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So when can I choose to opt out?


BurntOrange&White

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On 6/9/2018 at 11:30 PM, Smax said:

 

Very true, you'd know if you ever logged on to their website and played around with the plans

 

 

 

We have children on both sides of the aisle running this country

Whataboutism, But Hillary, Both Sides is all you have left.  It still rings hollow as your party controls all facets of government.  

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On 6/11/2018 at 2:46 PM, David Dennison said:

FWIW, Obamacare isn't going anywhere, and this is why.

blog_obamacare_kaiser_poll_income_june_2

Interesting that approval peaks with the elimination of the individual mandate.

 

But here is the real reason why the obamacare individual market is going nowhere.

 

https://www.washingtonpost.com/graphics/2017/national/obamacare-marketplace-insurers

 

wpoc.jpg

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On 6/11/2018 at 8:45 AM, Johnny Sack said:

Yes, yes it has.  The average family now is paying something like $25k in premiums and deductibles for health insurance before coverage kicks in.  And no subsidies if you make over $90k.  How is that fucking workable.  Here are some articles on it.

 

https://nypost.com/2017/09/06/obamacare-is-making-the-middle-class-the-new-uninsured/

 

https://www.forbes.com/sites/theapothecary/2017/08/17/new-research-shows-many-in-middle-aged-middle-class-cant-afford-aca-policies-in-2018/#4fc7a66d461f

Second sentence is misleading.  The average family isn't paying 25K in healthcare costs.   You're coming up with the worst case scenario for a family and selling it as average.  And aren't you a lawyer?  You should know that insurance coverage is more than just the ins company paying the doctor.  It's allowing you in to see that doctor at negotiated rates or buying that prescription for 20% of the retail cost.    And ultimately paying your costs if you unfortunately face those high medical costs.

ACA definitely has problems (every Dem agrees) and they can be fixed/adjusted.  However the Right has said that they won't allow them to be fixed even at the expense of you average Americans.  2019 looks to be even worse in terms of ACA premiums and Congress/WH has said that they're going to allow it.

 

 

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NGE, Johnny said ~$25k is the payout threshold the average family must meet before coverage kicks in.  He didn't claim they were actually paying that much in health care costs.  I don't know if that's true, but the BCBS silver tier plan that we have (Blue Advantage Silver HMO) is pretty close to that.  Without credits, it's ~$1,400/mo premium and $6K/$12.7K (individual/family) deductible, so roughly $16.8K (premiums) + $6K ("best case" deductible) = ~$23K annually before coverage kicks in.  I don't know if the plan we chose is typical of other plans on the exchange - we chose that plan for the Rx coverage (wife's pre-existing condition is expensive).

Edited by bernorange
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That's a little higher than the averages bern, but not too much so. 

1 hour ago, Nice Guy Eddie said:

Second sentence is misleading.  The average family isn't paying 25K in healthcare costs.   You're coming up with the worst case scenario for a family and selling it as average.  And aren't you a lawyer?  You should know that insurance coverage is more than just the ins company paying the doctor.  It's allowing you in to see that doctor at negotiated rates or buying that prescription for 20% of the retail cost.    And ultimately paying your costs if you unfortunately face those high medical costs.

We did this issue back on the shag. What you say regarding the allowed costs are of course correct; however, the insurance "discount" is a fantasy value created only because of the dysfunction of the system.  It is not a benefit of the system, it is one of its fundamental flaws.  

Edited by Anastasis
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I believe our plan is 1700 per month plus 100% of all expenses except well child, well woman/man and childhood vaccinations up to 5k per individual and 7.5k for family. Dental for the kids only. It’s cheaper to pay out of pocket for adult dental than pay the added monthly premium for that. So we spend 20k per year if we access the system only for 6 office visits plus maybe some vaccinations depending on the year. If we need more we spend another 5-7.5 k before the insurance company pays 1 dollar. Of course if we get to 31k total they pick up the rest. 

 

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1 hour ago, bernorange said:

NGE, Johnny said ~$25k is the payout threshold the average family must meet before coverage kicks in.  He didn't claim they were actually paying that much in health care costs.  I don't know if that's true, but the BCBS silver tier plan that we have (Blue Advantage Silver HMO) is pretty close to that.  Without credits, it's ~$1,400/mo premium and $6K/$12.7K (individual/family) deductible, so roughly $16.8K (premiums) + $6K ("best case" deductible) = ~$23K annually before coverage kicks in.  I don't know if the plan we chose is typical of other plans on the exchange - we chose that plan for the Rx coverage (wife's pre-existing condition is expensive).

The fact remains is that the average family does NOT spend 25K on healthcare.  It's a hypothetical situation.  I know that some may spend that much but its an extreme minority.   Talking about the <5% cases is not designing the best system.

EDIT:  I agree that the current system is not sustainable.  Healthcare costs (premiums and direct expenses) have and are rising too much in comparison to income.   Even when we applaud lower-then-expected increases, they're still too high.  Something has to break.   I work in healthcare and we are absolutely starting to see  insured patients behaving as if they don't have insurance due to their large deductibles.    In theory, this should lead to lower premiums as insurance cos pay out less but I don't know if that is the case.

Edited by Nice Guy Eddie
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On ‎6‎/‎5‎/‎2018 at 6:53 PM, JBJ said:

They'll just gut coverage.  You'll have medicare, but it won't pay for anything.

They already did that in the previous administration.

I'd like to opt out and go back to Aetna.

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