Affordable Care Act -- NOT Affordable

[mytwomonkeys]

Well, it seems we went from having the worst insurance this year to having it pretty good next year.

 

We'll only be paying $90/month for four people, our deductible is only $4000, and our max out of pocket is $8000.

 

I don't know why this year was so horrible but I'm happy with next year's policy.

 

wow. that is wonderful!!  i wish we had something along those lines!!

 

there is one plan at the market place that has a $562 monthly premium after the subsidy (we are also a family of 4).  we are really considering it & just revamping our budget completely. it has a zero deductible & the maximum out of pocket is $4,000 (but most things are covered 100% -- the copays are insanely cheap too).  anyway, the $200 plan (that is the cheapest) is just awful, so our reasoning is, for just a few more hundred dollars, why not get actual insurance that is great.  we are still trying to figure it out though, as that would leave little wiggle room in our budget.

[Joker]

Is that with a subsidy?

 

If I could get anything close to that, I would be doing cartwheels!

 

I am happy that some people are finding affordable premiums, though.

It's through dh's job.

[Donna A.]

Are there any others besides Samaritans Ministries??

 

Heather, I didn't read all 12 pages of this thread, so wasn't sure whether this question got answered.  We belong to Christian Care MediShare.  We had been considering one of the Christian sharing groups for some time, but previously had insurance through dh's job, so didn't need to make a decision until this year when he obtained a job without insurance.  We stood on the fence between MediShare and Samaritan for a while, and finally decided on MediShare.

 

Feel free to PM me if you have any questions, but I wanted to let you know that there is another option.

 

(And I find it interesting that in the wave of all the problems with Obamacare and the website, with some still insisting that it's a good thing IF they can ever get into the system, and others still insisting that we need to do whatever it takes to make it go away, that NO ONE in MSM is discussing *other* options that are available to many people.  Even some conservative groups are not mentioning it unless pressed, like Jay Sekulow on ACLJ the other day when someone called in to mention MediShare, and he cut her off saying "We don't do advertising here," but then went on to explain that in fact, many DO have other options.  The Amish are exempt, as are Muslims, I believe, or at least some Muslims because I understand that they have some sort of a religious exemption option like we do.  There may be others, as well.

 

Of course there's always the option of bowing out and just paying the penalty, but honestly? I think that's what they ultimately want, so I'm not going there.  I have issues with the IRS being in charge of this program. :glare:  Besides, I've read that what you THINK your penalty will be in the coming year(s) may not actually BE... particularly if your income level varies.  But no one is talking about that.  "Simply" paying a $95 or whatever it is penalty for 2014 sounds like a good solution, but those paying $95 up front may get hit later on if their circumstances change at all.  Sort of like back taxes.)

[shinyhappypeople]

....

[Leav97]

snip

 

 The Amish are exempt, as are Muslims, I believe, or at least some Muslims because I understand that they have some sort of a religious exemption option like we do.  There may be others, as well.

 

snip

 

 

Muslims are not exempt from ACA.

 

http://www.snopes.com/politics/medical/exemptions.asp

[Donna A.]

Muslims are not exempt from ACA.

 

http://www.snopes.com/politics/medical/exemptions.asp

 

Yes, I understand that, but Dhimmitude is not what I was referring to.  I was thinking they have some sort of *optional* medical sharing group (to join) similar to what we Christians have in Samaritan and MediShare.

 

Likewise, and to clarify since the article linked doesn't.... neither are we Christians (as a religious group) exempt.  Only those who choose to belong to, and qualify for, membership in an established Christian medical sharing group like Samaritan and MediShare are exempt.  But it's not the Christians themselves who are exempt; it's members of these particular groups which have been in existence for many years already, and are set up specifically to replace or supplement insurance, with specific rules to follow in order to meet qualification, who are exempt.

 

Thank you for the clarification on Dhimmitude for those who didn't know, Leav97. :)

[mommaduck]

Muslims are not exempt from ACA.

 

http://www.snopes.com/politics/medical/exemptions.asp

 

There are some issues with the exemptions and what they are based on. Amish DO place elderly in some nursing homes (we had plenty of anabaptist run nursing homes in Lancaster County, PA...my MIL works in one). The Amish HAVE taken welfare before...one bishop in Indiana gave his members permission some years ago, because many were working in factories and laid off. They are not completely self sufficient, because their communities have gotten too big to support everyone within the confines of the community. Some Amish hire outsiders (like my husband at one time) as co-owners in order to get around paying workers' compensation and social security. Some though, are hired as actual employees by outsiders and they DO pay into social security (though they may or may not collect...I can pretty much guarantee you that there are some that do collect ;) they just don't talk about it...many though are VERY wealthy...so again, you have wealthy people exempt). Given that new faiths and break off branches of faith appear all the time, putting a time limit and "recognizing" only certain faiths is discriminatory. There are also many people INSIDE of various faiths, where the faith itself may not directly teach one way or another on the issue, but there will be groups of people or individuals that are convicted and practice against medical insurance. Again, this law is very slanted and discriminatory in whom they let off and whom they don't...and it's based upon faulty presumptions and generalizations.

[Trish]

I didn't realize that the government has spent over $600 million on this dysfunctional website.  :ohmy:

Using 10-year-old software!

 

The original budget was under $100 million.

[LisaKinVA]

Using 10-year-old software!

 

The original budget was under $100 million.

 

The federal procurement system at work (IOW, not working).

 

Oh the stories...horror stories.

 

Talk about waste...it is such a complicated system.  Procurement contracts move at the pace of a slug crawling in salt (with the lawyers being the salt).  The easiest way contracts get done is to "copy & paste" (and people don't always read them, and multiple people trying to write different parts, then it goes to legal and gets mucked up...because you can't ask that, or this requirement is too narrow, or whatever), and I'm referencing MILITARY contracts (which SHOULD have specific goals & requirements).  Then, come the bids to be reviewed.  Someone may *know* company A is actually better suited to the job than company B, but because of how the RFP went out, no consideration can be given, and they are forced to give company B the contract...who then bungle the whole thing...and then the Admiral wants to know what went wrong.

[PeachyDoodle]

Using 10-year-old software!

 

The original budget was under $100 million.

 

Actually, the $600 million rumor turned out not to be true. The cost reported ($634 million) was the total of all the contracts between CGI (the main contractor on healthcare.gov) and Health and Human Services for the past seven years. The actual cost of the Obamacare website was closer to $94 million.

 

Of course, that's still an awful lot of cash wasted on a thoroughly unfunctional site that's the laughingstock of the IT community. A lot of people are now starting to speculate as to when the administration shuts the entire thing down until the bugs are worked out. Apparently another one of the contractors that was once touting its role on healthcare.gov on its own site has now scrubbed all traces of it.

 

Big mess.

[Scarlett]

Well I haven't bothered to get on since the roll out because I have heard so many people complaining about it. I do have a question though....for those of you who have managed to get a quote how did it compare to the Kaiser foundation calculator?

 

Dh's probation period will be up at his new job late November so that is when we will get info on their group premium costs and I will know if we even qualify for any subsidies.

[QueenCat]

(And I find it interesting that in the wave of all the problems with Obamacare and the website, with some still insisting that it's a good thing IF they can ever get into the system, and others still insisting that we need to do whatever it takes to make it go away, that NO ONE in MSM is discussing *other* options that are available to many people.  Even some conservative groups are not mentioning it unless pressed, like Jay Sekulow on ACLJ the other day when someone called in to mention MediShare, and he cut her off saying "We don't do advertising here," but then went on to explain that in fact, many DO have other options.  The Amish are exempt, as are Muslims, I believe, or at least some Muslims because I understand that they have some sort of a religious exemption option like we do.  There may be others, as well.

 

 

 

Muslims are NOT exempt from the requirement of having health insurance. That was a false rumor started by some fundamentalists. Groups can claim religious conscience exemption but it only applies to groups who do not approve of any kind of health insurance and do not  take social security or medicare.

 

[Mrs Mungo]

The federal procurement system at work (IOW, not working).

 

Oh the stories...horror stories.

 

Talk about waste...it is such a complicated system. Procurement contracts move at the pace of a slug crawling in salt (with the lawyers being the salt). The easiest way contracts get done is to "copy & paste" (and people don't always read them, and multiple people trying to write different parts, then it goes to legal and gets mucked up...because you can't ask that, or this requirement is too narrow, or whatever), and I'm referencing MILITARY contracts (which SHOULD have specific goals & requirements). Then, come the bids to be reviewed. Someone may *know* company A is actually better suited to the job than company B, but because of how the RFP went out, no consideration can be given, and they are forced to give company B the contract...who then bungle the whole thing...and then the Admiral wants to know what went wrong.

This is not *completely* accurate. There are ways that contracts can be written so that only one or two companies are eligible. Granted, not all people who write such contracts are skilled at making sure every little thing that they need is listed. I would suspect nepotism of some form before I suspected incompetence. But, there are so many things that go into it (like veterans' preference, which may or may not apply to *actual* veterans-have you seen the guy who was receiving preference because he was injured playing football for West Point but was never on active duty) that it is hard to say.

[Donna A.]

Muslims are NOT exempt from the requirement of having health insurance. That was a false rumor started by some fundamentalists. Groups can claim religious conscience exemption but it only applies to groups who do not approve of any kind of health insurance and do not  take social security or medicare.

 

 

Please see above for clarification.  We know that Muslims (as a religious group) are not exempt. :)

[Mommyof4ks]

If there was some magical 'catastrophic' insurance plan that covered ongoing care for kids born with serious disabilities, or many years of treatments for chronic illnesses, or the astronomical payments for terminal illnesses, I am unaware of it. That is what our new system is designed to provide. And, no, it does not pay for abortions.

We have had a high deductible plan since my son's cancer treatment, and that is the kind of plan that keeps people from declaring bankruptcy. Also, kids always get treatment at major children's hospitals. We met many people who had no insurance when we were going through that with our son, and those that could not pay were given funds from private donors who got a tax break for their donation to the hospital. It was a win win. Now the rules may change, and care for those that cannot afford insurance simply may not be available. There are additional taxes on nonprofit children's hospitals that provide free care thanks to the new law, so there will be changes I am sure. St Jude is the biggest loser in that vein.

[texasmama]

I was able to sign on to get an account yesterday,  It took about an hour and a half, and the questions were (IMO) unnecessarily detailed. Some questions were optional and obviously some sort of demographic data collection (such as had my 18 year old ever been in foster care???).  My favorite was the 10 ways they asked how all the people in our home are related and whether or not my minor children (ages 8, 10 and 13) are married or currently paying alimony.  The income portion was more difficult that I had anticipated, as my dh is self-employed.  I had anticipated a yearly AGI number from our tax return, but I was required to break it down by monthly income for each of us. I backed my part time income out and then divided what remained of our AGI by 12 and attributed it to him.  Our income can vary wildly from year to year so this is not the best system for us.

 

I will check back to see when I will be able to actually look at plans and pricing.  Although I was able to get through the process, it was very laborious and time-consuming.  I see that as a barrier for some people. 

[redsquirrel]

If people are having trouble with the website they can call 1-800 318-2596. It is a 24 hour number. I think that is the national number, and there are other individual numbers for each state. Well, I know NY had its own 1-800 number but it set up its own health exchange. Maybe if you live in a state without an exchange you need to call the national number.

 

 

[Susan in TN]

The yearly enrollment packet from dh's employer came in the mail today. I'm afraid to open it.

[LMV]

We have had a high deductible plan since my son's cancer treatment, and that is the kind of plan that keeps people from declaring bankruptcy. Also, kids always get treatment at major children's hospitals. We met many people who had no insurance when we were going through that with our son, and those that could not pay were given funds from private donors who got a tax break for their donation to the hospital. It was a win win. Now the rules may change, and care for those that cannot afford insurance simply may not be available. There are additional taxes on nonprofit children's hospitals that provide free care thanks to the new law, so there will be changes I am sure. St Jude is the biggest loser in that vein.

 

Kind of…basically hospitals that were non-profit and tax exempt are going to need to work a bit harder to show they truly deserve that tax exempt status by their contribution to the community.  Among other things hospitals need to perform a Community Health Needs Assessment every three years and have a plan for addressing that needs assessment.  IF they don't/can't do this then they will need to pay an excise tax starting with the 2013 tax year (so payable by spring 2014). Admittedly this may a bit more difficult for very specialized service providers with very specific target populations than for more general and full service facilities. 

[LMV]

Of course there's always the option of bowing out and just paying the penalty, but honestly? I think that's what they ultimately want, so I'm not going there.  I have issues with the IRS being in charge of this program. :glare:  Besides, I've read that what you THINK your penalty will be in the coming year(s) may not actually BE... particularly if your income level varies.  But no one is talking about that.  "Simply" paying a $95 or whatever it is penalty for 2014 sounds like a good solution, but those paying $95 up front may get hit later on if their circumstances change at all.  Sort of like back taxes.)

 

The penalty is set at a minimum of $95.  We have insurance coverage and shouldn't be paying this but if we were our penalty would likely be around $4,000 for 2014 increasing up to somewhere around $10,000 by  2016. Penalties beyond that haven't been specified as far as I know.

[LMV]

The yearly enrollment packet from dh's employer came in the mail today. I'm afraid to open it.

Be brave!  After all, you can only make an informed decision if you understand all of your options.

[Donna A.]

If people are having trouble with the website they can call 1-800 318-2596. It is a 24 hour number. I think that is the national number, and there are other individual numbers for each state. Well, I know NY had its own 1-800 number but it set up its own health exchange. Maybe if you live in a state without an exchange you need to call the national number.

 

But then there's this..... http://www.foxnews.com/politics/2013/10/18/reports-raise-concern-about-backgrounds-obamacare-navigators/?intcmp=trending

[redheadmom]

So we finally found out how the new healthcare rules have affected DH insurance through work. We have been lucky to have an insurance option that was a decent balance between premiums, co pays and deductibles. So for 2013 our premiums remain about the same, which is manageable. However, the co pays disappeared. Except for the few preventative things which are 100% covered, everything else is a $3500 per person deductible. We also lost prescription coverage co pays and they are now in our deductible.

 

Luckily we are healthy but everything is a lot more expensive. The exchanges won't be a benefit to us but I hope that somewhere someone is benefitting from all these new rules.

[Trish]

So are people starting to get signed up?

 

I'm a bit surprised at how many insurances the new regulations are going to affect -- we're okay this year because we're "grandfathered" through 2014. After that we have to be in compliance so that obviously means higher prices.

 

I'm also under the impression that employer-based insurances will not be affected this year, but after next year they WILL be. So everyone's rates will be going up.

 

Not sure what happens if they don't get the website fixed in a timely fashion, though. From what I heard this morning (there is a Congressional hearing today) they are expecting to talk about MAJOR security issues with the website.

 

Sigh.

[mytwomonkeys]

So are people starting to get signed up?

 

 

I could never get the website to actually work (after weeks and weeks). So I just gave up on it. I'll deal with it after the new year.

[texasmama]

I still cannot get fully registered on the website, even though I have been trying for over a month.  It asks the same questions over and over, is very slow moving, and it asks a large number of "optional" demographic questions which are unnecessary and slow down the system and the process, even if one chooses not to answer them.  After wading through again for over an hour last night, the system abruptly shut down.  Like other times this happened, I doubt any of the information was saved, and I expect to have to page through it all again.  I have about ten hours invested so far.

 

We can keep our individual policy if we want.  However, the premium is more than doubling to an amount that is unaffordable. ($1300 a month)  If the exchange is still not allowing us to choose insurance through it by the end of December, I will be cancelling our current insurance due to the premium increase, and we will be uninsured until the mess is fixed.  Six weeks and counting until this occurs.

 

I'm not sure how this benefits us in any way.   My family is a typical middle class family, by the way, though I am not certain I understand what defines the middle class any more.

[Spryte]

We have good news.  DH's company covers all insurance costs for all families, but we were not sure if that would continue with all the changes - if cost were to go up radically, the practice would stop.  DH spoke to the insurance broker last week, then the CFO, and we're a go.  Insurance costs for the 3 families in the States dropped by 23%, though the deductible increased by $1000.  Even fully funding the HSAs, so the deductibles for each family will be covered, the company saves money.  It's a go.  I know how fortunate we are, esp after reading this thread.  Not sure how our coverage will change, but broker says it's similar.

 

FWIW, the European company probably sees the decrease in health coverage costs as a checkmark for the ACA working.  They have been astounded by the cost of providing health care coverage here.

 

 

[Pawz4me]

Our group insurance through DH's employer increased by only $20 per month, with no changes in co-pays and only a $100 increase in deductible.  That's the smallest increase we've ever had that I can remember!

[MomtoCandJ]

If you want to check for prices with subsidies go to thehealthsherpa.com. You can't buy from them but it does give you a much better idea of how much you would pay and gives you the phone number to sign up directly to a plan if you choose. There is an article about this site on CNN :)

I have already used the site my only gripe is they don't give details about the plans.