Don't Blow Off ObamaCare

By Jeralyn, Section Obama Administration
Posted on Tue Dec 24, 2013 at 05:26:57 PM EST
Tags: health care (all tags)

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Update: Deadline extended until Friday for Colorado, no excuses needed, and on the national exchange until Thursday for those who had trouble logging on today (Official notice here.).

Midnight is the deadline to sign up for a health insurance plan under the Affordable Care Act for coverage beginning Jan. 1.

I spent a good part of the day checking out the plans and talking to a very helpful Colorado Health Exchange adviser. (Yes, I was on hold for 40 minutes, I was 86th in line, but it was worth it. He spent 40 minutes with me reviewing the best plans for the benefits I wanted.)

There are some great deals available on the Exchange and a ton of plan options. The website for Colorado is fast and easy to navigate. You can also access the details of each plan's coverage so you aren't buying a pig in a poke.[More....]

I still haven't decided whether to switch plans, but I could save $200 a month in premiums and go from a $3,000 deductible to a $750 deductible with an individual Gold plan and 100% coverage after the deductible. The downside is it is an HMO not PPO so it doesn't cover out of network doctors and providers -- and it's not an HSA. I still have a few hours to decide.

If you don't have health insurance, or if you want to lower your premiums, check it out. You have until Midnight.

I think the media and Republicans have unfairly distorted "Obamacare." Check it out for yourself and see if you don't agree.

Let us know if you signed up today and why, or if you checked it out and didn't, why not.

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Don't Blow Off ObamaCare | 48 comments (48 topical)

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Obamacare in Oklahoma (5.00 / 2) (#4)
by RAJensen on Wed Dec 25, 2013 at 11:16:06 AM EST

Oklahoma has one of the lowest premiums. My wife 63 years old hasn't health insurance for 6 years due to a pre-existing condition since I was layed off and retired early. Together we get 30K in social security. The ACA does not consider the untaxed portion of social security in calcuting family income. Tried to enroll her since October. The website was finally fixed. Got appoval in 30 minutes and selected as Blue Cross Blue Shield Silver Advantage policy with 94% cost sharing plan. The plan cost $446 per month before subsidy. The monthly premium after subsidy is $55 a month with a $500 deductible and a $500 maximum out-of-pocket cost. The BCBS rep called and told us we were enrolled and we recieved our bill for the first months premium.. $55 which we will mail out after Christmas. That's what a McDonald's or Walmart worker who earns 15K or 20K if filing jointly can expect in Oklahama City.

http://www.valuepenguin.com/health-insurance/OK/blue-cross-blue-shield-blue-advantage-silver-ppo-003

I am still confused (none / 0) (#5)
by ragebot on Wed Dec 25, 2013 at 12:45:00 PM EST

Jeralyn mentioned something about comparing the in network and out of network costs. When I checked the silver plan you linked to there was something about 20% coinsurance for some of the out of network plans for some of the cost sharing levels but there was a blank for other cost sharing levels including the 94% level you chose.

Can anyone explain in simple English what this means?


ragebot (5.00 / 1) (#12)
by RAJensen on Wed Dec 25, 2013 at 05:28:34 PM EST

The most expensive plans with highest deductibles do allow out of network coverage with added costs such as 20% co-insurance for out of network. We were careful to look at the in-network doctors and hospitals. The Blue Cross and Blue Shield PPO network does include my wifes primary care physican who she has used for many years despite not having any insurance. and every major hospital in OKC accepts Blue Shield Blue Cross in the in network PPO. We live within two miles of the two largest hospitals in OKC and both are in network. We realize if a referral to a specialist is made we will be careful to select an in network physician. Consumers have to make choices and understand the policies before selecting one plan over the other.


Maybe I am just out of the loop (5.00 / 1) (#17)
by ragebot on Thu Dec 26, 2013 at 09:47:33 AM EST

but I still am confused about what 20% coinsurance means, not to mention what not having 20% coinsurance means.

I could be wrong about this but does it mean you have to pay 20% of the out of network bill or that the insurance company will pay the 20% and you pay 80%; or maybe it means something completely different. Does nothing in the column mean you have to pay 100% of out of network coverage.

When I am not traveling on my boat, sometimes out of the country, I have a Sprinter van modified as a camper and I travel from national park to national park. It is all good and fine if you live with in two miles of the hospital you are using but lots of folks are not in that situation and it seems like they would be out of luck if they have to pay for insurance that limits coverage to small geographical areas and even then you can not use all the doctors/hospitals in those areas.

I hope I am wrong about this but it looks like some folks may need a lawyer to help them select an insurance policy.


: 80/20 (5.00 / 1) (#25)
by vicndabx on Thu Dec 26, 2013 at 12:19:26 PM EST

Generally means, your insurer pays 80% of approved charges and your coinsurance is 20% of approved charges. As an example
Provider bills $100
Plan approves $80
Plan pays $64
You pay $16
Doctor can not bill you for $20 difference between $100 billed vs. $80 approved if he/she is in network.

: "...but it looks like... (none / 0) (#30)
by unitron on Thu Dec 26, 2013 at 02:38:23 PM EST

...some folks may need a lawyer to help them select an insurance policy."
So then it's just the same as it's been for years and years?

: Don't forget (none / 0) (#40)
by jbindc on Fri Dec 27, 2013 at 03:09:58 PM EST

That some of those "lower premium" plans may end up costing you more if you actually use your insurance. Why? They don't pay for doctors' visits (outside of preventive visits) until you meet your deductible. In other words - you will pay full price (plus your monthly premium) for a doctor's visit that is not under the umbrella of "preventive care". Now, most people who have insurance through their workplace don't have this restriction, and many people who have been buying individual plans all along, are familiar with this, but for the many first-time buyers of insurance, this will be another "sticker shock".

Do you (none / 0) (#15)
by Mikado Cat on Wed Dec 25, 2013 at 10:08:13 PM EST

have any concern about the $400 a month you are taking from someone else to pay for your insurance?


Merry Christmas Mr. Potter! ;) (5.00 / 1) (#19)
by kdog on Thu Dec 26, 2013 at 09:57:46 AM EST

As a taxpayer, insuring a couple 60-something fellow Americans sure beats funding another aircraft carrier, the DEA, or the next NSA spy program in my book.

It's called priorities...and ours are f*cked up.

What I'm concerned about is why we have to let Blue Cross/Blue Shield administer the f*cking thing at such a high cost...when Medicare could do it cheaper.


That is Really Low... (5.00 / 1) (#21)
by ScottW714 on Thu Dec 26, 2013 at 11:28:53 AM EST

...can't really get any lower, especially this time of the year.

What is your solution, refusing subsidies by folks who need them ? Yeah, it's a crying shame we allow people with low incomes to pay less for heath care...

Do you have any concerns about the million dollar bombs we lay worldwide being paid for by folks who will never in their wildest dreams make a million dollars ?

Or is that caveman mentality meant just meant for ACA recipients on Christmas ?


When you consider... (none / 0) (#31)
by unitron on Thu Dec 26, 2013 at 02:40:50 PM EST

...that while they were working and paying income taxes, they were helping cover stuff like giving free money to congresscritters who happened to own a farm...


Will you? (none / 0) (#33)
by Yman on Thu Dec 26, 2013 at 05:36:56 PM EST

... when you are collecting SS, Medicare, etc.

... Not to mention whatever government spending you've already benefited from ...


Self (5.00 / 1) (#41)
by Mikado Cat on Sun Dec 29, 2013 at 10:28:28 PM EST

employed most of my life, so I paid double what most do in SS, and will never get a fair return on what I paid in.

Stealing is wrong, putting the government in the middle to do the strongarm portion doesn't change the morality.


BS (none / 0) (#42)
by Yman on Mon Dec 30, 2013 at 07:54:42 PM EST

Define "fair return". Were you not your own employer? Then you paid no more than what someone earning your same income and their employer paid combined. Did someone force you to be self-employed?

Why don't you post your total contributions for SS and Medicare and I'll be happy to tell you at what age you will reach your break-even point. You'll be happy to learn it is much earlier than you believe. After that point, you can refuse any additional benefits so as to stop your "stealing."

BTW - Taxes aren't "stealing". They're the law based on a system of government we've agreed to live by as citizens of this country. If you don't like the tax laws then you need to work to change those laws. But now that you mention it, I am kind of tired of having my federal tax dollars go to support all those red "taker" states who receive far more money than they contribute, all the while complaining about their taxes.

Sound familiar?


BTW - You didn't "pay double" (none / 0) (#43)
by Yman on Mon Dec 30, 2013 at 08:45:36 PM EST

I know this because I've also been self-employed for most of my life. In reality, you get to deduct half of your self-employment taxes from your net income. Moreover, you only pay self-employment tax on your net business income, or what's left over after you subtract your business expenses. Additionally, the tax rate usually isn't on 100% of your net business income. In 2010, it was only on 92.35% of your net business income.

So the reality is that someone in the 25% bracket pays an actual tax rate of 12.36%, not 15.3% (your "double" claim). All of which, of course, is before you take advantage of any self-employed income tax deductions which aren't available to W-2 workers - expenses for computers, cell phones, internet, home office expenses, mileage expenses, health insurance premiums, travel expenses, self-employment retirement assets, etc., etc. All of which also assumes that a self-employed taxpayer scrupulously claims all of the income they actually receive.


We pay double (none / 0) (#44)
by Jeralyn on Tue Dec 31, 2013 at 01:09:45 AM EST

I pay as employer and employee. I'm not buying your smoke and mirror arguments (or going to respond further.) It is what is is. The self-employed pay both the employer's share and the employee's share. It's unfair.


: How is it "smoke and mirrors"? (none / 0) (#45)
by Yman on Tue Dec 31, 2013 at 06:32:02 AM EST

This may be a sore spot for you, but my argument is not "smoke and mirrors". Yes, the self-employed pay both shares, but they also get to deduct the employer share from their net income before their tax liability is calculated. This is even if they don't form an S-corp to reduce the rate further and before including the other deductions they can take that W-2 earners can't.
BTW - I was self-employed for the past 15 years.

Signed Up (none / 0) (#1)
by squeaky on Tue Dec 24, 2013 at 05:39:48 PM EST

Thanks to your reminder in yesterdays open thread... I was under the impression that I had until the 31st... at least that is what my healthcare provider (Oxford aka UnitedHealthCare) told me in a mailing..

But that was a pitch to get me back after telling me I would be cancelled as December 31... Looks like I got a better plan than I had for half the price... it includes meds and dental..

The comparable plan Oxford sent in the mail was more than twice the one I would up signing up with.. and more than the one that they had on my NYS health care signup site..

took about 10 minutes to decide..

: good for you (none / 0) (#2)
by Jeralyn on Tue Dec 24, 2013 at 06:25:09 PM EST

I'm glad it worked out. I read your comments in the open thread, and that's what got me to check today.

I have left my insurance (none / 0) (#3)
by the capstan on Tue Dec 24, 2013 at 08:15:08 PM EST

with the organization for which my husband worked. (He died back in 2006.) The organization deducts payments for health care monthly from my pension check--a supplemental plan for medicare. It is not the cheapest on the market, but it leaves me with no med bills or co-pays at all (IF medicare approves of the expense). Next October I may investigate further, but there is an issue of security and convenience involved.

You are lucky you don't live in Guam. (none / 0) (#6)
by Abdul Abulbul Amir on Wed Dec 25, 2013 at 01:35:50 PM EST

Good luck finding 2014 individual coverage there.

Awww (5.00 / 1) (#7)
by squeaky on Wed Dec 25, 2013 at 01:46:17 PM EST

Looking our for the poor people of Guam... nice christmas spirit for a hard line GOPer who usually does not give a sh*t about the disenfranchised..

Here as a comment from your link in to your pants on fire compassionate (cough cough) plea to repeal the ACA:

Should we repeal Medicare Part D too?
Because it had many roll-out problems that were uncannily similar to ACA. Only difference is that -- unlike Republicans -- Democrats didn't relentlessly demagogue it for 3 years and they cooperated with efforts to fix the problems and unintended consequences with Medicare Part D.
I'll let Newt Gingrich explain to you why you can't have guaranteed issue without an individual mandate:
[quote] We believe that there should be must-carry, that everybody should have health insurance, or if you're an absolute libertarian, we would allow you to post a bond, but we would not allow people to be "free riders" failing to insure themselves and then showing up in the emergency room with no means of payment. If you have must carry, then the insurance companies have told us that we can have must-issue, and you will therefore have a system in which you don't have to worry about cherry-picking and maneuvering. ... This is the kind of general model we will be advocating.[/quote] ---Newt Gingrich (May, 2009)

Squeaky, I'm glad everything has (none / 0) (#8)
by jimakaPPJ on Wed Dec 25, 2013 at 02:30:55 PM EST

turned out well for you but comparing Part D problems and Obamacare is apples and oranges. And to be fair, the complexities are also like apples and oranges.

Plus, you didn't lose your existing drug insurance plan, you could actually keep it if you wanted it (Period!) ;-)

The Part D problems were not technical and centered around trying to get an older population to understand the "doughnut hole," etc.

"The issue with Medicare Part D is there were choices of 70 to 100 plans," Brailer said. "People were overwhelmed with the choices, with the options available and didn't know how to navigate and pick one. I don't remember a conversation at all blaming any IT people. This was about how do you really navigate through all these choices."
Meanwhile, most people who logged on to healthcare.gov in the opening weeks couldn't even get far enough to review what options were available.
Also, prescription drugs are a relatively small and easy-to-understand part of health care. Shopping for an insurance plan is more complicated.

And when I read thus:

"These days, nine in 10 seniors who utilize the program report they are satisfied with it."

I just wanna cringe and then demand to see the complete poll. I can't believe 9 out of 10 are happy with having to justify every non-generic drug change by their doctor and waiting for the decision. Not to mention having the insurance company drop a drug off the approved list and not having to notify all users by mail.

Maybe that was what Ted Kennedy and other Demos were thinking about when they were opposing Part D.

But I am glad to know you are a great fan of Newt! Of course I'm still trying to find out what elected position he held in 2009.


Hahahahaha (none / 0) (#9)
by squeaky on Wed Dec 25, 2013 at 03:11:25 PM EST

Hmmmm no link? Oh well google to the rescue:

Did Medicare Part D have the same rollout problems as the Obamacare online marketplaces?

Our ruling [Tampa Bay Times]
Israel said, "Things went wrong with the Medicare prescription D plan that George Bush rolled out." There definitely were problems, and in some cases, the parallels between the prescription benefit program's introduction and the Obamacare marketplaces are strikingly similar. While we also found some serious differences in the laws, we can't find fault with Israel's fairly general statement.
We rate his statement True.

oooops..


No 2014 individual insurance in Guam (none / 0) (#10)
by Abdul Abulbul Amir on Wed Dec 25, 2013 at 04:06:47 PM EST

Is far worse than anything ii part D. Part D took insurance coverage from no one.

It is far worse than the "you can keep your plan" lie. Those folks will have no plan at all. Newly uninsured courtesy of Obamacare, Reid, Pelosi, and the Dem party.


Yes (none / 0) (#11)
by squeaky on Wed Dec 25, 2013 at 05:01:35 PM EST

Far worse: PURE EEEEEEEEVIL

Lies... Deceit... the eeeeeeevil D, are going to bring Amurika down..

The plan no doubt was hatched as a muslim commie whose birth certificate was faked.

If you wanted a man to encourage the van,
Or harass the foe from the rear,
Storm fort or redoubt, you had only to shout
For Abdul Abulbul Amir

hahahaha


Per Squeaky (none / 0) (#14)
by jimakaPPJ on Wed Dec 25, 2013 at 05:37:00 PM EST

Well, if you insist/

lol


Squeeky You are Missing the Apples... (none / 0) (#22)
by ScottW714 on Thu Dec 26, 2013 at 11:40:49 AM EST

...and oranges. They are about D's & R's, not the actual programs. You see when the R's roll out something and it's a complete wreck, those are the apples, when the D's do it, those are the oranges.

So when Jim says "it's like comparing apples to oranges" what he really means "Is the republicans are infallible because Fox told me so, never mind what you see, our program is better and your programs are the GD devil in it's Muslim form". There is not a policy, including Iraq, in which the truly deluded, like Jim will not profess it's better than anything D-related. Pretty sure Jim still thinks Hussein was behind 9/11 and how are you going to argue with that. Apples and oranges.


Yes (none / 0) (#24)
by squeaky on Thu Dec 26, 2013 at 12:09:05 PM EST

Although, as is par for the course with jim, the most hilarious thing was that the quote he used to support his BS, was cherry picked from an article concluding that the rollout problems between Medicare part D and Obamacare faced are comparable.

Apples to Apples was the answer, but Jim the sleuth that he is, decided that he could make the case with an out of context cherry picked quote, that D and R are apples to oranges.

And, I do think you may share something with Jim, when you characterize Obamacare as a complete wreck.. and Fox..

always interesting to see strange bedfellows when it comes to grinding political axes.... although not so strange at TL..


I Meant the Rollout... (none / 0) (#26)
by ScottW714 on Thu Dec 26, 2013 at 12:40:53 PM EST

...which was a train wreck.

I like the underlying legislation in that is was the best deal at the time, but I don't like for profit companies being mixed in with mandates. We are basically guaranteeing them business with no benefit, and the IRS becoming the enforcement of the mandate. Not a bad niche if you are a business, but sucks for the country.

Better than what we had, but like most, ideally, expanding Medicare would have been my choice.


Yes (none / 0) (#27)
by squeaky on Thu Dec 26, 2013 at 12:57:00 PM EST

Single payer, medicaid or other may have been better... but gotta start somewhere and for me, and many friends, this is a huge improvement.

And, had you said "train wreck", rather than complete wreck, regarding the rollout which just ended, (medicare D was the comparison), that would have been an apt analogy.

"Complete wreck".. that describes something vastly different, imo.

I am sure you meant train wreck.. I agree..


Ted Cruz Called it a Train Wreck... (none / 0) (#47)
by ScottW714 on Thu Jan 02, 2014 at 01:45:04 PM EST

"I would do anything and I will continue to do anything I can to stop the train wreck that is Obamacare,"

- Ted Cruz

Granted he's not talking about the rollout, but the point is still the same.


Huh? (none / 0) (#48)
by squeaky on Thu Jan 02, 2014 at 03:01:36 PM EST

The operative word in Cruz's statement is hardly "train wreck".

What he said:

I will do anything to STOP... Obamacare..


Right... (5.00 / 2) (#49)
by ScottW714 on Fri Jan 03, 2014 at 11:18:16 AM EST

...my point was I think Cruz was using what he felt was the strongest language possible to describe Obamacare, so if he had thought a complete wreck was worse, he would have used it.

The point really was your argument about train wreck vs. complete wreck was beyond silly as it's extremely subjective. But I get it, you like to argue, even over the most inane stuff, especially with people who agree with you.


: Hilarious (none / 0) (#50)
by squeaky on Fri Jan 03, 2014 at 02:05:47 PM EST

But I get it, you like to argue, even over the most inane stuff, especially with people who agree with you.
And hilarious to know that you think you are better than some because you do like to argue, particularly when you think it is silly argument and not worth the effort.
And we are certainly not in agreement about Obamacare. I would never characterize it as a train wreck, or a complete wreck.
I would characterize Obamacare as a big victory for American citizens, and am not surprised that the rollout had bumps along the way. Certainly nothing remotely catastrophic like a wreck of any sort.

Your sudden concern ... (none / 0) (#34)
by Yman on Thu Dec 26, 2013 at 05:43:41 PM EST

... for the citizens of Guam would be touching ...

... if it was real.


Heh (none / 0) (#13)
by jimakaPPJ on Wed Dec 25, 2013 at 05:35:15 PM EST

Don't forget it took France (none / 0) (#16)
by fishcamp on Thu Dec 26, 2013 at 07:27:20 AM EST

fifteen years to roll out their health program from the end of WWll until 1960. I realize we don't live in France but it is an indicator of how difficult these programs are. And yes I think Medicare part D is changing before our very eyes with no notification. I'm trying to get back to no meds at all but I think I'm stuck with the acid reflux and prostate pills. Strangely they're saying vitamin pills are not doing much or any good. Sorry no link for that statement but it has been in the news regularly.

fishcamp (none / 0) (#18)
by ragebot on Thu Dec 26, 2013 at 09:51:18 AM EST

for quite some time many health professionals have said taking vitamins is a waste of money and can have a down side if you don't stay well hydrated. Just as an aside acid reflux, and to some extent prostrate issues, are symptoms of diet issues.

I know this is something we have all been told till we are sick of hearing it but the best thing many folks could do is get more fiber.


Fiber... (none / 0) (#23)
by ScottW714 on Thu Dec 26, 2013 at 11:48:30 AM EST

My motto, be kind to your prostate and it will be kind to you. No such thing as too much fiber as far as I am concerned.

FYI, I picked up a Nano QX, so far I had had to replace the body, a motor, and bought two extra batteries. My dogs want to strangle you I imagine, they were down with the little car I have, but the quad is causing them great stress.

Been looking at the 350 QX, if this keeps my attention for a couple months, I will definitely upgrade. Too much fun, and so far with everything I am maybe $150 into it.

Thanks for the recommendation.


DIY RC (5.00 / 1) (#28)
by ragebot on Thu Dec 26, 2013 at 01:06:39 PM EST

is often much cheaper and quicker than ordering parts. On most of the mini quads you can use one of the tops of the frozen Coke drinks they serve at burger joints, those clear half dome things. I went to Burger King a few times just to order the frozen Cokes so I could get the tops, but the last time a employee there just gave me half a dozen. You can use a soldering iron to create the holes or a hobby knife or finger nail clippers. Soda straws are also useful for structural repairs. Generic batteries are a lot cheaper than the ones you get from blade. Ebay sells them as well as other online hobby shops.


I love reading you guy's comments (none / 0) (#35)
by ZtoA on Fri Dec 27, 2013 at 12:28:38 AM EST

Its like reading a foreign language which I don't understand. Or maybe its just late and after too many days of partying....


: Está usted en lo cierto la primera vez (5.00 / 1) (#37)
by CoralGables on Fri Dec 27, 2013 at 08:36:30 AM EST

Es un idioma extranjero.

Ordering Parts... (none / 0) (#38)
by ScottW714 on Fri Dec 27, 2013 at 09:16:39 AM EST

...for me is going down the the local RC hobby shop about 7 mins away. They carry Blade.

In your videos of the Everglades, what sort of camera did you have strapped onto the quad ? That FPV has got me all excited, but first I think I need to learn the basics before I start taking dollars up in the air.

And Z, FPV is first person view. It's basically taking a camera, mounting it on a some sort of remote controlled aircraft, then using either a small screen or a pair of goggles to fly as if you were in it. HERE is a video, if you look close, the 'pilot' is sitting in a chair wearing goggles flying the aircraft.


: Cheap Ebay Camera From China (none / 0) (#39)
by ragebot on Fri Dec 27, 2013 at 11:21:52 AM EST

that is no longer being sold since newer, smaller, better, cheaper, higher resolution cameras are now being sold. Just as lots of folks still have a laptop one or two (or more) years old the same goes for FPV platforms. Almost without exception the newer stuff is better.
There are at least two basic types of setups, one with one camera for capturing vids and a second camera for FPV flying and two one camera for both. Fat Shark is the Toyota of FPV goggles/camera, problem is that at the low end you are looking at you will probably be buying a ready to fly setup with what ever FPV setup they are using at the time you are buying. Here is a link to help you get up to speed.
FPV Forums
But keep in mind if someone asked you to recommend a lawyer you would want to know a lot more before providing a recommendation.

Two tablespoons of extra virgin (none / 0) (#20)
by jondee on Thu Dec 26, 2013 at 11:00:27 AM EST

olive oil a day cleared up my acid reflux problem that was jolting me out of bed in the middle of the night. Don't ask me how it worked, but it did -- probably something to do with balancing intestinal Ph..

Since I started using the olive oil, I've had maybe three fairly mild reflux episodes in the last two years. All thanks to my friend's Sicilian grandmother who used olive oil as a universal panacea.


: Thanks for the tip jondee (none / 0) (#36)
by fishcamp on Fri Dec 27, 2013 at 08:29:18 AM EST

and I have been consuming more olive oil since Zorba got me going on the very tasty Kalamata olive oil. Pills have always been difficult for me to take and as one doctor told me all drugs have side effects. Strange getting older we slam a shot of olive oil instead of tequila. Zorba come back and bring your friends...we miss you.

We have a new giant mid east market (none / 0) (#46)
by Mikado Cat on Tue Dec 31, 2013 at 08:00:21 PM EST

not to far away, Ansar Gallery, nice to have a big selection of olives. I've been buying pounds of the mixed to try different types, wife just wants Kalamata. Lots of kinds of fresh baked bread. Odd thing so far I don't like the cookies much that I've tried, kind of dry, but I'm not a coffee drinker, which they may need.