Uninsured fundies and Obamacare

[countressrascal]

I wanted to chime in here...don't know much about Obamacare, but I have plenty of experience with healthcare. I have lupus, and my daughter was born with a solitary kidney and had high grade reflux (surgically corrected, has autism, and endured many, many months of various therapies (OT, feeding, speech, etc). My husband left his last job almost exclusively because of the medical insurance--we could not afford the $1200 a month in premiums (for an 80/20 plan) for our employer sponsored insurance (through IBM). My daughter had surgery in Feb and the COPAY for her procedure was $6000. No one can afford that.

As far as Nationalized Health Care....I am all for it. I think Obamacare is stupid and just prolongs the inevitable. No one can afford the insane prices for medical care. Our current insurance does a "medical spending account" and deposits a chunk in at the beginning of the year. This forces us, as consumers, to spend our dollars more wisely. So every time someone in my family needs a test/procedure/specialist, I have to call around like I'm calling for a car repair quote, to make sure I'm getting the best deal. I think insurance companies LOVE this, because you're doing all the legwork for them, getting the best prices. In the end that saves them money, and I really think this is the future of healthcare...force it on the consumers to do the dirty work for you.

I also discovered that as someone who has a high deductible insurance plan, that pharmacies will charge you higher prices. I now use GoodRx for my generic meds, using my insurance I would be paying hundreds more.

Also as far as waiting---we all wait, even in the US. I took my kid to Urgent Care the other day (because her PCP does not take urgent appointments anymore) and waited 2 hours. When I wanted an appointment to see a lupus specialist, I waited 6 months. When my ped made a referral to have my son evaluated for autism, the place I called told me, "I don't know that we'll ever have an available appointment for you, but we'll be glad to put you on the waiting list...."

And don't even get me started on all the children's therapies that aren't covered by anyone. My kids went without OT and ST for years because I could not afford it.

It seems like the only people who have a positive view of America's health care system are the ones who rarely use it. Anyone who has battled cancer, or a chronic disease, or has a disabled child, knows our system sucks.

Everyone deserves affordable, high-quality healthcare.

Shaylahc-

I don't know how old your children are however here is a suggestion to either receive no cost or low cost OT and ST is your public school system. They have to provide it for students that require it. It is also true if your child is enrolled in HeadStart. Check those two things out. I would also call your State Department of Family and Children Services- your child has a congenital conditions they should also have those services to help you out. Yes you might have to travel and wait but as you know when you have a child with special needs that is the norm.

Hope this will help you.

[Stephanie66]

I have a question. I am getting married on Oct 26, so obviously I won't be eligible for Medicaid anymore. The original plan was I was going to just go on his company's insurance, but do I have the option to buy insurance through the exchanges if it is cheaper? (Not sure I can get a better deal, as he has very good insurance, just wondering.)

[thekate]

I have a question. I am getting married on Oct 26, so obviously I won't be eligible for Medicaid anymore. The original plan was I was going to just go on his company's insurance, but do I have the option to buy insurance through the exchanges if it is cheaper? (Not sure I can get a better deal, as he has very good insurance, just wondering.)

You can shop on the exchange, or just browse for comparison, but none of those plans will cover you until Jan 1, so you would need something in the meantime if you don't go on your husband's insurance.

Congratulations!

[Stephanie66]

You can shop on the exchange, or just browse for comparison, but none of those plans will cover you until Jan 1, so you would need something in the meantime if you don't go on your husband's insurance.

Congratulations!

Thanks! The main issue with going on his insurance is it raises the deductible and out of pocket maximums. However, doctor appointments and prescriptions don't count towards the deductible, so as long as we are both done having catastrophic health conditions, we should be fine. :)

[lizziesmom]

It seems like the only people who have a positive view of America's health care system are the ones who rarely use it. Anyone who has battled cancer, or a chronic disease, or has a disabled child, knows our system sucks.

Everyone deserves affordable, high-quality healthcare.

This, in a nutshell, says it all.

[shaylahc]

Shaylahc-

I don't know how old your children are however here is a suggestion to either receive no cost or low cost OT and ST is your public school system. They have to provide it for students that require it. It is also true if your child is enrolled in HeadStart. Check those two things out. I would also call your State Department of Family and Children Services- your child has a congenital conditions they should also have those services to help you out. Yes you might have to travel and wait but as you know when you have a child with special needs that is the norm.

Hope this will help you.

My children are older now (save for my son who is 9). You have to qualify to receive help through the school system. Your kids have to be a certain % delayed in order to qualify. My 14 year old (said daughter referenced above) was "graduated" from speech therapy (through the public school) at age 4 even though she was barely intelligible. When she got to elementary school I fought like crazy to get her speech therapy, only to find out she wasn't considered "disabled enough" to qualify. I have 1 kid with an IEP, 1 kid who needs a 504, and 1 kid who I need tested for LD. If there is anything that makes my head want to explode more than healthcare issues, it's dealing with the school system when your children have disabilities. But that is a thread for another day.

I remember when my 14 year old needed ST and our insurance company said they would only cover it if it was the result of an injury (brain damage). They don't cover developmental disabilities. Yes, there are a lot of plans in place for the severely disabled, but there are many kids who fall through the cracks because they don't qualify for assistance.

ETA in NC OT is only given as an "added" service. You can't qualify to just receive OT through the school system, it's only if you're getting services for other things (ST or PT) that you can get OT. Ask me how I know, I have 2 dyslexic/dysgraphic children.

ETA I do appreciate the thought!

[twinmama]

I looked up my guesses for my most vocal acquaintance about ACA. She has no insurance and is livid about having to buy insurance. Her grand cost looks to be about $280 a year and she'll have health insurance! She's livid about this imposition on her life. :angry-banghead: :cray-cray:

I wish I could tell that lady about the fucking insurance nightmare that happened to me. Pregnancy = pre existing condition, so I could not get better insurance. Babies came 11 weeks early with shit insurance. We make too much money to get any help, so we owe the hospital over $40,000 (which is great, considering the original bill was over $700,000). But we'll be paying for it until our 2 year olds are in college. NONE of that would have happened under ACA and we didn't do anything wrong. We had insurance, it was the only thing offered at my husband's work then and we could not afford a single private plan (there were 3 available in the county we lived in, the cheapest was $1500/month). We did nothing wrong, got caught in a few horrible loop holes and an unexpected medical emergency and we'll be paying for it the next 20+ years.

[CynicMom]

I have really excellent insurance. Really excellent. I'm all for Obamacare, but I think many others who also have excellent insurance are worried that their plans will get reduced. Some conservative friends are already posting fears on facebook of this very thing. I bet that's driving a LOT of the opposition.

The more fundamental reason is that Republicans need a rallying cry to swell them to victory in the next round of elections. Most of Obama's actions are big and complicated and hard to reduce to a slogan. Obamacare is catchy! Easy to remember! It's just like opposition to Hillarycare witch worked out well for the GOP. Why not try that again?

Edit: grammar

[WonderingInWA]

My children are older now (save for my son who is 9). You have to qualify to receive help through the school system. Your kids have to be a certain % delayed in order to qualify. My 14 year old (said daughter referenced above) was "graduated" from speech therapy (through the public school) at age 4 even though she was barely intelligible. When she got to elementary school I fought like crazy to get her speech therapy, only to find out she wasn't considered "disabled enough" to qualify. I have 1 kid with an IEP, 1 kid who needs a 504, and 1 kid who I need tested for LD. If there is anything that makes my head want to explode more than healthcare issues, it's dealing with the school system when your children have disabilities. But that is a thread for another day.

I remember when my 14 year old needed ST and our insurance company said they would only cover it if it was the result of an injury (brain damage). They don't cover developmental disabilities. Yes, there are a lot of plans in place for the severely disabled, but there are many kids who fall through the cracks because they don't qualify for assistance.

ETA in NC OT is only given as an "added" service. You can't qualify to just receive OT through the school system, it's only if you're getting services for other things (ST or PT) that you can get OT. Ask me how I know, I have 2 dyslexic/dysgraphic children.

ETA I do appreciate the thought!

Yep, this happened to my son, too. Our insurance wouldn't cover private speech therapy that we knew he needed from the time he was 3. So we waited until he was in kindergarten at the public school (actually had him tested by the speech therapist there 3 months prior to the beginning of school because the therapist was a friend of a friend). He didn't qualify for speech therapy (i.e. wasn't "disabled enough") until he was in 4th grade, and only then it's been 30 minutes a WEEK, which honestly doesn't help at all. He's in 6th grade now, and still talks like he's got marbles in his mouth. And he's got braces, so that doesn't help either. But at least he'll have straight teeth. And, ironically, insurance DOES pay for that! Sigh.

[Coconut Flan]

I'm so sorry twinmama.

This woman I was talking about had to have gallbladder surgery a couple of years ago. She who is so resistant to getting insurance had zero problem with the hospital writing off 95% or more of her charges. She was absolutely gleeful about it.

[Loveday]

I have really excellent insurance. Really excellent. I'm all for Obamacare, but I think many others who also have excellent insurance are worried that their plans will get reduced. Some conservative friends are already posting fears on facebook of this very thing. I bet that's driving a LOT of the opposition.

I have excellent insurance, too. I'm not worried about my plan being reduced, really, I'm just wondering if anything about it will change with ACA, if the cost will go up or down, if deductibles will change, that sort of thing. We're about to get our yearly info/enrollment packet, though, so I'll find out soon. :think: I'm kind of ashamed to admit I really know nothing about ACA at all, so reading some of the posts in this thread have been a start and a help.

[twinmama]

I'm so sorry twinmama.

This woman I was talking about had to have gallbladder surgery a couple of years ago. She who is so resistant to getting insurance had zero problem with the hospital writing off 95% or more of her charges. She was absolutely gleeful about it.

Thanks Abigail. It's infuriating to be in such a stupid predicament when we made no stupid decisions or bad choices. But we have two healthy kids so I try to focus on that, they're worth the $40k!

That woman reminds me of my aunt who is in her 60s and clearly on Medicare, yet is against all that government interference and help. I just want to tell her that I'd respect her opinions a lot more if they weren't so clearly hypocritical.

[mockingbird]

I have really excellent insurance. Really excellent. I'm all for Obamacare, but I think many others who also have excellent insurance are worried that their plans will get reduced. Some conservative friends are already posting fears on facebook of this very thing. I bet that's driving a LOT of the opposition.

I agree this is behind some people's worries/opposition. I know a very conservative woman on another board whose plan has already been changed for the worse and I do sympathize in a way, but at the same time she is very hateful (like, Lori-level hateful, I don't even read her posts most of the time because they are so mean) so that makes it hard for me to feel sorry for her. Also, I tend to think the good of other people being able to get insurance coverage outweighs the bad. I mean we'll see once it starts, but I think it's a good direction for our country to go.

I have great insurance too, but I think my family's insurance company already made a lot of the required changes last year, so I'm not sure what if anything will change on Oct. 1.

So funny, I remember I had to watch the 2008 presidential candidate debate for class and write up an opinion paper on who I agreed with. This was before Romney decided to be against the ACA because Obama/Democrats even though he implemented a very similar law - and his was my favorite healthcare plan!

[WonderingInWA]

Let the fun begin. I just went onto Live Chat on HeathCare.gov. I went through 3 or 4 exchanges with the agent who answered my call. At first she wanted me to call my own state's hotline, and then she answered a vital question wrong.

Sooooo, that's what we're dealing with there. The "helpful" agents are in place, but they aren't giving good answers or are ping-ponging us to someone else. NICE! I want that job!

ETA: And my question was pretty straightforward: How do I arrive at my "income" number in order to use the online calculators for ACA premiums? Since my only income is child support and alimony/spousal support, so I have to count both? Her answer was yes. Then I said "Even though child support isn't taxable income for me?", and then she said "oh, yes, you're probably right there". LOL. Ohhhhh boy.

[Mecca]

I have excellent insurance, too. I'm not worried about my plan being reduced, really, I'm just wondering if anything about it will change with ACA, if the cost will go up or down, if deductibles will change, that sort of thing. We're about to get our yearly info/enrollment packet, though, so I'll find out soon. :think: I'm kind of ashamed to admit I really know nothing about ACA at all, so reading some of the posts in this thread have been a start and a help.

I am currently on my husband's insurance. We just had the yearly benefits meeting last night. The first thing the H.R. rep said was "ObamaCare has drastically changed what we, [insert company name], can offer you." We have gone to a good insurance plan to an insanely high deductible Health Savings Plan that also has a high monthly premium. This new plan will now not cover a few meds of mine.

I do not know what to fully think just yet about our benefit changes, but I admit I am not buying their explanation. Even some of their powerpoints in the presentation had incorrect information listed. IMO, I think a lot of corporations are using "ObamaCare" as an excuse to dump coverage/benefits on their employees while finding inventive ways to avoid the penalties. "ObamaCare made us do it" kind of reasoning.

[Coconut Flan]

I agree it's excuse. ACA is not forcing anyone to reduce benefits. They are trying to take advantage of the situation.

[gravelmonkey]

That stinks. I know it's not the fault of the ACA, but "forced" reduction of benefits is just another straw on the camel's back of the workforce.

[lizziesmom]

There are too many people out there who will blame Obamacare for whatever. Two quick stories: A local business owner in my town told her employees that if Obama was reelected she would be forced to terminate some people because of Obamacare. Not only did she not terminate anyone when he was reelected, but she's opened a second title company office. BS.

My very conservative friend's son (21, one year of college) says he can't get a job because of Obamacare. I guess his lack of education, poor work history and attitude have nothing to do with it.

[salex]

I agree it's excuse. ACA is not forcing anyone to reduce benefits. They are trying to take advantage of the situation.

Well, as a person who is in a very small company that has always offered health insurance, the cost of our health insurance has increased as ~ 20 percent per year the last several, to the point we have not been giving raises, and finally moved to a policy we agree is not as good as we had before (higher deductible, etc) in return for the insurance company assuring us they won't increase rates more than 10% this year. Everyone insured in our company was in in the decision (it is a very small company) So, no we were not forced by the law to change our policy, but the price increases did in fact become unworkable. We hope always to offer insurance (no one in our company would qualify for any assistance in payments if we went to a personal exchange) but we will check out the small business exchanges when they come out next month (postponed).

[Mama Mia]

Well, as a person who is in a very small company that has always offered health insurance, the cost of our health insurance has increased as ~ 20 percent per year the last several, to the point we have not been giving raises, and finally moved to a policy we agree is not as good as we had before (higher deductible, etc) in return for the insurance company assuring us they won't increase rates more than 10% this year. Everyone insured in our company was in in the decision (it is a very small company) So, no we were not forced by the law to change our policy, but the price increases did in fact become unworkable. We hope always to offer insurance (no one in our company would qualify for any assistance in payments if we went to a personal exchange) but we will check out the small business exchanges when they come out next month (postponed).

But that isn't due to ACA, that's due to the insurance companies bleeding people to death to get as much income as possible so that even with being required to spend a certain percentage on actual healthcare , their bottom line profits would still be huge.

I think thre are some definite improvements with ACA, but would much rather they had gone for universal coverage similar to other industralized countries, instead of giving the insurance companies even more power.

[salex]

But that isn't due to ACA, that's due to the insurance companies bleeding people to death to get as much income as possible so that even with being required to spend a certain percentage on actual healthcare , their bottom line profits would still be huge.

I think thre are some definite improvements with ACA, but would much rather they had gone for universal coverage similar to other industralized countries, instead of giving the insurance companies even more power.

It is a result of ACA, both the way it was designed and they way it is being implemented. I agree, universal coverage/single payer would have been preferable, I think the long term goal from both sides of the aisle is to get to that, but that no /few politicians have the balls to say it publically --so making it more and more difficult for businesses to offer insurance (or give larger companies the excuse not to) and making the exchanges / individual options expensive and a PITA will make people ask for and eventually beg for single payer. But that is a while off . I feel there are many successful examples around the world that people could have picked from when designing ACA, but it feels more like they ignored the best practices and reinvented the wheel, or compiled a lot of poor practices into one big thing.

I am happy for those who can now get insurance, but I am not delighted that I now have the worst insurance I've had in 35 years.

[OkToBeTakei]

So basically the insurance companies still rule? :cry:

[thekate]

So basically the insurance companies still rule? :cry:

Yes. Obamacare is really private insurance regulation reform + individual mandate. It doesn't change anything on the healthcare delivery end.

[lilah]

They get a bill from the hospital. An astronomical bill. But if they don't pay, it's not like the hospital can come and repossess the medical care. The unpaid bills will get reported on the person's credit history and possibly also sold to third-party debt collectors. In some states, debt collectors (whether the hospital or a third party) can garnish a person's wages for unpaid debt. Medical debt is responsible for a lot of people declaring bankruptcy, too.

In the end, the hospital doesn't get paid. Sometimes, if the patient applies to the hospital's charity program, the hospital will greatly reduce the bill and allow the patient to pay in installments.

The hospital gets a write-off for the unpaid bills (even if an inflated amount was charged for this exact purpose), the person's credit takes a hit (but it might suck already), and the person may or may not pay some amount.

One wrinkle is that recently the federal government gave states the option of expanding Medicaid to healthy, low income adults. (Before that it applied only to low-income pregnant women, children, and some disabled people and to a small handful of super low-income healthy, non-pregnant adults.) The thing is, the states have to opt in. The federal government has agreed to pay the vast majority of the cost of expanding coverage (at least for a certain number of years; I don't recall the details). Many, many states, including mine, have refused to expand coverage. Because that would be, like, big government. So in many places it's still very hard for healthy but poor adults to get non-emergency health care.

(Someone correct me if I'm wrong on any of these points.)

what I keep telling people is that for every uninsured person who uses the er and doesn't pay the hospital has to eat the cost so the cost for insured people goes up. If we paid to insure everyone there would be more prevention and emergency visits would be covered.

[August]

The Washington Post has an article about the ACA (Obamacare, natch) today. I highly recommend it. The amounts cited were $400 a month AT MOST, and every single one of those people will get a subsidy making their insurance free to $100 a month.

I'm pretty sure the Bible had something to say about lying ($1500 a month, really?), but what do I know? I'm a Buddhist.

I doubt that figure very very very much. We currently pay $650 a month, and the employer kicks in $1300. Are they really saying it's going to drop to 20% of the previous price?

I have a lot of problems with Obamacare, but since they couldn't get a single payer tax-funded system through it is better than nothing.