Unaffordable Care Act

[Jamie D]

Beyond Obamacare glitches, some consumers face dramatically higher rates

Christian Science Monitor | Linda Feldman

* As Obamacare begins to roll out, some people who already buy insurance on the individual market are getting cancellation notices – and offers for coverage at double and triple their old rates.

Problems with the main Obamacare website, HealthCare.gov, have dominated headlines since the site opened for business on Oct. 1.

But another problem is surfacing: Some consumers who have been buying their own insurance are getting cancellation notices – and offers for insurance at dramatically higher rates.

There are multiple reasons this is happening. First, the Affordable Care Act (ACA) sets minimum standards for benefits, including mental-health and substance-abuse treatment, maternity care, prescription drugs, and rehabilitative care, which were not included in many of the old plans. Also, insurance companies are now required to take all comers, regardless of their health status, and so rates are rising to cover their costs as well.

Not quite Nirvana, is it?  We are seeing market forces come into play.  And those who secretly wrote and politicked for this travesty of a law, left us out on purpose.

Full article at the link, above.

[mythy]

Hey there

So forgive me if this was already asked, but what specifically does the Affordable Care Act cover for trans people? I have been told by many people that apparently it will be harder to discriminate against trans folks, and that there will be coverage for trans related health care, but I have been having an extremely hard time finding out what exactly that means. Basically, is SRS covered by ACA and if only some aspects of this process are covered, what are they?

Links are also greatly appreciated!!

[Heather]

Hey there

So forgive me if this was already asked, but what specifically does the Affordable Care Act cover for trans people? I have been told by many people that apparently it will be harder to discriminate against trans folks, and that there will be coverage for trans related health care, but I have been having an extremely hard time finding out what exactly that means. Basically, is SRS covered by ACA and if only some aspects of this process are covered, what are they?

Links are also greatly appreciated!!

I think it just means they can't deny you coverage based on your gender or gender identity. If I remember correctly their was no law saying that insurance companies couldn't deny your claim based on your gender. So insurance companies was using that loophole to deny all kinds of claims saying that transitioning was to blame. Like I heard a transwoman broke her leg and the insurance company used her being trans as to the reason why she broke her leg thus denying the claim. And actually I don't think ACA actually makes insurance companies cover SRS your kinda out of luck there. 

[Jamie D]

DEMOCRATS TO AMERICA: WE OWN THE GOVERNMENT!

uexpress | Ann Coulter

In the current fight over the government shutdown, Republicans are simply representing the views of the American people.

Americans didn't ask for Obamacare, they don't want it, but now their insurance premiums are going through the roof, their doctors aren't accepting it, and their employers are moving them into part-time work -- or firing them -- to avoid the law's mandates.

Contrary to Obama's promises, it turns out: You can't keep your doctor, you can't keep your insurance -- you can't even keep your job. In other words, it's a typical government program, but this one wrecks your health care.

Also, the president did raise taxes on the middle class in defiance of his well-worn campaign promise not to. Indeed, Obamacare is the largest tax hike in U.S. history.

Full OpEd at the link

[Yukari-sensei]

Hey there

So forgive me if this was already asked, but what specifically does the Affordable Care Act cover for trans people? I have been told by many people that apparently it will be harder to discriminate against trans folks, and that there will be coverage for trans related health care, but I have been having an extremely hard time finding out what exactly that means. Basically, is SRS covered by ACA and if only some aspects of this process are covered, what are they?

Links are also greatly appreciated!!

SRS is not covered, but some states are trying to make provisions to ensure HRT is covered. Unfortunately the right wing media picked up on it and has been blasting the idea. There were some horrible comments there about the transgendered community in the comments thread.

There are some things it does ensure and here are the links...

http://www.huffingtonpost.com/sean-cahill/the-affordable-care-act-real-benefits-for-lgbt-people_b_3867921.html
http://www.thenation.com/article/169391/what-affordable-care-act-means-transgender-people#
http://cooperproject.org/lgbt-health-disparities-and-the-affordable-care-act/
http://transgenderequality.wordpress.com/2013/09/19/whats-in-the-health-care-marketplace-for-trans-people/

A side note on one of the positives that is not discussed very often by hospitals (I wonder why ) is under the ACA hospitals are graded on patient satisfaction. Green is best, yellow means improvement is necessary, and red means unacceptable. Hospitals will not only have their JCAHO certification downgraded/reviewed, but compensation for Medicare and Medicaid patients will be downgraded until their satisfaction reaches adequate levels...

In my geographic area only one hospital was green and two are yellow. The rest were red.  I can name 13 hospitals off the top of my head... and if that is all of them, 77% are unacceptable No wonder the storm from hospitals about the ACA 

There is alot of room for improvement, don't you think?

[Rachel]

I just heard that starting January 1, 2014 employer paid health insurance will be Federally taxed as ordinary income. I do not know this to be true or false. Does anyone know if employer paid health care will become ordinary income?

I pay $125.00 per week now toward health benefits and my employer pays about $250.00 per week (about $12,000 per year) is there a "Cadillac" plan that is taxable? What is that?

I pay $125.00 per week for therapy in addition to $125.00 per week for health care or about $12,000 per year. So my out of pocked now is $12,000 per year and employer is $12,000 per year. Will I pay an additional $4,000 per year if taxed on the employer contribution for a total of $16,000 per year my cost?

[Red Leicester]

I just heard that starting January 1, 2014 employer paid health insurance will be Federally taxed as ordinary income. I do not know this to be true or false. Does anyone know if employer paid health care will become ordinary income?

I pay $125.00 per week now toward health benefits and my employer pays about $250.00 per week (about $12,000 per year) is there a "Cadillac" plan that is taxable? What is that?

I pay $125.00 per week for therapy in addition to $125.00 per week for health care or about $12,000 per year. So my out of pocked now is $12,000 per year and employer is $12,000 per year. Will I pay an additional $4,000 per year if taxed on the employer contribution for a total of $16,000 per year my cost?

"Largest tax increase" in the history of the world.  This is pathetic.

[mrs izzy]

I just heard that starting January 1, 2014 employer paid health insurance will be Federally taxed as ordinary income. I do not know this to be true or false. Does anyone know if employer paid health care will become ordinary income? ATM FALSE

I pay $125.00 per week now toward health benefits and my employer pays about $250.00 per week (about $12,000 per year) is there a "Cadillac" plan that is taxable? What is that?

I pay $125.00 per week for therapy in addition to $125.00 per week for health care or about $12,000 per year. So my out of pocked now is $12,000 per year and employer is $12,000 per year. Will I pay an additional $4,000 per year if taxed on the employer contribution for a total of $16,000 per year my cost?

If they ever change the law it will most likely be on higher wage earners. Its something that congress might do to get more money for them to .iss away.

Izzy

[Rachel]

Thank you. I checked a few sources and the tax starts as ordinary income on employer plans over $25,000 per year.

I recently switched health plans and have  $600 deductible in network and $800 out of network. However, they are supposed to cover Trans* therapy 80% after the deductible. I just submitted my 1st form for reimbursement. I hope I am covered.

[TerriT]

This thread is fantastic! Jamie, Shantel, Tatyana and the rest of you girls, you bring a tear to my eye *hugs*

Here is some news from my part of the country:

"Cindy Vinson and Tom Waschura are big believers in the Affordable Care Act. They vote independent and are proud to say they helped elect and re-elect President Barack Obama.

Yet, like many other Bay Area residents who pay for their own medical insurance, they were floored last week when they opened their bills: Their policies were being replaced with pricier plans that conform to all the requirements of the new health care law.

Vinson, of San Jose, will pay $1,800 more a year for an individual policy, while Waschura, of Portola Valley, will cough up almost $10,000 more for insurance for his family of four." San Jose Mercury News

Or this tiny dose of reality from a Daily Kos "diarist":

"My wife and I just got our updates from Kaiser telling us what our 2014 rates will be. Her monthly has been $168 this year, mine $150. We have a high deductible. We are generally healthy people who don't go to the doctor often. I barely ever go. The insurance is in case of a major catastrophe.

Well, now, because of Obamacare, my wife's rate is gong to $302 per month and mine is jumping to $284.

I am canceling insurance for us and I am not paying any >-bleeped-<ing penalty. What the hell kind of reform is this?

Oh, ok, if we qualify, we can get some government assistance. Great. So now I have to jump through another hoop to just chisel some of this off. And we don't qualify, anyway, so what's the point?

I never felt too good about how this was passed and what it entailed, but I figured if it saved Americans money, I could go along with it.

I don't know what to think now. This appears, in my experience, to not be a reform for the people.

What am I missing?

I realize I will probably get screamed at for posting this, but I can't imagine I am the only Californian who just received a rate increase from Kaiser based on these new laws." link

"The trouble with Socialism is that eventually you run out of other people's money."

[Shantel]

All I can say to anyone who voted in favor of "Hope and Change" is how is it working for you? We are just seeing the tip of the iceberg so far, harsh reality is only just beginning to set in. It's no longer a single party blame game either, the entire system is totally corrupt leaving me with a feeling that we are like steerage class passengers aboard the Titanic!

[Yukari-sensei]

Well we could have had single payer healthcare instead, but some people thought that wasn't star spangled"free" enough.

Compulsory consumption is a sign of capitalism btw, not socialism... If it actually were socialist (most people really don't understand what they mean when they use that term)or at least Republican (political philosophy not the political party!) it would have been much cheaper... but insurance companies are people too... or so some people claim, and it would have left them out in the cold if we went single payer...

[Samantha Stone]

No one has mentioned that the young and old with pre existing conditions can now get insurance.  The excluding of sick people is a failure of our current health system.  Even young healthy people can get a terrible disease.

Samantha

[genderhell]

"Largest tax increase" in the history of the world.  This is pathetic.

It is far worse than imaginable.

They are about to give amnesty to the estimated 11-30 million illegal aliens in the USA, and let them bring in their immediate and extended family so another 50 million of the poorest people from Mexico, Central and South America , and give them free health care.

[VeronicaLynn]

None of this gets to the root of the problem, that doctors and hospitals charge way too much for just about everything they do. There's no reason SRS, for example, should cost anywhere near what it costs. There's also no reason why spending a night in the hospital should cost anymore than spending the night in a Holiday Inn. They justify this with stupid accounting tricks costing in the MRI machine and other expensive equipment, that are not even used or needed for most people. Why not just make that illegal, and maybe your hospital doesn't need an MRI machine, and maybe go after the manufacturer of MRI machines, because they are probably overcharging as well. The public good really would be served best with all health care companies being required to become non-profit agencies, and cutting out the insurance industry all together, because why should they get a cut at all?

[Danielle Emmalee]

None of this gets to the root of the problem, that doctors and hospitals charge way too much for just about everything they do. There's no reason SRS, for example, should cost anywhere near what it costs. There's also no reason why spending a night in the hospital should cost anymore than spending the night in a Holiday Inn. They justify this with stupid accounting tricks costing in the MRI machine and other expensive equipment, that are not even used or needed for most people. Why not just make that illegal, and maybe your hospital doesn't need an MRI machine, and maybe go after the manufacturer of MRI machines, because they are probably overcharging as well. The public good really would be served best with all health care companies being required to become non-profit agencies, and cutting out the insurance industry all together, because why should they get a cut at all?

I disagree.  Competition and greed lead to improving technology, procedures, and better doctors.

[VeronicaLynn]

I disagree.  Competition and greed lead to improving technology, procedures, and better doctors.

The inner libertarian in me agrees, but there is not competition in the current system, or under Obamacare. You go to what hospital the ambulance takes you to. For something less urgent, you go to whatever clinic your insurance has a contract with, or you have to pay with your own money. This is not competition. If you want true competition, health insurance would have to be banned entirely, then people would shop around somewhat, but would still have go to whatever hospital the ambulance takes you to if you have a medical emergency.

[Danielle Emmalee]

The inner libertarian in me agrees, but there is not competition in the current system, or under Obamacare. You go to what hospital the ambulance takes you to. For something less urgent, you go to whatever clinic your insurance has a contract with, or you have to pay with your own money. This is not competition. If you want true competition, health insurance would have to be banned entirely, then people would shop around somewhat, but would still have go to whatever hospital the ambulance takes you to if you have a medical emergency.

I mostly agree.  What's wrong with privatized insurance though or private non-profit-help-the-people-that-can't-afford-better-healthcare organizations?

[VeronicaLynn]

Mainly that you have to be in their network, rather than choose the doctor you think is best. Plus, why does there have to be some middle man that takes a cut? Healthcare, in general, would be cheaper if there was not a middle man. Doctors would also have to charge less, if most people just walked out of their offices when they saw the prices, just like what happens at a restaurant that tries to charge $100 for a hamburger.

[amZo]

Well we could have had single payer healthcare instead, but some people thought that wasn't star spangled"free" enough.

"If You Think Health Care is Expensive Now -- Just Wait Until it's Free."  - P.J. O'Rourke