truth is though, if you can’t afford the deductible, what with the market price of decent insurance pre ACA , you couldn’t afford anything but the more threadbare plans that would pay a set fee for some services you really get sick, you are screwed. This particular level of income (borderline) was meant to be covered by the Medicaid expansion so you could check there. But, of course, the governors who made their states opt out has presented a problem. This opt out was placed there by the Supreme Court. Not the people who crafted the law. That expansion was meant to cover this particular income level and the Supreme Court and the GOP did away with that half of the states. So….I don’t know.

  • Whitewitch

    I was so sad when he betrayed us all…and we who loved him soo…..

    Guess it is hard being President – so I can’t really judge why he did what he did…but he did it…and we will live with the consequences (and he never will because he will be a millionaire).

  • Whitewitch

    SSSsshhhhh don’t give the BeccaM away – she is the mole that knows it all ::giggle::

  • http://adgitadiaries.com/ karmanot

    Single Payer was Obozo’s promise, until he sold us out with insurance lobby whore Baccus in a back room deal. We wanted socialized medicine and what was forced on us is neo-liberal, profit driven scam.

  • http://adgitadiaries.com/ karmanot

    “The rabbit hole runs deep, don’t it?” Becca, what do you really know about BENGHAZI? sigh

  • MyrddinWilt

    I am pretty much convinced that many of the troll comments are paid for by GOP astroturf outfits. Not all of them or necessarily most of them. But the way the crazy is so tightly synced with the Fox News/Rove/Koch talking points of the day is beyond a coincidence.

    I also get suspicious of the types who pop up every election to tell us that we should all stay home and let Mitt Romney get elected because Obama isn’t a real Democrat. That turned out so well when Ralph Nader allowed W. to get close enough to steal the 2000 election, didn’t it/

  • http://adgitadiaries.com/ karmanot

    Bammm! Good one Becca. I wish Obozo had been more forthcoming several years ago about the plan and all this kerfuffle might have been avoided, Thanks for doing the numbers!

  • lynchie

    You are so right. I admit the web site is shaky at best hopefully it will get fixed sooner than later. It should have been tested and they should have asked a number of people in various states to test out the system but that is all in the past. What we have is the start of a decent health care plan that will have to be modified over the next few years to make it better.

  • http://www.rebeccamorn.com/mind BeccaM

    True, not everybody will be a success story. And nearly everyone who isn’t is deserving of a more fair shake.

    As ever, it’s never enough just to pull premium numbers from the website. That’s only part of the picture, and in most cases (not mine though, because NM insurance IS cheap), the premiums are going to seem inflated beyond reason.

    We learned that much from those debunked Hannity interviewees, all of whom misrepresented their true position and eligibility. Like I said in the post above, it’d be easy for someone from Arkansas to complain, “OMG — $850 a month for insurance? I can’t afford that — that’s a quarter of my monthly income! More than my mortgage!” — except it isn’t that much, not after we find out that at $40k a year, they’re entitled to an 81% subsidy.

  • PeteWa

    omg… all this time I completely missed the computer reference… d’0h.

  • http://www.rebeccamorn.com/mind BeccaM

    Probably not. I imagine the next layer of accusation is that those aren’t really my Healthcare.gov results or some kind of kerning analysis to prove I doctored the graphics.

    But the motivation for that only makes sense if I already have some kind of super-duper seekrit employer-provided insurance, and am not, as I’ve repeatedly stated, a self-employed technical consultant who didn’t have health insurance at all from 2003 to 2011…

    The rabbit hole runs deep, don’t it?

  • lynchie

    They are made up of Rob Ford and his 2 brothers

  • lynchie

    It doesn’t matter what proof you show these people they do not believe. Fox and the other networks have nothing good to say about the ACA, it is all bad all the time. Here in Pa. we have a governor who is not going to participate and you must go through the federal site. My daughter is currently paying $398 to Highmark, it just went up $55 a month. Through the ACA for a better plan it is $177 and she is eligible for a reduction because of income. Not every story is a winner but if you don’t shop on the exchanges and know what you are currently covered for you are never comparing apples for apples

  • http://www.youtube.com/watch?v=bcrEqIpi6sg Moderator4

    And we thank you, BeccaM.
    Since we all have lives and duties apart from here, and we cannot be on duty 24-7, we also depend upon the commenters to flag inappropriate posts as well, or otherwise email John. You are all Moderators, and we appreciate the assistance. ;)

  • http://www.rebeccamorn.com/mind BeccaM

    And I presume the utterly weird possibility of an original-poster’s subsequent follow-up comments being banned? *grins* ;-)

    Seriously though — you folks are the best.

  • Whitewitch

    $100k hospital bill has nothing to do with affordable – that is bankruptcy…heck for many people $6k would push them to bankruptcy.

    I think that might be the missing piece, so many wealthy people who think this option was a good idea don’t understand what $6,000 is or even what a $200 monthly premium would do to a middle class family that doesn’t get subsidies, but has the premiums….

  • slappymagoo

    No offense, but I get the sinking feeling that the people who are you calling you a liar – by and large the same types who still aren’t convinced Obama wasn’t born in Kenya and the fact that nobody’s produced a Kenyan birth certificate that passes the smell test only proves how far Obamabots are willing to go to keep it a secret – aren’t going to believe the proof you offered.

  • Hue-Man

    Is that you Rob Ford?

  • Moderator3

    Whew. At first I thought you said “our cracked team of Moderators.”

  • http://www.rebeccamorn.com/mind BeccaM

    Well, more affordable than a $100k hospital bill…

  • Whitewitch

    So it goes back to whether someone actually has $6,000 to “set-aside” , getting to take it off your taxes or having it like my flex-account where it is pretax deducted from my salary before being taxed…I still could not find $6,000 if my life depended on it…

    Thanks Becca….

  • PeteWa

    that’s the exact reason why all the “taxes are bad” group are such idiots, they don’t want to look at the actual costs and “corporate taxes” they pay.
    so much more for less.

  • http://www.rebeccamorn.com/mind BeccaM

    Definitely agree. Those need to come down. But I’ve noticed how with some of these plans, the high deductible runs up close to the out-of-pocket maximum which, if things work as they’re supposed to (no guarantee of that, but still) after that, it’s 100% coverage.

  • http://www.rebeccamorn.com/mind BeccaM

    HSAs have been around for quite a few years. Not all plans qualify for them, but they’re intended to be a way for someone to set aside pre-withholding dollars to cover any out-of-pocket expenses (including deductibles).

    I don’t have recent experience with HSAs, but my recollection was they were subject to various limits — maximum you could put in, whether they can be rolled over to subsequent years, and so on. (Not to be confused with Healthcare Reimbursement Accounts, which some generous employers offer.)

    Here’s the wiki entry for HSAs:

    http://en.wikipedia.org/wiki/Health_savings_account

  • Whitewitch

    Define affordable. $234 a month with a $6,000 deductible?

  • perljammer

    I’ve been wondering about those deductibles myself. On my employer-provided plan, my deductible is $2500, but it doesn’t apply to regular doctor visits, preventative care, or drugs; those just have a co-pay. The deductible only comes into play when hospitalization enters the picture. For example, a few years back my wife had an aneurism (yikes!) and ended up at UCLA Med Center for a week, half of which was in intensive care. The hospital bill for that extravaganza came to $102,000; our cost was $2500.

    But getting back to Whitewitch’s comment — even if the deductible for the ACA plan works the same way I just described, $6000 is a lot of money. If you qualify for a significant subsidy, that may be more money than you’ve ever had in one lump. Assuming you can work out a payment plan, that’s going to look a lot like a car payment (with no car to show for it), which could definitely be a budget buster.

  • Indigo

    I believe it! In fact, the ACA has already lowered the price on my monthly purchase of a generic water pill to treat my hypertension. The system is working.

  • Whitewitch

    I am so ignorant about such things…but I don’t really understand a “healthcare savings account”. When you say tax free – you mean if I have anything to put the cost against it reduces my taxes yes? So if I (and this is not the case with me), if I had a debt on my taxes I could reduce it by the amount of the healthcare savings account – yes?

    I had huge expenses one year for a double mastectomy – and those were only the amounts I had to pay after my insurance coverage was deducted. Once a person has had a devastating medical thing – the reality of $6,000 deductible is clear. It took me 5 years FIVE years to pay off that debt, I lost my house and I now have very shitty credit. So medical coverage is important – none of knows when we will be struck down.

  • http://www.rebeccamorn.com/mind BeccaM

    Oops, sorry about the handle mix-up — my age is showing, since I’m sure you know the other music-related version.

    But anyway, Perljammer (make hands type that right), it is my hope you, Ezpz, and Nicho and others who have different ideas or opinions go right ahead and put them out there. Tell me I’m wrong. Point out the glaring problems yet in ‘Obamacare’ and the weaknesses, and the fact it does still cost too damned much.

  • http://www.rebeccamorn.com/mind BeccaM

    I do agree with you: The deductibles need to come down. One thing to remember is a high deductible makes one eligible for a healthcare savings account — so that part would be tax free.

    I’ve also seen — but need to do some more research into — how in some markets there are these add-on plans which do nothing but cover the deductible.

    Single payer is the ultimate answer. And along the road to that, a public option.

  • perljammer

    Thanks for the kind words. I enjoy the discussion, and now and then I will take a devil’s advocate position just to add spice to the debate. Civil discourse on important topics is vital if we want to keep from joining the ranks of those whose contributions to the discussion consist of parroting the talking points of either side.

    By the way, the first part of my handle is “perl”, not “pearl”. I’m guessing you’ll get the pun, being a bit of a computer geek.

  • http://www.rebeccamorn.com/mind BeccaM

    Or click on the link to the calculator, which I included in the post above. ;-)

  • Hue-Man

    I found the troll comments very disturbing. I don’t view 99% of the commenters here (at least, the ones we see after moderation) as AmericaBlog boosters – I don’t mind contrary views but vicious personal attacks have no place here or elsewhere.

    The PBS Obamacare piece earlier this week – the family of four from Colorado – made me realize something about socialized medicine; I’ve never worried about whether I could afford to get treated if I got sick, whether doctors, ER, hospital, surgery. I’m not in some special class, everyone is in the same position. The Colorado couple’s daughter incurred a hospital bill of $17,000 for E. coli food poisoning that would have had a huge impact on their family finances. Here, the bill to the patient would have been zero…

    The Commonwealth Fund survey from earlier this month asked whether the respondents “experienced cost-related access problems”: Canada – 13%, US – 37%. http://www.commonwealthfund.org/Publications/In-the-Literature/2013/Nov/Access-Affordability-and-Insurance.aspx The percentage isn’t zero because Canadian Medicare excludes dental, vision, pharma, psych, physio.

    The 37% figure is staggering because it must include Americans with employer provided health care or who are on Medicare but can’t afford the co-pays, maximums, etc. BTW, UK – 4%!

  • http://www.rebeccamorn.com/mind BeccaM

    That’s right. Coincidentally, both New Mexico and Pennsylvania, the two states I checked first while researching this post, have fairly strong state insurance commissions.

    Let’s also not forget that, right now, PPACA is geared more towards getting people who have no other insurance signed up for Silver-level coverage, not Platinum.

    Believe me, I think PPACA is in dire need of additional reforms. Streamline the application process. Find some way to put a public option in there. Drastically simplify how subsidies are figured out, and find some way to alleviate the unnecessary sticker shock. Start the move towards single-payer. Will we get these? Probably not anytime soon.

    But I’ve decided to be pragmatic. We have this, which unfortunately will still leave millions of Americans out in the cold yet, but provide millions with access to insurance they simply could not get at any price before. Nobody will see one of those letters like I included at the top of the post — whether it’s migraines or cancer cited as the reason for ‘pre-existing condition’ rejection. No one will have to pay a higher premium because they’ve undergone chemo. Millions will qualify for Medicaid who did not before (but I wish the Feds would find some way to force expansion in the GOP states that refused to do so). And there are the subsidies, which aside from some meager pre-PPACA tax deductions, didn’t exist before.

    Or we have the GOP alternative, which is to go back to 2009. And worse, their only concrete proposals would make it harder to sue for medical malpractice and let insurance companies sell across state lines — creating a run to the bottom, just like has happened with credit cards.

    Just my opinion, but I think PPACA’s good outweighs the bad. Not by as much as I’d hope, but still. The Republican proposal is nothing but bad, with zero good.

  • Whitewitch

    Great article as always Becca. I think the thing that concerns me most is where someone is paying $263.46 a month for coverage and then has a $6,000 deductible. How does one find $6,000 a year to cover the deductible, when they are already paying $3,161.52 per year in premiums…and this is not even for the best of the plans. I don’t have a dog in this fight because thankfully I have insurance through my employer….but there was a time when I was a single mom and didn’t have the benefit of workplace insurance and this frankly would have been devastating for me…first I could never have found the additional $3,000 a year to even pay for insurance (there were years I didn’t have a car because I could not afford insurance coverage to drive and used a bike with a seat on the back for my son).

    I grieve that what came out of the ACA is more profit for insurance companies and really non-coverage (with a $6,000 a year deductible – you would simply have to die before getting care) for most americans. And less spendable money for the necessities of life. I hope I am wrong – really I do – but it is not looking way. Single Payor is the only and best answer.

  • Badgerite

    The word doesn’t seem to be out yet. But if you can’t find affordable health insurance in this program, you are just not looking closely enough. Which is why it is imperative that the government make its website easy and efficient to use. No possibility of confusion or inaccurate information.

  • Badgerite

    You can quickly find out a rough estimate of the tax subsidy, which would be automatically deducted from the premium bill before it is sent to you, by just using google.
    Type in Kaiser Family Foundation Calculator. The first link up will take you to the Subsidy Calculator. It’s estimates are based on income, state, county, etc, so it should be pretty accurate. Google —— Kaiser Family Foundation Calculator ——click on first link up.

  • http://www.rebeccamorn.com/mind BeccaM

    Some comments either didn’t make it past the initial hurdles, and several of the worst were taken out by our crack team of Moderators — but not before I saw the remarks. What struck me most wasn’t even the anger or personal attack, but the sense I got of ‘cornered animal’ in the lashing out. Anger, but a whole lot of fear also.

    It is beyond any doubt to me whatsoever that single-payer is the answer. It’d be cheaper. Easier to administer. Every single American would know they had baseline coverage no matter what. That is what we need.

  • chris10858

    I’ve learned over time that whenever a Republican starts screaming something… s/he is usually the one who is doing the same thing.

  • chris10858

    I went to the Cali site and used their tool. I looked at two people aged 55 and the highest Platinum level plan was $1,100-1,500 a month for both people which is a good deal more than the premiums here in Florida. Not sure why that area of California is running so high but that is set with the health insurance companies and the state regulators and not with the feds, right?

    At my old employer here in Florida though, premiums for employee and spouse ran around $800/month and that includes a $2,400 deductible whereby my insurance paid for absolutely nothing until we first paid out that minimum amount.

    ObamaCare might not be a perfect system (Medicare for ALL would have been better) but for those people who are self-employed or who have medical problems and can’t otherwise get insurance, it can be the difference between life and death.

    As Obama said once (paraphrasing): Don’t let the imperfect get in the way of what is achievable.

  • http://www.rebeccamorn.com/mind BeccaM

    Hi Pearljammer. This post wasn’t directed at you, or Nicho, or anybody else who disagreed with me on points of my Monday post. That kind of debate, disagreement, and even a little arguing I totally welcome and approve of. I love you guys.

    This was more for the Fox News-watching types, which you may have seen over there.

    And as for that ‘equivalent plan’, it wouldn’t surprise me if your premium coverage would run to $1850/month if you had to pay full freight. But as ever, don’t forget to add in the possible premium subsidies. The one detail everybody forgets is that.

    And if you were unemployed and had nothing to fall back on, you’d probably qualify for Medicaid.

    So the real point is, okay, if things went pear-shaped for you (and millions of other Americans), the situation would not be limited just to “have job = have decent health insurance” versus “no job or low-paying job or self-employed = can’t get or afford insurance at all.” At minimum, in a whole lot of cases, it’d be possible at least to get a heavily subsidized bronze or silver plan, or (in the non-GOP tantrum states) maybe even Medicaid. Would it always be as good as the former employer-provided plan? Possibly or probably not. Would it be better than nothing at all, no ‘insurance’ other than the emergency room and whatever someone’s meager savings could cover? I think so.

  • chris10858

    As always, a great article. Thanks, Becca! It’s just so sad that conservatives don’t care about things such as reality or facts. (Facts do tend to have a liberal bias, ya know!) Progressives do tend to look at things more logically and if proven wrong, they are a lot less likely to deny the truth.

    Meanwhile, some conservatives I know are making all sorts of excuses as to why they are not going to signup for ObamaCare, even those who have no health insurance and have serious health issues. Some of the reasons include “I don’t have time to waste an hour on the site.” or “I heard Obama is going to force people to get RFID radio transmitters inserted into their bodies as a requirement of ObamaCare and that is the mark of the beast!”.

    It’s funny to me how the party of so-called personal responsibility has suddenly morphed into a party that is espousing people to forego getting health insurance and to just use the Emergency Room instead. I am not a psychologist but I believe the term “bat-shit crazy” might be apropos to them at this point. LOL

  • PeteWa

    nice run down of the numbers, Becca.
    I must have missed the “you lie” comments, hope it wasn’t from the regulars who should know where you’re coming from after all these years.
    alternately, the subsidies part of the post does somewhat break my brain – just looking at those numbers alone (as if more proof was needed) it’s quite clear that single payer would be a boon for all, except for those pampered parasites at the top of the US health care scam.

  • http://FreakoutNation.com/ Anomaly 100

    Congrats! I loves me some good news.

  • Mike_in_the_Tundra

    You go girl!

  • perljammer

    I never thought you were lying, and I’m glad it worked out so well for you. My own situation is quite different. If I didn’t have an employer-provided plan that costs me $350/month to cover myself and my wife, I would be looking at about $1850/month on the Marketplace for (nearly) equivalent coverage. I’ve been back to the Covered California site several times to verify that I didn’t do something wrong. Apparently, Ventura County is a high healthcare cost area.

    It appears that others are being disappointed as well. Hopefully, this will turn out to be a bureaucratic screwup that will eventually get fixed. http://politicalticker.blogs.cnn.com/2013/11/19/bad-news-for-woman-cited-as-obamacare-success-story/?hpt=hp_inthenews

  • FuzzyRabbit

    Nice work, Becca.

  • Dan Corjulo

    Great Job Becca

    This took a ton of work, It is much appreciated. At the very least it makes those of us rooting for ACA to work feel better.

  • cold340t

    Didn’t need to do any research to like the ACA. I am an employer and the first thing I got was a letter stating a 1%( @200/yr) premium reduction, then my coverage improved, next my renewal increase was half what it was in prior years. Oh, don’t start me on the “dreaded” Tax credits, the ones that go up again in 2014. Oh, the horrors of….the ACA! It’s killing my small business….NOT!

  • ComradeRutherford

    “In fact, Joe Wilson was the one who lied.”

    Of course he did, he’s a Conservative who was heckling the first non-white US President. He can only ever lie.

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