Jump to content

Menu

Why are some people in the US with no health insurance?


Jean in Newcastle
 Share

Recommended Posts

Just because it is law that a family must have it, doesn't mean they CAN AFFORD IT. I have friends who have no health insurance - they do not have a low enough income to qualify for medicaid, or they have an income that qualifies their children for medicaid, but not the adults in the family; their work insurance program isn't affordable for them, but because their work offers it, they generally get fewer (if any) subsidies... and, to be frank, the plans on the dot gov site are NOT affordable when you're struggling with basic bills. 

 

You can consider my reply to be a vent. I have good friends and close family members who are struggling even MORE now because of the mandate - the mandate meant they have to have insurance, but it didn't make it any more affordable for many people, and these are people who didn't have it in the first place because of the cost. That it is now "law" does nothing to help the situation.

 

ETA: for example... out of curiosity, I went to the dot gov site to compare prices. My husband's company is amazing and they cover our insurance costs almost 100%, but I wanted to see what the stink is about. I went on and entered a friend's income and family dems, because I knew this friend was struggling to keep both food on her table AND pay for the insurance offered by her husband's company. The prices quoted, since insurance was offered through her DH's company (even though that was hardly affordable considering what they pay him), were ridiculous considering the yearly income amount I put in - high monthly premiums (700-800+ monthly), or nice low monthly premiums but ridiculously high deductibles that had to be met (in the ballpark of several thousand per family member) before much was covered. Again, just because it's law now doesn't mean those lacking it suddenly have thousands monthly to pay for it.

  • Like 35
Link to comment
Share on other sites

The monthly premiums are many times an outrageous cost for high deductible and little coverage! Our rates rose recently to where we would be paying paying close to the same amount as our monthly mortgage. That was ridiculous and something had to give! Now we participate in a Christian medical sharing plan instead of insurance. This exempts us from the penalty.

 

The self pay rate for the uninsured at some private medical facilities and MD offices is sometimes less than the out of pocket cost for the insured patient. My insured friend that pays to close to $800/month on a plan with her husband went to the dermotologist for a procedure and paid her part. She recommended the same dermotologist to her uninsured friend who needed the same procedure. The MD office charged her uninsured friend less for the same procedure than what the copay amount was for my insured friend.

  • Like 5
Link to comment
Share on other sites

No, it's not "because they can't afford it, it is simple as that." There are still too many who truly can't afford it, there are states that chose not to expand medicaid to help certain people, and there are those that choose to pay the penalty because they believe they do not need, nor want to pay, for health insurance. It's a mix. I'm going to go as far and say there's a small number( if you believe their comments online) who refuse it merely because they think they're paying Obama for it.

 

OK.

  • Like 1
Link to comment
Share on other sites

On a not really related note...but when DS went to the Spark thing at MIT, they would not allow people to attend unless they show they have insurance that will pay hospitals in Mass.  Seems kinda crazy.  This was only for a few hours on a Saturday and Sunday.  It's like what...Mass is another country and you can't visit unless you have the right stuff?  Geesh

 

 

 

 

  • Like 1
Link to comment
Share on other sites

Where I live Medicaid is only for children up to a certain age and pregnant women. So the income thing would be irrelevant if you were male or not pregnant.

 

Here I believe it can cover some adults with dependent children, generally in cases of adults with serious medical problems (like my sister with her heart condition, who would qualify in some states, including my own, but for some reason doesn't qualify in her state).

Link to comment
Share on other sites

On a not really related note...but when DS went to the Spark thing at MIT, they would not allow people to attend unless they show they have insurance that will pay hospitals in Mass.  Seems kinda crazy.  This was only for a few hours on a Saturday and Sunday.  It's like what...Mass is another country and you can't visit unless you have the right stuff?  Geesh

 

My son had to show proof of insurance when taking courses at Duke through the TIP program.  This was back before the ACA---and NC did not have anything equivalent to Romney care.  Off topic but I wanted you to know that your situation was not unique.

  • Like 2
Link to comment
Share on other sites

My son had to show proof of insurance when taking courses at Duke through the TIP program.  This was back before the ACA---and NC did not have anything equivalent to Romney care.  Off topic but I wanted you to know that your situation was not unique.

 

Although this wasn't really a "program".  It lasted a few hours. 

 

It just doesn't feel right to me that they can exclude people for that reason.

  • Like 2
Link to comment
Share on other sites

We have a not-awesome ACA plan that costs us, per month, the same as the mortgage on our nice 3000 sq ft home. And that is with a 10k deductible. That is insane and that is why people don't have insurance.

  • Like 6
Link to comment
Share on other sites

I'm an Overseas American, and we are exempt from ACA, but we are not exempt from high costs for Medical insurance. Early in 2009, after most of my income ended and the U.S. Dollar was extremely weak, ,we had to cancel our great PPO plan.  We have very inexpensive (mandatory) medical coverage now. Primitive but better than nothing.

 

The issues regarding ACA may disappear, at the end of June, when the Supreme Court makes their ruling, regarding the 36 or 37 states that do not have their own exchanges and the subsidies that are paid to some ACA policyholders in those states.  If the Supreme Court rules that is NOT OK, the ACA will probably collapse.

 

Interesting about the costs charged by doctors to uninsured patients who pay for their own care by themselves.  I remember, many years ago, when I subscribed to the International Edition of the Miami Herald newspaper. A man who lived somewhere in South America didn't want to have surgery in the country he lived in (IMHO, he should not have chosen to live there if that was the case).      He was advised to contact the International Offices in hospitals in Miami, to get a good price...   That reminds me of a British man I know who lives in the Philippines. He does not trust the doctors there and he goes to Thailand for major checkups and he had a surgery in Thailand.

Link to comment
Share on other sites

I don't have it currently because I can't afford it. My husband has it through his employer, but to add me it would cost another $700 a month. I believe I can buy it on the marketplace, but last I looked, it was too much for our budget. Not to mention, I need to see a specialist for some issues and they aren't covered by the insurance offered. Not only would I need to pay the premiums for insurance I wasn't using, but I'd have to pay out pocket for my specialist. 

 

I haven't looked into exemptions or alternatives recently. 

  • Like 1
Link to comment
Share on other sites

My very basic bronze plan went from $16 / month last year to $112 / month this year for exactly the same plan with a very high deductible.  That's an insane increase.  I've moved to a Christian health sharing plan.  I'm so very disappointed because we need a major overhaul of our health care system.  This isn't it. 

 

ETA:  The plan covers just myself.  My daughters are on CHIPS.

 

Link to comment
Share on other sites

On a not really related note...but when DS went to the Spark thing at MIT, they would not allow people to attend unless they show they have insurance that will pay hospitals in Mass.  Seems kinda crazy.  This was only for a few hours on a Saturday and Sunday.  It's like what...Mass is another country and you can't visit unless you have the right stuff?  Geesh

 

Eh, you can write gobbeldygook in there and get away with it.  Our German exchange student last year went to HSSP at MIT last year (same waiver form as Spark), and she just wrote in her German insurance info (she had to pay here and send her bills to Germany for reimbursement), and they didn't bat an eye. If you write something on the line, they don't look closely at it. 

 

  • Like 2
Link to comment
Share on other sites

I don't have it because I can't afford it, plain and simple.  My kids have Medicaid, but as it was not expanded in my state, I don't qualify for it.  Premiums for just me were north of $400 per month with a $10k deductible.  Utterly stupid.  And so far, I've been exempt from the fine for whatever reason (probably income but I don't know; Turbo Tax does it for me :D)

  • Like 4
Link to comment
Share on other sites

We don't have insurance right now.

 

D lost his job and benefits. He's working on developing a small business, so I guess technically self-employed (not officially yet).

 

Our kids have Medicaid, we have access to the VA. 

 

After we relocate, I will seek employment. I'm not sure if I will receive benefits or not. It looks like yes, but I won't know till I find a position. D well remain self-employed.

 

I hope we aren't penalized. That would be unfortunate. It feels like a poverty tax.

  • Like 3
Link to comment
Share on other sites

We are in a state with expanded Medicaid.  We all qualified when my husband lost his job.  Then, he got a job in another state.  So, his employee sponsored health care doesn't start right away, and once we leave this state, we lose the state health care.  So, we found ourselves in a medical insurance black hole.  Couldn't take state sponsored health care with us, couldn't get health care in a new state right away.  We wound up getting a Christian share program for the black hole time.  I found it ironic that here we are trying to follow all the rules and due to moving out of state, can't take it with us and can't get it there right away.  So, without these Christian share programs, we would have also been out of health insurance not due to cost or desire, but just due to a system that is totally inflexible.  

  • Like 2
Link to comment
Share on other sites

I'm an Overseas American, and we are exempt from ACA, but we are not exempt from high costs for Medical insurance. Early in 2009, after most of my income ended and the U.S. Dollar was extremely weak, ,we had to cancel our great PPO plan.  We have very inexpensive (mandatory) medical coverage now. Primitive but better than nothing.

 

The issues regarding ACA may disappear, at the end of June, when the Supreme Court makes their ruling, regarding the 36 or 37 states that do not have their own exchanges and the subsidies that are paid to some ACA policyholders in those states.  If the Supreme Court rules that is NOT OK, the ACA will probably collapse.

 

So the "issues" with the ACA will go away when i collapses...which means we will have even more citizens who cannot get access to any health insurance.

Yep.That will make it all better,

 

  • Like 6
Link to comment
Share on other sites

It feels like a poverty tax.

 YES!!! Did you know that part of the plan all along on how to pay for subsidies is money from people who chose to pay the penalty?  Who are those people?  The poor.  The rich can afford health care.  The people who figure out paying the penalty is cheaper than the actual insurance are the poor/ lower middle class.  

  • Like 5
Link to comment
Share on other sites

So the "issues" with the ACA will go away when i collapses...which means we will have even more citizens who cannot get access to any health insurance.

Yep.That will make it all better,

 

I guess I don't understand this part. I'm not aware of any person (not even one) who can more easily afford insurance through ACA, than they could before, speaking specifically about lower income adults/families.

My disabled mother (lupus, seizures, strokes) is paying $400/monthly for health insurance (which doesn't include vision or dental at all), has a ridiculously high deductible, can't afford the new seizure medication her neurologist wants her to take, and only has a household income of about 25-30K yearly. $400/monthly, with a high deductible, out of pocket up-front payment required for diagnostics (most recently the CT Scan her doctors ordered), high co-insurance rates, etc, is NOT any more "accessible" for her now.

  • Like 10
Link to comment
Share on other sites

I guess I don't understand this part. I'm not aware of any person (not even one) who can more easily afford insurance through ACA, than they could before, speaking specifically about lower income adults/families.

My disabled mother (lupus, seizures, strokes) is paying $400/monthly for health insurance (which doesn't include vision or dental at all), has a ridiculously high deductible, can't afford the new seizure medication her neurologist wants her to take, and only has a household income of about 25-30K yearly. $400/monthly, with a high deductible, out of pocket up-front payment required for diagnostics (most recently the CT Scan her doctors ordered), high co-insurance rates, etc, is NOT any more "accessible" for her now.

I am terribly sorry for your mother, but may I inquire how she paid for her significant medical expenses prior to the ACA? A high deductible plan kicks in after a hospitalization for example.

 

Excluding dental and vision from medical is also mind boggling to me.

Link to comment
Share on other sites

I'm just looking for factual answers, not a debate on the law.  I'm asking because I thought it was now law that you had to have it and yet I keep hearing about people who don't.  

Because they either do not know they are required to have it, they can't afford it at all, or they are willing to pay the penalty (which is going to increase every year for a few years to force them into it). 

 

There are still people who can't afford insurance  and still eat even if they "have access" to it.  

 

Well, I have access to a mansion, if I want to and can pay for it.  It's not what you have access to, it is what you actually can obtain. 

  • Like 3
Link to comment
Share on other sites

I guess I don't understand this part. I'm not aware of any person (not even one) who can more easily afford insurance through ACA, than they could before, speaking specifically about lower income adults/families.

My disabled mother (lupus, seizures, strokes) is paying $400/monthly for health insurance (which doesn't include vision or dental at all), has a ridiculously high deductible, can't afford the new seizure medication her neurologist wants her to take, and only has a household income of about 25-30K yearly. $400/monthly, with a high deductible, out of pocket up-front payment required for diagnostics (most recently the CT Scan her doctors ordered), high co-insurance rates, etc, is NOT any more "accessible" for her now.

Same here.  I do not know a single person who has not been hurt by the ACA financially.  I do know a few that are now not barred from insurance while having a pre-existing condition, but that doesn't mean it is affordable. 

 

Our family deductible is around 10,000 now, if I recall correctly (and that is with a white collar, professional job).   Each person has a personal $5000 deductible that has to be reached.  Insurance gives us a rather small discount on certain procedures or drugs, I guess.   

 

God willing, on any given year (except when I had surgeries) we will never hit this.  So we have catastrophic insurance that costs us thousands of dollars a year and is all out of pocket until a very high threshhold. 

 

Welcome to America. 

  • Like 7
Link to comment
Share on other sites

I guess I don't understand this part. I'm not aware of any person (not even one) who can more easily afford insurance through ACA, than they could before, speaking specifically about lower income adults/families.

My disabled mother (lupus, seizures, strokes) is paying $400/monthly for health insurance (which doesn't include vision or dental at all), has a ridiculously high deductible, can't afford the new seizure medication her neurologist wants her to take, and only has a household income of about 25-30K yearly. $400/monthly, with a high deductible, out of pocket up-front payment required for diagnostics (most recently the CT Scan her doctors ordered), high co-insurance rates, etc, is NOT any more "accessible" for her now.

 

It varies quite often based on the state exchanges.

Rough numbers from a recent HHS report the number of uninsured since the ACA was implemented has fallen by 16 million, and the % of Americans without insurance has fallen from roughly 20% to around 13%.

 

http://aspe.hhs.gov/health/reports/2015/MedicaidExpansion/ib_UncompensatedCare.pdf

 

With that said I think we should still find ways to do much better.  If those in favor of repealing the ACA would put forth a proposal that covers even more Americans I would jump behind their proposal with both feet.

  • Like 7
Link to comment
Share on other sites

I am terribly sorry for your mother, but may I inquire how she paid for her significant medical expenses prior to the ACA? A high deductible plan kicks in after a hospitalization for example.

 

Excluding dental and vision from medical is also mind boggling to me.

I can't speak for the other poster, but insurance actually used to pick up most of the cost.  When my mother passed away, I think I ended up paying maybe $1,000 total to settle all the bills, which came months later, not the moment you cross the threshhold coming home, like today.  Insurance picked up everything.  She paid into it for many years, never using it, and when she needed it at the end of her life, it was actually useful.

 

Not very true anymore. 

  • Like 4
Link to comment
Share on other sites

Our kids have Medicaid, we have access to the VA. 

You should be fine with VA coverage. That was one of the issues brought up to claim that the Burwell v. King complainants didn't have standing.

 

I guess I don't understand this part. I'm not aware of any person (not even one) who can more easily afford insurance through ACA, than they could before, speaking specifically about lower income adults/families.

 

You live in a state that didn't expand Medicaid coverage. The 8 million newly insured tend to live in states that did accept that federal program.

  • Like 4
Link to comment
Share on other sites

So the "issues" with the ACA will go away when i collapses...which means we will have even more citizens who cannot get access to any health insurance.

Yep.That will make it all better,

 

We need to eliminate insurance companies, who profit from the misery of others while denying as many claims as possible. 

 

Then we need to eliminate the pathetic sick care we have in this country, where the only answer is to "cut if out or medicate".   

We need health care.  We don't have it. 

  • Like 9
Link to comment
Share on other sites

My very basic bronze plan went from $16 / month last year to $112 / month this year for exactly the same plan with a very high deductible.  That's an insane increase.  I've moved to a Christian health sharing plan.  I'm so very disappointed because we need a major overhaul of our health care system.  This isn't it. 

 

ETA:  The plan covers just myself.  My daughters are on CHIPS.

Wow.  Yes, huge increase.

My friend, whose husband was unemployed went from $400 to $800 a month abruptly.  That was really hard for them, expecially being, well, unemployed. 

 

However, he now has employment and insurance. 

Link to comment
Share on other sites

Same here.  I do not know a single person who has not been hurt by the ACA financially.  I do know a few that are now not barred from insurance while having a pre-existing condition, but that doesn't mean it is affordable. 

 

Our family deductible is around 10,000 now, if I recall correctly (and that is with a white collar, professional job).   Each person has a personal $5000 deductible that has to be reached.  Insurance gives us a rather small discount on certain procedures or drugs, I guess.   

 

God willing, on any given year (except when I had surgeries) we will never hit this.  So we have catastrophic insurance that costs us thousands of dollars a year and is all out of pocket until a very high threshhold. 

 

Welcome to America. 

 

I would say your sample size must be extremely limited for the bolded statement to be true.  I also find it interesting how every premium increase and deductible increase post 2010 is blamed on the ACA, which somehow blissfully ignores the rapid premium increases we have been experiencing in this nation since the 90s.

 

Oddly enough, average premiums from 2014 to 2015 have been flat. The average deductible increased by 1%.

http://www.ncsl.org/research/health/health-insurance-premiums.aspx

 

 

 

  • Like 6
Link to comment
Share on other sites

We need to eliminate insurance companies, who profit from the misery of others while denying as many claims as possible. 

 

Then we need to eliminate the pathetic sick care we have in this country, where the only answer is to "cut if out or medicate".   

We need health care.  We don't have it. 

 

Okay.  I think we have a starting point of agreement.  The question then becomes what do we replace them with?

 

I won't address your second line as it is one of those statements that kind of sounds good but doesn't have any true meaning.  Sometimes surgery is required.  Sometimes medication is required.  I am not sure if turning health care into a sound bite really helps.

Link to comment
Share on other sites

The premium plus the high deductible and copays are much more than the penalty plus paying out of pocket if the person is in good health.

 

Depends and there is no way you can accurately make a blanket statement like that.

 

I think we do need to quit pretending that the high number of uninsured in this nation are able to have better access by paying OOP.

  • Like 3
Link to comment
Share on other sites

The premium plus the high deductible and copays are much more than the penalty plus paying out of pocket if the person is in good health.

 

I would like to go back to PPO. Those plans were much better.

Our high deductible plan (utilizing a health savings account) has been a huge cost savings. We should have gone that way years ago.
  • Like 4
Link to comment
Share on other sites

The 4 adults in my home don't have it bc of the cost. Pure and simple. If by some miracle we scraped the funds together, we then wouldn't be able to afford the copays and deductibles.

 

But all of that aside, I think the discussion is moot to the real issue.

 

Having insurance does not mean you are getting healthcare. It is NOT the same thing. Millions of people before ACA and millions of people after it pay a fortune for healthcare or have state insurance and go without care every single day bc they still can't afford it and or get access to it. Medical bills were the leading cause of bankruptcy even for people who did have insurance before ACA and I don't see signs of that changing after ACA either.

 

Personally I think this entire mess is a national disgrace.

 

ETA: We pay entirely out of pocket or not at all. Our vision and dental is cheaper than with insurance with the exception of braces. That's painful regardless of insurance. My dh's insulin is $200 per bottle but even adding up all his insulin and insulin materials and blood work for the year, it came out cheaper than the cheapest plan on the market for only him. (Not covering me too.)

 

I recently had an emergency room visit for me. Adding in all our medical expenses even with that (we keep medical bills for this comparison purpose and if we get lucky for tax write offs) - still cheaper than the cheapest medical plan we could have purchased.

  • Like 14
Link to comment
Share on other sites

The 4 adults in my home don't have it bc of the cost. Pure and simple. If by some miracle we scraped the funds together, we then wouldn't be able to afford the copays and deductibles.

 

But all of that aside, I think the discussion is moot to the real issue.

 

Having insurance does not mean you are getting healthcare. It is NOT the same thing. Millions of people before ACA and millions of people after it pay a fortune for healthcare or have state insurance and go without care every single day bc they still can't afford it and or get access to it. Medical bills were the leading cause of bankruptcy even for people who did have insurance before ACA and I don't see signs of that changing after ACA either.

 

Personally I think this entire mess is a national disgrace.

 

I agree 100% with the bolded.

 

I can't agree with the paragraph prior as that is dependent upon what type of access many people have and is often dependent on how the state exchange was set up.  I have a SIL who is self employed and will tell you she absolutely has benefited from coverage she was able to get from her state exchange.

  • Like 1
Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

 Share

×
×
  • Create New...