Obamacare

[katmondoo]

My daughter called Humana to ask about Obamacare. They told her they will have to offer more services but in turn it will raise her costs much higher. She is ranting and raving about people on food stamps and those who will have free medical while she works as a grocery store clerk and will now be making less because she has to pay higher premiums. Does anyone know if this is true. I thought they had to give the people more services because they make too much in profits. My understanding was it would cost less or the same with more coverage.

[datasuspect]

1. what do you expect from republican legislation?

maybe we should all just start wearing turkeys on our feet.

[Melinda]

2. Grandfathered plans under ACA:

Under the ACA, grandfathered plans:

Cannot Significantly Cut or Reduce Benefits. For example, if a plan decides to no longer cover care for people with diabetes, cystic fibrosis or HIV/AIDS.

Cannot Raise Co-Insurance Charges. Typically, co-insurance requires a patient to pay a fixed percentage of a charge (for example, 20% of a hospital bill). Grandfathered plans cannot increase this percentage.

Cannot Significantly Raise Co-Payment Charges. Frequently, plans require patients to pay a fixed-dollar amount for doctor’s office visits and other services. Compared with the copayments in effect on March 23, 2010, grandfathered plans will be able to increase those co-pays by no more than the greater of $5 (adjusted annually for medical inflation) or a percentage equal to medical inflation plus 15 percentage points. For example, if a plan raises its copayment from $30 to $50 over the next 2 years, it will lose its grandfathered status.

Cannot Significantly Raise Deductibles. Many plans require patients to pay the first bills they receive each year (for example, the first $500, $1,000, or $1,500 a year). Compared with the deductible required as of March 23, 2010, grandfathered plans can only increase these deductibles by a percentage equal to medical inflation plus 15 percentage points. In recent years, medical costs have risen an average of 4-to-5% so this formula would allow deductibles to go up, for example, by 19-20% between 2010 and 2011, or by 23-25% between 2010 and 2012. For a family with a $1,000 annual deductible, this would mean if they had a hike of $190 or $200 from 2010 to 2011, their plan could then increase the deductible again by another $50 the following year.

http://www.healthcare.gov/news/factsheets/2010/06/keeping-the-health-plan-you-have-grandfathered.html

Of course she can always drop Humana and find what best works for her at the Health Insurance Marketplace:

http://www.healthcare.gov/law/information-for-you/individuals.html

[riqster]

3. What state?

I wouldn't take Humana'a word for it, she should go to the links above, or check the state website if they are setting up exchanges.

[EC]

4. Subsidies..

She'll likely qualify. I can't wait for it to take effect, so I'll have better insurance. What I have now is a joke and will have to change once the ACA takes effect. She likely would have had cut hours or no job if it weren't for food stamps by the way.

[Tarheel_Dem]

5. Where does she live? Some good info in this thread except, predictably, response #1.

Obamacare Gets Some Good News From California

—By Kevin Drum

| Fri May. 24, 2013 7:56 AM PDT

A few days ago I mentioned some good news out of Oregon: competition among health insurers was forcing down the price of coverage on the state's new Obamacare exchanges. Yesterday we got more good news from a much bigger state: mine. Wonkbook has the deets:


In 2009, the Congressional Budget Office predicted that a medium-level "silver" plan — which covers 70 percent of a beneficiary's expected health costs — on the California health exchange would cost $5,200 annually. More recently, a report from the consulting firm Milliman predicted it would carry a $450 monthly premium. Yesterday, we got the real numbers. And they're lower than anyone thought.



As always, Sarah Kliff has the details. The California exchange will have 13 insurance options, and the heavy competition appears to be driving down prices. The most affordable silver-level plan is charging $276-a-month. The second-most affordable plan is charging $294. And all this is before subsidies. Someone making twice the poverty line, say, will only pay $104-a-month.

Sparer plans are even cheaper. A young person buying the cheapest "bronze"-level plan will pay $172 — and that, again, is before any subsidies.

http://www.motherjones.com/kevin-drum/2013/05/obamacare-gets-some-good-news-california