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That Obamacare thing

That Obamacare thing

Old Jan 5th 2016, 12:57 am
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Default That Obamacare thing

Has anyone on here (who is somewhat unhealthy) got direct experience of buying an individual plan on the exchange and actually using it?

I just wondered what you thought of it. E.g. the deductibles for prescriptions and so on.

I was trying to help someone with it the other day and my head nearly exploded. Seems to me that 90% of the plans really aren't all that serious, like the companies don't really think that anyone will actually buy them and you have to search out the 10% of plans that are realistic. And you do that by figuring out who the largest healthcare company is in that jurisdiction and looking at the half dozen plans they offer.

I.e. it's largely smoke and mirrors by the insurance companies to comply with the law. Based on the number of plans that are sold, in small States it must be a bit of a joke, I see Nevada scrapped their exchange because the number of plans being sold there was so small.
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Old Jan 5th 2016, 1:17 am
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Default Re: That Obamacare thing

Originally Posted by Steve_ View Post
Has anyone on here (who is somewhat unhealthy) got direct experience of buying an individual plan on the exchange and actually using it?

I just wondered what you thought of it. E.g. the deductibles for prescriptions and so on.

I was trying to help someone with it the other day and my head nearly exploded. Seems to me that 90% of the plans really aren't all that serious, like the companies don't really think that anyone will actually buy them and you have to search out the 10% of plans that are realistic. And you do that by figuring out who the largest healthcare company is in that jurisdiction and looking at the half dozen plans they offer.

I.e. it's largely smoke and mirrors by the insurance companies to comply with the law. Based on the number of plans that are sold, in small States it must be a bit of a joke, I see Nevada scrapped their exchange because the number of plans being sold there was so small.
There's no legal requirement for insurance companies to offer plans on an exchange. Also, what do you mean by plans that "aren't all that serious"? Do you mean in terms of cost in relation to other plans on the exchange?
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Old Jan 5th 2016, 2:42 am
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Default Re: That Obamacare thing

My OH has bought coverage through the CT exchange since the inception of affordable care. It has saved him a lot of money on premiums and he is happy with the coverage he chose.
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Old Jan 5th 2016, 3:01 am
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Default Re: That Obamacare thing

From what I've read the insurance companies are stuck between a rock and a hard place and it is taking a few turns of the wheel for things to work out.

On the one hand the government is setting stiff rules to try and control rising costs. Except these rules are only being imposed on the insurance companies because there are fewer of them. The costs from the Providers are still rising uncontrolled. Blue cross az allegedly made huge losses last year dipping into their reserves. Another az insurer folded. So the story goes the majority of the losses are down to just a handful of patients (e.g. long term childhood cancer care running into millions of dollars). Pre aca they would have dropped these patients like a rock now they have to keep paying out (boo hoo) .

The main solution is to run with very narrow networks, limited free appointments, limited formularies, larger copays and coinsurance. The smart patient has to spend a lot of time running permutations checking formularies and networks. For my wife it came down to one of her meds not being covered by blue cross but was covered by aetna.
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Old Jan 5th 2016, 3:05 am
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Default Re: That Obamacare thing

Obama messed up health care for a lot of people.
The plans have to have a fit of a lot of things, which a lot of people don't need. It is hard to find an affordable health care plan these days.

Remember the "if you like your plan you can keep it" lie he told. Then 5 million people had their plans scrapped by insurers when Obamacare came in to force. My premiums and deductible both went up thanks to this fiasco.

Nevada scrapped its exchange after sinking $75 million in to the project with Xerox, for it to be plagued with technical issues. Nothing at all to do with a lack of plans....
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Old Jan 5th 2016, 3:28 am
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Default Re: That Obamacare thing

News flash, your rates were going up before the aca. In fact the rate at which premiums have gone up is now less.

http://www.politifact.com/truth-o-me...alth-insuranc/
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Old Jan 5th 2016, 4:15 am
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Default Re: That Obamacare thing

Originally Posted by thinbrit View Post
Obama messed up health care for a lot of people.
The plans have to have a fit of a lot of things, which a lot of people don't need. It is hard to find an affordable health care plan these days.

Remember the "if you like your plan you can keep it" lie he told. Then 5 million people had their plans scrapped by insurers when Obamacare came in to force. My premiums and deductible both went up thanks to this fiasco.

Nevada scrapped its exchange after sinking $75 million in to the project with Xerox, for it to be plagued with technical issues. Nothing at all to do with a lack of plans....
"The study finds that 22.8 million people signed up for coverage between September 2013 and February 2015, while 5.9 million lost coverage, leading to a net gain of 16.9 million. "

17 million gained coverage under ObamaCare, study finds | TheHill
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Old Jan 5th 2016, 4:33 am
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Default Re: That Obamacare thing

Originally Posted by sir_eccles View Post
From what I've read the insurance companies are stuck between a rock and a hard place and it is taking a few turns of the wheel for things to work out.

On the one hand the government is setting stiff rules to try and control rising costs. Except these rules are only being imposed on the insurance companies because there are fewer of them. The costs from the Providers are still rising uncontrolled. Blue cross az allegedly made huge losses last year dipping into their reserves. Another az insurer folded. So the story goes the majority of the losses are down to just a handful of patients (e.g. long term childhood cancer care running into millions of dollars). Pre aca they would have dropped these patients like a rock now they have to keep paying out (boo hoo) .

The main solution is to run with very narrow networks, limited free appointments, limited formularies, larger copays and coinsurance. The smart patient has to spend a lot of time running permutations checking formularies and networks. For my wife it came down to one of her meds not being covered by blue cross but was covered by aetna.
So if the insurers are still getting the screw from Providers, they'll eventually revert to a 'Kaiser' like model where they run the kit and the kaboodle?
It will still take a while for the market to even itself out, you'd imagine.
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Old Jan 5th 2016, 5:53 am
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Default Re: That Obamacare thing

Originally Posted by Giantaxe View Post
There's no legal requirement for insurance companies to offer plans on an exchange. Also, what do you mean by plans that "aren't all that serious"? Do you mean in terms of cost in relation to other plans on the exchange?
There are just loads of silly plans listed that no-one in their right mind would buy, e.g. with ridiculously high deductibles and extremely poor prescription drug coverage and there's like maybe one doctor on the other side of town "in network" and stuff like that.

I just got the impression they weren't seriously looking for customers, except for one insurance company that had some marginally okay looking plans.

Just seemed to be all smoke and mirrors, i.e. a publicity stunt because no-one wanted to admit that only one company was serious about offering plans.
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Old Jan 5th 2016, 6:07 am
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Default Re: That Obamacare thing

Originally Posted by thinbrit View Post
Nevada scrapped its exchange after sinking $75 million in to the project with Xerox, for it to be plagued with technical issues. Nothing at all to do with a lack of plans....
I know they had problems with the contract, but with only 75,000 people signing up they just don't need their own website as far as I can see.

I'm not sure what the total number of people is that the exchanges were intended to help, but so far only about 3.4% of the population has signed up, so people using the exchanges are pretty rare. Most people get healthcare through Medicare or a group plan at work.
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Old Jan 5th 2016, 2:08 pm
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Default Re: That Obamacare thing

Originally Posted by sir_eccles View Post
News flash, your rates were going up before the aca. In fact the rate at which premiums have gone up is now less.
Rates typically always go up. I was used to paying slightly more each year for the same coverage. After Obamacare, I was paying significantly more to get a plan that for me offered significantly less value.

The market now has lots of new people taking minimum coverage polices that dilute the average family cost of healthcare.




Originally Posted by Steve_ View Post
I know they had problems with the contract, but with only 75,000 people signing up they just don't need their own website as far as I can see..
lol, it wasn't just problems with the contract, the software just didn't work. people lost faith in it. Of those 38,000 people who signed up, the software was so flawed EVERY ONE of them would have had to enroll again.
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Old Jan 5th 2016, 2:26 pm
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Default Re: That Obamacare thing

Originally Posted by thinbrit View Post
Rates typically always go up. I was used to paying slightly more each year for the same coverage. After Obamacare, I was paying significantly more to get a plan that for me offered significantly less value.
It's obviously a case of your mileage may vary. This year, my OH was able to change to a newly offered ACA plan that gave him the same coverage as last year, but at a lesser cost. Dealing with the exchange while choosing and enrolling in the coverage has been the hard part; once enrolled his coverage has functioned very smoothly and saved money.
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Old Jan 5th 2016, 3:33 pm
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Default Re: That Obamacare thing

Originally Posted by username.exe View Post
So if the insurers are still getting the screw from Providers, they'll eventually revert to a 'Kaiser' like model where they run the kit and the kaboodle?
It will still take a while for the market to even itself out, you'd imagine.
Yes and then the insurers will merge into one and we can have single payer.

Originally Posted by Nutmegger View Post
It's obviously a case of your mileage may vary. This year, my OH was able to change to a newly offered ACA plan that gave him the same coverage as last year, but at a lesser cost. Dealing with the exchange while choosing and enrolling in the coverage has been the hard part; once enrolled his coverage has functioned very smoothly and saved money.
This is one of the things that is taking a while for people to realize. You can change your plan each year! Pre aca you took the one plan your work offered and didn't complain when it went up 10% each year. Now you have the freedom to switch insurer.
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Old Jan 5th 2016, 3:58 pm
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Default Re: That Obamacare thing

Originally Posted by sir_eccles View Post
Yes and then the insurers will merge into one and we can have single payer.



This is one of the things that is taking a while for people to realize. You can change your plan each year! Pre aca you took the one plan your work offered and didn't complain when it went up 10% each year. Now you have the freedom to switch insurer.
And you don't get dumped or become uninsurable if you have the audacity to get sick...
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Old Jan 5th 2016, 4:03 pm
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Default Re: That Obamacare thing

Originally Posted by Giantaxe View Post
And you don't get dumped or become uninsurable if you have the audacity to get sick...
Precisely. You can take a low premium/high deductible plan if you are in good health (and know you can cover the deductible if necessary); but if things change during the year, you can choose something more appropriate to your new circumstances next time around.
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