Just checked my new ACA rates

[RayLib]

Well, the so called ACA keeps going up up up! Me, my wife and 3 kids.

2013 BCBS rate - $ 456 (blue saver)
2014 BCBS ACA rate - $1099 (blue silver saver) +141%
2015 BCBS ACA rate - $1299 (blue silver saver) + 18%
2016 BCBS ACA rate - $1699 (blue silver saver) + 31%

31% increase for 2016!!!

Since I don't qualify for any subsidy, I have to pay it all. So, the AFFORDABLE Care Act is not affordable for me.

[darkangel218]

1. That is why we need a single payer system.

Even if the ACA works for some, it does not work for many, sadly.

[Scuba]

61. Medicare for all, including dental, optical, hearing aids and mental health services.

And yes, we can afford it.

[Baobab]

159. The limit on profits violates WTO rules so it is likely just temporary

(Note there are elements of satirical/sardonic thinking in my rant here, please understand I am very very very tired of telling people all this, it takes a toll on somebody, so please understand - the core is factual and please i beg you verify it and learn more about it, by googling phrases i use. We have been victimized by a huge scheme, we of planet Earth. )

In 1998 the US signed a document - part of the WTO GATS understanding on financial services which contains something called a standstill clause that freezes all regulations and creates what is in essence a one way street So called "progressive liberalisation" - You should Google that term. Basically, as Lori Wallach discussed in a Democracy Now episode around two years ago about TiSA, in a show entitled "a plan that only banksters could love" the WTO General Agreement on Trade in Services agreement which will be merged with TiSA has special dates that will apply to set a ceiling for any public "state owned enterprise" "non conforming monopoly" etc, Rollback means that regulations literally have to be - will likely have to be "rolled back" to their state when the financial part of the GATS was signed (1998) if challenged (and its guaranteed that insurance firms will challenge it because its seen as a trade barrier, preventing international firms that want to enter the market - also open hospitals or set up arrangements to treat sick Americans overseas, for example in india. this maintains a healthy profit margin and is compatible with the free trade ideology of both US political parties, generally the trade deals and the secrecy has been a model of cooperation and consensus between the two US parties. (See "Washington Consensus" )

In exchange for opening "essentially all service sectors and modes of supply" services and their labour become tradeable commodities on the international market - with contracts to perform work, such as run schools, prisons, and perhaps even legislatures - except for the politicians (privatizations scope would be determined by the two part test found at GATS Article I:3 (b) and (c) - Those services that fail the test because they are not completely free and services provided as an exercise in governmental authority to low bidding firms, (which is called Mode Four) countries corporate leaders get concessions like National Treatment and Most Favored Nation (abbreviated MFN) in the foreign lands. Also, "the rise in monthly premiums may be reduced by 2.7% over ten years" (sound familiar) . Low cost providers with offices of convenience in countries with favorable regulatory structures and low wages may even operate hospitals. International services firms already have a presence in prisons, refugee detention and health care plan management, may be able to open new facilities outside of the US to care for the indigent sick. The demand for 'cafeteria style' plans that target specific diseases for extra coverage may be popular. For example, people could pick from a list of diseases to cover, excluding ones they felt were unlikely. Also firms can offer discounts to people who are willing to agree to be put into suspended animation if they become sick, allowing them to be shipped to the other side of the world for lower cost treatment, assuming their credit card is not declined.in short I can see a huge expansion in selling of "consumer driven" health care plans in the US that offer high deductible catastrophic coverage, and US firms will get the right to sell insurance and open factories in other countries and be treated exactly as if they are a domestic firm there. Plus profitability will be maintained. Former employees, such as doctors nurses, teachers, programmers, etc who clearly have lost their jobs as a result of treaties may receive retraining benefits.
The additional regulations - enacted after the signing of the GATS likely violate its standstill which reads as follows. " Standstill Any conditions, limitations and qualifications to the commitments noted below shall be limited to existing non-conforming measures." TiSAs standstill clause is essentially the line at the very beginning of the so called "mandate" which reads as follows" In detail, the agreement should seek to bind, in general, the autonomous level of liberalisation of the
parties " Those words will be seen as basically blocking any New Deal like programs in order to ensure that corporations have a level playing field. Also, dozens of other provisions act to systematically make cost reduction impossible without maintaining the rigid ideology of good better best being bought only by money-

Limits in medical underwriting are likely to be dumped too as violative of both standstill and the "fair and equitable Treatment" (FET for short) legal standard- as violative of the rights of investors to regulatory constancy- The other poster who said that our system really doesn't have any way to ask a company to not make its accustomed profit on something, was right, the lack of cost controls is a regrettable part of our private for profit only system, a uniquely American aspect that we are now successfully exporting by means of trade deals, resistance is futile, as shown by the failure of proposals such as the one linked here to gain buy in from the stakeholders, these deals are procedurally superior to national laws so they take precedence, as shown by the tone of this UNlinked document- ht tp://ww w.euro parl.eur opa.eu/sides/getDoc.do?pubRef=-//EP//NONSGML+AMD+A8-2016-0009+002-008+DOC+PDF+V0//EN (may need to remove the spaces then plug it into browser and then when it starts arriving, right click, save it as filenameyouchoose.pdf and then open- if the mime types are wrong and it doesnt open a PDF viewer as it should-)

that violates the Constitution, also we cannot switch to single payer because that would violate around a dozen provisions in the GATS ( see "The potential impact of the World Trade Organization's general agreement on trade in services on health system reform and regulation in the United States" by the late Nicholas Skala, RIP )

and also TiSA which is almost completed Also TPP and TTIP its likely. (see https://www.policyalternatives.ca/sites/default/files/uploads/publications/National%20Office/2016/02/Major_Complications.pdf especially the discussion of Achmea/Eureko v. Slovak Republic which you can find a factual summary of in the document here ) An long planned "solution" to the crisis created by rigid mercantile ideology is of course, more of the same- TiSA likely will push wages down by globalizing healthcare and education, maintaining profitability by opening services - "everything you cannot drop on your foot" to competition. Global subcontracting with no wage parity requirement, with disciplines on domestic regulation" to insure that no regulation is "more burdensome than necessary to ensure the quality of the service" Its likely that the convenient emergency would help with the sensitive nature of the transition, that, especially if they get the timing just right so it all falls apart creating a health care emergency just as the TiSA is signed. TiSA is almost completed in Geneva. So that is all basically in the pipeline -

May the Good Lord have mercy on our souls.

Too much </sarcasm>

[cantbeserious]

2. Embedded Greed In The For Profit Health Insurance System Will Drive All To Single Payer

eom

[Travis_0004]

20. I thought profits were limited under the ACA

[cantbeserious]

21. Fixed Profit On Top Of Escalating Cost = Increased Pain To Citizens

eom

[Baobab]

160. Not an innocent DEATH SPIRAL - something much much worse- a crime against humanity disguised as one

International Journal of Health Services - State Health Reform Flatlines (2008)

Its informative to read this IJHS paper on how many times we have tried the same approaches and every single time the same result occurred as now.

When the information about GATS and tiSA and WTO is combined with the above and we realize that scheme to use trade deals to future proof the future and trade jobs for markets has been cooked up over the past 20 years, a conclusion is reached that they knew exactly that their free market economics "experiment" would fail right around now

People should also be aware that the REAL "reason we cant have single payer" is GRANDIOSE, DELUSIONAL BAD TRADE POLICY.. (WTO blocks on affordable health care Paper that I linked earlier by Nicholas Skala in JHS not linked so that I am not determined by AI to be spamming)

Please see also PNHP Research Page

the point I am making is the last seven years of PreventCare (TM) can be seen as a intentional delaying tactic to act as a bridge until they could nail down the future with the three TRADE DEALS meanwhile hundreds of thousands of people have died.

the point I am trying to make is that we've been set up in a particularly cynical, evil medical economics experiment on human beings without informed consent, resulting in the unnecessary deaths of at least 2 million innocent people (100,000/yr x 20 years) "excess deaths amenable to improved access to health care".


See

https://en.wikipedia.org/wiki/Declaration_of_Helsinki

https://en.wikipedia.org/wiki/Nuremberg_Code

[progree]

26. There is no specific limit on profits, but spending on admin + profits must not exceed 20%

There is no "fixed profit" either, that 20% of all non-medical-benefit costs is a maximum, not a guarantee. Some are incurring losses on their ACA business. What their profit margin is depends on how competitive their market is, whether they estimated their costs and claims experience correctly when they set their premiums, etc.

[VanillaRhapsody]

3. Are you in a state that expanded Medicaid?

A family of 4 can get subsidized up to $90k a year

..

[mucifer]

5. OP said s/he doesn't qualify for a subsidy.

[VanillaRhapsody]

9. Well then..

They make too much money...if you make more than 400% of poverty level....be thankful for the caps....rhats what pays off for them.....I am not fooled by this bullshit....they wont go bankrupt by medical bills anymore....

By the way....caps on overhead now 20% thanks Obamacares.....

[progree]

8. For the ACA subsidies, it doesn't matter whether one is in a Medicaid expansion state or not

They apply in all 50 states. I believe 2015 poverty levels are used for 2016 subsidies. ACA subsidies go up to 400% of poverty levels, which is $97,000 for a family of 4. Family of 5, which the OP indicates he has, is $113,640.

http://obamacarefacts.com/federal-poverty-level/

Persons in household, Poverty level, 400% of poverty level

1 $11,770 $47,080
2 15,930 63,720
3 20,090 80,360
4 24,250 97,000
5 28,410 113,640
6 32,570 130,280
7 36,730 146,920
8 40,890 163,560

Medicaid expansion only goes up to 138% of the poverty level in Medicaid expansion states.

[VanillaRhapsody]

13. If you are in a state that didnt no....

[progree]

14. The Medicaid expansion thing affects only Medicaid. It has nothing to do with

the ACA tax credits that go up to 400% of the poverty level. Those apply in all 50 states.

[Cigar11]

4. Good thing ...

there's always the open market.

[RayLib]

6. Comparing

BCBS to United Healthcare, the only 2 choices, and they have the same rate.

[VanillaRhapsody]

10. But NOW there are max out of pocket....no more going bankrupt....there is a lrice for that...

[RayLib]

11. Yeah,

Like going bankrupt now!

[VanillaRhapsody]

12. No you are not......

How would a major surgery work for you without that cap?

How about some cancer or open heart surgery?

[RayLib]

17. Keep it you can

I am unaware of a surgery that would have exceeded $1 million cap that was on my pre-ACA plan, but nice try.

[VanillaRhapsody]

18. No it wasn't

Thats why even those with insurance filed for bankruptcy....not any more....nice try..

.http://obamacarefacts.com/dollar-limits/

[progree]

22. Did you have a cap on what you paid out of pocket on your pre-ACA plan?

I think that is what VanillaR was referring to. The cap on the total of the deductible + copays in a year.

[font color = red]on edit:[/font] http://obamacarefacts.com/health-insurance/out-of-pocket-maximum/

[RayLib]

28. In 2012

My daughter had an emergency appendectomy. I paid a $75 copay.

I think now I would have to pay $12500, the max out of pocket? I am not sure how the 70/30 copay and 6000 deductible works for something like an appendectomy.

[progree]

35. And now..

>> I think now I would have to pay $12500, the max out of pocket? <<

Sounds about right for a family of 2 or more. [font color = red]ON Edit: That's not the amount you HAVE to pay out of pocket, its the MAXIMUM amount you could pay for all medical expenses in a year (not including the premiums, but including deductibles and copays)[/font]

>>I am not sure how the 70/30 copay and 6000 deductible works for something like an appendectomy.<<

All medical expenses up to $6,000 in a year, you pay. Kaching.

Then above that level, 30% of all costs.

I have no idea what an appendectomy costs, I suppose I can look it up in HealthCareBlueBook or somesuch (which are average rates)

But if some surgery costs say $20,000, and that is your only medical expense in a year, you'd pay:

$6000 deductible
$4200 (remaining $14,000 * 30% copay)
----------------------------------------------
$10,200 Total

[hr]
If you had $4000 in other medical expenses in a year, than that surgery above would cost you:

$2000 remainder of the $6,000 deductible
$5400 (remaining $18,000 * 30% copay) [font color = red]On Edit: I corrected this[/font]
----------------------------------------------
$7,400 Total (such a bargain. limited time only. Act now and save!)


That's only if you are in network. The hospital might be in network, your surgeon might be in network, but the anesthesiologist might not be -- you could end up paying his/her entire bill, though I think most insurance plans have maybe a 50 or 60% copay on out of network providers, not 100%. (ACA's out-of-pocket maximums don't apply to out-of-network providers)

By the way, I sympathize on your premium increase. Mine went up 31% from $419/mo to $553/mo. (I'm single). And my copay for most procedures went up from 10% to 15%. And I don't qualify for subsidies either.

[VanillaRhapsody]

42. That is EXACTLY what I was talking about!

Last edited Sun Dec 6, 2015, 02:47 PM - Edit history (1)

Thanks!

[VMA131Marine]

15. so there are 5 in your household and you don’t qualify for subsidies

According to the table, that means you make over $113,640 per year or more than $9,470 per month before taxes, FICA etc. Seems like it should be doable.

Also the $1699/month premium is about equal to the total monthly cost of my employer provided insurance (employee + employer contribution of which I pay about 45%).

[RayLib]

16. Doable???

The premiums are increasing 31%!!! Not sure where I will find the extra $400, since there are no raises this year.

Were we not promised the ACA would bend the cost curve down? Hah! It has bent it way up instead!

31% increase! The bronze plan now costs more than my silver plan last year!

[VanillaRhapsody]

19. On $113,000 +?

Not buying...

[RayLib]

23. 31%. increase!!

That's just the year. It went up 141% the first year! You are right in not buying the "affordable" part.

[VanillaRhapsody]

24. So come on then

Whats your yearly....tell us how much it hurts!

[RayLib]

25. Not a bit

Cause I won't pay it! How much do you make a year? Hurry, so I can tell you how to spend it.

[VanillaRhapsody]

32. Good luck with your high stakes gamble...

Last edited Sun Dec 6, 2015, 02:59 AM - Edit history (1)

Hope you stay well...

[VanillaRhapsody]

89. Yeah.....you said you are not going to pay for it....

Thats a high stakes gamble with your health ...

[uppityperson]

27. you make $8000+ a month and can't find an extra $400?

[RayLib]

29. Not with

3 kids in college!

[RayLib]

31. 31% increase!

[uppityperson]

36. My insurance went you that much before ACA. Now not so much. Isn't it wonderful your kids

can stay on your insurance while in college?

[darkangel218]

39. Please ignore the negative comments.

You don't deserve this kind of hate, it is not your/our fault insurance companies age money hungry vultures.
We can only hope we will get single payer passed by the next administration.

[darkangel218]

37. What is that supposed to mean?

[VanillaRhapsody]

33. You can afford 3 kids in college and your complaining?

Cry me a river....

And those 3 kids can now stay on your insurance until they graduate and beyond.....THANKS to Obamacare.

[darkangel218]

38. Whow...

[pintobean]

40. Jury results

On Sun Dec 6, 2015, 02:19 AM an alert was sent on the following post:

You can afford 3 kids in college and your complaining?
http://www.democraticunderground.com/?com=view_post&forum=1033&pid=369

REASON FOR ALERT

This post is disruptive, hurtful, rude, insensitive, over-the-top, or otherwise inappropriate.

ALERTER'S COMMENTS

Insensitive post, please hide it.

You served on a randomly-selected Jury of DU members which reviewed this post. The review was completed at Sun Dec 6, 2015, 02:34 AM, and the Jury voted 0-7 to LEAVE IT.

Juror #1 voted to LEAVE IT ALONE
Explanation: No explanation given
Juror #2 voted to LEAVE IT ALONE
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Juror #3 voted to LEAVE IT ALONE
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Juror #4 voted to LEAVE IT ALONE
Explanation: No explanation given
Juror #5 voted to LEAVE IT ALONE
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Explanation: No explanation given
Juror #7 voted to LEAVE IT ALONE
Explanation:

Thank you very much for participating in our Jury system, and we hope you will be able to participate again in the future.

[JonLeibowitz]

45. I am floored by this comment

I am sorely disappointed in DU now. I thought this site would be at least somewhat liberal. Looks to me I am surrounded by freepers.

[LibDemAlways]

54. Awful, isn't it? A man is being reamed for

putting his kids through college. I've been here since Day 1 and can't believe what I'm seeing. No one should have to choose between educating his kids and paying for health insurance for his family. It's unacceptable that rising costs continue to put the squeeze on people. You'd think that would be one thing most people who call themselves Democrats could agree on, but apparently not. The ACA is simply not working for some, including the OP who appears to be new to DU. He probably thought he was coming to a safe haven for Dems and ended up unfortunately in the lion's den.

[darkangel218]

57. I was the one who alerted to that heartless comment.

7+0 to leave it. Lol.. What a freaking joke!!!

[LibDemAlways]

85. The poster who made that comment has no

conception of what it takes to put a kid through college today and apparently labors under the illusion that money grows on trees.

[Nictuku]

76. Divide and Conquer - Works every time

I don't like to post much here any more. Seems you get 'attacked' no matter what you post.

Aren't we all on the same side?

[LibDemAlways]

78. We should be, but we're not. Years ago

I posted in the lounge about a horrific restaurant experience I had in which the kid at the next table screamed for twenty minutes straight and threw food and plates while his parents ignored the whole thing. That innocuous post ignited a flame war the likes of which I couldn't fathom. I had people on here telling me it was that kid's God given right to scream his lungs out and I should stay home if I didn't like it.

That experience convinced me that on DU there is no such thing as general agreement about anything. A new poster explains his health care premium situation and backs it up with facts and becomes a target. Par for the course. I post way less than I once did, too, and for the same reason.

[Depaysement]

62. Who pays your healthcare premiums?

It sounds like it's a third party. The guy's paying a lot in premium for health care.

[VanillaRhapsody]

65. I do....

Sounds like the guy can afford it.....read the entire thread.....

[Depaysement]

73. I did

It is a lot of premium.

I pay health care premiums for my employees. On principle, I still refuse to make them pay any part of the premium, but the amount keeps increasing rapidly, so I may have to reassess that policy.

[VanillaRhapsody]

83. So....

He makes alot of money apparently....

He will never be pre-existing conditioned.....has a cap....is guaranteed yearly exams and preventative medicine free of charge....and his kids can stay in his policy through college and beyond......he is still getting more for his money than ever before ...

[LibDemAlways]

34. RayLib, I feel your pain. No one should be telling you

what you can afford. I just finished putting my daughter through 4 years of a public university. My bank account is way, way down. Over the course of those 4 years, I shelled out over 125K. I can only imagine the hit you are taking with 3 kids in school. And, I agree, your health insurance premiums are outrageous. For you and many others, the ACA is not affordable -- not if you want to eat, have a roof over your head, pay your utility bills, deal with the cost of transportation, and on and on....and pay for college for 3. I totally get where you're coming from.

[VanillaRhapsody]

41. Bullshit...

Its called The Affordable Care Act....

If one if those 3 kids came down with a major illness. ..he would be thanking his lucky stars....at least the other 2 would not have to sacrifice as a result...

[darkangel218]

44. What if he can't afford the premiums???

Should he pull his kids out of school to be able to afford the health insurance?

[VanillaRhapsody]

46. What would a poor person do?

What would he do if one of the 3 got Cancer? What would happen to the other 2 then?

[darkangel218]

48. That is WHY we need to stop defending the ACA and fight for single payer!!!!

ACA doesn't even work in the states wich refused the Medicaid expansion!
If a poor person , who doesn't make yne required 13.5k a year in one of those states , will be shit out of luck and probably lose their life! Because the ACA left it up to the States, to expand the Medicaid, among other messed up things.

So don't even go there.

[VanillaRhapsody]

66. Bullshit

Even Sanders says we should defend it....

[JonLeibowitz]

71. Yes, defend it from Republicans trying to gut it.

However, we can have a frank discussion about the extent to which it is successful. And, if necessary, conclude that SP is a better overall system (look what group you are commenting in) to expand and improve the ACA into.

[still_one]

128. The same thing that would have happened before the ACA, no coverage. While I understand and agree

with single payer, that just isn't going to happen for some time, regardless of who becomes President. At the very minimum, until the next census occurs will we have a shot at taking back the house.

That is why in the interim, they need to change the criteria so more people qualify for the subsidy. While that won't be a difficult as getting single-payer passed, it is still unlikely to happen for the same reason

[LibDemAlways]

51. I can't speak for the OP. However, if he says he can't afford the premiums for

his "silver" plan, I have no reason to doubt him. I have personal experience, however, with the silver plan sold through Covered California. Premiums are high, coverage sucks, and policy holders are not thanking their lucky stars when they discover that their shitty insurance covers practically nothing.

I am still helping a relative pay off $11,000 in uncovered medical expenses for a 2 day hospital ordeal in July of 2014. His bullshit ACA "silver plan" through Covered California with a $700/mo. premium proved to be mostly useless.

This country needs single payer/Medicare for all. Until that happens people will continue to be priced out of the market. Some will go without insurance. Others will buy ridiculously overpriced policies that are a joke. The winners for now are the insurance companies, which continue to charge more and cover less. What a racket.

[VanillaRhapsody]

67. How so?

Please elaborate or go on....

[RayLib]

114. I had insurance

Before. You sure are abusively defensive about the ACA, and seem willingly oblivious to it's myriad flaws!

[VanillaRhapsody]

145. Try living without....

Then you would understand its significance....

[Nay]

74. And don't forget, he and his wife are expected to save a couple million $$ for

their own retirement, too.

For most people all this shit is undoable.

[LibDemAlways]

81. Absolutely. As the parent of one

child whose savings were decimated by her college education, it is incredibly difficult to save or even make ends meet. Husband recently turned 65 and has no hope of retitring. I'm 63, still working, and taking care of my 93-year-old mother. House is falling apart. Car needs a major repair. Health insurance premiums through the roof.

On paper our income looks decent and we should be doing ok. The reality is far different, as I suspect it is for many.

[VanillaRhapsody]

84. Thats not because of the ACA....

[LibDemAlways]

90. The Affordable Care Act was a gift to the

greedy CEOs of the insurance industry. It has nothing to do with providing care at a reasonable cost to the American consumer.

[VanillaRhapsody]

91. Said the upper middle class guy that can afford 3 kids in college....

When was the last time you had to choose between food and a prescription?

[VanillaRhapsody]

121. Most people

Do not have a couple million stashed away for retirement

[blm]

79. The ACA or the finagling being done by BCBS against the spirit of the ACA?

People tend to forget the loopholes put into the ACA by GOP in committee in order to protect profits for the health insurance industry whose interests they serve.

Democrats on the committee should NEVER have accommodated the GOP on the proposals they added. They forced them through and then wouldn't support the overall bill, anyway. They are Lucy with the football, and Dems remain the trusting Charlie Brown - idiots.

[LibDemAlways]

80. The ACA in principle is very different from the ACA in practice.

The Covered California plans - my point of reference - are outrageously expensive with huge premiums, big deductibles, and lousy coverage. Those who just miss the subsidy cut off are majorly screwed. This thread suggests that health care coverage in the US is still in need of significant overhaul. Single payer/Medicare would be a Godsend for many.

[VanillaRhapsody]

86. That is a problem with California....not the ACA

[Skittles]

47. you can thank repukes for college costing so much

[darkangel218]

49. What about the "leave it up to the States" to decide expanding Medicaid

And leave if up to the private insurances to increase premiums?? The ACA is no where close to perfect or appropriate. Poor people here in FL are left to DIE, because the ACA left it up to our local gov to decide the faith of medicaid expansion. And our gov VOTED AGAINSt IT.

We need single payer, period. The ACA is flawed and its not working.

[progree]

52. The ACA did NOT leave it up to the states to expand Medicaid. That was a fucked up 5-4

Supreme Court decision.

On June 28, 2012, the U.S. Supreme Court issued its decision in the case challenging the Affordable Care Act (ACA). The Court upheld the constitutionality of the ACA’s individual mandate, which requires most people to maintain a minimum level of health insurance coverage beginning in 2014. A majority of the Court also found the ACA’s Medicaid expansion unconstitutionally coercive of states, while a different majority of the Court held that this issue was fully remedied by limiting the Health and Human Services (HHS) Secretary’s enforcement authority. The ruling left the ACA’s Medicaid expansion intact in the law, but the practical effect of the Court’s decision makes the Medicaid expansion optional for states.

http://kff.org/health-reform/issue-brief/a-guide-to-the-supreme-courts-decision/

[darkangel218]

53. Why didn't the President veto it?

Maybe he couldn't, I don't know. But the matter of fact is that many of the very poor are left to die.

The $13.5 K a year requirement is a bunch of baloney , and the poor are losing their lives because of it.

We need SINGLE PAYER STAT!!

[progree]

55. President can't veto Supreme Court decisions

Nobody at the time the ACA was written and passed dreamed that the Supreme Court would object to the Medicaid expansion and effectively make it optional for the states. There is nothing in the ACA that specifies that it is optional for the states, nothing for Obama to have vetoed on that score.

Single payer would be good, far better than the nonsense we have. But it is not the paradise that people make it out to be. Medicare is "single-payer", and yet it is estimated that Medicare beneficiaries over their lifetime after 65, pay on average 50% of their medical costs. It is definitely not free like so many think.

What I'm saying is we want to make sure single payer is really single payer (the government), and not the government and the patient. Or that the average patient ends up paying maybe 10% of the total cost, not 50%.

[darkangel218]

56. Then lets fight for it and not compromise to private ins companies!!!

We are still "we, the people" arent we?

[VanillaRhapsody]

87. Yes....those the other people

Are not going to let that happen...

Its not just a problem of private insurance getting in the way....

[VanillaRhapsody]

68. Then take it up with

Their Republican governors...

There is nothing in the ACA that prevents any state from going Single Payer.....even Bernie's home state of Vermont STILL hasn't done that.

[JonLeibowitz]

72. Do you understand that this isn't a Sanders vs. Hillary discussion? This is real people hurting

and trying to advocate for a better system, regardless of primary contests. You keep bringing up Sanders when others don't.

[krawhitham]

146. You just wrinkled my brain

Last edited Tue Dec 8, 2015, 09:47 AM - Edit history (1)

13 thousand posts and you believe it may be possible for the POTUS to veto a supreme court decision

[VanillaRhapsody]

153. Good catch...

[marble falls]

63. You have three kids in college but can't afford to insure them????? Sounds fishy.

[LibDemAlways]

82. He is no doubt facing thousands upon thousands

in tuition payments and living expenses for hs kids every couple of months. College, even public college, is ridiculously expensive. My one daughter graduated in June from a public university that cost $125K for 4 years. We struggled mightily to pay for it so she woukdn't be saddled with a bunch of loans. Very easy to see that the extra $1700 a month for health insurance which probably has high deductibles and co-pays could be a huge burden. Only someone without kids in college could have made your statement.

[VanillaRhapsody]

88. And?

What do you think poor people are dealing with

Would you trade with them?

[marble falls]

108. How can he afford NOT to insure college aged students? If I was making $100K....

a year, I could afford to educate three kids. I know because I made a little under that and I educated three kids, two with advanced degrees and two with Summa Cum Laudes. And you bet your bippy I kept them insured.

[RayLib]

116. Haha

Tuition, room and board are $8500 per semester, after scholarship for 1 child, at state run schools. Throw in miscellaneous expenses, books, blah blah, and 60% of that annual GROSS income of yours is gone. (I have 3 kids, do the math) Tack on another $20k for payroll and income taxes, and $20k for the ACA, and, well, there is literally nothing left!

You know not of what you speak!

[LibDemAlways]

119. Some of the posters here (and I put the most

obnoxiously vocal one on ignore this morning) seem to think that just because you don't qualify for a subsidy, you have unlimited funds that make it easy to meet all expenses. I put one child through public college and it took a huge chunk of my retirement savings. I did it gladly, but it was not easy.

No one should have to pay $1700 a month for health insurance - especially for the silver plan, which in my state, California, sucks. That's insane regardless of income. I guarantee that the crooks in Congress don't pay that kind of money for their insurance, and they'd be outraged if they had to.

I hope you don't give up on DU based on the posters who live in la la land and assume you can just go out to your garden and pick money off of trees. There are many people on here who live in the real world and work to make it better for everyone. At any rate, welcome to DU and thanks for sharing your story.

[VanillaRhapsody]

122. The real world indeed

[darkangel218]

140. +1

[marble falls]

141. And yet I have three "kids" educated and employed. Must have been a miracle.

[still_one]

133. it is not unusual for college to cost 25K and up per year per child, including books, board and room

[VanillaRhapsody]

143. But it doesnt have to cost that much

If you cannot afford that.....there are other options.....and.there are loans.....

[still_one]

102. That could easily run 300K plus for 4 years. That is why some who

think a 100k is middle class or greater, it depends on a lot of factors, and one size does not fit all

They really should take more things into consideration in determining the subsidy

[VanillaRhapsody]

123. Subsidies for a family of 4 is $97k a year

[still_one]

126. Do you have any idea how much it costs to send a kid to college, plus a mortgage, homeowners

insurance, automobile insurance, car payments? The way the ACA is setup if this family of 4 makes 98000, no subsidy.

Maybe some here do not understand, but I could see how a family of four making 100K could very will struggle to pay a health insurance premium of 1000+ dollars a month because they do NOT qualify for the subsidy.

However, if you want to talk what it was before the ACA, the premiums with much less coverage for a family of four, not covered by an employer plan were considerably more money than the ACA premiums are today. That still doesn't mean someone based on their circumstances wouldn't have problems with such a premium.

I stand by my post, more criteria needs to be taken into account to determine the subsidy

[VanillaRhapsody]

129. What if you had 12 kids?

Sounds like Obamacares is not really your problem

I didnt have a rich daddy that foot the bill for my college education....somehow I manage...

Most people do not have Daddy pay for thier college outright.....must be nice...

[still_one]

130. I don't have a problem, I have the means, but a lot of what is referred to as the middle class do

have a problem making ends meet, which is why more criteria needs to be taken into consideration so more qualify for the subsidy

[VanillaRhapsody]

144. Upper Middle Class....

Be real....

[still_one]

147. No offense but you really have no idea what you are talking about. It also depends where you live

[VanillaRhapsody]

150. if you can afford 3 kids in college....

and are making more than 8 grand a month....yeah...that pretty much says it all...

[still_one]

151. We just disagree on this, and that's ok. That is what a discussion board is all about

[VanillaRhapsody]

152. How?

Ridic....I am not buying that load he is peddling....

[still_one]

154. ok, I am not going to debate this with you. Take care

[VanillaRhapsody]

156. The dude that wrote this OP

Already got served a pizza....and here you are still defending this nonsense...perhaps he can offer you a slice in consolation...

[still_one]

157. I am not defending the OP. What I am saying there are people who are on the borderline, just over

limit for a subsidy, and it could be a hardship for those people. That is why the ACA allowed people to opt out of the ACA if 8% of their income was less than the premium for the Bronze plan.

In other words, those who wrote the ACA knew there would be situations where the ACA could be a hardship on people whose income is just slightly above that they do not qualify for a subsidy.

It is situations like that which need to be corrected.

I had no idea the OP was a troll, but the OP wasn't the point I was addressing. My point was that certain deficiencies exist with the ACA, and they need to be corrected

[VanillaRhapsody]

158. Look....a family of 4 are subsidized up to $97k!

This is not the sword to fall on over Obamacares...some people will jump on any bandwagon criticising it.

Hell I have to pay school taxes....yet I had no children....is that fair? No....but its the price I pay for living here....life is never going to be completely fair. Am I going to starve to death over it? No....and neither would that guy if it were true....which I never believed....Come on.....he claimed to be outright able to straight up pay for 3 kids college...most people take out loans for that! I sure as shit know a boatload of folks that would trade problems with that guy...

[VMA131Marine]

75. So there's a lot more to this story that you are leaving out

What's the deductible on the new plan?
What's the max-out-of-pocket limit on the new plan?
Did you spend more than the deductible on health care this year?
Did you exceed the max-out-of-pocket limit this year?

If your only interaction with the health care system every year is routine check ups then a silver plan is probably more than you need. But if you hit the max-out-of-pocket then the plan, as expensive as it is, is still saving you money overall - a lot of money actually. As I said in my first response, the total cost of my employer provided insurance, i.e. the employer and employee funded contributions together is about $200 more than you are paying for a $3,000 deductible and a $7,000 out-of-pocket limit, so the price for 2016 isn't out of line with the rest of the market. I did see a much smaller increase in 2016 premiums than you so you actually paid a lot less for insurance this year than I (and my employer) did.

I'm not arguing that the ACA is perfect, far from it. Just that your current premium doesn't seem to be greatly out of line considering your income and there are ways to lower it if you are not currently spending close to the deductible or OOP limits. The one thing you don't know is what your premium would be without the ACA. Do you or any of the other members of your family have conditions that would preclude them from getting insurance at all? Would your college age kids be able to afford insurance if they couldn't stay on your plan? It's only when those questions are answered that it would be clear whether ACA is working for you or not (and, to be honest, ACA wasn't really designed to help people with your (and my) income levels).

[RayLib]

112. Point is

My premiums have almost quadrupled under the "ACA" in 3 years, and New policy has higher co pays and deductibles than pre-ACA. It is just outrageous.

[VanillaRhapsody]

124. I do not believe you...

[still_one]

101. Medicare for 2 with a drug plan and supplemental F it can run

easily 500 dollars plus a month

[RayLib]

7. That's over $20,000 per year!

Just for premiums!!! Not including the $6000 deductible, or the co-pays.

But at least the premiums are tax deductible, NOT!

[progree]

43. Medical costs, including premiums, are tax deductible -- the amount above 10% of your AGI that is.

Any medical expenses YOU (not your employer or other 3rd party) paid in after-tax dollars, and... etc.

If your AGI is say $120,000, than medical expenses above $12,000, including premiums, are probably deductible. So with a $20,000/year premium, it looks like you can deduct $8,000 of that (if your AGI is $120,[font color = red]000[/font]), and any other medical expenses you incur. [font color = red]Ooops Edited the 2nd AGI number[/font]

I know it still sucks.

Here's one on premiums
http://www.healthedeals.com/articles/are-health-insurance-premiums-deductible

[Squinch]

77. What would you pay for private insurance for the 5 of you?

I mean insurance not purchased through the ACA?

[RayLib]

113. It's actually about

$30 higher in healthcare.gov than it is directly from BCBS. I don't qualify for subsidies.

[Squinch]

149. It is very expensive, but you are no worse off

than you were without ACA, and you do have the wherewithal to pay insurance so you don't run the risk of bankruptcy in the face of a serious illness or accident.

Many who make very little money are much better off with the ACA. In the past, they could not afford any insurance, and were often financially destroyed by an illness or accident.

It's not perfect, but it's better than it used to be.

[darkangel218]

50. We need a single payer system asap, or we are fucked.

This is as simple as I can put it.

[VanillaRhapsody]

125. You think single payer is free?

[darkangel218]

131. What a silly question..

[VanillaRhapsody]

134. Did you ask a question?

Besides single payer is NOT going to happen until Republicans do not have the Senate and House......better accept that and adjust.

[darkangel218]

136. No thanks.

Bernie will change the status quo, or at least try to. All this "accept and adjust" mantra coming from the Clinton campaign makes no sense. We don't want more of status quo.

Bye now.

[VanillaRhapsody]

138. Bernie is no magician

A President cannot give us Single payer by decree...its naive to think so...

Democrats seem to know this.....things that make you go hmmmm.....

[darkangel218]

139. Whatever. Nt

[VanillaRhapsody]

142. Whatever is right.....

Republicans don't disappear if Sanders is elected...

[Zinner88]

58. This is why we need Bernie

This is why we need to elect Bernie Sanders. He's the only one who hasn't sold out to these people and the only one who will rein in the greed. Neither HRC or the Republicans will do anything that cuts into the profits of insurance or Big Pharma.

[darkangel218]

59. +1

[VanillaRhapsody]

69. Uh Bernie supports this system

Hell even Vermont has still not implemented Single Payer though there is nothing stopping them

[Historic NY]

103. The costs and tax increases necessary were staggering....

1. Vermont insisted on platinum-plated insurance coverage

The market-oriented way to bring prices down is to give consumers more control of their own health care dollars, like they have in every other aspect of the economy. If you as an individual control the money, you’re going to shop around for the best combination of quality and price. If somebody else is paying for the care, you’re less likely to care about how much anything costs.

Unfortunately, that basic insight is anathema to the progressive left. Single-payer advocates believe, on principle, that health care is best when it is “free to the patient at the point of care.” On the back end, of course, you pay for it in taxes, and in between the government decides whether or not you should be allowed to have that knee replacement or that mammogram. This is what we call rationing.

Sure enough, the Vermont plan insisted on not merely gold-plated health insurance for all Vermonters, but platinum-plated health insurance. As a point of comparison, the Bronze-level plans on the Obamacare exchanges have an actuarial value of 60 percent: meaning, for every dollar in health costs that a policyholder incurs, the insurance company will plan to pay 60 percent, and the patient will pay 40 percent in the form of co-pays, deductibles, and the like. Silver plans, used as the benchmark for Obamacare’s subsidies, have an actuarial value of 70 percent; Gold plans, 80 percent; Platinum plans, 90 percent.3. The Vermont plan would have required a 160 percent tax increase



The Shumlin administration, in its white-flag briefing last week, dropped a bombshell. In 2017, under pre-existing law, the state of Vermont expects to collect $1.7 billion in tax revenue. Green Mountain Care would have required an additional $2.6 billion in tax revenue: a 151 percent increase in state taxes. Fiscally, that’s a train wreck. Even a skeptical report from Avalere health had previously assumed that the plan would “only” cost $1.9 to $2.2 billion extra in 2017.

In 2019, Costa estimated that Green Mountain Care would have required $2.9 billion in tax revenue vs. $1.8 billion under pre-existing law: a 160 percent increase in revenue.

And the Shumlin administration was already backtracking from raising that kind of levy. After small businesses pushed back against a proposed 11.5 percent payroll tax, Gov. Shumlin promised to offer a grace period to businesses with fewer than 100 workers. That would have reduced Green Mountain funding by another $500 million or more, according to Costa, funding that would have to be made up in taxes elsewhere.

A big part of the reason why the Vermont plan was so expensive is because it tried to replace federally-subsidized insurance with state-subsidized insurance.

http://www.forbes.com/sites/theapothecary/2014/12/21/6-reasons-why-vermonts-single-payer-health-plan-was-doomed-from-the-start/





http://www.benefitspro.com/2015/02/05/why-vermonts-single-payer-system-didnt-work

[VanillaRhapsody]

106. Thus we have Obamacares....

[snot]

132. It doesn't require that kind of tax increase on everyone equally.

It does require that we tax the 1% a lot more than we have been for the last few decades.

[Historic NY]

135. The you didn't click through to find out why Bernies state Vt. couldn't do it...

and the 1% answer won't work . Vt. was facing an 11.6 % payroll tax. Somehow single payers people don't think they will won't have to pay anything. Even if they offered a lessor plan it wasn't worth it.

[Kilgore]

64. I feel your pain.

$989 for me, my wife, and one kid for a stinking $10,000 deductable bronze plan.

Please give me the bad old days when I was paying $475 with a $1,000 deductable. I don't want to hear that "but you get so much more now" bullshit. Don't need lactation services, pregnancy care (hell we are approaching 60!), drug rehab, and mental health.

[VanillaRhapsody]

70. You have three kids in college and pretend you can't afford

To insure them? That kind of pain?

[Kilgore]

92. WTF? I dont even have three kids!!

What I do have is a paycheck that has NOT GROWN and now having to budget for premiums that are over twice as much and a deductible that is ten times as much as my previous non-ACA policy. BTW before you begin down the cap path, ours had a 2 million.

That's pain as in BOHICA

Its also called smaller vacations, tighter grocery budget, and generally living close to the edge for my family.

FU** ACA, give me my old policy, FU** the A-holes who passed it. It has caused my family more financial pain than any other thing this administration has done. A shining example of Fu**ed up legislation.

[VanillaRhapsody]

93. Your old policy would

Let you get pre-existing conditioned out and no cap....letting you fall into bankruptcy...

My god....some never know when they've got it good...

A single person up to $ 45k.....gets subsidized.....a family of 4 up to $95k....

But you would rather we go back to gewer people with coverage at all and 18,000 a year dying from it....

[Kilgore]

94. Bullshit

I don't live in a theoretical world, and I don't write checks out of a theoretical checkbook.

1. We have no pre-existing conditions.

2. We did have it good, its called our old non ACA policy.

3. We don't qualify for subsidies, so it does not make any difference. And before you tell me that because we don't, we should have plenty of money to pay, stop to think that some of us help support the less fortunate in our families.

4. The ACA is a steaming pile of legislation. It should instead have addressed getting coverage for those who could not get it. Instead it fu**ed up policies and coverage that were working.

It is this one issue that makes me think our party had their collective heads up their butts when they passed it. A wonderful opportunity to craft legislation that would solve problems, streamline processes, and lower costs. Instead we end up with this.

Yes I am pissed, my daughter just broke her arm from a slip on the ice. Do you know how much my wonderful ACA compliant policy paid? Zero, Zip, Nada. It all went to my $10,000 deductible and was paid out of my pocket. Do you know what that little bit of ACA joy will be doing to our Christmas plans??

[VanillaRhapsody]

95. Bullshit.....you were not immune to

A pre-exusting condition then.....it could happen to anyone....

[Kilgore]

99. I have to deal with the cards as they dealt to me.

They dont include preexisting conditions

[VanillaRhapsody]

96. Those less fortunate in your family ALSO have

Health insurance access now....my god!

[Kilgore]

100. They do, and they did before.

It just costs them less since they have access to serious subsidies.

[VanillaRhapsody]

107. Well thats good.....now they wont go without....

And you wont be on the hook for thier medical bills....be grateful for that sheesh

[VanillaRhapsody]

97. Thats bullshit...

I have BCBS.....had a plate put into my wrist surgery....I paid $1000 period...

I am not fooled by this nonsense....

[Kilgore]

98. So lets agree to disagree

You think the ACA is wonderful.

I think its a steaming pile of expensive dog crap.

You keep it and enjoy it.

I will continue to find a way out.

[VanillaRhapsody]

109. Nope...i do not agree

Last year I was between gigs drawing unemployment....not the first time....but THIS time I could search for gainful employment without the added stress of worrying about medical bills.....guess what....I got a Blue Cross and Blue Shield Silver plan...for $61 a month with subsidies.....which I paid back with my income taxes after I found work....

So you damn skippy I support this plan....beats the holy hell out of COBRA.....perhaps you would like to pay for COBRA....but not I...

Some cannot see the forest for the trees...so no I don't agree to disagree....

[RayLib]

110. Happy about your success...

With the wrist surgery. But, FWIW, as I mentioned earlier, my daughter had an emergency appendectomy. I paid a $75 copay with my pre-ACA BCBS PLAN!

The whole point of my post is that my premiums have almost quadrupled under the "ACA", and now my copay and deductible is higher. I hear you on no preexistings, no cap, blah blah blah, but those are hypotheticals, and my out of pocket now is IMMEDIATE REALITY and OUTRAGEOUS!!!

And quit playing the class envy income card. Those posts come across as a petty and vindictive.

I work hard, started my own business, and travel 75% of the time. I could take a salaried job, and then I could get employer provided health, but at significantly lower income and student loans for my kids.

Oh, and with pre-ACA BCBS, my kids could stay on my policy as long as they were full time undergraduate students.

[VanillaRhapsody]

111. So?

Talking about class envy.....I dont envy you....I make a fine salary myself......you sound elitist..I just don't begrudge the next guy.....you have been told over and over the benefits you are experiencing...you are getting much more bang for your buck.....but all you seem to care about is the fact that you are seeing an increase.....like THAT never happened before ACA...

We have already established you are already pretty blessed...

[RayLib]

115. None

Of those benefits come close to compensating for the quadrupled premium. I am not "experiencing" any additional benefit. I would prefer not to have your blessed increased benefits in exchange for my old policy and premium that worked fine.

Elitist, hah! Glass houses for you, Winston. Keep telling me how my Chocolate Ration has been increased by the Ministry of Plenty.

[VanillaRhapsody]

117. A 30% increase is not

Quadrupled....that would be a 400% increase...

Me thinks this story is smelling fishy....

[RayLib]

118. From original post

2013 BCBS rate - $ 456 (blue saver)
2014 BCBS ACA rate - $1099 (blue silver saver) +141%
2015 BCBS ACA rate - $1299 (blue silver saver) + 18%
2016 BCBS ACA rate - $1699 (blue silver saver) + 31%

$456 increased to $1699 is almost quadrupled!

Your previous comment suggests you are projecting your mendacity...

[VanillaRhapsody]

120. Uh I have had BCBS all those same years...

Silver.......mine has NOT risen 400% not even close...

I call bullshit something still smells...

[abelenkpe]

104. 10,000 deductible?

That's harsh. Seriously. We need single payer.

[mwrguy]

105. now we know what's in the bill

Thanks, Pelosi.

[stopbush]

127. 37 posts. Welcome to DU...I guess.

[darkangel218]

137. What's your point?

[uppityperson]

148. FWIW, check his profile. eoom

[VanillaRhapsody]

155. We called it....

And look who all crawled out of the surbase to support this trolls bullshit meme ....