Obamacare's Unlikely Winners

[TomCADem]

Source: National Journal

Sue Spanke of Missoula, Mont., was highly displeased this fall when she learned her health insurance had been canceled.

"I got so mad that I went to my phone and started calling all the political people and giving them what for," Spanke told The Billings Gazette. That was before she learned she was eligible for a policy at a much lower cost.

After angrily calling her state auditor's office, Spanke, a self-employed artist in her 50s, found she was eligible for a federal subsidy. Her new insurance will cover her for a mere $30 to $40 a month with a deductible of only $500. She had been paying $350 a month for a Blue Cross policy with a $5,000 deductible. "I went from a horrible policy that didn't cover anything, that was breaking me, to the best policy at the best price I've had since I was in my 20s," she said.

With the website largely fixed, one of the last lines of attack against Obamacare is that the president lied when he said if people like their insurance plans, they can keep them. The White House is hoping stories like Spanke's will inoculate them against those arguments. And the positive stories abound.


Read more: http://www.nationaljournal.com/politics/obamacare-s-unlikely-winners-20131217

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The MSM is largely refusing to follow-up on their stories of people getting their insurance cancelled as the celebrate President Obama's "Lie of the Year." Yet, here is a surprising story that actually follows-up on some of these cancellation stories.

[Liberty Belle]

1. I supported Obamacare but I got screwed.

I know it helped many people including friends of mine. But my policy was cancelled. I'm in CA which decided NOT to let people keep their plans another year.

I can't qualify for subsidies and couldn't afford anything in the Obamacare because my income was a bit too high. So I'm stuck paying over $100 more a month for a lousy policy with a much higher deductible and higher copays with a company with terrible reviews,, and when they are forced to be ACA compliant in January the rates get jacked up another 5%. I already had my rates TRIPLED to get any coverage at all last year, so this is horrible. I can't afford it, but can't afford no coverage either. I'm 55 and wish they'd just let me go on Medicare early. This is terrible.

I should add I was on Aetna with a great plan. They pulled out of CA due to Obamacare. Then I was on Blue Shield, a better policy at slightly more. They cancelled me with no notice, too this month and I'm stuck now with CIGNA which had bad reviews. I have no other options. I am paying $550 or so a month now for ONE PERSON and it goes up 5% more in January.

How is this "reform?"??????? I head a nonprofit, earned only $8,000 a year last year but becaause of my husband's income I cna't qualify for anything. His income goes 100% for our mortgage, 2 car payments, utilities, food, property taxes, insurance for homes and cars, and virtually nothing else. We're in CA where cost of living is high, hihgest utilities in the nation. Damn, this is NOT what I voted for!

[waronxmas]

2. My Brain Hurts

Am I alone in being really confused by this story? First you don't qualify because you earn too much and are purchasing a plan for one adult (you) alone. Then you're the head of a nonprofit making only $8000 a year who's husband pays all the bills. Why aren't you on his plan? Why are you all on your lonesome? Why don't you get rid of one of your cars? Nah, I'm just going to stick with this post as being from Crazytown, CA.

[kelliekat44]

3. You are not alone. Just too many holes... nt

[Amonester]

4. Answer: No. You're not alone. Add me on the list.

These exact same questions arose as soon as I reached the rich-hubby part.

Hubby hates wife???

[Liberty Belle]

32. What a disgusting thing to say.

Hubby loves wife which is why he wants me to have better healthcare than the terrible policy at his office, on a bad HMO where I sued a doctor for malpractice. He still has the bad plan because hes fairly healthy and we can't afford for us both to buy private insurance, but I've had a few health issues and nearly died twice due to HMO doctors' incompetence. When he changed jobs he promised me he'd help me buy decent insurance, since his old firm had good insurance and new one doesn't.

And I am totally resentful of people here who seem to think a person should have to sell a house or car to get insurance -- it should NOT be that way in America.

[SoapBox]

5. No...you are not alone.

I thought the same but waited to see what others had to say.

Now mind you, I'm no expert BUT I think we would need a LOT more specific details before casting off the ACA altogether. I'm sure that there are going to be issues for some but I think that the first reply needs to seek out professional assistance on her plan.

[kag]

10. Yeah, she lost me pretty early on...

when she went from making too much money to making only $8000 a year to having a husband who rakes in the dough.

But I truly cried "troll" when she said that her husband's salary went to pay for their "homes" and "cars"--plural. Seriously? I think perhaps she needs to sell one of her homes to pay for health insurance.

[Hassin Bin Sober]

21. Caca de toro is what it is.

[LiberalFighter]

22. Someone needs to reevaluate their situation.

Especially the part about insurance just for herself. It would be much more economical to be part of her spouse's plan instead of having her own. At least I would think it would be.

[Liberty Belle]

23. Your answers make no sense.

I'm no on my husband's plan because he has as terrible HMO and I sued a doctor on it for malpractice before. I promised myself I would never, ever, no matter what go back into that HMO.

Getting rid of a car is impossible. My husband works 45 minutes away and there is no public transit to his office.

I am a news editor. I have to have a car to go wherever news is breaking. I cover wildfires in remote back country areas, for example.

[Liberty Belle]

28. He has a terrible HMO

where I once sued a doctor for malpractice. I don't want anything to do with that plan, ever, or any HMO as this was the second time I almost died. It was bad - necrotizing bone infection requiring a horrific surgery to fix. Would you want to go back to a doctor who did that? In the specialty I need, he's the only doc on the plan anywhere close to where I live. I wouldn't send my worse enemy to that quack.

[Amonester]

6. Can we have more... hmmm.. details? Husband income? House value?

Cars? Old, or new?

Numbers not clear.

[Liberty Belle]

24. My car is a 2003, 10 years old, very high miles.

Hubby's is a couple of years more recent.

[Liberty Belle]

31. Older cars, mine is 10 years old, hubby's a bit newer, modest Toyotas, nothing fancy.

Bought the house at $240K some years back, average house price for this region, and the market's tanked since then so not too much equity. I am not comfortable sharing hubby's income without his permission but we are solidly middle class, not wealthy. And we've had other expenses, just put 2 kids through college and buried his Mom, so no money left.

[waronxmas]

7. At least one thing is for sure...

...they need to go back to the financial drawing board if 100% one of the spouses incomes goes to just paying bills. Forget about Healthcare, what happens if he loses his job? Even if 100% of their $8000 income goes to savings every year, that's probably only good for a few months max. Especially in California.

[SheilaT]

8. Another one who doesn't make sense of this post.

Lousy policy? The ACA isn't letting you have a genuinely lousy policy any more. The policies actually have to cover real medical care. As you correctly noticed, the insurance companies have been raising rates steadily. What was the great plan that you formerly had?

For what it's worth, I've heard more horror stories about Blue Cross than about any other insurance company. I know my stories, are just anecdotes, but still . . . .

Many years ago Blue Cross Blue Shield was the premier health insurance company in this country. Some fifty years ago, in 1962, when we moved from NYS to Arizona, my mother kept her BCBS plan from New York because, well because. There were five children (ages 7 to 15) and she needed to have something. I honestly have no idea what she paid, but I do recall that why my brother broke his arm that wounded up requiring surgery, the BCBS plan made a huge difference. I doubt she paid much, if anything, out of pocket. He was actually in the hospital for a week.

Anyway, now, some fifty years later, many things are very different.

[4lbs]

9. Mark me as another person wondering why she's not on her husband's healthcare plan.

In any case, you must be making a lot of money combined to not qualify for any subsidies.

Here's what I get just after a quick 5 minutes on the CoveredCA website with the shop and compare tool:

Number of people in household: 2

Household income: $60000

Age of Adult 1: 55 years old

Age of Adult 2: 58 years old (Just guessing)

Zip Code: 92123 (just a generic one for San Diego County)


Silver 70 plans (they cover 70%, you pay the other 30%, $2000 individual deductible, $4000 family deductible, $250 drug deductible) are around $480 (after premium assistance) that covers both of you. That's like $240 per month for each of you.


Gold 80 plans (cover 80%, you pay the other 20%, no deductible) are about $650 (after premium assistance). That's $325 per month for each of you.


I've discovered that any household income above $62000 doesn't qualify for premium assistance.

[Liberty Belle]

30. I sued a doctor who almost killed me on hubby's HMO.

I want nothing to do with them. I couldn't change doctors and he wouldn't prescribe antibiotics after he cut my mouth to the bone during "routine" sinus surgery. I got a necrotizing bone infection and needed a horrific surgery to fix what he did. I got stuck paying 100% of it (oral surgery, not covered by the lousy HMO). I ran out of money and couldn't pay the lawyer to take it to court, so the incompetent doctor walked. Who would want to stay with a plan like that? This was my third nightmare experience with an HMO. Years ago I had a ruptured disk in my neck; an HMO doc refused to prescribe an MRI until I brought in WHeeler's textbook of orthopedics to prove my symtoms were literally textbook. Another time my daughter broke her foot and the HMO pediatrician refused to order any tests. We paid out of pocket and proved it was broken.

I will never, ever, put myself or my kids on an HMO again where you can't change doctors when you get an idiot.

My husband is willing to take his chances with his firm's insurance, but I'm just not willling to do that given my bad history with the company. Would you?

[Ikonoklast]

12. "...insurance for homes and cars..."

How many homes do you own?

You have a mortgage, I see that, but do you also own another home?

[Liberty Belle]

25. WE only own one home.

and with the mortgage crash here it isn't quite underwater but probably close.

[MoonchildCA]

13. Cigna does not even offer coverage through the exchange.

So if what you're saying is true, you are doing something wrong. If you don't apply through the exchange, CoveredCA, you don't get a subsidy.

[lolly]

15. Yeah, this story touches all the bases

It seems like a pastiche of the Obamacare horror stories--like the one in the OP--that have been repeatedly played up in the media.

Several of them, IIRC, fell apart when it was revealed that the "victim" hadn't even bothered to look at the exchanges but had simply taken their insurance salesman's word for it on the best policy available.

Several also were sure they had a great plan, but upon further inspection were found to have ridiculously inadequate plans.

[Liberty Belle]

29. Believe me I researched every option.

I've talked to our Congresswoman about it to, a Democrat like me, and she agreed some fixes are needed to address cracks in the system. Just because the system overall has helped a lot of people doesn't mean there isn't room for improvement. She agreed, fixes are needed.

[Amonester]

33. Keep up the pressure on her, don't let her ever ignore your problems

Thanks for explaining more, and use your position to try to contact others who may have similar problems with this Republican plan, so you could apply heavier pressures on her, and regularly too (like once a week, if not daily).

[Liberty Belle]

26. I can't afford the exchange plans. I don't qualify for subsidies.

Hubby's plan is terrible - an HMO so bad I sued a doctor for malpratice. HMOs almost killed me twice.

So I'm stuck buying private healthcare through CIGNA at a highway robbery rate that is still cheaper than the exchange for me.

[Letsduthisnow]

19. My story has some similarities.

I make 35k and my wife makes 25k.

My insurance was $200 a month, A PPO plan, for me and my son. Decent everything.

My wife at her work has insurances a offered for $300 a month .

My work makes you pay a penalty if your spouse can get her own insurance through her employer.

We are in out 20s so she has done without it for a few years.

This year the same PPO plan is $300 for me and my son, but my employer has offered another High Deductible plan so as to make sure they are offering affordable basic insurance. This HDHP is only $110 a month, but it has no copays, no hospital copay, no prescription copay until I hit $5500 deductible.

[Lenomsky]

20. Math 101

$8,000 per annum - 12 x $550 ($6600) = $1200 pay per annum.

Something amiss here me thinks but think positive you have a mortgage, 2 cars, fully insured, plenty food, sunny climate so things could be worse you could be poor!

[Liberty Belle]

27. The healthcare reforms were not supposed to put people in the poorhouse

and that's pretty close to what it's doing to us. It's supposed to lift people out of poverty, not put them into it.

And it costs gas to run those two cars, too.

I know we could be worse off, that's not the point. The point is that the ACA is taking what little we had away and that's just wrong.

[MrModerate]

11. People appalled that their deficient plans had been cancelled seem to be finding . . .

That they don't 'like' them after all.

[FSogol]

14. K & R. n/t

[neffernin]

16. The ACA is hardly universally good

I do know a few people who are going to have a really hard time affording healthcare in the new exchanges. Mostly sub-30's who earn enough to not get a whole lot of subsidies but don't earn enough to do much beyond live very modestly. That extra few hundred bucks a month is huge for such people.

Additionally the amount it makes us as a country rely on the health insurance industry sickens me. Nothing is better than the passing of this GOP crap with the stamps of democrats on it. Yes, its an improvement from what we had before, but I still just hope that single payer is a possibility someday.

[WinstonSmith4740]

17. Just out of curiosity...

I got so mad that I went to my phone and started calling all the political people and giving them what for," Spanke told The Billings Gazette.

After she discovered she could get better insurance for less money, did she call "all the political people" and tell them she was wrong?

[Drunken Irishman]

34. Probably not.

[maxsolomon]

18. She reacted with her reptile brain

OBAMA CANCEL POLICY! HULK SMASH!

She's Exhibit A for why Americans are so stupid. Take a deep breath and THINK. Check your facts before you start running your mouth.