$40 Per Month, that's why the GOP is afraid of a successful ACA

[vinny9698]

Among them was Sandy Calderon, a 24-year-old house painter who said she never has had health insurance.

"It's hard to live through your day hoping you don't get sick," said Ms. Calderon, who learned she might be able to buy a minimal plan for as little as $40 a month. Once she is covered, she said, "I think I'm going to feel very, very secure."

[gopiscrap]

1. Exactly

[leftstreet]

2. What's the deductible?

Is it the shitty bronze plan that requires you cover 40% of costs?

[johnd83]

3. I am guessing it is catastrophic

which is still not great, but if the person gets in a bad car accident the bill will be in the thousands rather than the hundreds of thousands...

[joeglow3]

4. So, instead of being bankrupt, they will be bankrupt?

Awesome!!!

[johnd83]

6. The extremely poor will be on medicaid

at least they were supposed to be. It would be a hardship but most people could pay off a few thousand over a few years.

[joeglow3]

8. 76% of Americans live paycheck to paycheck.

27% have ZERO savings. NOWHERE near that number qualify for Medicaid.

So, most likely, nothing has changed for her, except she gets to pay $40 a month.

[johnd83]

12. Medicare for all would be no better

Medicare doesn't cover everything. My parents have been going nuts because they are changing the medicare supplement plans which are almost as expensive as the exchange health plans. In a perfect world people would get free health care but it is not realistically going to happen.

[joeglow3]

17. Don't try to sell me a turd, even if you think single payer won't happen

[johnd83]

20. Maybe a personal story

but realistically the ACA is so much better than what was around before. I have had health problems and thankfully had insurance, but when I was a student my insurance was woefully inadequate. I had a $1200 RX limit. Those plans are now illegal (except for catastrophic plans). I couldn't even buy better insurance because of my age and pre-existing condition. I paid thousands out of pocket for medicine. Don't even try to tell me that this is somehow a worthless change. I had to forgo medicine because I couldn't afford it but could have under the new ACA plans. I was able to afford it last year when I got what is basically a platinum plan through my new job after graduating. If you think this is so awful, than F - you, some of us needed even this years ago.

[joeglow3]

21. You got yours, so fuck the millions who can't get theirs

To those millions, this is a turd that changed nothing for them, except lets them pay money for no change.

[johnd83]

23. Ok, let's talk about the 76% you spoke about

The vast majority ALREADY PAY FOR INSURANCE through through their company. In fact it is around 85% of americans.

So who is left:

-Part time workers
-Unemployed
-Small business employees

The only group there that won't qualify for medicaid is the small business employees. The rest will get medicaid. Did I get mine? Yeah, but there are millions of people who would fall into my situation. Do they count for nothing too? Is it not possible that millions of us will benefit?

[LukeFL]

54. Agree. Something is something

Yes, ACA needs fixing but in realist uh it benefits ain't of people that have been forgotten by the system

[pnwmom]

25. Many more people will now get benefits.

We still have to work on making it possible for 100%, but the ACA has gone a long way toward filling in the gaps.

[missingthebigdog]

27. And she gets free birth control. And a free annual exam. And free immunizations. . . .

ALL of the plans are required to provide preventative care/ screenings at NO cost.

And she gets peace of mind that if she does have a catastrophe, the blow will be limited- making payment arrangements for a several thousand dollar hospital bill beats being on the hook for tens of thousands of dollars any day.

I would WAY rather see single payer. But this is what we have, and is better than what we had.

[Benton D Struckcheon]

34. Minor point:

Prices for stuff covered by insurance are a lot less than if you are charged as an uninsured individual. That's because the insurance company generally makes deals with hospitals on what they can charge. So the savings from being insured vs not are very very big.

[duffyduff]

30. There are no cost controls on premiums.

I think people are going to be in for sticker shock when this thing finally settles.

Medicaid for older people is nothing but a loan with your estate for collateral.

[Ms. Toad]

35. Not correct.

Premiums are limited to cost of care provided + 10-15%. Millions have already been rebated during the past two years because the insurance companies charged more than they were permitted.

[Tarheel_Dem]

52. Thank You! I don't know why people on the left insist on mischaracterizing the benefits. It's not

as if there aren't tons of material out there debunking the myths & distortions.

[frazzled]

5. Yeah, and even a 24-year-old house painter can fall off a roof

or have an undetected heart problem that requires outrageously expensive surgery, or ... get pregnant.

Any single one of these things would be catastrophic, and even a relatively high deductible plan could save tens of thousands of dollars in a single incident. This young woman understands what "security" means. Too bad some here still do not.

[joeglow3]

7. Secure if she has tens of thousands of dollars in savings

which most do not. Bankrupt is bankrupt. So, nothing has really changed for her, except she gets to pay $40 a month. GREAT!!!

[johnd83]

9. Medicaid...

[joeglow3]

10. Not even close

http://www.democraticunderground.com/?com=view_post&forum=1002&pid=3768958

[JDPriestly]

32. If she doesn't qualify for Medicaid, she might be able to qualify for a subsidy for a better plan.

Or she might be able to cut some of her expenses. Say, drop cable TV or live without a cell phone. That would be better than having lousy insurance. It is a matter of values.

If she already cannot afford cable TV or a cell phone, she should qualify for assistance to pay for a good medical insurance plan.

$40 -- how many lunches do you carry instead of eating fast food carry-out?

That's how we used to live. It's just some sort of idea people have now-a-days that they need all these gadgets and fast food, etc. but don't need to have health care insurance.

I bet she buys insurance for her car.

[frazzled]

14. You're so wrong on this ... but be my guest

Don't buy yourself insurance. I really don't care. Most people, including this smart young woman, are thankful to have the chance to purchase it.

[joeglow3]

18. And the insurance companies are thankful to have the chance to sell it

And let her pay $10,000 a year in deductibles. Reality will set in on her soon enough.

[frazzled]

22. Wrong again

First, with that catastrophic plan (only for people under age 30) she gets 3 primary care visits plus any preventive services per year for free before any deductible kicks in. And the most she would ever have to pay, even if she incurs $250,000 in bills for a year, is $6,350.

So, if she got pregnant in California (I don't know where she lives, I'm just saying), and needs a Caesarean section to deliver the baby, she will only have to pay $6,350 of the average $38,590 it costs. And the damned guy who got her pregnant should pay for at least half of that.

If she breaks her back and becomes a quadriplegic and needs to be in a nursing home for a year ... count the cost into the hundreds of thousands. (Of course, she'll become eligible for Medicaid, for free, because she'll be unable to work.)

There are a thousand things that can happen. Hopefully, none will.

[duffyduff]

31. Nobody can afford the "bronze" plan which is junk.

The insurance industry that wrote the law made sure they would force most people into junk bronze plans. More money for them, less money and lousy care for YOU.

The "best" plan, the platinum, is unaffordable, too.

ACA is nothing but corporate welfare.

[missingthebigdog]

37. Some people cannot afford the Bronze plan- or any plan. but for others:

Let's think this through.

My 25 year old son has a "pre-existing" condition- he was born with one kidney. This condition has not caused him any significant problem that typical people don't have, but it made health insurance really expensive. $1300.00 per month expensive. With exclusions for preexisting conditions. And a $2000.00 deductible, 20% co-pay.

So, in a year when he didn't need any care, he would be out $15,600 in premiums alone. If he needed care, and it wasn't kidney related, he would also be out the full cost of the care, up to $2000.00, plus 20% of costs over the $2000.00.

So, for a $25,000 hospital bill, he would be out of pocket $6,600.00, plus the premium. Total yearly cost: $22,200.00

Now, he can get a plan for $80.00 per month. If he doesn't use it, that is $960.00 per year- a savings of over $14,000.00. And he gets flu shots and some preventative care at no cost.

If he does need to use it, there is a $1000.00 deductible. On the bronze plan, he then has a 40% co-pay. The same $25,000.00 hospital bill would be $6,350.00- the maximum out of pocket cost on an ACA plan. Total yearly cost: $7310.00

Still a lot of money, but manageable debt. And that figure still holds if the bills are $250,000.00 instead of $25,000.00. Still just $7310.00.

This plan isn't all it could be. But it is a lot more than we had.

[Ms. Toad]

43. The bronze plan (catastrophic coverage) is a smart plan for some people

I used catastrophic coverage plans for about 5 years when the only other coverage available to me cost $1,500+/month. Those plans gave me the option to stop the hemorrhaging if a catastrophe happened (and one of those years it did).

As to whether it is a junk plan, it isn't. If I was young and healthy and could afford a little beyond the premium each month (but not as much as the bump up to a Silver plan), I would likely choose a bronze plan and bank the difference in premiums until my HSA reached the size of the deductible - and assuming I remained in good health, only replenish it after that as I used it.

That is not to say that everyone can afford to put money in an HSA (which is how the Bronze plan is intended to be used), but that it is a good option for those who can and don't want to buy insurance they don't believe they need.

It also is, at least, a stop gap if nothing else is available (which is how I used it during the years I had that kind of plan).

I'm glad they did not remove that option and force everyone into a regular plan - and that they improved it so even people with catastrophic coverage can check in with a doctor short of using the ER. Different situations call for different coverage, and the bronze plan creates that flexibility.

[kestrel91316]

11. I'm getting the shitty silver plan and my premiums will be under $50. $500 deductible,

$2750 out-of-pocket cap.

It's horrible, I know.

I should have gone with the fancy medical professional's group plan that I was on ($500/mo plus $5000 or $7500 deductible - I forget - and a $10k out-of-pocket cap plus zero coverage of any prevention or meds or anything until the limits were met) - until I simply couldn't afford to have insurance AND see a doctor occasionally anymore.

[johnd83]

13. Yeah I don't get the animosity either

Are these things perfect? No. Are we going to get anything better? Doubtful, so we need to fight to keep at least this much...

[Whisp]

15. I do

[kestrel91316]

16. I happen to think that we WILL get something better down the road.

Will I live long enough to see it? I'm not sure. But I will keep pushing for improvements as long as I live.

[johnd83]

19. I am *not* saying don't work toward something better

Last edited Wed Oct 2, 2013, 05:49 PM - Edit history (2)

but realistically the ACA is so much better than what was around before. I have had health problems and thankfully had insurance, but when I was a student my insurance was woefully inadequate. I had a $1200 RX limit. Those plans are now illegal (except for catastrophic plans). I couldn't even buy better insurance because of my age and pre-existing condition. I paid thousands out of pocket for medicine. Don't even try to tell me that this is somehow a worthless change.

Edit: Woops, missed a double negative...

[kestrel91316]

24. I'm not saying that at all. I am a huge fan of ACA. The subsidies will allow me to have medical

insurance again for the first time in years, since I got priced out in spite of being healthy as a horse.

I have avoided doctors for 6 or 7 years for fear of winding up with the dreaded pre-existing condition like mild hypertension or a breast lump and then being completely screwed for life and losing my practice (my only asset) in bankruptcy. This Great Recession has been hell on my client base, and by extension me. ACA can't come fast enough for me. I'm almost 57.

[Yo_Mama]

28. Yeah, only in the US do people avoid going to the doctor for problems

because they are afraid that if they are diagnosed they will never get insurance again, and thus be unable to ever treat them!

ACA will end this lunacy for many. As our system was, no one was really insured. You were just insured while you could pay the premiums - but if you got sick and couldn't work you couldn't pay for your insurance any more, so no dice.

[johnd83]

40. I had a typo in my last post...

of course we can work toward something better in the future...

[Bluenorthwest]

36. You typed the exact same words once in this thread already....

I cut and pasted this from upthread
" I have had health problems and thankfully had insurance, but when I was a student my insurance was woefully inadequate. I had a $1200 RX limit. Those plans are now illegal (except for catastrophic plans). I couldn't even buy better insurance because of my age and pre-existing condition. I paid thousands out of pocket for medicine. Don't even try to tell me that this is somehow a worthless change."

I find that to be kind of creepy.

[johnd83]

38. I was responding to another cut and paste response nt

[maxsolomon]

57. My work insurance has a $1000 deductable.

And the out-of-pocket cap is higher, too.

[cbdo2007]

26. Still probably less than she would pay under Universal Health Care....

so what's the big deal?

Some of you will just hate on everything.

[SoCalDem]

51. the "shitty bronze plan" still beats hanging around the ER for 6 hours

and then ducking collection calls because you owe 100% of the most expensive treatment going...


and it will allow poorer folks to ease their way into medical care they have gone without for a long time....and maybe 40% is better than 100% to them.

[LukeFL]

29. What happens to us in Florida?

Our state is not enrolled in the exchanged like Kentucky and California are.

Do we get to enroll in the marketplace of the ACA?

[johnd83]

33. Yes, healthcare.gov nt

[lunatica]

39. You can enroll in the Federal exchanges.

[LukeFL]

44. Will the rates be higher because slick Scott

Didn't enroll the state? My question is, will we be punished?

[lunatica]

45. No, no one will be punished

For the states who refused to start their own exchanges the Federal exchanges are there for the people to enroll themselves in. They are the same for everyone. You don't have to pay a penalty or make due with less because the governor in your state is a stupid ass.

Google Federal exchanges and it'll take you there.

I imagine that they're good for people who move around a lot too.

[MH1]

46. Except for the Medicaid "donut hole" in states that didn't expand Medicaid.

In those states, there is now a gap between the income level where one becomes ineligible for Medicaid, and the level where the ACA subsidy kicks in. If I understand it correctly. So someone who is just barely ineligible for Medicaid, will still be priced out of insurance because they won't get an ACA subsidy - they were supposed to be covered by the Medicaid expansion.

Of course we know what party the governors of those states come from.

[B Calm]

41. The GOP knows they are on the wrong side of history

[Rex]

42. YES! While their loony leader read Green Eggs and Ham

Obama enforced a law to give everyone a chance at obtaining healthcare! Say goodbye to the GOP for a few election cycles. Hell, make it forever.

[MH1]

47. That's what some liberals were crowing after the 2008 election. How's that working out?

"Say goodbye to the GOP for a few election cycles. "

Then in 2010, we not only lost the House, we lost the state houses and control of redistricting. Now it is much easier for most Republicans to be re-elected than most Democrats - because the Republicans designed it that way by gerrymandering. Dems got a lot more votes (a million? millions?) in 2012 for House seats, but the Republicans still hold the House (and claim the American people chose them).

My point is just, don't be like the football team ( *cough* Eagles *cough* ) who kicks ass the first half of the game, then slacks off for the rest of the game and wonders why they lose the game.

[Rex]

48. You mad bro?

[MH1]

49. Of course I am, about what's going on now because the loonies are running Congress.

Aren't you?

[LukeFL]

50. You are right. We liberals have our own

Utopia and dreaming or being dreamers is one if them.

You are right. How the hell will we compete against them in 14?

[Niceguy1]

58. by dropping the meme

Of millions nore votes for the house. The races are by district , not by nation wide counts of district votes. That way of thinking is self defeating....we need to make every district a priority.

[secund2nun]

53. single payer needed

While I am not a big fan of this I won't mind it if it leads to a single payer system. Plus I do like the fact that it makes costs very low for the lower class...but I don't like the idea of having to buy insurance.

We really need single payer.

[gopiscrap]

55. Welcome to DU

[gopiscrap]

56. Absolutely, I totally agree with you.