Obamacare Premiums

[Proud Tiger 4,261]

A lot has been discussed here about Obamacare.......plusses and minuses. One of the negatives was that premiums were going to go up beyond what they ordinarily would. I'm curious how that has been the case for folks here if anyone wants to share. Any additional comments on how you like it is also welcome.

[Farmer Brown 2,391]

I had to cancel my insurance. It went up to $1400.00, from $450.00. I make too much money for a subsidy and I file taxes on less than $30,000. I had surgery 14 months ago. The bill was, roughly, $30,000. I negotiated cash discounts and paid about $10,000. I hate Obamacare. It was rammed down our throats without a bi-partisan effort. That is why I say, to heck with the socialists. Just do what you need to do in Congress without their support. All they are going to do, is oppose Trump and all Republicans. To quote the last illustrious speaker of the house, during the first Obama term, “We have to pass the bill so that you can find out what is in it, away from the fog of the controversy.” Oh, they really cared what the majority of American citizens wanted. They created a unsustainable mess.

[homersapien 11,354]

Trump promised affordable health care insurance for all.

Still waiting.

[Brad_ATX 13,654]

11 hours ago, Farmer Brown said:

I had to cancel my insurance. It went up to $1400.00, from $450.00. I make too much money for a subsidy and I file taxes on less than $30,000. I had surgery 14 months ago. The bill was, roughly, $30,000. I negotiated cash discounts and paid about $10,000. I hate Obamacare. It was rammed down our throats without a bi-partisan effort. That is why I say, to heck with the socialists. Just do what you need to do in Congress without their support. All they are going to do, is oppose Trump and all Republicans. To quote the last illustrious speaker of the house, during the first Obama term, “We have to pass the bill so that you can find out what is in it, away from the fog of the controversy.” Oh, they really cared what the majority of American citizens wanted. They created a unsustainable mess.

This same thing just happened with the tax cut bill by Republicans.  Democrats don't hold a monopoly on ramming through legislation.  And remember, Dems still took over a year of committees and negotiating before passing with the regular 60 vote threshold in the Senate. Republicans used an obscure rule to pass the tax cuts with 51 in the Senate and despite a larger percentage of the public being against the bill.  And they passed major legislation that will have long lasting effects in just seven weeks, which is not a compliment.  Basically, you have zero moral high ground to stand on here.

As for Proud's question, yes, our premiums increased some.  However, in my situation, Obamacare is saving me money.  My wife has conditions that without this law, she would be denied insurance by almost every company.  Rarely is there a year where we don't meet out of pocket max's for her.  Without the rules in place by Obama care, we would be nearly bankrupt.

[Proud Tiger 4,261]

12 minutes ago, Brad_ATX said:

 

As for Proud's question, yes, our premiums increased some.  However, in my situation, Obamacare is saving me money.  My wife has conditions that without this law, she would be denied insurance by almost every company.  Rarely is there a year where we don't meet out of pocket max's for her.  Without the rules in place by Obama care, we would be nearly bankrupt.

Thanks for your response. I'm not looking for partial political response, just honestly want to see how it is working in a sample of people. Of course some here are capable of an intelligent response. Glad to see Obamacare is helping in your case and hope your wife's condition is successfully taken care of.

[4AUsince62 10]

Yes, my insurance went up but it has been rising astronomically for the past 10 years. I paid less a year for BCBS then, than I do a month now for United. Our HR department actually told us we wouldn’t see a huge increase due to the ACA because they anticipated it and did it the year before.  Hate them or not, insurance companies are in business to make money. Until health care cost are brought down nothing will change that. I will add this though, talk to your doctor and see what they think about it. I’m sure some like it but I haven’t spoken to one yet that does. Our company doctor actually “retired” to here because of the ACA; too much red tape. He and his nurse practitioner make more working 20 hours a week here than he would have made under the ACA. They were well respected and thought of too. There are good things about it for sure but way too many issues for most in my opinion.

[Proud Tiger 4,261]

2 hours ago, 4AUsince62 said:

Yes, my insurance went up but it has been rising astronomically for the past 10 years. I paid less a year for BCBS then, than I do a month now for United. Our HR department actually told us we wouldn’t see a huge increase due to the ACA because they anticipated it and did it the year before.  Hate them or not, insurance companies are in business to make money. Until health care cost are brought down nothing will change that. I will add this though, talk to your doctor and see what they think about it. I’m sure some like it but I haven’t spoken to one yet that does. Our company doctor actually “retired” to here because of the ACA; too much red tape. He and his nurse practitioner make more working 20 hours a week here than he would have made under the ACA. They were well respected and thought of too. There are good things about it for sure but way too many issues for most in my opinion.

All my doctors hate it too.

 

[bigbird 60,368]

4 hours ago, Brad_ATX said:

 My wife has conditions that without this law, she would be denied insurance by almost every company.  Rarely is there a year where we don't meet out of pocket max's for her.  Without the rules in place by Obama care, we would be nearly bankrupt.

Same with my son and our family. While I didn't like the everything with it, the pre-existing condition and life time Max parts have allowed my family to survive financially.

[Proud Tiger 4,261]

1 hour ago, bigbird said:

Same with my son and our family. While I didn't like the everything with it, the pre-existing condition and life time Max parts have allowed my family to survive financially.

Is it cheaper than what you had or could get on your own.?

[bigbird 60,368]

1 minute ago, Proud Tiger said:

Is it cheaper than what you had or could get on your own.?

We spend 1 to 2 million a month on his medicine. Before Obamacare, we could not get private insurance. I had to take jobs that paid little enough to keep him on Medicaid. Since then, my premiums for the insurance through the schools I've been at have gone up tremendously, but I am able to have him covered.  Because of the ability to have him in my insurance I have been able to take much higher paying jobs as well as my wife being able to go back to work.  Good thing is we meet the family out of pocket max by the 2nd week of January. 

[Brad_ATX 13,654]

1 hour ago, bigbird said:

We spend 1 to 2 million a month on his medicine. Before Obamacare, we could not get private insurance. I had to take jobs that paid little enough to keep him on Medicaid. Since then, my premiums for the insurance through the schools I've been at have gone up tremendously, but I am able to have him covered.  Because of the ability to have him in my insurance I have been able to take much higher paying jobs as well as my wife being able to go back to work.  Good thing is we meet the family out of pocket max by the 2nd week of January. 

To be clear, my like was for the explanation, not the situation.  Hope you continue to find treatments for your son Bird and best wishes.

[bigbird 60,368]

52 minutes ago, Brad_ATX said:

To be clear, my like was for the explanation, not the situation.  Hope you continue to find treatments for your son Bird and best wishes.

 Thank you. No explanation necessary.   

[alexava 6,973]

Like others, my out of pocket increased more the two years beforehand and a little after it passed. But my increases have been very manageable. Most people I work with have children 18-26 and love the peace of mind of covering their kids. I know several people like Farmer Brown who are self employed or retired but under 65 who are KILLED BY THE PREMIUMS. That is the part that has to be fixed.  You can't call it affordable care act when it makes it less affordable. But Trump campaigned on making it " great for EVERYONE " then admitted he had no idea what he was talking about.. Insurance companies made record profits last year , like up 50% from normal. We need to cut them out of the equation..

[AUDub 11,131]

11 minutes ago, alexava said:

Like others, my out of pocket increased more the two years beforehand and a little after it passed. But my increases have been very manageable. Most people I work with have children 18-26 and love the peace of mind of covering their kids. I know several people like Farmer Brown who are self employed or retired but under 65 who are KILLED BY THE PREMIUMS. That is the part that has to be fixed.  You can't call it affordable care act when it makes it less affordable. But Trump campaigned on making it " great for EVERYONE " then admitted he had no idea what he was talking about.. Insurance companies made record profits last year , like up 50% from normal. We need to cut them out of the equation..

Hey, my wife works for one of those insurance companies! ?

(but you’re correct)

[alexava 6,973]

29 minutes ago, AUDub said:

Hey, my wife works for one of those insurance companies! ?

(but you’re correct)

I know that feeling. My wife works for a defense contractor (HR). Trump is good for that business and this company does real, needed work.But,  I also think we spend too much on defense. 

[DKW 86 7,411]

Two-edged Sword:

1) It has cost me my plan (if you like your plan you can keep your plan). That was a bald-faced lie. Truth be known, it is why the Dems lost 1200 seats and Cheeto is president.

2) Losing my plan cost me my doctor, much higher premiums, and much much higher out of pocket costs that went thru the roof. My surgery last year cost Kim and I  $8K or so out of pocket. Before 2010,  i would have been out less than $500 hospital, doctor visits, prescriptions and all. I work with people that are living in pain because they have to put off surgeries, knee and hip replacements, back surgeries until they can afford to have the surgeries. This is sometimes a 2-3 year process.To get by, doctors were giving opioids. Now they cant anymore. It is costing real people real pain for real amounts of time and NO ONE GIVES A DAMN ABOUT THESE HARD WORKING MIDDLE-CLASS PEOPLE. THEY ARE CALLED DEPLORABLES by the Elites in the US.

3) OTOH, My Friends and Family have benefitted mightily from the ACA. Pre-existing and Lifetime are HUGE PLUSSES. Carrying a child to age 26, HUGE PLUS! The Cost for Affordable Premium Care was put where the average Alabama Worker could get it with subsidies. People I Know and Love benefitted big time from it all. People that had little to no insurance benefitted big time from it. 

4) Why it could not have been a Legislative WIN-WIN is a mystery. But for some of us, we got screwed, blewed, and tattooed with the lies while others benefitted big time.

5) All that said, we need Medicare for all. Get it over with.

[Grumps 3,693]

I absolutely think that if properly regulated, then the private sector could provide better and less expensive medical care than could the government. However, there is NO WAY that healthcare, the way that is it currently run, can be regulated to get the free market back into control. For that reason, I agree with DKW that Medicare for all is inevitable, so let's just rip off the Band-aid quickly and move forward.

Our government is so corrupt that they keep telling us that insurance reform is what we need when what we need is healthcare cost reduction. EVERYONE knows this and yet we keep on talking about insurance.

[Brad_ATX 13,654]

1 minute ago, Grumps said:

I absolutely think that if properly regulated, then the private sector could provide better and less expensive medical care than could the government. However, there is NO WAY that healthcare, the way that is it currently run, can be regulated to get the free market back into control. For that reason, I agree with DKW that Medicare for all is inevitable, so let's just rip off the Band-aid quickly and move forward.

Our government is so corrupt that they keep telling us that insurance reform is what we need when what we need is healthcare cost reduction. EVERYONE knows this and yet we keep on talking about insurance.

100% spot on in many ways.  There is no reason a piece of cotton gauze should cost $100 during a hospital stay.  And yes, I've seen this on a bill for my wife before.  It's disgusting.

[Grumps 3,693]

7 minutes ago, Brad_ATX said:

100% spot on in many ways.  There is no reason a piece of cotton gauze should cost $100 during a hospital stay.  And yes, I've seen this on a bill for my wife before.  It's disgusting.

So do you think that reason that our government doesn't try to fix it is just because they are owned by the insurance companies and drug companies and hospitals and long-term care facilities? Or do you think it is for another reason?

[homersapien 11,354]

53 minutes ago, Grumps said:

I absolutely think that if properly regulated, then the private sector could provide better and less expensive medical care than could the government. However, there is NO WAY that healthcare, the way that is it currently run, can be regulated to get the free market back into control. For that reason, I agree with DKW that Medicare for all is inevitable, so let's just rip off the Band-aid quickly and move forward.

Our government is so corrupt that they keep telling us that insurance reform is what we need when what we need is healthcare cost reduction. EVERYONE knows this and yet we keep on talking about insurance.

It sort of depends on what you mean by "private sector".  It seems to me that any "proper regulation" would necessarily have to be organized - if not defined - by the government.  

In other words, the insurance companies cannot be trusted to operate a system that is optimized for the public good instead of their profit, by definition. 

Now if by "private sector" you mean for example, an independent council or group with a public commission to set policy, that would be feasible.  But that would be just a different form of "government".   As I recall, Denmark approximates such a system.

You still have the issues associated with free market profitability, such as marketing and profit margins.  Going by medical loss ratios (MLO), the insurance companies have an inherent built-in cost penalty of about 15-20%

I would just like happy to see more acknowledgment of basic principles that ultimately determine the cost of medical insurance, for example, like universal (mandatory) participation. 

The notion that Obamacare had it wrong by trying to mandate participation was itself fundamentally wrong.

[homersapien 11,354]

1 hour ago, Brad_ATX said:

100% spot on in many ways.  There is no reason a piece of cotton gauze should cost $100 during a hospital stay.  And yes, I've seen this on a bill for my wife before.  It's disgusting.

That has more to do with hospitals gaming the system to cover their losses from uninsured patients.

[homersapien 11,354]

58 minutes ago, Grumps said:

So do you think that reason that our government doesn't try to fix it is just because they are owned by the insurance companies and drug companies and hospitals and long-term care facilities? Or do you think it is for another reason?

Assuming you don't mind if I weigh in, the short answer is "yes".

One of the fundamental paradoxes we would rather deny is that we are apparently unwilling as a society to allow service providers to simply let the uninsured "die on the sidewalk" (so to speak).  

Such basic question of what sort of society we want must ultimately be addressed politically, but our politicians have no stomach for it, especially if it's going to piss off major campaign contributers.

 

[Proud Tiger 4,261]

2 hours ago, Brad_ATX said:

100% spot on in many ways.  There is no reason a piece of cotton gauze should cost $100 during a hospital stay.  And yes, I've seen this on a bill for my wife before.  It's disgusting.

You should go to the hospital and complain. I did once and told them I was going to call my insurance about it. They managed to reduce the bill significantly

[Brad_ATX 13,654]

2 hours ago, Grumps said:

So do you think that reason that our government doesn't try to fix it is just because they are owned by the insurance companies and drug companies and hospitals and long-term care facilities? Or do you think it is for another reason?

The high cost of products is largely due to hospitals overcharging people who can pay to cover for those who can't.  I get that, but it's still wrong.  As for government, I think you have two very polarized sides trying to have this discussion.  One would likely welcome a single payer system, while the other is vehemently against it.  The problem is if that some kind of long term bi-partisan solution isn't found soon, the healthcare market will continue to be volatile and we, the consumer, will continue to take the brunt of political gamesmanship.

[Proud Tiger 4,261]

26 minutes ago, Brad_ATX said:

The high cost of products is largely due to hospitals overcharging people who can pay to cover for those who can't.  I get that, but it's still wrong.  As for government, I think you have two very polarized sides trying to have this discussion.  One would likely welcome a single payer system, while the other is vehemently against it.  The problem is if that some kind of long term bi-partisan solution isn't found soon, the healthcare market will continue to be volatile and we, the consumer, will continue to take the brunt of political gamesmanship.

I agree but in almost all cases the private sector can do things better than the gov't. Getting the gov't out of health care is the first step in any approach with a chance to succeed. And as immigration grows, the number of people getting free health care will grow so that problem has to be solved as well.

If the gov't does insist on control of health care, why don't they just give everyone the same health care insurance Congress and gov't retirees have? I say that at the same time as I note I am a gov't retiree. My monthly rate actually went down this year.