So very challenged.. help me process..re ACA

[cilla4progress]

So I just heard Cruz spew on about how ACA is raising costs for many, and that Obama's promise that you can keep your insurance, was a lie.

Do you know: I am a DIE-HARD LEFTY and was very hopeful and supportive of ACA. But what Cruz said is ABSOLUTELY TRUE FOR MY FAMILY!

Yes, there are other universal, overriding, perhaps, issues, that ACA is the 1st step and will hopefully take us to single-payer. ACA provides many, many advances outside of the cost issue.

ACA is a cost-sharing device and our family based on our very middle-class income is being asked to shoulder more of the burden, which is unfair.

If one of my right-wing cousins were to put this question to me, I would have to answer that Cruz is correct in what he says about ACA raising my costs and that I can't keep my insurance that I was fine with, pre-ACA!

[valerief]

1. Thank you for your concern.

[bunnies]

6. Never would have believed Id see an 'I stand with Ted Cruz' post on DU.

Strange days.

[ScreamingMeemie]

9. Ted Cruz is a blustering ass.

When I see women (especially) posting these things here on DU from a position ( married and lucky enough to have health insurance) I was once in, it makes me sad.

[bunnies]

12. Agreed.

And like so many of these posts, the OP refuses to provide details. You come with this "Cruz is right" bullshit you better be prepared to back it up with facts. Im SO sick of this shit.

[cilla4progress]

22. ditto

Thanks for considering my question seriously; for taking me at my word as to my politics; for challenging your OWN preconceived notions and considering a thought outside your narrow world-view. It's very grown-up of you.

[bunnies]

32. Your post is entirely fact-free. Dont know what you expected, really.

Critically thinking people dont just take peoples words for things. Did you really think a post on a DEMOCRATIC board stating: "Cruz is right, no really, trust me" would be received well? Gimme a break.

[cilla4progress]

38. You have heard NOWHERE ELSE

that costs are going up for some, under ACA?

[bunnies]

39. No one who would support such claims with numbers, no.

You yourself admitted right in this thread that you dont even know what your costs would be under the ACA. You seem to be assuming they will rise because thats what youve heard from somewhere, no?

[cilla4progress]

42. I did some research for you...

Here's a starting point:

http://www.mercurynews.com/nation-world/ci_24248486/obamacares-winners-and-losers-bay-area

<Snip>


Cindy Vinson and Tom Waschura are big believers in the Affordable Care Act. They vote independent and are proud to say they helped elect and re-elect President Barack Obama.

Yet, like many other Bay Area residents who pay for their own medical insurance, they were floored last week when they opened their bills: Their policies were being replaced with pricier plans that conform to all the requirements of the new health care law.

Vinson, of San Jose, will pay $1,800 more a year for an individual policy, while Waschura, of Portola Valley, will cough up almost $10,000 more for insurance for his family of four.

"Welcome to the club," said Robert Laszewksi, a prominent health care consultant and president of Health Policy and Strategy Associates in Virginia.

[bunnies]

43. More fact-free, unconfirmable claims.

Very helpful.

[kmkrause]

44. Their previous plan SUCKED! and didn't meet the new standards.

They're paying into the individual market. How much would their premiums be, if they joined into a insurance pool on the ACA marketplace?

[cilla4progress]

7. ??

[ScreamingMeemie]

2. Well, this "single parent" who Cruz was also bold enough to talk for/about...

thanks you.

You see, for the first time in 4 years, I can purchase affordable insurance so that I might actually be able to buy prescription blood pressure medicine and RA treatments here in the US, instead of from India. So that I can actually visit a doctor again.

No, Mr. Cruz does not, and could not, ever speak for me.

But I thank you for helping me to shoulder my burden.

What Mr. Cruz said (which was all-encompassing) does not ring true for all...

[cilla4progress]

4. Thank you for sharing your experience.

You're welcome, I guess?

[JoePhilly]

3. Your post dosen't have enough info.

How did you get insurance before?
How much did it cost?
What did it cover?
What were your out of pocket costs before, and now?
Deductibles?
How much will you save on preventative care (much of which is now free)?

Its hard to try and determine why you ended up paying more without more information on your situation.

[cilla4progress]

5. Lots of posts on this.

Have moved past the numbers crunching. You can read for yourself in many, many sources, that for certain slices of the population, costs in the exchanges are going up. I'm sure it's googlable.

Now a postscript for my family is that it may be that the union (Teamsters) will be saving us. My husband had the option of joining the union at work. If everything falls into place, we will have better, affordable insurance.

I'm assuming it's because, again, of cost-sharing, which, admittedly, is the essence of insurance. Teamsters would be a large pool.

[DoBotherMe]

8. Join the Union

the dues are minor compaired to the benefit and strength of the Teamsters. Dana ; )

[cilla4progress]

10. Yes, very excited about this.

Re-affirms my belief in them. I will make sure everyone, especially my right-wing cousins, is aware that this is how we solved this problem. Hopefully it will also benefit unions, in expanding membership.

[JoePhilly]

11. Your OP asks for help ...

... lacking more detail provided here (not in other places), I doubt anyone can "help".

Your "cost sharing" assumption could be wrong. No way to even attempt to determine that with the info provided here.

What kind of responses are you expecting?

[cilla4progress]

14. How to process

hearing truth from Cruz! And what to say to rightwing blowhards who may ask me, about it.

Look, I signed up to volunteer for ACA as an in-person assister. I was all in. I lost my job in August, and with it about 1/4 of our household income. I had an individual policy my employer paid part of my premium for.

When I started noodling around on the exchanges in September and early October (haven't been able to fully create my profile yet) I discovered that my premium and deductibles were doubling, tripling from my previous plan - and this was computed on my new, lower income (about 394% FPL) The final straw was that my old policy (which I believed I could keep) was closing.

Yes, there are many other facts and issues that make ACA is a big step in the right direction. But on this very bottom line issue: costs going up under ACA, regrettably, Cruz is being factual! I can't tell you how horrifying this fact is to me!

If you want to flame me, have at it. If you want to think I'm being selfish or stupid, same. If you want to listen to me, and put yourself in my shoes and help me process this fact, I would find it helpful.

That's all.

[handmade34]

17. 1st... Cruz is not telling the "truth"

it is amazing what one can do with numbers, data and other information to make it fit an agenda

[cilla4progress]

33. But he is true about

costs going up for some under ACA. I am really anxious to read more about this. I didn't expect it. Did you?

[DoBotherMe]

30. Here is a calculator to help get an estimated cost

However, if anyone covered smokes, the premium increases by 50%. Dana ; )
http://kff.org/interactive/subsidy-calculator/

[cilla4progress]

36. Great site.

Thanks.

[karynnj]

56. Comparing your part of an employer subsidized plan to the full cost under ACA is ridiculous

1) That is not your current choice.
2) For most decent employers, that comparison would be you paying a lot more now.

This has NOTHING to do with ACA. A fair comparison would have been the cost of a reasonable plan on the open market that you could have bought when you lost your job - and the plan you now can get under ACA.

It is likely that there are people for whom what Cruz says is accurate. However, beware of people comparing apples and oranges -- ie catastrophic plans that pay only when costs are extremely high and plans that pay preventative costs. Be especially careful when an insurance company says they are charging more for a better plan.

[bunnies]

13. Youre a "DIE-HARD LEFTY" who thinks its "unfair"...

if you have to pay a bit more to help those less fortunate? Interesting.

[cilla4progress]

18. It IS unfair

What's happening to you under ACA?

There are a hell of a lot of more well-funded interests out there who could / should be tapped to pick up these costs. If you don't think I have a lot of charitable interests and other places and people I do help out...

Do you think our cost-sharing in America is fair?

I didn't come here to fight.

[bunnies]

29. Whats happening to me under ACA?

Absolutely nothing. I have no income due to needing a surgery I cant afford and dont have health insurance. For me to buy insurance under the ACA I would have to pay full price with no subsidies.

And yeah. Im for single payer for everyone. Like most die-hard leftys are.

[stevenleser]

49. Can you estimate your 2014 income as $12000? I mean if you get the surgery...

...you might be able to work, right? It's not an unrealistic estimate. That would put your premium at around $12/mo for a silver plan.

[bunnies]

52. hmmm.

You might be onto something there, Steven. Assuming the joint replacement went well... I'd be able to work again after a few months. I wonder what would happen under a worse-case scenario though. Would they come after me for the $300+ a month?

Im definitely going to look into it though. Thanks for the idea. It might be my only hope if NH doesnt expand medicaid.

[stevenleser]

54. No, they won't come after you. I saw a note to that effect. If you overestimate your income

to make over 100% of poverty, they will not come after you. If you underestimate your income, that is a different story.

[bunnies]

55. omg, Steven...

If I could jump through this screen and hug you I would. I just found an article confirming everything you said. I'm literally so happy that Im on the verge of tears. No. Im actually crying. You just saved my life. I cant thank you enough.

[stevenleser]

57. Oh it so made my day to be able to help. I wish this information could get to more people.

This is the antidote to all of those horrible GOP governors who refused to expand Medicaid.

Glad this will help you!!!!!

[bunnies]

58. It'll do more than help. It'll give me my life back.

I havent had any meaningful use of my right arm in almost a year now. And I recently learned that its getting to the point where the elbow is nearly too damaged for a joint replacement. I was resigning myself to the fact that I'd never be able to live normally again. But you have given me a big, bright, glowing ray of hope.

Tonight, I will toast to you, my friend. I cant wait to tell bunnies-mr. You changed two lives today.

[handmade34]

15. ...

"ACA is a cost-sharing device and our family based on our very middle-class income is being asked to shoulder more of the burden, which is unfair"... that is what all taxes and insurance are and it isn't necessarily unfair...

many pay property taxes to support schools that no one in their family attends... just one of many examples of being part of a community and shouldering the burden when others aren't as fortunate...

I pay lots in auto insurance and have never had an accident or claim... another example

I used to pay BCBS upwards of $24000/year and never had a doctor's visit or claim

400% of the poverty level for a family of 4 is upwards of $90,000 and subsidies are available up to that level... ???

Under the Affordable Care Act, if your 2014 income is between 138 and 400 percent of poverty level for your household size, you can purchase health insurance on a state-run exchange (such as Covered California) and receive a federal tax subsidy to offset all or part of your premium.

[cilla4progress]

20. So far I have been unable to complete my profile

and get to the subsidies. That would make a difference.

It doesn't make sense to me that a family at our income level's costs would go UP under ACA. It is contrary to my understanding.

At the very least, I thought we could stay where we were - health care in our dysfunctional system, i.e., incompetent, at moderate affordable cost that covered most of what we needed.

I don't know about you, but we are clinging tooth and nail to hold onto our middle class status. One big emergency, crisis, or expense, and we are down for the count.'

I lost my job due to layoff in August. At 58 y.o. I am finding no job prospects.

[handmade34]

23. best not to make judgements

about affordability until the fog clears... and as for the job... just wait till you pass 60

the thing is... we really all need to be patient with each other as we all have very different life experiences and are sitting in very different places (financially)... but... never good to side with Ted Cruz... he has his own agenda and he doesn't care about you and me; he already has excellent health insurance

[cilla4progress]

34. Thank you.

I agree about the fog clearing. I've been holding back since I couldn't get fully online.

You seem sensible - you should be able to see I'm not "siding with Ted Cruz." I'm horrified to hear words of truth coming out of his mouth, words that apply to me, and anticipating how I (or others, including the administration) would / will respond to his charge?

It is TRUE, that for some, costs are going up. What does Pres. Obama have to say about this? Did you know that this would happen? Did I miss something in the run-up? If I hadn't also lost my job, if I were still working, it would be easier to suck up the extra costs.

I feel like I was asking for an intellectual exercise that most here aren't prepared (or interested) to engage in...

[enough]

25. If you haven't completed your profile and don't know what the subsidies are,

how do you know whether your premiums are going up or down? I'm not understanding. I thought the subsidies were an integral part of the system.

[ScreamingMeemie]

26. That's what blows my mind. "very middle class" equates to a subsidy.

Unless one is messed up to what middle class is.

[cilla4progress]

35. Based on preliminary calculations.

I don't know if things changed upon complete implementation, but as a volunteer In-Person Assister trainee we were allowed access to the system early and that's where I get these numbers.

[ScreamingMeemie]

41. Get upset and claim Mr. Cruz is right when you do actual calculations.

I'm sorry, but I very much doubt your story now. Again, I'm sorry, but... again...I can offer proof. Can you?

[kmkrause]

51. How did you get insurance before?

Was it through work or the individual market?
If through work, you have to add the costs that your employer paid towards your premiums plus what ever you paid out of your income. That is the actual premium price.

You claim your premiums went up under the ACA but you have not yet been able to create a profile or see if you qualify for subsidies. Then how can you claim it went up?

If your Husband is able to access affordable health insurance through his employer for himself and his family that meets the new standards, then you will not be able to get subsidies on a plan through the ACA market place.

[Myrina]

16. Same here

47 yo single female, don't qualify for any subsidy.

The $200/mo bronze I can afford, but not when its combined with a $6000 deductible, $50 office visit charge and 60% copay. That makes it useless for me.

[handmade34]

19. my understanding

is that subsidies are available up to 400% of poverty level... $46,000/year for a single person

[cilla4progress]

21. Wow - amazing no one has taken me seriously here.

I think it says more about some people on this board than it does anything.

Amazing how narrow-minded and unwilling to 1) give others on this board credit - take them at their word - for their values and beliefs; 2) the lack of intellectual curiosity that is sometimes here.

Just wow...and disappointing.

Is there no one here who can think outside the box, or all of you responders just tied so hard into one train of thought you can't explore or consider a thought or question outside the party line?

[ScreamingMeemie]

24. Well, there's a diehard Lefty response if I ever heard one.

Thank you for the "you're welcome I guess...?" from earlier.

What's disappointing is that you continue to believe that Mr. Cruz is somehow telling the truth.

I can post actual proof that he is lying. Can you??

I am also sorry that I am somehow not worthy, in your reasoning/your words, of health insurance. I thought my post would open your eyes...instead they remain shut to others.

Remember this, I was once just like you. Married, awesome health insurance, and then that went away. That happens in the blink of an eye. You'll be grateful for ACA then. I do not wish that on you, however.

Thanks a billion...I guess?

[nenagh]

28. I'm Canadian and I'm hoping you (all) get health care that you are pleased with.

I want to wish you all every success...

ps, I was very fortunate to have been part of a Union.. and it made a great difference in my coverage.

But that is apples and oranges to your situation.

[EC]

27. What you're describing is pretty much

how insurance has always worked. Everyone who pays in supplies the cost of anothers care. So what is your complaint?

[cilla4progress]

31. Bottom line is

insurance costs ARE going up for some under ACA. Even for those who already had insurance. Even for those who are not wealthy - who are solidly middle class. This is a fact, and was not made clear by the administration in implementing ACA. To the extent Cruz and others repeat this, there needs to be a response.

Whether and how ACA supporters are prepared to address that, is critical.

Pretending that costs aren't going up for some is a delusion.

[athena]

46. I hate to disappoint you, but

most people can see that the ACA is a good thing. Many people have pre-existing conditions and can now get insurance for the first time. Many people, like you, had low-level coverage with annual or lifetime maxima, which meant that they were effectively without coverage if something bad ever happened to them. Fortunately, most such people, unlike you, can see that paying a little more for insurance that actually covers them is a good deal.

You seem to be hoping that there will be a huge public outcry by people who had bad insurance (and were too clueless to realize that their insurance was bad) who now have to pay a little more for better insurance. I hate to disappoint you, but it's not going to happen. People aren't stupid.

[cilla4progress]

48. How about pressure for single-payer, eh?

Get the profit all the way out of health care?

[athena]

50. The way to argue for single payer is not by posting thread after thread

complaining about how the ACA supposedly hurts you. Many of us here are in favor of single-payer health care but realize that single-payer health care will simply not happen in this political environment. Despite not having a public option, the ACA corrects many of the problems in the system and will prevent thousands of people from dying because of diseases that can be prevented if caught early. You, on the other hand, seem to be hoping that the ACA will fail and be repealed because of an outcry by those who had some sort of insurance under the old system. If such a thing happens, it will certainly not lead to single-payer health care.

Indeed, under single-payer health care, you would have to pay more. Given how much you've been complaining about having to pay a little more for better-quality health care under the ACA, I find it hard to believe that you are in favor of single-payer health care.

[athena]

37. As I posted on your last thread, your insurance was bad.

It went away for a very good reason: it had a low annual maximum, which the ACA has outlawed.

Here is my response on your old thread:
http://www.democraticunderground.com/?com=view_post&forum=1251&pid=331746

Your claim that you are losing out under the ACA is at best clueless. You had an annual max of $100,000, which meant that you would go bankrupt if you ever had a major accident or illness. The ACA has made that illegal, to your benefit. Yet you go around making the false claim that you have lost out under the ACA.

In case you suggest I don't know the difference between maximum out of pocket and maximum coverage, let me state it once again: no insurance company should be allowed to tell you that they will not pay more than $100,000 for you per year. The whole point of insurance is to pay for rare catastrophic events. Thanks to the ACA, no insurance company can now have annual or lifetime coverage maxima.

I think you're just trying to spread misinformation. I don't believe that you are a leftie. If you were, you would have continued the discussion on one of your previous threads, rather than posting new threads in which you omit important details like your former $100,000 annual maximum.

[cilla4progress]

40. hahahahaha

So you think it's effective to respond to every person whose costs are going up under ACA by beating down their positions case by case? Do you think that will be effective? As someone on another board stated, their insurance worked for THEM. Regardless of hypotheticals. $100,000 max. / yr. would cover everything except the most catastrophic (def: a momentous tragic event ranging from extreme misfortune to utter overthrow or ruin), i.e., RARE.

You don't think the administration, or ACA supporters, should craft an articulate response to Cruz's position, or that of others who find themselves in this boat?

You think you can just argue them down without coming up with a decent, acceptable explanation?

It's not just me, you know. It's an overall issue with ACA.

[athena]

45. Where is your evidence that anyone's cost is going up for no good reason?

Let me re-post the explanation I just posted on your other thread, since I suspect you will ignore it:

the whole point of insurance is to cover you in case of catastrophe. That's what the insurance industry is based on. Consider the following:

Suppose I have a 50% chance of being in an accident that will cost me $1000. Since I have more than $1000 in the bank, I can weather such an accident. I will not pay someone $500 to pay me $1000 in case I have that accident.

Now suppose I have a 0.01% chance of being in an accident that will cost me $1,000,000. Since I don't have anywhere near that in the bank, such an accident would bankrupt me. I would be willing to pay someone $500 to cover me in case of such an accident.

Now: suppose 100,000 people make the same calculation and pay $500 for this insurance. The insurance company takes in $50M. Since the risk is 0.01%, 10 people have the accident. The company pays $10M. It therefore makes a profit of $40M.

Think about that. That's the whole point of insurance. When you allow insurance companies to set annual or lifetime maxima, you are allowing them to increase their profit by refusing to do what they are supposed to do.

As much as you want to believe (or make others believe) that you had good insurance, you didn't. You should be thankful to the ACA for correcting a major problem in the system, which was allowing insurance companies to dump you in case of the very rare events they are supposed to cover you against. Given that the banning of maxima will reduce the profits that insurance companies make, it's not unreasonable to expect to pay a little bit more.

Finally, note that if you had had good insurance (i.e., one that didn't have annual or lifetime maxima), you could have kept it.

If you think that insurance that does not cover catastrophic events works for some people, then you probably also think that denying people coverage based on pre-existing conditions is also OK, since, hey, some people are lucky enough to not have any pre-existing conditions! Such insurance works for them!

Indeed, let's get rid of laws that ban the use of chemicals known to be carcinogenic! Such laws increase costs for companies, which means we all have to pay a little more. And not all of us get cancer!

[cilla4progress]

47. an article

http://www.mercurynews.com/nation-world/ci_24248486/obamacares-winners-and-losers-bay-area

<Snip)

But people with no pre-existing conditions like Vinson, a 60-year-old retired teacher, and Waschura, a 52-year-old self-employed engineer, are making up the difference.

"I was laughing at Boehner -- until the mail came today," Waschura said, referring to House Speaker John Boehner, who is leading the Republican charge to defund Obamacare.

<Snip>


I really don't like the Republican tactics, but at least now I can understand why they are so pissed about this. When you take $10,000 out of my family's pocket each year, that's otherwise disposable income or retirement savings that will not be going into our local economy."

Both Vinson and Waschura have adjusted gross incomes greater than four times the federal poverty level -- the cutoff for a tax credit. And while both said they anticipated their rates would go up, they didn't realize they would rise so much.

"Of course, I want people to have health care," Vinson said. "I just didn't realize I would be the one who was going to pay for it personally."

<Snip>

"I'm not against Obamacare," Waschura said. "It's just the initial shock. I'm holding out hope that there will be a correction over a handful of years."




This can be a conversation, not a fight. That is all.

[athena]

53. I don't see any evidence that you're interested in conversation.

You post a new thread every few days, claiming that your costs are going up under the ACA. You don't give enough details to allow people to realize that your old insurance had an annual maximum of $100,000, which makes it illegal under the ACA. It seems pretty clear to me that you are trying to create an impression in the minds of DUers that costs are going up under the ACA for those who are already insured.

BTW, there is no indication in that article that the people whose rates are going up had good insurance, nor that they can't easily find higher-quality insurance at a lower cost on the exchanges.

Let me quote the parts of the article that you ignored:

Adding a required list of 10 essential benefits to all plans is also significant. A study published last year in the journal Health Affairs said more than half of Americans who had individual insurance in 2010 were enrolled in plans that would not qualify because they didn't meet all the new requirements.

Wood likened these mandates to the higher cost of buying cars today that must have safety features like air bags and anti-lock brakes.

The law also will often make some policies more expensive because it limits out-of-pocket expenses to $6,350 annually for an individual and $12,700 for a family. In addition, the law restricts the minimum and maximum premiums that people can be charged based on their age.

I guess you're also opposed to requiring safety features in cars such as air bags and anti-lock brakes.

P.S. I note that you did ignore the quantitative explanation I provided. If you really wanted a discussion as you claim, you would not have ignored it.

[cilla4progress]

59. It would be like Pres. Obama

stating, when promoting ACA: now for some folks, costs will go up, because their plans will be improved. You may not be able to keep your insurance, either, since some plans won't comply with the new regs. Then we could have at least dealt with and anticipated the reality, instead of this last second sticker shock.

This was not how it was promoted. Costs would be going down, and at the very least, if you like your current plan, you can keep it.

"It seems pretty clear to me that you are trying to create an impression in the minds of DUers that costs are going up under the ACA for those who are already insured. "

Duh - YEAH!

You don't want anyone saying that their costs are going up because it conflicts with your agenda. Why don't you deal with the reality, instead of going over the same ground ad infinitum?

I've got to go...this is going nowhere. TS.