ObamaCare Info

[mom2rtk]

I'm not a giant fan (although i keep my fingers crossed that in the end years from now that perhaps this might bend the curve a little lower...)

Cross your fingers til the cows come home. There isn't a single thing in that law that will bend the cost curve.

 

[mikek]

Having a relative in cancer research for a major US hospital, I've been made aware that insisting on suppressing health care spending is likely to impact medical research as well.

An article in the Washington Post, by Ariana Eunjung Cha titled, “Americans win Nobel Prize in Medicine,” chronicles how three researchers have “’solved the mystery’ of how cells organize their transport systems with timing and precision.” This research is hoped to lead to future treatments for a wide range of diseases including diabetes, Alzheimer’s, epilepsy, and immunological disorders.

In her article Cha writes,

"Schekman, whose first major grant was from the National Institutes of Health in 1978, said winning the Nobel Prize made him reflect on how his original proposal might have fared in today’s depressed funding climate. ‘It would have been much, much more difficult to get support,’ he said.

“Likewise, Rothman wondered: ‘Would I have been able to have the initiative, to take the risk? I really am very concerned I would not have been.’

“Südhof said that the funding situation in Washington ‘worries me tremendously.’

“’I do think there’s a danger that … the system will stop and we won’t progress at the rate that would benefit our nation,’ he said.”

The Obama Health Law’s blind insistence on limiting health care spending thus threatens both access to life-saving medical treatment now and innovative cures in the future. Anyone who has chronic diseases in their family should be concerned about future cures and treatments as well as things like "getting free birth control".

seriously- obamacare does NOTHING to limit costs. In fact- by their own estimates it adds to health care spending in the coming years. And there's even a possibility that it could raise costs (as insurance companies have no incentive to pay less for medical care as the more they spend in medical care the more profit they are permitted to earn.)

 

[mikek]

...
Heres the thing leah, you can keep whatever insurance you have now. So if you have insurance simply keep it.
I'm keeping the same exact insurance I had last year. So who's ramming any thing down your throat?....

Wow- you really need to catch up. I realize this thread is giant- so here's the summary on this issue:

there's lies, and damn lies, and this one we've all been told is a damn lie. If you are one of the ones lucky enough to be covered by some giant company then obamacare really doesn't matter to you but yes your company can grandfather their plan existing plan under certain conditions and you can keep the insurance you have today.

Everyone else is in NJ hosed AND IS GETTING A NEW POLICY RAMMED DOWN THEIR THROAT.

Right here in NJ- EVERY single small business plan for groups of 2-50 and all individual plans (so exactly the people that are getting hammered and are paying 20% and the like for their healthcare) have been cancelled and will not be renewed past 12/31- so whenever your policy comes due in 2014 you HAVE NO CHOICE BUT TO GET A NEW OBAMACARE PLAN. Seems the regulatory burden of attempting to document plans could be grandfathered was more than the insurers wanted to deal with. It was not the governments intention but that's what happened when they published the actual regulations.

What's more- the vast majority of the new plans in NJ are ONLY EPO- where you may only go in network. Horizon BCBS and Health Republic only have EPO's. That leaved the sole remaining insurer on the exchanges, Amerihealth, as the only one with HMO or POS coverage where you have the possibility to go out of network if god forbid you get some horrific cancer and want to go to NYC or Philly for care.

YES- that's right- the exchanges chased away all but 3 companies. Supposedly there may be a 4th company selling insurance off the exchange come 1/1 but they too will only be selling bronze, silver, gold, and platinum plans too.
Aetna closed up shop in NJ- if you go to their website it says they dont want us.
United Healthcare/oxford doesn't have a website with pricing anymore so looks like they left.
Cigna also left- website too says no policies in NJ.

If you are older, apparently, your premiums go up (there's posts above explaining) . If you are younger your premiums go up for sure to help cover the rest of us. If you procreated "too much" and had more than 2.06 kids then your "family" coverage goes up too as you pay individually now and now longer get the 'group discount' of a family plan . Perhaps the subsidies will help but the premiums are higher for these groups.

If you happen to be a couple in your 30's with just one kid then your premium probably goes down.

I can't speak to the EPO issue in other states- but there are others who posted here that the small group and individual plans in other states are all being cancelled too.

Also, oddly, there appears to me many less HSA eligible plans then would seem to make sense with the giant deductibles most of the plans are showing.

edit- if you would like to confirm what i posted yourself, here's the NJ division of insruance's website of insureres: http://www.state.nj.us/dobi/division_insurance/ihcseh/ihcrates.htm#HealthCarrierContactInformation you can see how many of the approved insureres websites tell you they dont want to be bothered.
If you want to check prices and plan types for the 3 who will sell come 1/1:
Horizon BCBS: http://www.horizonblue.com/
here's health republic https://newjersey.healthrepublic.us/
and here's amerihealth http://www.amerihealth.com/health_plans/index.html
Knock your socks off.

 

[mikek]

Cross your fingers til the cows come home. There isn't a single thing in that law that will bend the cost curve.

there's tiny things in the current plan. But I'm going to be an optimist that they'll have to do something now that more people are being added to this broken system. It's just unsustainable.

 

[j's m]

Wow- you really need to catch up. I realize this thread is giant- so here's the summary on this issue:

there's lies, and damn lies, and this one we've all been told is a damn lie. If you are one of the ones lucky enough to be covered by some giant company then obamacare really doesn't matter to you but yes your company can grandfather their plan existing plan under certain conditions and you can keep the insurance you have today.

Everyone else is in NJ hosed AND IS GETTING A NEW POLICY RAMMED DOWN THEIR THROAT.

Right here in NJ- EVERY single small business plan for groups of 2-50 and all individual plans (so exactly the people that are getting hammered and are paying 20% and the like for their healthcare) have been cancelled and will not be renewed past 12/31- so whenever your policy comes due in 2014 you HAVE NO CHOICE BUT TO GET A NEW OBAMACARE PLAN. Seems the regulatory burden of attempting to document plans could be grandfathered was more than the insurers wanted to deal with. It was not the governments intention but that's what happened when they published the actual regulations.

What's more- the vast majority of the new plans in NJ are ONLY EPO- where you may only go in network. Horizon BCBS and Health Republic only have EPO's. That leaved the sole remaining insurer on the exchanges, Amerihealth, as the only one with HMO or POS coverage where you have the possibility to go out of network if god forbid you get some horrific cancer and want to go to NYC or Philly for care.

YES- that's right- the exchanges chased away all but 3 companies. Supposedly there may be a 4th company selling insurance off the exchange come 1/1 but they too will only be selling bronze, silver, gold, and platinum plans too.
Aetna closed up shop in NJ- if you go to their website it says they dont want us.
United Healthcare/oxford doesn't have a website with pricing anymore so looks like they left.
Cigna also left- website too says no policies in NJ.

If you are older, apparently, your premiums go up (there's posts above explaining) . If you are younger your premiums go up for sure to help cover the rest of us. If you procreated "too much" and had more than 2.06 kids then your "family" coverage goes up too as you pay individually now and now longer get the 'group discount' of a family plan . Perhaps the subsidies will help but the premiums are higher for these groups.

If you happen to be a couple in your 30's with just one kid then your premium probably goes down.

I can't speak to the EPO issue in other states- but there are others who posted here that the small group and individual plans in other states are all being cancelled too.

Also, oddly, there appears to me many less HSA eligible plans then would seem to make sense with the giant deductibles most of the plans are showing.

edit- if you would like to confirm what i posted yourself, here's the NJ division of insruance's website of insureres: http://www.state.nj.us/dobi/division_insurance/ihcseh/ihcrates.htm#HealthCarrierContactInformation you can see how many of the approved insureres websites tell you they dont want to be bothered.
If you want to check prices and plan types for the 3 who will sell come 1/1:
Horizon BCBS: http://www.horizonblue.com/
here's health republic https://newjersey.healthrepublic.us/
and here's amerihealth http://www.amerihealth.com/health_plans/index.html
Knock your socks off.

Mike, great post. I think you pretty much covered what's happening to the small business owners like us. The worst part is NJBCBS has been my continuous insurer since I was 18 until our group plan expires next September, close to my 64th birthday. I can't last the final year with them until I hit medicare. My DS goes out of state to college, 40 miles away from our house and his nearest hospital is not in network with the EPO plans or the HMO plans. My sister is a breast cancer survivor, my dad had melanoma and I won't be forced into an EPO.

I can't keep my plan and I can't keep my insurance company.

I want to be able to go to Disney and not have to worry the whole time I'm there that a medical issue might arise and WE WON"T BE COVERED. Oh, yes, the EPO's cover EMERGENCY ROOM ONLY out of network, not out of network ambulances, and not a hospital stay out of network, not doctors.

I'm angry at the insurance companies, I'm angry at the government for forcing us into the medal plans and for treating us like babies and into cookie cutter plans and not allowing us to choose coverage that is important to us.

People with large group plans aren't seeing the changes YET but I think we are only seeing the tip of the iceberg with insurance changes and it doesn't look pretty for the future.

 

[Muushka]

To be fair- it's not like they do any better hiring NSA employees...

True, but I don't willingly turn over all of my personal information to the NSA.

But all in all the ObamaCare law is awesome, isn't it?

 

[Robbi]

More information about why the obamacare website keeps crashing:
http://www.forbes.com/sites/theapot...now-health-plans-true-costs/?partner=yahootix

 

[mikek]

...
People with large group plans aren't seeing the changes YET but I think we are only seeing the tip of the iceberg with insurance changes and it doesn't look pretty for the future.

Yep eliza61 is going to be in for the same rude awakening eventually.

I read the CFR's (code of federal regulations) and it's not pretty- you can't get grandfathered forever.

Basically as soon as your insurer/employer decides to futz with things to much then you get tossed.

I read through quickly trying to figure out why the nuked all the small group plans. From what i recall:

They can only increase copays by $5 (as adjusted by the rate of medical inflation- so probably something like $6 at the moment- so $5 raises would be fine but $10 gets you ungrandfathered.)

ANY change in coinsurance rates. ANy change in deductibles.

They can only raise the premium contribution rate of contribution as March, 2010. So if in March 2010 they paid 80% of your premium they can not drop to less than 75%. But since all the premiums are going up the big companies are going to get antsy and want people to pick up more. (and for example my premiums went up 15-20 each year since- so if your company has been asking you to pay 1% more each year then in a 2-3 years more your are doomed too)

I may have mistaken memory- so anyone can feel free to read the enabling regulations on grandfathered plans themselve. The regulations can be found at 45 cfr 147.140:
http://www.ecfr.gov/cgi-bin/text-id...&view=text&node=45:1.0.1.2.62.0.27.15&idno=45

in more general terms i think part 147 of 45 CFR is the obamacare enabling regulations (although i am by no means certain and frequently once you get reading the CFR's they reference others). Also there is certainly something in treasury instructions the IRS to collect the fines, er taxes, er fines, er whatever we call them this week. There's probably some in department of labor dealing with unions and healthcare and the like.

For those who are wondering what the hec a CFR is- The legislature can write a bill and the president can sign it into law. But most times the laws are not all that specific (amazing huh since the ACA is like a bajillion pages?). So the law directs a regulatory agency to write regulations to carry out the intent of the law. In other words the bureaucrats write the 'rules'. So not only can the law be a mess but sometimes the rules make a mess. The Code of Federal Regulations (CFR) are all the rules. a 45 in front of the CFR means it's the Health and Human Services CFR. The first 3 numbers after the CFR are the actual regulation on a particular subject. And then it goes from there.

So the law says "everyone who likes their coverage today should be grandfathered" becasue that is what the president and the congresscritters told us all. But then DHHS had to get into the nitty gritty and define things such as "coverage today" aka 'coverage of march 2010' and how it was allowed to change until it was no longer the same coverage as march 2010. In their attempt to do the right thing they made it too difficult for the insurers to be able to certify anything (becasue what do they know about what I contribute to my employees insurance?) and so the insureres gave up.

From reading 147 i have no idea why they bailed on individuals except it was a convenient time and no one ever said that the 'insurers shall continue to offer the same plans of march 2010'.

 

[mikek]

More information about why the obamacare website keeps crashing:
http://www.forbes.com/sites/theapot...now-health-plans-true-costs/?partner=yahootix

I didnt even read the whole thing but form just hte first paragraph or two i belive it's 100% correct.

if you go right now to check pricing without filling out a plan. they WARN YOU IN BOLD OVER AND OVER AGAIN that the price you see is probably too high becasue you will get subsidies. NOT A SINGLE TIME does it say (even in tiny little letters) that their estimate MIGHT BE LOW- even though there are examples of how the estimates can be at least THIRTY PERCENT TOO LOW.

 

[HugsForEeyore]

I want to be able to go to Disney and not have to worry the whole time I'm there that a medical issue might arise and WE WON"T BE COVERED. Oh, yes, the EPO's cover EMERGENCY ROOM ONLY out of network, not out of network ambulances, and not a hospital stay out of network, not doctors.

This is my worst fear in all of this mess.

I am like some people here - my current individual plan is being cancelled and I have to pick an Obamacare plan. I currently have NJ Horizon Blue and they only have in-network plans to choose from. I realize that it doesn't matter if I pick bronze, silver, gold - if there are no protections from the costs of an out-of-network doctor or medical service, then you are just a bankruptcy waiting to happen. Or at least, a lifetime of massive debt and collection calls and destroyed credit.

When you are in a hospital or emergency room, sometimes you don't know who is providing your care and whether they are in or out of network. I learned all this the hard way - I recently had surgery when I only had a "catastrophic" plan (which covered only $2,000 of the total bill), and I basically ended up owing the price of a new car. So many of the providers who touched me - anesthesiologist, laboratories, MRI imaging, emergency room doctors - were from outside the hospital and out of network, and I wasn't given a choice of who to use. And they all wanted full payment - no one would offer a lower "self-pay" option. I lost just about all my assets. So yeah, I am bitter and skeptical of everything now.

And now with Obamacare, to still have no out-of-network protection AND to be paying high premiums and co-pays and co-insurance and deductibles, yeah it's a slap in the face. I know there are many people have survived OK through the years with in-network plans only, but I already been burned by this, and to not even have the option of out-of-network is frightening to me.

I also admit to a growing resentment for the entire medical profession (except nurses, my grandma was a nurse) - the second they lay a gloved hand on a person "underinsured" like me, your life is basically ruined. Which is ironic, the medical profession is suppose to help keep you healthy and alive. Instead, I view their services as the ultimate thing to avoid.

I give up. There are no solutions to this except be one of the lucky ones to work for the state/municipal/government or a large wonderful company, since they tend to have the best benefits.

 

[LaurLaur04]

This is my worst fear in all of this mess.

I am like some people here - my current individual plan is being cancelled and I have to pick an Obamacare plan. I currently have NJ Horizon Blue and they only have in-network plans to choose from. I realize that it doesn't matter if I pick bronze, silver, gold - if there are no protections from the costs of an out-of-network doctor or medical service, then you are just a bankruptcy waiting to happen. Or at least, a lifetime of massive debt and collection calls and destroyed credit.

When you are in a hospital or emergency room, sometimes you don't know who is providing your care and whether they are in or out of network. I learned all this the hard way - I recently had surgery when I only had a "catastrophic" plan (which covered only $2,000 of the total bill), and I basically ended up owing the price of a new car. So many of the providers who touched me - anesthesiologist, laboratories, MRI imaging, emergency room doctors - were from outside the hospital and out of network, and I wasn't given a choice of who to use. And they all wanted full payment - no one would offer a lower "self-pay" option. I lost just about all my assets. So yeah, I am bitter and skeptical of everything now.

And now with Obamacare, to still have no out-of-network protection AND to be paying high premiums and co-pays and co-insurance and deductibles, yeah it's a slap in the face. I know there are many people have survived OK through the years with in-network plans only, but I already been burned by this, and to not even have the option of out-of-network is frightening to me.

I also admit to a growing resentment for the entire medical profession (except nurses, my grandma was a nurse) - the second they lay a gloved hand on a person "underinsured" like me, your life is basically ruined. Which is ironic, the medical profession is suppose to help keep you healthy and alive. Instead, I view their services as the ultimate thing to avoid.

I give up. There are no solutions to this except be one of the lucky ones to work for the state/municipal/government or a large wonderful company, since they tend to have the best benefits.

I understand where you are coming from. BUT, most medical personnel aside from registration DO NOT know what kind of insurance you have or if you even have any. I agree that we should have out of network coverage.

 

[leahjade]

So who's ramming any thing down your throat?

You seem to forget that we will ALL be paying for this (The Congressional Budget Office (CBO) originally estimated that ObamaCare would cost about $1 trillion. But that estimate has already been revised upward several times, and even then, the CBO numbers are almost certainly an understatement. Former CBO Director Douglas Holtz-Eakin released his own analysis, finding that the law will cost $1.072 trillion in subsidies during the first ten years and another $2.85 trillion in the decade after that) so it is being rammed down my throat! Plus I'm not being selfish and just thinking about my increase, but my family members who are self-employed and are seeing huge increases, and my mom who found out her increase in Medicare supplemental insurance, so whether you want to face it or not - it is being rammed down America's throat.

 

[Traveliz]

What are there armed bands of GI men running around the country with automatic weapons forcing people to sign up. Is some one being held hostage over the computer, being tortured into going on the website.
Heres the thing leah, you can keep whatever insurance you have now. So if you have insurance simply keep it.
I'm keeping the same exact insurance I had last year. So who's ramming any thing down your throat?

I'm training at my company's human resource department and in fact if anyone wants to participate in the ACA they have to send in a notorized letter requesting the change from company policy.

So here's the solution. don't want to participate in the ACA don't sign up.

Now the few people I know who signed up, could not get insurance before and haven't had it for about 15 years so I'm thinking the last thing they are worried about is anyone's IT department.

A little short sighted. I am keeping my same insurance...for double the cost.

Liz

 

[leahjade]

PS I hope the unions don't get a break in this mess

In one state alone, the Service Employees International Union, which says its mission is 'economic justice,' received two grants totaling $2 million to make phone calls, robo-calls and go door to door. Think of how many low income women could get tested for cervical cancer with that money.

 

[manning]

Jobs are being eliminated in the medical field. I think I heard the number 8000 so far.

 

[leahjade]

Jobs are being eliminated in the medical field. I think I heard the number 8000 so far

Welch Allyn, a company that manufactures medical diagnostic equipment in central New York, laid off 275 employees this year, and planned on dropping roughly 10% of their workforce over the next three years.

"Health care reform mandates" are to blame for up to 400 jobs being dropped at Orlando Health.

One of the biggest medical device manufacturers in the world, Stryker confirmed 1,000 jobs were lost due to Obamacare.

Wake Forest Baptist Medical Center cited "the challenges of health care reform" while announcing the elimination of 950 jobs.

The medical device tax also claimed positions at Boston Scientific. The company first announced in 2011 that they would be cutting between 1,200 and 1,400 positions. Then in January of this year, they announced further layoffs for up to 1,000 employees.

Smith & Nephew, a global medical technology firm, dropped 100 employees.

A Blue Cross/Blue Shield health insurance office was closed, resulting in another 100 or so employees hitting the unemployment lines. The reason? Complexities in federal regulations and mandates implemented by Obamacare.

In March of 2010, medical device maker Medtronic warned that Obamacare taxes could result in a reduction of precisely 1,000 jobs. That plan became reality when the company cut 500 positions, and scheduled another 500 by the end of the fourth quarter in 2013.

Reading Hospital announced layoffs for 210 workers, and the elimination of another 181 jobs through attrition, citing federal health care reform requirements.

Abbott Laboratories announced a series of layoffs that would result in approximately 1,900 people being out of work. The company cited "U.S. health-care reform and the challenging regulatory environment” as a reason for the job cuts, then proceeded to donate money to politicians wanting to change Obamacare.

Public employees in Virginia fell victim to Obamacare's rules for part-time workers. A minimum of 7,380 jobs were converted to less than 30 hours per week.

The nation's largest movie theater chain, Regal Entertainment, reduced the workweek for thousands of their employees.

Kroger, a grocery store chain, reduced the hours of their staff.

Taco Bell slashed employee hours.

As did Wendy's, and also Denny's.

An executive from White Castle pondered only hiring part-time workers in the future.

Subway chains, and Carl's Jr. stores reduced positions to part-time.

Clothing retail chain, Forever 21, conducted staffing audits which resulted in non-management positions being reduced to 29.5 hours weekly. Forever 21 has over 27,000 employees.

400 employees at the Community College of Allegheny County saw their hours reduced.

The Wall Street Journal reported that numerous universities were scaling back the number of hours worked per week by their adjunct professors, in an attempt to avoid the new Obamacare requirements.

Hours for over 100 people in the Fort Wayne Community School District in Indiana have been reduced, including substitutes and support staff.

Phone operators in Affordable Care Act call centers noted the irony in "working for a call center and trying to help people get health care" but only at a part-time rate ... in order to avoid having to provide health insurance.

Repeatedly blaming Obamacare in a staff memo, UPS announced that 15,000 employee spouses are being dropped from their health insurance coverage.

Erick Erikson reported via Twitter that he had obtained an internal memo from Delta Airlines. The memo stated that the company would have to totally revamp their health care plans, and had to eliminate a plan developed specifically for pilots due to it violating the Cadillac tax.

The University of Virginia is dropping coverage for spouses due to federal health reform costs and penalties.

The owner of Professional Finance Company indicated that he may have to drop coverage for his employee's families. The company employs 170 people.

Health insurance coverage is being reduced for school districts in Pennsylvania.

The United Methodist Church recently announced that "clergy and lay employees" would be losing their coverage.

Wegman's, who had previously provided coverage for employees that worked 20 or more hours, announced they were no longer offering health insurance to part-time workers thanks to ObamaCare.

 

[Muushka]

In one state alone, the Service Employees International Union, which says its mission is 'economic justice,' received two grants totaling $2 million to make phone calls, robo-calls and go door to door. Think of how many low income women could get tested for cervical cancer with that money.

Ironic, isn't it. Like I said previously, slush fund.

I actually had the break that they will be getting an exemption from ObamaCare in mind.
The tax on the great plans that the unions have will be delayed (if they get their way).

 

[robinb]

leahjade, you should let everyone know you cut and pasted your last post from Freedomworks. Give credit where credit is due!

 

[robinb]

Everyone else is in NJ hosed AND IS GETTING A NEW POLICY RAMMED DOWN THEIR THROAT.

Please help me understand what is happening in NJ. Are companies required to drop their employee's insurance? Are insurance companies required to discontinue coverage to companies?

 

[scrapquitler]

Please help me understand what is happening in NJ. Are companies required to drop their employee's insurance? Are insurance companies required to discontinue coverage to companies?

I can't speak for New Jersey, as I am in CT, but from what I understand, any policy that is 'non compliant' the the new requirements set forth by the ACA can no longer be offered for sale. I have a very good HMO policy (which I like, except for the high cost) but my plan is 'non compliant' because it doesn't include dental care for children and maybe some other things as required by the ACA (and one of the things it doesn't have is high deductibles and coinsurance charges), so as of January 1, 2014, I am no longer allowed to have my policy because Blue Cross isn't allowed to offer it anymore. SO much for 'if you like your your insurance you can keep your insurance'. I think the people on this board who are in New Jersey are talking about the same situation that I am facing.'

I think the people who are noticing this happen the most are those of us who are self-employed and buy our policy directly from the insurance company.