Obamacare/Trumpcare Horror Stories

[NJHalo]

Just got my 2017 renewal rate, and I guess I can say I am "happy" that it only went up $102/month!

7% is not bad considering what I have been hearing 

[Blarg]

Yeah,  only $1,200 a year increase for "Affordable Health Care." 

[nate]

My friend's coverage is going up 26%.  CA small group coverage.

[Blarg]

Yeah but nobody saw this coming when they made it mandatory to carry health insurance. 

[Jay]

The good news is, the cost curve is bending...

 

[fan_since79]

I love this headline from CBS, Philadelphia:

Open Enrollment In Affordable Care Marketplace Will Bring Unpleasant Changes To Consumers

 

"unpleasant". Yeah, slightly.

 

[Tank]

don't worry, president hilary will fix everything.

[gotbeer]

Democrats' 5 Lamest Excuses For Obamacare's 22% Premium Hike

 

#5 is a @NJHalo special.

 

[Jay]

Our group PPO coverage (Aetna) through my wife's employer is not changing for next year and the premium is going up only a few percent. Why is it so different for Obamacare policies?

I think one difference is for things like colonoscopy which is considered a surgical procedure our coverage is 80/20 and I think Obamacare covers that at 100%. So why don't they reduce the coverage and bring the costs down?

 

[nate]

5 hours ago, Jay said:

Our group PPO coverage (Aetna) through my wife's employer is not changing for next year and the premium is going up only a few percent. Why is it so different for Obamacare policies?

I think one difference is for things like colonoscopy which is considered a surgical procedure our coverage is 80/20 and I think Obamacare covers that at 100%. So why don't they reduce the coverage and bring the costs down?

 

Your second question answers the first.  Large companies, especially self insured do not have to abide by many of the ACA regulations.

[Taylor]

On 10/25/2016 at 7:48 AM, Blarg said:

Yeah but nobody saw this coming when they made it mandatory to carry health insurance. 

I don't think the government should make it mandatory to carry health insurance, but I think it's stupid that anyone would choose not to have health insurance. I'm "young and healthy" and would be living with high anxiety all the time if I wasn't insured. There's so much that could go wrong and leave you with tens of thousands (or even hundreds of thousands) of hospital bills.

[Tank]

@nate, who decides how much prices go up with the ACA? are prices going up equally for Lakischa in Watts as they are for Gerald in Westwood?

[Catwhoshatinthehat]

59 minutes ago, Taylor said:

I don't think the government should make it mandatory to carry health insurance, but I think it's stupid that anyone would choose not to have health insurance. I'm "young and healthy" and would be living with high anxiety all the time if I wasn't insured. There's so much that could go wrong and leave you with tens of thousands (or even hundreds of thousands) of hospital bills.

Saying it's stupid not to have health insurance is something that's easier to say as you age and accumulate assets.  If I didn't have health insurance and needed medical care in my early 20's that led to expensive medical bills that's a reason to file BK.  In my late teens and early 20's possible health conditions or a medical scare were about the last things I was concerned with.       

[nate]

1 hour ago, Tank said:

@nate, who decides how much prices go up with the ACA? are prices going up equally for Lakischa in Watts as they are for Gerald in Westwood?

Under ACA there is no underwriting so the person doesn't factor into it.  Where they live does.  Every county is rated differently, it is completely based on the cost of care in those counties.

[Lou]

3 hours ago, nate said:

Under ACA there is no underwriting so the person doesn't factor into it.  Where they live does.  Every county is rated differently, it is completely based on the cost of care in those counties.

which is why most carriers have dropped out of the program.

imagine not taking driving records into consideration when issuing auto insurance. 

[nate]

17 minutes ago, Lou said:

which is why most carriers have dropped out of the program.

imagine not taking driving records into consideration when issuing auto insurance. 

The bigger problem is what was mentioned earlier.  ACA only works when everyone is covered.  You need lots of healthy people paying for insurance in order to pay for the medical costs of the unhealthy since ACA did nothing to lower the actual cost of care.  Since all ACA did we insure unhealthy people, it is costing a ton for the insurers.  That is why they are dropping out.

[Lou]

3 minutes ago, nate said:

The bigger problem is what was mentioned earlier.  ACA only works when everyone is covered.  You need lots of healthy people paying for insurance in order to pay for the medical costs of the unhealthy since ACA did nothing to lower the actual cost of care.  Since all ACA did we insure unhealthy people, it is costing a ton for the insurers.  That is why they are dropping out.

exactly. and we ended up insuring unhealthy people because each person's medical history wasn't taken into consideration. when you do that, that's what you're going to end up getting. anyone with a brain could see this coming. All those that had a problem getting decent coverage for a decent rate were going to jump at the chance. healthy people, especially those that are young and single, were going to go without coverage. 

[Lou]

also, the government's threat of imposing fines for those that don't buy coverage didn't scare anyone. 

[nate]

Yep, who could have guessed that an 1100 page law rushed to get passed would have so many flaws.

[Jay]

Who would have thought that some posers from academia would have a failed experiment?

[Lou]

anyone been to an ER lately? it's a clusterf*ck

 

[fan_since79]

4 hours ago, Lou said:

anyone been to an ER lately? it's a clusterf*ck

 

A friend's sister went to one a few months ago. She didn't know what was happening to her; trembling, profuse sweating, rapid heart beat, could barely walk. She sat in the ER for eight hours before being tended to. She went in at 7 pm and a doctor saw her at 3 am the next morning. By that time she had (mercifully) passed out and was in a deep sleep.

It turns out she had an unexplained incident of extremely low blood sugar (she's not diabetic or hypoglycemic). Once they saw her it took ten minutes to get her glucose back up. The bill was several hundred dollars, covered by insurance.

 

[Lou]

3 hours ago, fan_since79 said:

A friend's sister went to one a few months ago. She didn't know what was happening to her; trembling, profuse sweating, rapid heart beat, could barely walk. She sat in the ER for eight hours before being tended to. She went in at 7 pm and a doctor saw her at 3 am the next morning. By that time she had (mercifully) passed out and was in a deep sleep.

It turns out she had an unexplained incident of extremely low blood sugar (she's not diabetic or hypoglycemic). Once they saw her it took ten minutes to get her glucose back up. The bill was several hundred dollars, covered by insurance.

 

that's the norm

my advice to anyone who needs (or is with someone who needs to go):

if it's serious, i.e. not a twisted knee, rash, green toy army man stuck up your nose, etc, call an ambulance. do not drive to the hospital or you'll be camping out in the lobby for hours on end. if you arrive via ambulance, they see you immediately. 

took my mom one time post-obamacare and what had normally been about a 30-40 wait pre-obamacare, turned into a 10 hour wait just to go to the back to lie down and have a nurse exam her. from there it was another 3 hours until an actual Doctor made an appearance.  knowing some of the attending nurses and intake personnel, I asked why it took so damn long this time. they all said the same thing - obamacare. too many people showing up with non-emergency illnesses, injuries, etc.  and some people who may need medical attention but would have normally just dealt with it at home are now going to the ER since any condition they may have won't hurt their premiums or eligibility in the future. 

one of her doctors instructed me to call an ambulance every time from that point on. the next time I did exactly that and she was wheeled directly to the back, passing right by a packed lobby, and seen within minutes. 

[fan_since79]

My policy has a 24-hour telephone link to a registered nurse. This really helped in January, when I suddenly became very sick to my stomach and was vomiting for hours on end. The nurse gave me some great advice on the phone, and I ended up not having to call an ambulance. I was getting ready to, believe me. It would have cost a lot, because my policy doesn't cover much of that cost.

Turned out it was extreme food poisoning. Four days later I was back to 100%.

[Lou]

that's a great benefit to have. iirc, mom's portion of the ambulance cost is $150, which I'll happily pay over having to wait. I'll have to pull out the bill and see exactly how much the total charge for that scenic 3.2 mile ride came out to 

Edited October 30, 2016 by Lou