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I am a huge fan of President Obama, a huge fan of Obamacare and am overjoyed that people who need it most will finally be able to get affordable health care.  However, I am terrified of enrolling myself and it's very unlikely I'll do so.

Allow me to explain below...

I have private insurance that covers myself and my six year old daughter.  My husband is not on my plan.  I got my health insurance on my own in 2001, and it's not affiliated with my employer.  This was a blessing a few years ago when I stopped working for almost two years to care for my daughter.  I'm still not full time and probably won't be for many more years.  I'm very happy not to have to rely on employer sponsored insurance.

Here's the thing--I'm sick and likely will be for the rest of my life.  I have rheumatoid arthritis, fibromyalgia, and various other issues that include other autoimmune problems and medication related side effects (i.e. GI problems.)  My conditions are very well controlled with medication.  Controlled enough that I could work full time, but choose part time to care for my daughter.  

I get EXCELLENT care for my conditions, but it is very expensive.  I get an IV infusion every six weeks that bills for $6,000 (so something like $50,000 in unadjusted costs a year) and take about $500 worth of meds a month.  This is only the routine, predictable stuff.  This year I started to have problems with my feet and got an MRI, x-rays, nerve tests, etc.  I also get periodic pulmonary function tests to make sure my meds aren't really screwing with my ability to breathe.  If I stopped to add it up, my bills are easily $75,000 a year.

Right now, I have a $3,650 annual deductible and $0 copay after that.  We just got notice that my premiums are going up next month to $750 a month.  That is a lot of money out of pocket but for my situation, I am WAY ahead of the ball on this.  I joke that I know the exact minute I hit my deductible.  This year it was February 4th approximately 1:05pm, when I finished my first IV infusion of the year.  After that, I pay nothing but my premiums.

Now comes the scary part.  I checked into Obamacare and I see several plans available starting at $300/month and $3,500 max out of pocket.  How awesome is that??  But what happens if I sign on, everything is roses for a year or two or five, then the political wrecking ball swings the other way and Congress successfully repeals Obamacare?  

I would be so totally and completely fucked.

I would be where so many families are right now, with pre-existing conditions, huge medical costs, and no insurance company willing to lose money on them.  Without my IV infusions and meds, I would be unable to work and probably be laying in bed curled up in a big ball of pain.  

We all KNOW that this repeal crap won't stop for a long time.  Maybe the Republicans will be off licking their wounds for a little while after their little tantrum.  Maybe people will love Obamacare so much that R's will be terrified to touch it after it goes into affect next year.  Maybe Dems will win and keep control of both houses of Congress and the Presidency.  But maybe not.  And that's not a chance I can take.

I will cheer Obamacare and be thrilled for several families I know who will now get affordable care for their children with special needs.  But for now, I will be holding on to my current insurance with both hands, white knuckled and praying my premiums will stabilize.  I'm hoping with all my might that time will further strengthen Obamacare until I'm no longer too scared to join in.

5:39 PM PT: Update with some additional facts:

My current plan has been tweaked to comply with ACA.  I've gotten notices over the past few months about improvements made in order to comply.  So at least for the near future, I believe I still have the option to keep my insurance.  In my state at least, my insurer can't drop me as long as I pay my premiums.  They would have to drop the entire plan (or "expire" it) in order to drop me.

Sorry about my lack of responses so far.  I wasn't able to get back online until now.

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Comment Preferences

  •  By then, people will be loving the fact that they (21+ / 0-)

    have insurance.

    But if you have a good plan, and you can afford it, then you don't need to go onto the exchanges. It's your personal choice.

    "Nothing in all the world is more dangerous than sincere ignorance and conscientious stupidity." --M. L. King "You can't fix stupid" --Ron White -6.00, -5.18

    by zenbassoon on Wed Oct 16, 2013 at 01:30:10 PM PDT

    •  Not an expert, but aren't all plans not related to (1+ / 0-)
      Recommended by:
      Saru

      an employer (or Medicare/Tricare) now revised to be one of the metal choices?

      In other words, as of Jan 1st 2014, the plan the diarist describes is no more?

      Notice: This Comment © 2013 ROGNM UID 2547

      by ROGNM on Wed Oct 16, 2013 at 01:36:24 PM PDT

      [ Parent ]

      •  No. Only if the current plan does not provide (6+ / 0-)

        all the essential benefits that the ACA requires, such as maternity care, etc. A plan is considered equivalent to a metal choice if it covers that which the specific metal covers.

        I'd like to start a new meme: "No means no" is a misnomer. It should be "Only 'Yes' means yes." Just because someone doesn't say "No" doesn't mean they've given consent. If she didn't say "Yes", there is no consent.

        by second gen on Wed Oct 16, 2013 at 01:46:11 PM PDT

        [ Parent ]

  •  So sorry to hear about your illnesses (14+ / 0-)

    I hope all goes well.

    But "Obamacare" is just a marketing name. You're actually just signing up with private insurance companies like before. That part hasn't changed. So I don't see how selecting a private company participating in the exchange can be harmful. It's the same insurance companies.

    •  If repeal, how could pre-existing conditions (5+ / 0-)
      Recommended by:
      mumtaznepal, worldlotus, Saru, ybruti, kareylou

      not continue to be covered, they can't just throw everyone off their plans one day when they vote to repeal, it would cause chaos.....not sure how they can mess with this really

      "The poor can never be made to suffer enough." Jimmy Breslin

      by merrywidow on Wed Oct 16, 2013 at 02:11:34 PM PDT

      [ Parent ]

      •  Chaos (0+ / 0-)

        I agree it would be chaos, but that doesn't mean it won't happen.  I mean, look at the last two weeks.  

        •  But look what happened tonight (1+ / 0-)
          Recommended by:
          Saru

          They lost. It doesn't mean they won't huff and puff but it looks less like they'll blow the house down. If they keep it up, they could lose big in November 2014.

          Now, regarding your insurance--it sounds like you're basically happy with it. One of the first things Obama promised when putting together the ACA was that it would not force people to change their insurance if they were happy with it--so there's no reason for you worry one way or the other. "Obamacare" is not for you--and there's nothing wrong with that.

          And as far as "repeal could happen"...you know, an asteroid could crash into the earth in a few years, or a ginormous supervolcano underneath Yellowstone National Park could erupt, and wipe us all out...but I wouldn't base any important decisions on those possibilities.

          "All governments lie, but disaster lies in wait for countries whose officials smoke the same hashish they give out." --I.F. Stone

          by Alice in Florida on Wed Oct 16, 2013 at 06:18:42 PM PDT

          [ Parent ]

  •  Since you already have insurance... (16+ / 0-)

    ... you have that option. If it works and you can afford it, keep it.  

    And let's hope your insurance company continues to offer that plan at a cost you can afford.  If they change their policies in the future, at least the ACA will still be there.

    I'm glad you're able to get the care you need!  

  •  I don't think that will happen, mainly because (7+ / 0-)

    of what zenbassoon said.

    If you are worried, keep what you have for 6 months and see what the feedback is on Obamacare after people have really had experience with it. I think that by that time it will be clear that you are safe.

    Good luck to you!! Blessed be, that's a lot of illness to deal with.

    "Southern nights have you ever felt a southern night?" Allen Toussaint ~~Remember the Gulf of Mexico~~

    by rubyr on Wed Oct 16, 2013 at 01:36:21 PM PDT

  •  Spreading risk reduces cost (3+ / 0-)
    Recommended by:
    mumtaznepal, BlackSheep1, Saru

    So participating in the ACA exchange improves your future costs.  Better to join now and receive the reduced cost at the present and let the future take care of itself.  If ACA succeeds, you will benefit in the future, too.

    •  Easy for you to say (3+ / 0-)
      Recommended by:
      sewaneepat, BlackSheep1, Saru

      "Let the future take care of itself". I can see from the diarists explanation of the situation why she doesn't want to do that right now. Even your comment says IF the ACA succeeds. What if it doesn't? What if it is radically scaled back by a subsequent administration?  As it stands, the poster has options. Keep what she's got as long as it meets her needs, switch to an exchange at some point in the future if circumstances or needs change.

      “Texas is a so-called red state, but you’ve got 10 million Democrats here in Texas. And …, there are a whole lot of people here in Texas who need us, and who need us to fight for them.” President Obama

      by Catte Nappe on Wed Oct 16, 2013 at 01:57:29 PM PDT

      [ Parent ]

  •  obamacare won't be repealed (10+ / 0-)

    it will be expanded. the more people use it and get used to it, the more they will appreciate what an improvement it is, and the more they will realize they want even more improvement. this was step one.

    The cold passion for truth hunts in no pack. -Robinson Jeffers

    by Laurence Lewis on Wed Oct 16, 2013 at 01:40:31 PM PDT

  •  Because (8+ / 0-)

    Because HIPAA continuation is still the law.  Once insured, you can get something.  Your current policy could go byebye too.  No difference.  Go with the one that is best.

    •  I don't see any reason to spend the extra (3+ / 0-)
      Recommended by:
      kittycoldfeet, mumtaznepal, Saru

      cash if you can get something cheaper.  You're just burning money if you can get the same care for less money with a different insurer through the exchange.

      It's the same companies... no difference.

      I want to live in a world where George Zimmerman offered Trayvon Martin a ride home to get him out of the rain that night. -Bishop G. Brewer

      by the dogs sockpuppet on Wed Oct 16, 2013 at 01:48:23 PM PDT

      [ Parent ]

    •  You stand more........ (4+ / 0-)
      Recommended by:
      57andFemale, mumtaznepal, worldlotus, Saru

      of a chance of eventually getting fucked with a plan outside the ACA exchange. The ACA limits the Insurance Companies ability to screw with you. Some of those controls apply to policies outside the exchanges but some don't. You are safer under the exchange.

      BTW, the ACA will not be repealed except to replace it with a single-payer system such as Medicare for all.  It has been predicted that when the ACA is successful; the Insurance companies will start to drop out of the basic health insurance market because they can make bigger profits with specialty coverages such as cancer care.  

      The mass of men lead lives of quiet desperation--HDT

      by cazcee on Wed Oct 16, 2013 at 02:09:14 PM PDT

      [ Parent ]

      •  A reminder, Saru, that not all current plans have (2+ / 0-)
        Recommended by:
        worldlotus, Saru

        everything in them the new plans do - some current private health care plans are exempt from a few of the provisions of Obamacare.

        Perhaps you can talk to an Obamacare navigator in your state.

        "Privatize to Profitize" explains every single Republican economic, social and governing philosophy. Take every taxpayer dollar from defense, education, health care, public lands, retirement - privatize it, and profit from it.

        by mumtaznepal on Wed Oct 16, 2013 at 02:41:06 PM PDT

        [ Parent ]

  •  No one is going to repeal Obamacare (8+ / 0-)

    Once this thing gets rolling people are going to love it.

    Save the freaking $400/month for crying out loud!

  •  You're response is akin to.... (6+ / 0-)

    ...saying, "the terrorists won". Don't do it. Sign up if it's a better deal. It ain't goin' away. Ever.

    "Back off, man. I'm a scientist."
    -- Dr. Peter Venkman


    Join me, LOLGOP, Anne Savage, and Amy Lynn Smith at Eclectablog.

    by Eclectablog on Wed Oct 16, 2013 at 02:03:49 PM PDT

  •  What you need to find out about your... (5+ / 0-)
    Recommended by:
    MarEng, mumtaznepal, worldlotus, Saru, ybruti

    existing plan is whether or not it is open to new enrollees. If it is not, then you are almost bound to wind up in situation where the plan bleeds participants and winds up with only older and sicker ones. It will go into a death spiral as premiums go up and participants flee. Even if it enrolls new members, it still risks not being competitive with Obamacare options. For everyone like you, it will need dozens who use very little of their deductible in order for it to maintain viable premiums.

    My plan has been OK but premiums are exorbitant and in any event it is disappearing sometime in 2014. I'm not concerned about Obamacare being eliminated in a few years. By that time, it will be impossible to throw all those insured people out in the cold. The Rethugs know that and that's why they've been trying so hard to kill it before it takes hold. I suppose it's possible that Obamacare could not prove profitable enough for insurance companies and they begin to drop out. In that case, I think we'd wind up with something like Medicare for all.

    Just another faggity fag socialist fuckstick homosinner!

    by Ian S on Wed Oct 16, 2013 at 02:06:21 PM PDT

    •  Impossible (0+ / 0-)
      By that time, it will be impossible to throw all those insured people out in the cold.
      I can't rely on Congress to be reasonable and not just blow shit up.  The last two weeks have shown me that.
      •  Yeah but ultimately cooler heads prevailed... (0+ / 0-)

        and let's face it, corporate interests were aghast at the thought of default and probably forced the issue with the Rethug leadership. If Obamacare works fairly well over the next few years, then the medical industrial complex is not going to want it to be blown up. It will probably become as entrenched as medicare.

        Just another faggity fag socialist fuckstick homosinner!

        by Ian S on Wed Oct 16, 2013 at 10:45:16 PM PDT

        [ Parent ]

  •  I don’t blame you for being cautious (3+ / 0-)
    Recommended by:
    Catte Nappe, worldlotus, Saru
    I'm very happy not to have to rely on employer sponsored insurance.
    I am in pretty good health, but I hated having my health insurance tied to where I work for 35 years.

    First, my boss would read my application, and then insist that I remove some of my preexisting conditions, because he did not want the group rates to go up.  So I would remove them, and then call the insurance company after the application had been filed, and say, “I forgot some preexisting conditions.  I would like to add them now.”

    Second, my boss would change insurance companies every year, trying to save a few bucks, requiring new applications to be filled out.  I always had to get my doctor’s notes to see what she wrote down.  One time I forgot about the tendinitis I told her about, because it went away after two weeks.  If I had not gotten her notes, I would not have checked the box next to, “Have you EVER had any problem related to your skeletal-muscular system.”  Then, had I come down with a real problem like yours, the insurance company would have refused to cover me, on account of my not telling them about my “preexisting condition.”

    Third, my boss was always having a cash flow problem, and sometimes he would not send in the premium in order to keep the lights on.  But he wouldn’t tell me about it.  Once I found out that I had not been insured for six months.  I asked the next insurance company if they would notify me if the premiums were not paid, and they said, “No.”  Therefore, I had call every month to see if I was still insured.

    Fourth, when I got fed up and tried to get health insurance on my own, I found out the laws were written to discourage that.  I suspect the laws were written by the insurance companies.  So, as a practical matter, I was forced to be insured where I worked.

    I don’t blame you for wanting to keep your private insurance, which is completely under your control.  But don’t be surprised if the new regulations make that impossible.  They were probably written by the insurance companies.

    •  Wow (0+ / 0-)

      What a horrible experience!  It should be required that insurance companies have to notify the insured (not just the payor) that the coverage is lapsing.

      You're right.  Private insurance gives me control and that matters.

  •  If there is no need to switch, then you can wait (4+ / 0-)
    Recommended by:
    CupofTea, Catte Nappe, worldlotus, Saru

    and see how it all shakes out and hope the plan you have never changes either

    "The poor can never be made to suffer enough." Jimmy Breslin

    by merrywidow on Wed Oct 16, 2013 at 02:09:53 PM PDT

  •  Sounds like a perfectly good choice (6+ / 0-)

    And the fact that you have that choice dispels one of the GOPs many lies. I'm sure over time you'll re-evaluate, and may choose an ACA plan when it suits your. Or not. Either way you'll benefit from other aspects of the ACA that affect all plans. So good for you!

  •  If you have a plan at work you like, don't sign up (3+ / 0-)
    Recommended by:
    CupofTea, Saru, Alice in Florida

    I think one common mistake people make about the ACA is that everyone has to sign up(as spouted by the GOP). If your company offers insurance that you like and complies with the ACA-you don't have to sign up.

    I DO think there will be more changes coming to the ACA as problems develop, though probably not until Hilary's second term...I do hope that a public option is developed and we go the way of the Netherlands or Germany with the public option as a safety net if you don't have/can't afford private insurance.

  •  Isn't your insurance (2+ / 0-)
    Recommended by:
    Catte Nappe, Saru

    or any insurance just year-to-year?  At any renewal they can change everything or eliminate the whole thing?

    At least if your plan blows up you will be able to enroll in one of the Marketplace plans outside the normal enrollment period--a special enrollment period.  

    https://www.healthcare.gov/...

  •  making decisions by fear of what if's, especially (2+ / 0-)
    Recommended by:
    CupofTea, Saru

    when that what if is as near to 100% not going to happen, is not good.

    Obamacare will NEVER go away.  millions of people will be signed up by the start, and that number will only grow.  do you think there is any bunch of crazies that could manage to take insurance away from millions of americans?  mind you, that number will get to be in the 10's of millions relatively quickly.

    even if they someone slashed around the edges, the numbers who are already benefiting from the no pre-existing ban is probably a third of the country - that clause will NEVER go anywhere.

    even the current crop of crazies always acknowledge they would keep that provision.

    save the money w the ACA, be assured you will forever be able to buy insurance.

    "Don't Bet Against Us" - President Barack Obama

    by MRA NY on Wed Oct 16, 2013 at 02:25:43 PM PDT

  •  Holy Crap. Obamacare is the least of your (4+ / 0-)
    Recommended by:
    flo58, Catte Nappe, worldlotus, Saru

    worries.  Don't sweat the small stuff.  Do whatever you need for God's sake.  

    It sounds like you currently have the sweetest deal that I've ever heard of!  Man oh man, who the heck is your insurer?  My best friend has had multiple brain surgeries and is up to her last straw on her husband's employer's policy and oh my god she would kill for a 3650 and 0.

    Holy crap!  Thank the Dear Lord that the actuaries overlooked you!!!!

    Romney's whole business was about maximizing debt, extracting cash, cutting head counts, skimping on capital spending, outsourcing production, and dressing up the deal for the earliest, highest-profit exit possible. -- David Stockman.

    by CupofTea on Wed Oct 16, 2013 at 02:28:16 PM PDT

    •  Um. Why aren't you responding to anyone? nt (1+ / 0-)
      Recommended by:
      Saru

      Romney's whole business was about maximizing debt, extracting cash, cutting head counts, skimping on capital spending, outsourcing production, and dressing up the deal for the earliest, highest-profit exit possible. -- David Stockman.

      by CupofTea on Wed Oct 16, 2013 at 02:33:34 PM PDT

      [ Parent ]

    •  I was lucky (0+ / 0-)

      It was just luck frankly.  I work for a small business and at that time, everyone was healthy, so we decided to get underwritten for individual insurance and pay much lower premiums than a group policy.

      Since then, my health has gone crazy, two co-workers have had cancer, one developed sleep apnea and another diabetes.  So literally everyone has pre-existing conditions now!  I'm the only one who kept the individual insurance.  Others have gotten onto Medicare or spousal insurance.

      But seriously, my insurance company got the short end of the stick on this one.

  •  What happens when your private insurance (2+ / 0-)
    Recommended by:
    worldlotus, Saru

    company raises your premium to $1285 next year, in an attempt to force your expensive (for them) healthcare on to the large group coverage in #Obamacare?

    I wouldn't worry about Obamacare being repealed.  Not one bit.

    "Privatize to Profitize" explains every single Republican economic, social and governing philosophy. Take every taxpayer dollar from defense, education, health care, public lands, retirement - privatize it, and profit from it.

    by mumtaznepal on Wed Oct 16, 2013 at 02:34:58 PM PDT

  •  If we are in a situation..... (2+ / 0-)
    Recommended by:
    worldlotus, Saru

    ....where this merry band of sociopaths have control of the legislative and executive branches of government, so much will go apocalyptic that we won't know how to keep track.  This country will completely become a libertarian hell.  

    I agree with the commenter who said that ACA has common sense regulations and your current private plan is probably not going to be around soon anyway.  Private insurance will all come under the ACA exchanges sooner, not later.  

    Having been self-employed for the last 35 years, I can attest that eventually your premiums are going to skyrocket, your coverage will go down.  I saw my coverage erode and the costs soar with each year.  I would not be so confident that everything is going to stay the same.  

  •  Saru, the exciting thing is that now you, with (2+ / 0-)
    Recommended by:
    worldlotus, Saru

    a serious pre-existing condition, have a choice!

    That's SO exciting - you have a choice now!

    "Privatize to Profitize" explains every single Republican economic, social and governing philosophy. Take every taxpayer dollar from defense, education, health care, public lands, retirement - privatize it, and profit from it.

    by mumtaznepal on Wed Oct 16, 2013 at 02:37:29 PM PDT

  •  Obamacare will provide you a better deal, (2+ / 0-)
    Recommended by:
    Saru, Alice in Florida

    but you're concerned that Republicans might kill it in a futures, after it's worked for you?

    The answer: You will be in no worse shape later on then you are now.

    If your worst fears come true...you're back to doing what you're doing now. In the meantime, you get a much better deal.

    In addition, it seems highly unlikely to me that once the Affordable Care Act fully kicks in that those things that benefit people will be taken away any time soon, even by Republicans.

    •  Maybe not (1+ / 0-)
      Recommended by:
      Saru
      If your worst fears come true...you're back to doing what you're doing now
      That appears to be the (legitimate) fear. Leave the current known safe harbor of coverage, and they won't allow her to return later if ACA doesn't work out for her. It would be a new application for a new policy.

      “Texas is a so-called red state, but you’ve got 10 million Democrats here in Texas. And …, there are a whole lot of people here in Texas who need us, and who need us to fight for them.” President Obama

      by Catte Nappe on Wed Oct 16, 2013 at 05:58:26 PM PDT

      [ Parent ]

    •  No, I'll be in worse shape (0+ / 0-)
      You will be in no worse shape later on then you are now.
      I could be in much, much worse shape.  If ACA is repealed and the ban on pre-existing condition denials is lifted, I could find myself with no coverage and $75,000 in annual bills or no treatment and an inability to work.

      I know the majority here feels that ACA is here to stay but if we're wrong, I could be so very, very screwed.  This is a real concern and shouldn't be dismissed.

  •  If you qualified and saved thousands every year, (1+ / 0-)
    Recommended by:
    Saru

    you would be better off having that money even if ObamaCare got repealed. Before ObamaCare, insurance companies could drop people if they got sick. They could also deny people coverage based on preexisting conditions. If ObamaCare got repealed you would lose those protections.

    •  Not true (0+ / 0-)
      Before ObamaCare, insurance companies could drop people if they got sick.
      That's not really true.  Certainly some companies in the past used slimy ways to drop people after they get sick, like saying they lied on their application, but at least in my state Florida, if I continue to pay my premiums, they can't cancel my policy.  They would have to eliminate the entire plan, but they can't pick and choose.
  •  Excellent Diary (2+ / 0-)
    Recommended by:
    Saru, Catte Nappe

    There are lots of special paths through the next several years.

    Your plan sounds great to me. I know I would keep it, if I were in your position. You really have nothing to lose by waiting. And you have peace of mind. You might even find that your doctors have some advice for you in this matter.

    You can always buy another plan through the exchange during the next enrollment period, if you find a better one.

    Best wishes with your health.


    [ O Recommend   O Hide   O Bitch about this at the Help Desk ]

    by Pluto on Wed Oct 16, 2013 at 04:47:19 PM PDT

    •  Control (0+ / 0-)

      With my daily challenges, there is a lot to be said for having peace of mind and one less thing to worry about.

      It's funny because I saw my cardiologist today (yeah I know I didn't include chronic tachycardia on the list above, but I have that, too) and he's 100% on board with ACA because, as he said it, you can't opt out of getting hit by a bus.  He says if more patients kept up with basic preventative care, he would see far fewer patients in crisis.  However my rheumatologist is 100% against Obamacare and during the original debate had posters up asking us to contact our reps to discourage their vote.

  •  Keep in mind--the reason the Tea Party (0+ / 0-)

    was so desperate to try to stop the ACA now is that they are terrified that once it goes into effect, people will LIKE it. Ted Cruz even said so (I think he said something like "those freeloaders will never want to give up their government-subsidized health insurance".) So even if they want to repeal it, they won't be able to, because they know they'd lose.

    "All governments lie, but disaster lies in wait for countries whose officials smoke the same hashish they give out." --I.F. Stone

    by Alice in Florida on Wed Oct 16, 2013 at 06:29:01 PM PDT

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