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I came across this reader letter on TPM, where occasionally Josh Marshall shares readers' contributions in full because they are so worthwhile. (The last time I recall was in reference to Mitt Romney's taxes during the campaign). The writer castigates the group of 3% 'losers' for whining about losing their substandard insurance, and my own disdain projects to the media slavishly pounding this drum.

The perfect example of such a 'douche' is this woman, a self-described Obamacare 'victim', who posted her horror story on Facebook and was horrified when her 'friends' all explained to her why her insurance was horrible and she should be grateful. And then the NYT let her post an Op-Ed on their pages complaining about lack of sympathy on Facebook! Really!

The media is hyper-focused on the 3% of the population who are 'losing' their so-called health insurance, i.e. sub-standard insurance and raising this issue to a DefCon5 level of disastrous proportions and importance. They are doing it not because of some sudden newfound concern for people without insurance but rather the political harm it can inflict, and the delight in catching President Obama in a 'lie'. All that tells me is how trustworthy and honest the President has been if they are pouncing on this like cats on catnip. And we were treated yesterday to the spectacle of serial liar Mitt Romney going on about the President's 'dishonesty'.

Since it’s been estimated that about 3% of the US population will end up “losers” under Obamacare, I thought I’d write in and give you my perspective as a 3-percenter. However, I suspect that I belong to a smaller subset of the 3%, that being people who find it appallingly self-indulgent and shamefully self-pitying to think of ourselves as losers.

 Having insurance, even crappy insurance, in the individual market means we are almost by definition, healthy and relatively young. If we were not, we wouldn’t be able to get coverage of any kind in the non-group market. If our ACA-compliant replacement policy costs us more, it’s likely because we’re too affluent to qualify for subsidies.

That's who the media has brought out the violins for.
It takes a remarkable degree of self-absorption and sense of self-entitlement to be healthy, young(ish) and affluent—and yet consider oneself a “loser.” It’s a label I reject out of shame (no matter how much the lazy, superficial MSM want to fixate on me and my “plight”) NOT because there’s anything shameful about being a loser; the shame is in thinking oneself a loser when one is actually fortunate.
The writer goes on to point out who the real losers are: the 400,000 working poor in his state of Louisiana who will not get Medicaid because Gov. Bobby Jindal decided that would be better for his political advancement. And how fortunate he is, even if he has to endure some website glitches (and OMG maybe fill out a paper application) he knows he will not be one medical illness away from financial ruin.

This letter points to the venality and shallowness of the media's concern, focusing on these "losers". When did they ever show such concern for people with real problems of not being able to afford coverage, or being bankrupted by their medical bills - all of which the law is trying to correct?

I was fortunate before Obamacare, and now I am an Obamacare winner. Now if the media would just help more of the public understand how lucky us 3-percenters actually are, perhaps the public would start to recoil at the absurdity of the outrage being whipped up on our behalf, and we could start focusing on how to help the real losers: the working poor in refusenik states.
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Comment Preferences

  •  Tip Jar (209+ / 0-)
    Recommended by:
    Rileycat, Zacapoet, Diogenes2008, Lonely Liberal in PA, Youffraita, Lawrence, CwV, LookingUp, VeggiElaine, weck, Themistoclea, justiceputnam, ladybug53, Glen The Plumber, anna shane, sotiredofusernames, Laurel in CA, Fury, TheFern, MartyM, Gooserock, puakev, theKgirls, jamess, elmo, myboo, Ishmaelbychoice, karmsy, revsue, nosleep4u, Texknight, Nowhere Man, frsbdg, clinging to hope, Arilca Mockingbird, Its the Supreme Court Stupid, Byron from Denver, wader, sulthernao, Pat K California, BlackSheep1, Moody Loner, JeffW, Mentatmark, ricklewsive, splashy, Brooke In Seattle, reginahny, virginwoolf, Wary, madgranny, Another Grizzle, smartdemmg, We Won, pistolSO, Ooooh, kefauver, wu ming, majcmb1, Wreck Smurfy, Naniboujou, SteelerGrrl, boadicea, ferg, cotterperson, greycat, porchdog1961, billybam, Chitown Charlie, CoyoteMarti, Hirodog, Catte Nappe, Theodore J Pickle, FogCityJohn, sillycarrot, La Gitane, avsp, riverlover, GAS, TheDuckManCometh, murrayewv, K S LaVida, The Hindsight Times, gramofsam1, anodnhajo, Tunk, Smoh, badlands, deep, LLPete, Gowrie Gal, NYC Sophia, Involuntary Exile, OleHippieChick, awcomeon, princesspat, MRA NY, Grabber by the Heel, gizmo59, Matt Z, VTCC73, kaliope, CJB2012, Chaddiwicker, basket, a2nite, FindingMyVoice, kerflooey, jan4insight, jimstaro, rasbobbo, Tara the Antisocial Social Worker, FiredUpInCA, catly, Clive all hat no horse Rodeo, gmats, maybeeso in michigan, dufffbeer, J9, joegoldstein, Black Max, blue jersey mom, JDWolverton, Tonedevil, jack 1966, Safina, tweeternik, YaNevaNo, slowbutsure, Eric Nelson, belinda ridgewood, congenitalefty, bleeding blue, CoExistNow, cama2008, countwebb, tgypsy, ramara, Pluto, carolanne, ichibon, CA Nana, CitizenKane, xaxnar, Buckeye Nut Schell, flumptytail, stagemom, Nulwee, CenPhx, Kevskos, susans, tofumagoo, katrinka, TKO333, hungrycoyote, AllisonInSeattle, Phoenix Woman, historys mysteries, nirbama, kyril, Lujane, USHomeopath, ceebee7, wasatch, highacidity, This old man, Jeff Y, Josiah Bartlett, sethtriggs, viral, kkkkate, eeff, wilywascal, Vico, HarpboyAK, Mark Mywurtz, myeye, Curt Matlock, marina, flowerfarmer, MadRuth, HeartlandLiberal, Raggedy Ann, henlesloop, coppercelt, pamelabrown, i dunno, otto, pioneer111, third Party please, DRo, juliesie, Rashaverak, basquebob, Al Fondy, Kristina40, collardgreens, oslyn7, MarkInSanFran, VickiL, zerelda, kathny, limae, royce, Ice Blue, sea note, emmasnacker, Great Ape, thomask
  •  This is exactly right. (41+ / 0-)

    The 3% that are effected "negatively" are actually being pushed out of a ripoff into a legitimate plan and because it is real insurance, not a scam, it will cost a little more. And as pointed out, they must be fairly affluent to not qualify for subsidy.
    What bothers me are the so called Progressives that are chiming in on the Obama LIED/Obamacare=FAIL mantra. The fact that there's at least one up all the time here at dKos and they are all over the rest of the Left Media as well.
    This is how we lose elections folks.
    Made up stories and terrible slants that paint Democratic efforts as total fails even when they are actually wins, pounded home in a constant drip feed so that every time a casual reader/Shallow voter opens up the site they get a dose. Eventually it seems that this meme must be right because they find it everywhere, every day.
    That Shallow voter is effectively discouraged, doesn't vote, doesn't donate, doesn't help with GOTV.
    Having phonebanked and doorknocked on many campaigns, I have heard the results first hand and watched the GOP zoom past us.
    It sucks.

    If I ran this circus, things would be DIFFERENT!

    by CwV on Sat Nov 16, 2013 at 10:12:10 AM PST

    •  he can go direct to insurers too (14+ / 0-)

      Another way he is not a loser, is since he is not eligible for a subsidy, he can go direct to the insurer and buy direct.

      All plans on the individual market are now ACA compliant - no swiss cheese policies, full of holes that leave him exposed to financial ruin.

       He can also go through a broker for advice, but really there is no more fear of being sold on a crap plan - there >ARE no more crap plans for sale..

    •  Some people's insurance costs a LOT more (9+ / 0-)

      Older people who had good insurance because they were healthy are, in some cases, having to pay premiums that are not a little more, but a lot more.  Like $5000 more a year.  For worse policies.

      We may think that these people have been able to get cheap insurance for years because they were lucky, and now they ought to start contributing to help out people who are not so lucky. But it does no good to pretend they do not exist. They do exist, and clever underwriters have been able to find them and give them insurance that takes into account their lower risk of bad health events.

      •  I'd have to see those stats (17+ / 0-)

        being older is already costly.  If someone had a plan so good it was better than what's now required, seems highly unlikely to me that costs could go up that much.  

        •  Remember that their old plan (3+ / 0-)
          Recommended by:
          Heavy Mettle, Phoenix Woman, DRo

          may have required that they have no pre-existing conditions while the new plan allows for those. Actually, I suspect older individuals might see more of a jump. Relatively few young people have pre-existing conditions, so adding those into the pool might not cause as large a jump as adding those with pre-existing conditions into a pool of older people.

          If someone had a plan so good it was better than what's now required, seems highly unlikely to me that costs could go up that much.  
        •  Don't forget that great policy could be cancelled (2+ / 0-)
          Recommended by:
          Heavy Mettle, Cordyc

          if the policy holder was diagnosed with cancer.   It happened all the time.  .

      •  If they're older with low premiums (18+ / 0-)

        People who have good insurance, with low premiums, who are older (but still healthy) should perhaps bear in mind that it won't last forever.

        Under the system before ACA, there would have come a day when they got something--even a minor something--that tells the insurance company they have moved into pre-existing condition territory.

        When that day came, pre-ACA, they would see their premiums skyrocket, if not lose coverage altogether.

        Because, of course, the ones complaining bitterly about the increase in premiums surely don't want all the stuff from ACA that would be good for them--like no rejection for pre-existing conditions, same premiums as everyone else--but want to dump everything that is not as good for them personally.

        Sometimes, in this life, a major change in the law, affecting a major industry, does not go 100% in your favor. Sometimes, you benefit from some changes, and lose from others.

        •  People quickly forget the benefits and take (8+ / 0-)

          them for granted but the disadavantages are long remembered
          Because, of course, the ones complaining bitterly about the increase in premiums surely don't want all the stuff from ACA that would be good for them--like no rejection for pre-existing conditions, same premiums as everyone else--but want to dump everything that is not as good for them personally.

          •  Not just one's own coverage (9+ / 0-)

            I heard a woman on the Diane Rehm show last week who was complaining about having to pay (under the PPACA) for addiction treatment coverage that she will never need. While I'm happy that this woman does not have a chemical dependency problem, she has forgotten the societal costs of addiction. I don't think it occurred to her that we all eventually pay for another person's drinking problem in our auto insurance rates. We also pay increased rates for home insurance because of drug addicts trying to find ways to pay for their habit. These a just a couple of the indirect costs we all pay for having some members of our society not being able to access the full range of healthcare they need.

        •  Absolutely! I'm one of those lucky elders (12+ / 0-)

          and the no pre-x or dumping provisions help me sleep well at night, even though I don't need them now.

          When the power of love overcomes the love of power, the world will know peace.

          by CoyoteMarti on Sat Nov 16, 2013 at 12:05:24 PM PST

          [ Parent ]

        •  If people can't afford to spend more money... (3+ / 0-)
          Recommended by:
          greenbell, Victor Ward, Jarrayy

          on a premium, then they just can't afford it.

          The plethora of high co-pays and deductibles on the exchange make clear this is insurance - not health care.  Therefore, there will be financial drain for those least able to pay for those expenses.

          The premiums are the same for the wealthy as those on the low-to-mid segment of the middle class.  Thus, these high premiums for 50+ folks is a disproportionate tax placed on us.

          We cannot solve the problems that we have created with the same thinking that created them." - Albert Einstein

          by CarolinW on Sat Nov 16, 2013 at 01:44:46 PM PST

          [ Parent ]

          •  I'm not following you (3+ / 0-)
            Recommended by:
            Phoenix Woman, kyril, Sparhawk

            Older folks are the 'winners' in this, with younger healthier folks having to pay higher premiums and likelly will not use any or a lot of healthcare. They are subsidizing the less healthy population and this is by design. RW conservatives have gone so far to call it generational theft.

            •  It's about cherrypicking (4+ / 0-)
              Recommended by:
              BldrJanet, Ian S, ferg, kyril

              If you are 50 or older, and you managed to get insured, you are healthy. The people with expensive pre-existing conditions couldn't buy insurance.

              So, if you were a healthy 50-year-old, you were a much much better risk than the average 50-year-old. And you could get a cheap premium.

              Now you have to pay the rate for an average 50-year-old, which is a lot more, because it includes the costs for all those expensive people who couldn't buy insurance before.

              I personally know several people who are facing big premium hikes, even though they had good insurance before. This is what is happening to some healthy older folks.

            •  It's the difference between "older folks" (2+ / 0-)
              Recommended by:
              Clues, Heavy Mettle

              as a group, and as individuals. While it's true that as a group, older people, especially those with pre-existing conditions, will benefit, there are going to be people (at all age levels) who end up paying more for their insurance premiums. And any time you've got a sudden increase in an expense, it's not going to be pleasant, and for some it will be an actual financial drain. That pretty much was guaranteed by the fact that the overall cost for healthcare was going to be spread more equitably (but not as equitably as an actual progressive healthcare tax!). But this was something that no-one would dare say out loud during the campaign for the ACA, because it would have meant certain death for the bill.

              I can accept that as a political necessity without having to demonize anyone affected negatively by the ACA. There are some privileged jerks complaining when they can actually easily absorb the higher premiums. But not everyone in this situation is "entitled" or narcissistic or able to easily pay the increased cost. I am sympathetic to anyone in this situation, even if I think that in the long run it is the right thing to do...

              "The universe is made of stories, not atoms." -Muriel Rukeyser

              by tubacat on Sun Nov 17, 2013 at 01:20:34 AM PST

              [ Parent ]

              •  Ahh yes, in other words, people needed to be (0+ / 0-)

                tricked.  The premium increases needed to come as a big fat surprise, an unbudgeted expense right before Christmas.  I sure can see why that was a great idea especially when you need buy in from people not just today, but next year and the next few years because frankly we really don't have a clue if this law is going to be affordable, do we?  

                Classic centrism, screw the rubes in the fine print, brought to you by the people who invented NAFTA and the CCPI.

                •  We know that the old system was not affordable (0+ / 0-)

                  or sustainable. Hopefully the ACA is a step toward a rational single-payer system, one that would require people to think about a healthcare system as something they need to shop for, but something we all contribute to and benefit from.

                  "The universe is made of stories, not atoms." -Muriel Rukeyser

                  by tubacat on Mon Nov 18, 2013 at 01:20:57 AM PST

                  [ Parent ]

          •  It's not a TAX it's a product that costs a certain (1+ / 0-)
            Recommended by:
            Phoenix Woman

            amount and of course for someone with less money it's proportianately more. That's like saying if it costs more of your income to buy bread or gasoline, that's a TAX. Good God.

            •  Of course it's a type of tax... (1+ / 0-)
              Recommended by:
              greenbell

              It's not actually health care, it's health insurance.  So, it's a pool of money that will be distributed and regulated as one needs care (unlike other nations where the government takes that role).  However, this dispensing and regulation is being done here by the health insurance companies.

              In other first world countries, the amount of tax paid (which pays for health care) is proportional by the amount of income earned.  

              Therefore, the premiums on the ACA exchange, which are high for those 50+, are a disproportionate tax for the older low-to-middle income crowd.

              Do they ask you for ID and charge you a lot more for bread and gasoline when you're over 50?

              We cannot solve the problems that we have created with the same thinking that created them." - Albert Einstein

              by CarolinW on Sun Nov 17, 2013 at 07:07:37 AM PST

              [ Parent ]

              •  Insurance is a 'product' (0+ / 0-)

                that's what they call it - 'insurance products' just like anything else

                •  If I need health care, it's not a "product" (1+ / 0-)
                  Recommended by:
                  greenbell

                  "like anything else."  It's potentially my survival.  And, a "product" is typically not mandated for everyone to buy, particularly not one that ties to my ability to have health care.  If the insurance industry calls it a "product," it's because their corporate PR people want you to think about the buying of insurance, rather than real nationalized health care.

                  By the way, did you actually read what I wrote?:

                  In other first world countries, the amount of tax paid (which pays for health care) is proportional by the amount of income earned.  

                  Therefore, the premiums on the ACA exchange, which are high for those 50+, are a disproportionate tax for the older low-to-middle income crowd.

                  My goodness...

                  We cannot solve the problems that we have created with the same thinking that created them." - Albert Einstein

                  by CarolinW on Sun Nov 17, 2013 at 07:57:22 AM PST

                  [ Parent ]

          •  That's why there are subsidies. (5+ / 0-)

            I'm thinking that $5000 more per year does not figure in subsidies older healthy people might qualify for.

            And am I the only person who remembers Obama saying that keeping existing insurance policies did not apply in the individual market? I have no question that it applied to employer-provided policies - and these are subject to change anyway by the employer and/or the insurer.

            Also, please let's stop saying the ACA has failed. Provisions already in effect are quite successful. State exchanges seem to be doing well.

            What had all the glitches was the HHS insurance exchange website.

            Being attentive to the needs of others might not be the point of life, but it is the work of life. It can be ... almost impossibly difficult. But it is not something we give. It is what we get in exchange for having to die. - Jonathan Safran Foer

            by ramara on Sat Nov 16, 2013 at 05:55:33 PM PST

            [ Parent ]

            •  I thought I was the only one that remembered. (4+ / 0-)

              He was speaking to folks with employer-provided insurance or folks in other large group plans, like unions and associations. They represent 95 percent of already insured Americans.

              I remember this because I was individually insured and had seen it all. I knew that it did not have an association umbrella protection. In the individual market, it's every man for himself. I was mildly jealous of the 95 percent because they had safety in numbers. And they would keep their group insurance.

              •  Well, I knew it (3+ / 0-)
                Recommended by:
                Heavy Mettle, Pluto, greenbell

                because I'm on Medicare and it doesn't apply to me, yet it was clear in my mind as soon as this craziness began.

                The real problem with ACA is that it does nothing to contain healthcare costs, and if anything breaks down, that will be the main problem. Remember that skyrocketing costs were one of the main reasons for reform, just after the number of uninsured.

                Being attentive to the needs of others might not be the point of life, but it is the work of life. It can be ... almost impossibly difficult. But it is not something we give. It is what we get in exchange for having to die. - Jonathan Safran Foer

                by ramara on Sat Nov 16, 2013 at 07:55:24 PM PST

                [ Parent ]

                •  ACA is working to bring down healthcare costs (3+ / 0-)
                  Recommended by:
                  tofumagoo, tubacat, Dvalkure
                  The law includes innovative tools to drive down health care costs.  It incentivizes efficient care, supports a robust health information technology infrastructure, and fights fraud and waste.  After decades of growing faster than the economy, last year, Medicare costs grew by only four-tenths of a percent per person, continuing the trend of historically low Medicare growth seen in 2011 and 2010.
                  http://www.hhs.gov/...
                  •  Yes but (1+ / 0-)
                    Recommended by:
                    Pluto

                    Medicare sets the rates it will pay for different things. That kind of provision is not included in ACA. No one is doing anything about regulating what the actual cost of a CT scan is, or the cost of chemotherapy drugs.

                    I don't mean the cost of insurance.

                    Being attentive to the needs of others might not be the point of life, but it is the work of life. It can be ... almost impossibly difficult. But it is not something we give. It is what we get in exchange for having to die. - Jonathan Safran Foer

                    by ramara on Sat Nov 16, 2013 at 08:29:28 PM PST

                    [ Parent ]

                    •  PLease read furhter (3+ / 0-)
                      Recommended by:
                      Phoenix Woman, kkkkate, tubacat
                      Major progress in Medicare is sparking smarter care in the private market, and it’s working to bring down costs in the private market. Overall health-care costs grew more slowly than the rest of the economy in 2011 for the first time in more than a decade. And just last week, USA Today Site exit disclaimer reported health care providers and analysts found that “cost-saving measures under the health care law appear to be keeping medical prices flat.”

                      Even though the health care law is working to bring down costs, critics continue to claim the law is too expensive.  In reality, the law is fully paid for, and according to the independent Congressional Budget Office, the law reduces the deficit over the long term.  The facts show that employers, patients and our federal budget can’t afford to roll back the law now:

                      Fully repealing the Affordable Care Act would increase the deficit by $100 billion over ten years and more than a trillion dollars in the next decade.  It would also shorten the life of the Medicare Trust Fund by eight years.
                      Health care spending grew by 3.9% in 2011, continuing for the third consecutive year the slowest growth rate in fifty years.
                      Health-care costs grew slower than the rest of the economy in 2011 for the first time in more than a decade.
                      The proportion of requests for double-digit premium increases plummeted from 75% in 2010 to 14% so far in 2013.
                      Medicaid spending per beneficiary decreased by 1.9% from 2011 to 2012.
                      Medicare spending per beneficiary grew by only 0.4% in fiscal year 2012.
                      Slower growth is projected to reduce Medicare and Medicaid expenditures by 15% or $200 billion by 2020 compared to what those programs would have spent without this slowdown, according to CBO.

                    •  I don't know where you;re getting that idea nt (0+ / 0-)
                      •  We will see some reductions (2+ / 0-)
                        Recommended by:
                        Heavy Mettle, amsterdam

                        ...in the rate of increase, due to larger national pools and fraud controls, etc. But, costs to consumers are not really factored, except as government costs for subsidies to individual plans and medicaid. This becomes deficit neutral within a decade, and there will be a slowdown in deficit growth.

                        But again, premiums will still increase y.o.y. and insurers can price fix inside markets in a number of ways because they are exempt from antitrust laws. And there are no discounts on pharmaceuticals for Americans by law. The trade agreements being negotiated may even eliminate many generics.

                        Now that the government is paying subsidies directly to them, they are identical to defense contractors.

                        All that aside, I fully approve of the ACA. I'm going after hearts and minds and paradigm shifts.

            •  Obviously the media has blanked out on it (1+ / 0-)
              Recommended by:
              ramara

              I don't literally remember him saying that, but it certainly was understood who and what he was addressing and meant by 'if you like your insurance you can keep it'

        •  This isn't always true (1+ / 0-)
          Recommended by:
          Heavy Mettle

          In some cases if they were able to obtain continuous coverage they wouldn't be re-evaluated. Some states (ie WA) would allow pre-existing conditions to be ignored when switching from a exhausted cobra policy onto an individual plan.

          The problem is of course if they have any breaks in coverage then the pre-existing conditions would become an issue. Those who have pre-existing conditions and are able to stay on a plan which most people with pre-existing condition are no able to join wind up with quite a good deal!

          Under the system before ACA, there would have come a day when they got something--even a minor something--that tells the insurance company they have moved into pre-existing condition territory.

          When that day came, pre-ACA, they would see their premiums skyrocket, if not lose coverage altogether.

      •  I'm 64, very healthy, have individual policy now (23+ / 0-)

        and my comparable ACA policy in IL (same high deductible but now with a ton of first dollar preventive benefits) will be $100 more per month. I do qualify for a small subsidy but frankly I would have no problem paying the full extra if I were still working at the job I recently left to go self-employed. I am the prefect example of more employment flexibility due to the ACA.

        When the power of love overcomes the love of power, the world will know peace.

        by CoyoteMarti on Sat Nov 16, 2013 at 12:01:24 PM PST

        [ Parent ]

      •  Paying more for "worse policies"? (12+ / 0-)

        I'd have to have a hell of a lot more information before I'd believe this claim.  How are the ACA-compliant policies worse?  Do they cover fewer services?  Do they have higher deductibles?  I know policies under the ACA don't have things like lifetime caps or exclusions for pre-existing conditions, so they're certainly not "worse" in that respect.

        When it comes to insurance, the devil is always in the details.  As a lawyer who used to do insurance coverage work, I'd have to see the policy you're talking about and compare its terms to an ACA-compliant policy.  Until I've read every exclusion, addendum, rider, and coverage limitation, I'd be unwilling to make any kind of judgment.

        "Ça c'est une chanson que j'aurais vraiment aimé ne pas avoir écrite." -- Barbara

        by FogCityJohn on Sat Nov 16, 2013 at 12:09:00 PM PST

        [ Parent ]

        •  you mean there may be fine print? (2+ / 0-)
          Recommended by:
          Heavy Mettle, FogCityJohn

          I think mostly it's talking about the high deductible but everything after that.

          Of course if you got sick in September, you would have no more insurance in January.  

        •  The ACA changes to caps and such already happened (4+ / 0-)
          Recommended by:
          venger, Heavy Mettle, BldrJanet, Pluto

          The ACA removal of lifetime cap and such were already part of purchasing individual health insurance before the exchanges.  

          Therefore, the "bronze" policies on the exchange are, for my husband and I, a fairly lateral step in coverage (deductible went up) - but our premium will go up 35%.

          We cannot solve the problems that we have created with the same thinking that created them." - Albert Einstein

          by CarolinW on Sat Nov 16, 2013 at 01:51:01 PM PST

          [ Parent ]

          •  I guess it doesn't count then, because it happened (1+ / 0-)
            Recommended by:
            otto

            in the past?

            The ACA removal of lifetime cap and such were already part of purchasing individual health insurance before the exchanges.  
            or what is your point?
          •  Huh? (3+ / 0-)
            Recommended by:
            Heavy Mettle, sethtriggs, otto

            So let me see if I understand your point.  The ACA removed lifetime and annual caps, and so now insurance policies can't include those terms.  As a result of that change, you're making a "fairly lateral step in coverage," because the ACA reforms went into effect before you bought your policy?

            If that's your point (and I honestly can't say whether or not it is), then you're getting better insurance (i.e., a policy without caps) because of the ACA, yet you're calling this a lateral step in coverage.

            Color me confused.

            "Ça c'est une chanson que j'aurais vraiment aimé ne pas avoir écrite." -- Barbara

            by FogCityJohn on Sat Nov 16, 2013 at 09:46:18 PM PST

            [ Parent ]

            •  The premium for us is now higher... (1+ / 0-)
              Recommended by:
              greenbell

              The early parts of the ACA did have positive results in removing caps, ridding us of pre-existing conditions, etc. We had already shifted our plan a while ago when these changes occurred.

              However, the insurance available on the exchanges that we can afford isn't that wonderful (unless you have a lot of money for a "gold" plan) - and the cost for us went up 35%.  The 50+ rates are expensive. And, there are the higher deductible and co-pays on the "bronze" level plans (which is all we can afford).

              The rise in premium is significant as we are on a very tight budget, but make just above the cap for subsidy.

              As I've said before, the ACA system is a disproportionate "tax" on those over 50+ who are on the lower end of the middle class.

              To be honest, when I went on the exchange to find new insurance (our current policy is ending - and is 35% higher on the exchange), I cried in frustration.  People in our financial situation (low-to-middle part of middle class) seem to get forgotten by those in Washington.

              I just wish there was some awareness and empathy to be found here on Daily Kos.

              We cannot solve the problems that we have created with the same thinking that created them." - Albert Einstein

              by CarolinW on Sun Nov 17, 2013 at 07:23:07 AM PST

              [ Parent ]

              •  Um, most of us here on Daily Kos ... (0+ / 0-)

                would give you single payer if it were up to us.  If we had our druthers, the government would be picking up the tab for your health insurance.

                Sorry if you're in the small group of people who will be paying more.  But one of the reasons you're paying more is because you are getting more coverage.  The cap elimination and the end of pre-existing condition exclusions means more things are covered.  Not to mention the other required coverages under the ACA (e.g., preventive care).  The other thing that's important is the fact that your coverage will now remain in place over time.  You didn't necessarily have that security in the pre-ACA days.

                And since you raised the issue of empathy, try to remember that this law is going to let a lot of people get coverage who were excluded before.  As a person with HIV, this law is a huge load off my mind, since it means I'll be able to get coverage even if I lose my job.  So when you complain about costs, recall that for some of us, the ACA could mean the difference between life and death.  Maybe that will give you some additional perspective.

                "Ça c'est une chanson que j'aurais vraiment aimé ne pas avoir écrite." -- Barbara

                by FogCityJohn on Sun Nov 17, 2013 at 02:02:01 PM PST

                [ Parent ]

        •  They have smaller provider networks (1+ / 0-)
          Recommended by:
          kyril

          and higher deductibles.

      •  Links please? (2+ / 0-)
        Recommended by:
        Tonedevil, Heavy Mettle

        Otherwise, I call bullshit.

        "Detective, if ignorance was a drug, you'd be high all the time." Sam Tyler, 'Life on Mars'

        by Kokomo for Obama on Sat Nov 16, 2013 at 03:14:59 PM PST

        [ Parent ]

      •  I'm in that group and my cost hasn't changed (1+ / 0-)
        Recommended by:
        Heavy Mettle

        To stay insured I've had to go to the least cost real insurance that is offered in CA.  It is a 5200 deductible PPO and with no preexisting conditions will cost $502 in 2014.

        A Bronze plan in the Exchange with a deductible of 4500 and a few no cost visits to the doc is $530.  

        I am Grandfathered into that plan and as the letter reminds me, should my health status change the rate can go up!

        So for $1 per day I can get a lower deductible and a GUARANTEED rate that will not rise should I get sick.

        It doesn't take a rocket scientist to figure out that the ACA is the way to go.

        And this is all without any subsidy.  If I qualify for subsidy then even the Platinum plan is more affordable than my current Grandfathered plan.

        I have no sympathy for whiners who are to lazy to shop.

        Congressional elections have consequences!

        by Cordyc on Sun Nov 17, 2013 at 07:39:44 AM PST

        [ Parent ]

    •  Well, not all of us had crappy insurance (29+ / 0-)

      We had a very high deductible plan because we are fortunately healthy, and if we got sick, we could afford to pay the deductible. We viewed health insurance only as protection against a catastrophic illness that could wipe us out financially.

      We are "losers" under the ACA in that we will have to pay at least initially much more for coverage; however, we no longer have to worry about being able to switch insurance policies should one of us develop one of those pesky pre-existing conditions (increasingly likely to pop up as we age).

      And then of course, we get the generalized benefit from living in a society where fewer people die or go bankrupt when they happen to fall seriously ill. That's priceless.

    •  What is "fairly affluent"? (3+ / 0-)
      Recommended by:
      offgrid, anna shane, Heavy Mettle

      Presumably one would have to be above the median income for the country to be fairly affluent.  Does that mean that more than half of all Americans will receive a subsidy?  If so, doesn't that point to something seriously flawed in the program if we are paying insurers at least some money to cover more than half of the population?  

      •  actually it saves money (14+ / 0-)

        it's cheaper to help people get insurance than it is to pay for the medical costs of the uninsured. Weird, but true. The only reason to not pay subsidizes is not wanting to, there is no sound fiscal purpose.

        Also, since there is real competition for the first time in our history, costs will be controlled and over time the sharks will leave it to the non-profits and go find blood somewhere else.  

        •  This is such an important point. (6+ / 0-)
          it's cheaper to help people get insurance than it is to pay for the medical costs of the uninsured. Weird, but true. The only reason to not pay subsidies is not wanting to, there is no sound fiscal purpose.
          I'm trying to answer a friend who says "No one can believe that you add 30 million new people and the cost will go down." Do you have a link about this, preferably with charts and lots of numbers?

          The spirit of liberty is the spirit which is not too sure that it is right. -- Judge Learned Hand, May 21, 1944

          by ybruti on Sat Nov 16, 2013 at 11:23:29 AM PST

          [ Parent ]

          •  it's counter intuitive? (5+ / 0-)

            This is for the MSNBC guys to answer in that very cool way. The uninsured get lousy treatment, sure, and nothing until they are very sick, so not only are our rates are a lot higher to cover them, our taxes end up paying the most costly end of life care.  We pay at both ends.  

            There will some upcoming examples, from the states that did not expand medicare. Their hospitals will no longer get our tax subsidies for their uninsured, so their charges will have to all go to the insured. Then of course the nay-sayers will point out that in those states insurance rates are higher than ever.  

            The Republican governors can screw their own voters to keep the undeserving alive?  

            •  correction (2+ / 0-)
              Recommended by:
              Heavy Mettle, ladybug53

              the republican governors may screw their own residents just to prevent the undeserving from getting the early lifesaving care?  

            •  Do you mean that everyone's insurance (1+ / 0-)
              Recommended by:
              Heavy Mettle

              rates are higher because there are 30 million uninsured, some of whom end up in emergency rooms and hospitals with no reimbursement? It would help to have those statistics.

              The spirit of liberty is the spirit which is not too sure that it is right. -- Judge Learned Hand, May 21, 1944

              by ybruti on Sat Nov 16, 2013 at 04:58:05 PM PST

              [ Parent ]

              •  Make that "everyone's insurance rates WERE higher" (2+ / 0-)
                Recommended by:
                ybruti, Heavy Mettle

                because of the millions of uninsured, etc. etc.  That's one of the main reasons for the ACA - to reduce (if not eliminate) the number of uninsured people by bringing them into the insurance system so that "we" who pay taxes and insurance didn't keep having to pay for expensive emergency room visits for "them."

                Linky:

                Key Facts about the Uninsured

                "The universe is made of stories, not atoms." -Muriel Rukeyser

                by tubacat on Sun Nov 17, 2013 at 01:32:08 AM PST

                [ Parent ]

                •  Also, the larger the pool of insured, (2+ / 0-)
                  Recommended by:
                  Heavy Mettle, tubacat

                  the lower the rates for everyone, as shown by single payer systems. Even if 2/3 of the uninsured qualify only for Medicaid, that still leaves 10,000,000 new participants in the exchange plans.

                  The spirit of liberty is the spirit which is not too sure that it is right. -- Judge Learned Hand, May 21, 1944

                  by ybruti on Sun Nov 17, 2013 at 05:08:31 AM PST

                  [ Parent ]

                  •  According to the Kaiser Family Foundation, (1+ / 0-)
                    Recommended by:
                    Heavy Mettle

                    over 47 million non-elderly Americans were uninsured in 2012.  The ACA cannot help insure undocumented immigrants or legal immigrants in the country less than five years because they are ineligible for federally funded health coverage. See Key Facts About the Uninsured Population.

                    The spirit of liberty is the spirit which is not too sure that it is right. -- Judge Learned Hand, May 21, 1944

                    by ybruti on Sun Nov 17, 2013 at 05:23:40 AM PST

                    [ Parent ]

        •  I understand your point (3+ / 0-)
          Recommended by:
          Heavy Mettle, anna shane, Pluto

          but it doesn't address my question.  I think to hail this approach as sound fiscal policy (the transfer of the public coffers to private insurers) when the truly sound policy would be to transfer them to Medicare.  I don't see how one could call a policy sound if it includes the govt paying private insurers to cover more than half of the population, especially when there is no guarantee that all of these people will actually be able to afford CARE, given deductibles and co-pays.  How does ACA prevent these people from delaying care due to inability to pay until something catastrophic occurs, thereby running up addtional medical costs, which would result in higher premiums for all?  

          •  we didn't have a majority to pass that (6+ / 0-)

            but this removes the huge profits, and since there is competition for the first time ever. The most important part is the preventative care, that lab work that reveals the problems.  It isn't really preventative, it's more catch it quick.  

            •  Agreed - the term preventive is a misnomer (1+ / 0-)
              Recommended by:
              anna shane

              or at least misused. If they 'catch it', they haven't prevented anything.

            •  This is twice that you have responded (2+ / 0-)
              Recommended by:
              Heavy Mettle, Pluto

              to my comments with unresponsive matter.  This comment does not address the issue of how this is "sound fiscal policy" if the government is subsidizing more than half the population to pay for insurance, which is not the same as actual care.  The fact that a Medicare expansion did not pass (can I borrow your crystal ball?  Since there was no vote on the expansion I'd love to know how you are certain we didn't have a majority to pass that) is irrelevant to whether this is sound fiscal policy.  

              You seem to be tossing out various unrelated talking points instead of engaging the issue.  In your most recent post, you claim that we will now have competition for the first time.  That is simply not true, certainly not in my state.  Please clarify how there was no choice prior to ACA.

              •  we didn't have a majority to pass universal (2+ / 0-)
                Recommended by:
                Heavy Mettle, high uintas

                I wanted medicare for all too, but McGovern didn't win and that one was not going to fly.  Nancy Pelosi did not have those votes.  She can count, she doesn't rely on a crystal ball.  We're Democrats but not all quite the same amount of left.  

                If the law is as written, there will be competition, even in your state. It's the first time because we haven't been able to compare plans before now, and because the rules allowed for a certain amount of dishonesty in selling the plans.  I should have said real competition?  I guess they were competing for a few young healthy people, but not very hard, I don't think, they sort of owned the game, so they could sort of make the rules.  

                Is the market really competitive when some insiders have special access?  Don't rules that apply to all make for competition?  

                I think you're having a hard time with the concept of paying subsides for insurance that provides free so-called preventative care has to cost more than not covering them, but we pay one way or another.  I can't give you the link, I think it was Chris Hayes.  

              •  She doesn't need a crystal ball (3+ / 0-)

                There was no hope for that vote. But then everyone who was paying attention back then knows that. All that happened 4 years ago, why are we talking about it now?

                And daddy won't you take me back to Muhlenberg County Down by the Green River where Paradise lay. Well, I'm sorry my son, but you're too late in asking Mister Peabody's coal train has hauled it away. John Prine

                by high uintas on Sat Nov 16, 2013 at 07:07:38 PM PST

                [ Parent ]

              •  orestes, I'll answer your question. (3+ / 0-)
                Recommended by:
                Heavy Mettle, high uintas, tubacat

                I have never been in denial about the fact that there are no serious up front cost controls in the individual ACA market. No collective bargaining. In fact, there are incentives to drive costs up. That's what the 80/20 red herring does.

                The whole point of the ACA was to reduce the number of uninsured in America. About half of the uninsured were priced out of the individual market. (The rest are the negligent or the "young invincibles"). The government will be directly subsidizing (paying insurers) for people at certain levels above the poverty line. Those who can afford insurance will be fined if they don't buy it (the mandate). Some are so poor they will go on Medicaid.

                The other goal of the ACA was to create consumer protections for those with insurance and to keep it affordable. Those with group insurance (95% of the insured) can collectively bargain for affordable rates. So they can keep the plans that are offered by their groups.

                But those in the individual market (currently about 5% of the insured) are still on their own. Therefore, the ACA will be directly subsidizing (paying insurers) for people at certain levels above the poverty line to keep their ongoing insurance affordable. Some who are well off will pay the full sticker price. Sometimes that is higher that the non-ACA compliant plans they currently have.

                Over time, the volume of the insured can drive down costs in many areas. But for all of the above, there is no bargaining with pharma. All Americans pay retail, no matter the volume.

                Is it sustainable? Probably not. But by then, all Americans will come to believe that health care is a human right and the future will have to accommodate itself to their beliefs.

    •  I agree with you but it's hard to blame them (1+ / 0-)
      Recommended by:
      Heavy Mettle

      for being confused with Clinton playing political games.

    •  I'm trying to understand what you mean by this: (1+ / 0-)
      Recommended by:
      Heavy Mettle
      And as pointed out, they must be fairly affluent to not qualify for subsidy.
      You do understand that a husband and wife family with one child, and both mom and dad are first year teachers in a right to work state (not even a pro education state with strong union presence)....would be "affluent" enough to not qualify for a subsidy?  
    •  That's not true... Not everyone is benefitting (5+ / 0-)
      Recommended by:
      greenbell, Heavy Mettle, venger, Pluto, Clues

      Our insurance policy is being discontinued at the end of the year.  We were told by the company to go to the ACA exchange in our state.  On the exchange the same company has included the same "bronze" policy we already had - with a 35% increase in premium.

      FYI:  "bronze" policies (what those of us on the lower-end of middle class and over 50 can afford) have high premiums with big deductibles.
      By the way, insurance is NOT health care.  If we were to, heaven forbid, use the "bronze" plan, we would go further into a financial hole.

      To upgrade to silver:  double our current premium

      Our subsidy:  zero

      Why?  Because hubby and I together earn just above the limit (62k).  In our area, we are low-to-mid level middle-class.  Therefore, we are just making our bills - and are now stuck with higher premium insurance for the same coverage.

      Honestly, there is nothing wrong with really looking at how these changes are not helping everyone, particularly those 50+ who are not on high earners.

      We cannot solve the problems that we have created with the same thinking that created them." - Albert Einstein

      by CarolinW on Sat Nov 16, 2013 at 01:39:07 PM PST

      [ Parent ]

      •  I had said all along that the cut off point (4+ / 0-)
        Recommended by:
        Tonedevil, jdsnebraska, Pluto, CarolinW

        for subsidies was not high enough especially in high cost of living areas (4x poverty or whatever it is )
        The federal gov't has a cost of living allowance adjustment for employees living in high cost areas so it's already been figured out, they can just apply it to subsidies. I don't see why this can't be another 'administrative' fix

        •  Yeah I agree with this. (2+ / 0-)
          Recommended by:
          Heavy Mettle, Pluto

          I would vastly prefer to scale the subsidies back after 400% FPL instead of the cliff, or at least some kind of locality adjustment, say, based on the average cost of a policy relative to the national mean or something.  Or, they could use the same adjustments that they use for federal employee salaries that account for cost of living.

          For example, as I understand it, the NC exchange is relatively expensive, possibly because BCBS is the only participant that covers the entire state.  The Bronze level plans are about 50% more expensive compared to what I can get here.

          Doubt it could be done without an Act of Congress, considering that it would have substantial impacts on the tax code, but you're probably more likely to win Powerball at this point.  It's definitely on the list of fixes that would be helpful once we get a Congress that isn't full of sociopaths.

      •  If you aren't getting a subsidy (2+ / 0-)
        Recommended by:
        Heavy Mettle, Pluto

        you could look into getting a new policy outside of the Exchange.  It's not a sure bet that you'll save that way, but it could be worth a look.

      •  There's nothing wrong with looking at things as (4+ / 0-)
        Recommended by:
        high uintas, Heavy Mettle, Pluto, otto

        they are.

        The US is taking a significant step by ending discrimination against people with pre-existing conditions.

        Till now, people aged 50-64 enjoyed health insurance premium rates that were held down by excluding all but the healthiest applicants.  Your old policy is nothing like the policies offered on the exchanges because medical underwriting isn't allowed for new insurance that goes into effect on Jan 1 2014.

        You compared the premium rate and deductible of your old policy to the exchange offerings but you said nothing about the one feature that makes all the difference. Without medical underwriting, insurers can't exclude applicants they suspect will need expensive treatment for illness.  Maybe the higher premium of an exchange policy is a bitter pill. I don't see how anyone could rationalize a lower premium they had till now as better or preferable, when its availability depended on the misfortune of the insurance have-nots. The lower rates were made possible by denying insurance to people who needed it because they were sick.  

        The US is taking a significant step by ending discrimination against people with pre-existing conditions and it’s important not to lose sight of that. This advancement is baked into the new policies offered on the exchanges.

        The list of preventive health care offerings is also worth reviewing. There are some very pricey procedures included with $0 co-pay and $0 deductible. Some of the most expensive preventive offerings are routinely recommended by doctors for people in the 50-64 age group. This is an important benefit that can actually “pay for” a big chunk of the annual premium.

        Spouses in the 50-64 age group, with income just over the 400% of FPL cutoff and living in one of the areas where premium rates are high, should ask why the cost varies so much from state to state. I live in an area where I have a choice of 116 policies. With that degree of competition, rates are much lower. Contact the insurance commissioner in your state and find out why rates are high when there’s supposed to be a rate review process.  The public has been deceived by reports that average your rate with a 27 year-old’s rate. That’s why we have rate shock. If there are no affordable rates in your area, the market has failed and that’s what your state officials need to hear.

        Lastly, it’s worth noting that medical expenses, including health insurance premiums are deductible when income tax is filed.  There’s a formula for calculating the deductible amount with a slightly different method for self-employed people. With the premiums some people will be paying, this should not be overlooked.

        There is no existence without doubt.

        by Mark Lippman on Sat Nov 16, 2013 at 06:54:54 PM PST

        [ Parent ]

        •  The higher premium as a "bitter pill"... (1+ / 0-)
          Recommended by:
          greenbell

          is disproportionately high for those over 50 and not higher wage earners.  And, if people don't have the means to pay more, what should be done?

          We can all say, "Well it's a step in the right direction."  Perhaps down the road it will be.  For this moment, my husband and I will have to pay more for a "bronze" plan with high deductible and co-pays.  At our income level, if we actually become ill, how are we to pay for those costs?

          Saying one can take a deduction on those costs only really significantly helps those who make more income and have other deductions, as well.

          My point is that, as it stands, the ACA exchange policies continues the penalties for being older and for not being a higher wage earner as we buy health insurance.

          And, let's not talk about how this is not actually health care that we're paying for... but, money given to health insurance companies.

          We cannot solve the problems that we have created with the same thinking that created them." - Albert Einstein

          by CarolinW on Sun Nov 17, 2013 at 07:43:53 AM PST

          [ Parent ]

          •  The rates aren't high everywhere. Where I live, (0+ / 0-)

            they're surprisingly low, even for consumers age 50+.

            I could say that the ACA works fine here so my anecdote cancels out yours.

            The rates aren't set by the ACA. They're set at the state level but they don't correlate to red and blue states.

            Here are the unsubsidized rates of the second lowest Silver and lowest Bronze for a 60 year old in 18 different cities. (FYI, the rate for two 60 year olds is almost always double the rate for a single 60 year old.)

            City 2nd Lowest Silver Lowest Bronze
            1-60 year-old 1-60 year-old
            no subsidy no subsidy
            New York City $390 $308
            Burlington $413 $336
            Portland $427 $350
            Albuquerque $450 $329
            Baltimore $484 $310
            Washington DC $521 $357
            Cleveland $529 $376
            Denver $531 $395
            Richmond $537 $361
            Los Angeles $541 $398
            Billings $548 $437
            Sioux Falls $561 $508
            Omaha $576 $418
            Seattle $601 $452
            Providence $622 $446
            Indianapolis $626 $531
            Portland $626 $499
            Hartford $697 $493
            Hartford, CT is 80% higher than New York City.  California is one of the most expensive markets. When you look at locations like San Francisco, its rates are even higher than what's listed here for LA. It's state insurance commissioner reviews rate hikes but has no authority to refuse or reduce them. Legislation to give him the authority failed in the state in 2011.

            You can't say that big cities are more expensive because New York City's rates are low. You can't say that rural states are more expensive because Vermont's rates are low. There's no real correlation to anything between the states. The problems are within each state.  Some states had the foresight to create favorable market conditions.

            You cant fix the problems without knowing what they are. All you can do is bark at the moon. Find out what's going on in your state. You have representation there.

            Here's something for you to contemplate about the insurance companies, if they bother you. No one wants to give their money to them. The ACA includes a provision that waives the individual mandate and the shared responsibility penalty for consumers when the lowest cost Bronze plan available is more than 8% of income.  I'd never recommend or endorse going without insurance, but the ACA does give you the choice to do so if the market offers nothing affordable.

            If you want to do without insurance companies in the concrete world where I live, it also means doing without insurance. And the ACA gives you that option if you meet the qualification.

            There is no existence without doubt.

            by Mark Lippman on Sun Nov 17, 2013 at 11:41:15 AM PST

            [ Parent ]

  •  Obama blinked (2+ / 0-)
    Recommended by:
    Fury, Heavy Mettle

    In trying to save the likes of Mary Landrieu, he may well have doomed his signature act. I am not surprised, just disappointed, that he fell for it again.

    Let the red state Dems die a horrible political death. It's is far better that dooming health care back to status quo.

    ...the GOP seems perfectly willing to hold their breath until the whole country turns Blue.

    by tommy2tone on Sat Nov 16, 2013 at 10:15:29 AM PST

  •  it's highly uneven (1+ / 0-)
    Recommended by:
    Heavy Mettle

    a few people paying  more vs. lots of people dying.  

    But the insurance companies have had to weigh in and seems they don't want to keep those special policies for the very few, (at least not exactly.  They'd probably do it if they could charge more and provide even less,) but they won't deliver what they first offered to get those people signed up with them, with the thus better chance of keeping them by tricking them into staying, with their tried and true tricky insurance techniques.  

    Does anyone know how many are actually grandfathered, and how many of their actually grandfathered policies are still an option?    

    •  I've been trying to look into this and it's (1+ / 0-)
      Recommended by:
      anna shane

      hard to get the numbers. About 16 million have individual insurance and about 2 to 4 million have had them cancelled. So i dunno - the rest grandfathered?

      •  In California (9+ / 0-)

        my adult son has individual insurance, that has not been cancelled, but it's 60 bucks more a month than a better plan with the same company on the exchange.  So, there are those kinds to consider.

        I want to know how many can keep their 'junk' plans. My son's plan isn't junk, it just costs more and has higher co-payments. They're counting on a few just rolling over, and not comparing costs and benefits.

        The California exchange works great, it even lets Medicare people use it for their supplementary plan.

        If  Chris Christie had done the same for New Jersey, instead of leaving it to the Fed's to do it for him, they'd have theirs working too.  

        Christie pissed in his state's soup. I am glad Californians were smart enough to elect a Democratic governor. We used to do that too, we sadly gave the nation Ronald.  

  •  Thanks for posting this (7+ / 0-)

    It's an excellent perspective that should be the real focus of media coverage about the ACA.

    It's similar to the "Lucky Duckies" comment about taxes - all those poor people who don't earn enough money to pay taxes sure are lucky, aren't they? I'm throwing the "bullshit" flag.

    The United States does not negotiate with terrorists - that includes Republicans.

    by frsbdg on Sat Nov 16, 2013 at 10:45:29 AM PST

  •  This is my feeling exactly. (13+ / 0-)

    Speaking as someone whose been in the individual market for ten years now,  I am thrilled to have actual, quality insurance mandated by the ACA even though it will cost me an extra hundred bucks a month.  Real insurance for me,  real insurance for everybody else.  It really does beg the question of why we didn't do this twenty years ago.

    "Goodnight, thank you, and may your God go with you"

    by TheFern on Sat Nov 16, 2013 at 10:55:55 AM PST

    •  Then it should have been the Quality Insurance Act (3+ / 0-)
      Recommended by:
      Heavy Mettle, TheFern, ferg

      not the Affordable Care Act.  You can't blame people for being surprised that it's going to cost them more money when the sales pitch was affordability.  The burden shifting isn't particularly equitable either.  Some people feel they're the losers because it's costing them more money.  Why is that surprising?  It's costing them more and it's not costing the guy next door with the employer paid policy more and the person with the lower income down the street is getting the subsidy but they aren't.   If they're not political, they're just annoyed, inconvenienced, not feeling any direct benefit and suspecting they were tricked into something and they aren't even clear on what they were tricked into.  

      This needed a lot more marketing and more carrots and fewer sticks at least until it got established.

      •  except (3+ / 0-)
        Recommended by:
        kefauver, Tonedevil, Heavy Mettle

        that quality is in the eye of the beholder, and there are now limits on how much of a person's income can go to insurance companies?  

        •  But there's wiggle room on the limits (2+ / 0-)
          Recommended by:
          anna shane, Heavy Mettle

          or at least they're not exactly clear.  Like I scared myself into a high deductible plan which prorated is higher than I was paying for COBRA because the very clearly stated word UNLIMITED under the column on out of network maximum OOP made me darn right queasy.  I'm pretty familiar with the hospital systems in my state and while most of the narrow networks appeared to include at least one quality hospital, I still know that depending on your illness or injury you would ideally choose different hospital systems so if you are a middle class person who would want the best for you child or spouse in the case of a major illness or injury I'm not so sure your costs are necessarily as limited as first appears.  

          Minnesota has already had to do some scrambling to adequately cover some rural areas which because it is Minnesota they did quite quickly but we've also got a pretty healthcare aware public here.  But then, I guess I'm saying we're starting from a better place than many states so I suppose I'm underestimating the benefits of this law in states that have wretched healthcare and little regulation.

          •  yes (2+ / 0-)
            Recommended by:
            Heavy Mettle, Tonedevil

            they estimate the out-of-pocket costs in California, and so you can get an estimate and pick the lowest one, but then there are still chances to pay more or get less.

            It's really a crap shoot, my parents had the greatest insurance, they were told, it cost the most anyway, but when my mom got sick there wasn't a private room available, so she was with six others, so that was paying more for nothing, and they 'forgot' to send her home with the right instructions along with forgetting about a home health care nurse. And my dad's cancer could have been caught early, if his high price doctor had thought to order one test.  They always had insurance, that wasn't the problem.  

            These so-called preventative tests have to be mandated by government, or some will get substandard care regardless of their super great covers everything plan.  

            As far as finding the best doctor for the specific condition, good luck with that. What we all need is way more information, and with any luck that's coming too.  

  •  Yes, the ones I feel sorry for the most (13+ / 0-)

    Are the child-free poor, most of whom are working, in the states that have refused to expand Medicaid. They will be completely cut out of anything, through no fault of their own, while those that have more money will be able to get health insurance in their states. They have been responsible, or lucky, by not having children, but are being penalized for it.

    How can that be moral, justified, or decent? What's astonishing to me is those that have more money whining about having to pay a bit more for much better insurance, when these other people who are much worse off are completely cut out and not able to buy anything.



    Women create the entire labor force.
    ---------------------------------------------
    Sympathy is the strongest instinct in human nature. - Charles Darwin

    by splashy on Sat Nov 16, 2013 at 11:05:33 AM PST

  •  I say fuck them (2+ / 0-)
    Recommended by:
    Heavy Mettle, a2nite

    You're right they're losers.  Listen to them.  It must be increasingly hard for them to deny what losers they already were.   Let me get the little violin out for you losers.  It's definitely a rough life being a short-sighted whiner.  That's why they call you a "loser".

    Republicans: Taking the country back ... to the 19th century

    by yet another liberal on Sat Nov 16, 2013 at 12:07:32 PM PST

  •  If Sarah Palin was right about one thing . . . (3+ / 0-)
    Recommended by:
    Heavy Mettle, a2nite, Eric Nelson

    it was the "gotcha media."

    Heaven help us if they ever paid the slightest bit of attention to her utter ignorance, lack of curiosity, extremism and general unfitness for high office, but "I can see Russia from here" is one of the catchphrases of the century.  And if she hadn't given them little gifts like that in order to get their gotcha moment on her, they'd have paid no attention whatsoever to all the important stuff.

  •  I may end up a loser, and I'm fine with it (11+ / 0-)

    I used to work in academic research, where I got an absolutely great insurance package -- employer subsidized nearly all of the premium, very low deductible ($250), strong negotiation with providers to lower the allowed charges (no balanced billing for the difference from "retail"), etc.

    At the moment, I'm on COBRA. Still the same great insurance, but I have to pay the entire premium myself. That's about $550/month. My COBRA coverage will probably run out soon, perhaps as early as February 2014, in which case I'll have to buy an individual policy.

    The premium for the university's group policy is the same for everyone who's covered (in 2014, they may be increasing it a bit for smokers). But Washington's individual market is both smoking-rated and age-rated. IOW, the older you are, the more you pay.

    As a 63-year-old, then, I'll be very near the top of the premium range for an individual plan. I have several medical conditions requiring maintenance drugs (over half a dozen prescriptions) and semi-annual bloodwork. I've looked at both in-exchange and out-of-exchange plans (I don't qualify for a subsidy), and the best gold-level plan I've found is about $200 more expensive, with higher deductible, higher out-of-pocket maximum, and somewhat higher drug costs. Thankfully, my healthcare providers are in that company's network.

    So, if I have to switch to an individual plan, it'll be more expensive than what I have now. But I'm perfectly OK with that. I'm still going to get my money's worth out of it:

    • My meds alone cost over $150/month (that's the insurer's negotiated price ... retail would be twice that, or more), out of which my current co-pay is $14. It'll be higher under an individual plan, though I don't yet know how much.
    • I have weekly visits to a psychotherapist, each of which would cost $110 out-of-pocket if uninsured. My current co-pay is about $12.50 per visit, and it would be no more than $16.50 under the individual plan.

    Unlike a Republican, I understand and accept what might happen to me. I consider myself fortunate that I don't qualify for the subsidy, because it means that I'm making enough money to live on.

    I'll always be UID:180, even if Markos tries to pry it away.

    by N in Seattle on Sat Nov 16, 2013 at 01:41:22 PM PST

    •  Recent Subsidy Error Snafu in WA Exchange Site.... (2+ / 0-)
      Recommended by:
      N in Seattle, Heavy Mettle

      Hi, N in Seattle, long time, no "see" (Jim Ferguson here)...

      I worked at Verizon Wireless until our big layoff last year in Bellevue and, after the employer-paid months, have been paying $475.00/month COBRA, which runs out at the end of the year.

      I'm going to school at Edmonds Community College to retrain (Computer Information Systems) and collecting Unemployment/Training benefits, so my income for 2013 is based on the UI figures, but isn't any more than that ($26,000.00/year).

      Knowing that COBRA will run out, I did my research and selected the Molina Gold with the $200.00 annual deduct. and $40.00 annual prescription deductible, $6350 out of pocket limit, no lifetime caps, etc. (All not bad and I didn't want a higher deductible than that.)

      The original subsidy quotes on the WA Exchange for me were excellent: a 452.00 subsidy for a single, aged 54, non-smoker. It yielded a premium quote for Molina Gold at ca. $143.00/month. About such a figure I could find no reason to complain at all.

      However, I was then alerted via email and the WA Exchange's website that there had been an error in the income/subsidy qualification calculations and that it had effected a number of people, including me and that we would get additional communication from them about it, showing the new subsidy amount.

      This week, that quote came.  Instead of $452.00 for the subsidy, it is now just $264.00. Therefore, the Molina Gold will cost me not $143.00/mo, but $330.00/mo - more than double.

      My big concern isn't actually the premium increase in and of itself; my concern is because this more-than-double increase is based on only a $26,000.00 income. I know that I will qualify for Medicaid (AppleCare in WA, of course) starting in April, because UI runs out for good at the end of March. (I'm in school at least until Aug 2014, btw.)   However, I'm really concerned, because based on these "corrected" subsidy amounts in WA state, they've really set the bar for eligible subsidies too, too low. That is, if I were still working and making what I made at Verizon (about $46.000/year), there would be no subsidy at all, and I'd have to pay almost $600.00/month as a single man. Maybe my expectations are too high, but it does seem to be more confirmation to me that the ACA is benefitting insurance companies way too much. Really, I hope that if more people are experiencing this sort of thing, that this will lead to more impetus to move toward Single Payer. (And I'm saying this as resident of one of the states that did the "right thing":  accepting the Medicaid Expansion, setting up the Exchanges, etcetera. I can only imagine the dire straits I'd be in if I were in one of the states without the new expansions under the ACA...)

      I am indeed happy with what appear to be some improvements in the Molina plan and I think ACA is a good start, but only a start.

      I hope you don't mind the long post, and it is a little jumbled. I've been trying to find experiences close to mine reflected on the local blogs, or DKos posts that are in the Seattle area, but so far, I haven't seen anything.

      On the other hand, my perspective may be wrong. But it seems to me that when I do get even a low-paying job, I won't qualify for  a subsidy even then. (Not a sustainable situation, if this will be everyone's experience.)

      BTW are you still in the 43rd? I still live up here in Bitter Lake, but we were redistricted from the 46th to the 32nd LD. At least at the Congressional level, we are in Jim McDermott's district again.

      I hope you're doing well.

      Jim

  •  One more thing to add (4+ / 0-)
    Recommended by:
    Heavy Mettle, Eric Nelson, Pluto, ferg

    The idea of the law was that it could be adjusted and changed as it went along, making it fit better into the needs of the population. With the current GOP and the state refusing to expand medicaid, the fact is...

    1) it has become impossible to make minor adjustments to benefit everyone

    2) the risk pools in the federal exchanges for refusnik states have deepened, thereby raising the premiums in those states - on purpose.

    With such a large segment of the congressional population at the state and federal levels trying their hardest to make this not work, it is amazing that it works at all!

  •  Chris Hayes most excellent rant.. (4+ / 0-)

    ..against the MSM and the RWNJ’s with a reminder for Dems falling prey to RWNJ propaganda and running scared from PPACA –  Besides being weak and stupid it won’t work (last part is my take)

    Even the NYT’s has bitten on the latest BS from the paste eaters

    Chris Hayes is pissed-off and gets down to it:

    (short commercial – sorry)
     link:   http://video.msnbc.msn.com/...  

    Since there is no transcript available I was going to write this out, but it is so much better to hear it right from Chris Hayes himself imo.

    Plus interviews with Howard Dean and John Nichols with their opinions on this.

    Chris is correct:  “The only way out is through” - Get it together

    Thx Heavy Mettle - much needed to be said

  •  A solution-Really. (1+ / 0-)
    Recommended by:
    Heavy Mettle

    I once had a client who had his "Welfare" (Whatever they call it now.)  check cut because he told the case worker he had pan-handled the money for the bus fare to get to the office.  She counted it as income.  Self righteous bitch that she was.

    From social work I learned that there are three kinds of people.  The helper who will always interpret the rules to benefit the client.  The give a shit who just does the paperwork. As long as the boxes are checked you get whatever benefit you are trying for.  And the gatekeeper who believes that their job is to weed out those undeserving of help.  But that's a whole nuther story.    

    So maybe you have an income from panhandling or some other creative source.  Whose to say.  

    A bad idea isn't responsible for those who believe it. ---Stephen Cannell

    by YellerDog on Sat Nov 16, 2013 at 09:30:44 PM PST

  •  Some questions about ACA "losers" (1+ / 0-)
    Recommended by:
    Heavy Mettle

    If older people are buying their own insurance, that indicates they are self-employed. This means they can deduct the cost of the insurance. (I haven't done this, so I don't know what percentage they can deduct, but I know it can be done.) So you would have to adjust the tax savings before stating "$5000 more". Also, I looked at our state exchange and noticed that the cost difference per month for the Bronze and the Gold plan wasn't much. The Gold plan looks pretty cushy. Could come in real handy.

Pat K California, Phoenix Woman, Alexa, MadRuth, ferg, Gooserock, Emerson, alicia, wu ming, cotterperson, Vico, eeff, frsbdg, figdish, MarkInSanFran, niemann, Heart of the Rockies, checkmate, rasbobbo, susans, BlackSheep1, Wee Mama, amsterdam, boadicea, limae, Chitown Charlie, splashy, wader, revsue, Texknight, NYC Sophia, elmo, Lawrence, Catte Nappe, riverlover, JayBat, AllisonInSeattle, zerelda, ybruti, Curt Matlock, tomjones, Black Max, Josiah Bartlett, murrayewv, Gowrie Gal, kbman, maybeeso in michigan, historys mysteries, NoMoreLies, ichibon, v2aggie2, Tonedevil, kefauver, basquebob, juliesie, viral, Brooke In Seattle, Kevskos, bleeding blue, jimstaro, Fury, ladybug53, Ice Blue, blue jersey mom, kaliope, Tunk, FindingMyVoice, Pluto, kathny, xaxnar, third Party please, K S LaVida, Hirodog, myboo, Themistoclea, hungrycoyote, dopper0189, seefleur, mooshter, Dvalkure, Naniboujou, The Hindsight Times, Ooooh, katrinka, CA Nana, Persiflage, Clive all hat no horse Rodeo, BB10, NancyWH, sea note, Nulwee, anna shane, clinging to hope, tgypsy, AdamSelene, puakev, HeartlandLiberal, flumptytail, pioneer111, Wreck Smurfy, homerun, gizmo59, Zacapoet, JDWolverton, jack 1966, JeffW, kimoconnor, GAS, OleHippieChick, Youffraita, Involuntary Exile, Buckeye Nut Schell, jamess, Lujane, tofumagoo, royce, pamelabrown, smartdemmg, Jeff Y, catly, Al Fondy, HarpboyAK, JamieG from Md, billybam, watercarrier4diogenes, Diogenes2008, maggiejean, ceebee7, ronnied, TheFern, LeftOfYou, Tara the Antisocial Social Worker, CamillesDad1, EquationDoc, virginwoolf, dRefractor, winkk, Ibis Exilis, LookingUp, collardgreens, coppercelt, henlesloop, awcomeon, FogCityJohn, willynel, gramofsam1, VickiL, Goingallout, Kristina40, DiegoUK, nirbama, ericlewis0, USHomeopath, Onomastic, kerflooey, mama jo, slowbutsure, jardin32, La Gitane, gmats, deeproots, CoExistNow, cama2008, boomerchick, sethtriggs, thomask, MRA NY, peregrine kate, Safina, VTCC73, SteelerGrrl, Mentatmark, CoyoteMarti, Rashaverak, Laurel in CA, YaNevaNo, Sister Inspired Revolver of Freedom, Cordyc, tweeternik, anodnhajo, pistolSO, We Won, ahumbleopinion, Eric Nelson, tb92, a2nite, congenitalefty, This old man, jan4insight, carolanne, belinda ridgewood, reginahny, MartyM, ricklewsive, flume, avsp, rat racer, Glen The Plumber, ShoshannaD, Arilca Mockingbird, countwebb, weck, Rileycat, Smoh, Another Grizzle, Ishmaelbychoice, oslyn7, TheDuckManCometh, Mark Mywurtz, patbahn, kkkkate, ginimck, Great Ape, joegoldstein, wilywascal, astage4444

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