8 ms·

When I read this stuff, I'm a little astounded about how bad the situation must be in other states. Here in the Pacific Northwest, my premiums have actually be

by Frondo 11y ago

When I read this stuff, I'm a little astounded about how bad the situation must be in other states. Here in the Pacific Northwest, my premiums have actually been going down and the plan offerings are getting better. The provider I was on did go out of business so I had to switch, and I'm now paying less for more services. And, to be totally frank, having had a pre-existing condition that kept me from buying any insurance (literally no one would sell to me pre-ACA), the law's been a net positive for me. I feel bad for people in other states, in Oregon it was been a pretty sweet deal for me.

mgkimsal 11y ago
Yeah, it's pretty crappy in NC. First year of ACA we only had one company even offering any insurance in my county. And yeah, it's county-based for some reason - if I lived 2 miles in another direction I'd have had multiple options about 10-15% cheaper than what I had available. Second year we had another option in our county which was about 15% higher than BCBS (which had gone up about 25% from the year before). Apparently some/much of this has to do with our state choosing to opt out of dealing with increased medicaid funding, so... yay... I guess they get to show obama how bad ACA is by... digging in their heels while we all just pay insanely increasing pricing? We are > 100% from where we were wrt premiums from 2012. I expect some increase every year. I don't expect > 100%. Colleague of mine is now facing > $1800/month health insurance pricing. He's... early 50s, married, 3 kids. This is with a $10k deductible. Another colleague with just one spouse and a child was facing going from $1300->$1650 this year, again with a fairly hefty deductible. Given that this is effectively only something you'll get any benefit from if you're in a horrific accident of have a massive illness, this is now just really expensive catastrophic insurance. I might feel slightly better about some of this if I actually knew anyone personally (beyond Frondo now!) who's benefitted. In my social circles, this has not even been close to a win for anyone. Either insurance has gone way up for people who can afford it, or it's still too expensive for some of my friends who are still unable to afford it (because they don't make enough money to qualify for the 'subsidized' pricing). Bring on single payer...
- zrail 11y ago
  We started on a $1500 indv / $3000 fam deductible PPO in 2014 for about $800/mo for two people. In 2015 the premiums went down maybe 0.5%. In 2016 the premiums have gone up 6% and the out of pocket max went up $500 per person to $4k. ACA has absolutely been a net positive in my life. I had cancer in 2012 and so it would have been literally impossible for me to get health insurance outside of a group plan. With ACA I've been able to go independent, start my own business, choose my own clients, and fully control my destiny.
  - ghaff 11y ago
    The ability to get insurance for an affordable price (the parameters of which I realize people differ on) with pre-existing conditions outside of group plans has been one of the big wins of ACA. It's at least reasonable to argue that particular problem could have been addressed outside of the massive and controversial implementation that was ACA as a whole.
    - briandear 11y ago
      I agree. The Federal subsidies should actually be limited to subsidizing pre existing condition coverage. I am willing to allow tax dollars to cover the difference of pre-existing condition coverage since it would be a net gain for everyone. The problem is that the subsidies are available for everyone, regardless of prior insurability, thus, just like student loans have accelerated college cost inflation, subsidies for almost everyone in the middle classes have resulted in price increases. Essentially, pre-existing condition insurability is where the government could have make a huge impact with minimal disruption to the overall system. Much like there are government mortgage guarantees available for higher risk borrowers, the same kind of system could have helped the pre-existing conditions people get coverage while not throwing the baby out with the bath water. The alleged goals of the ACA were to get everyone insured. However it shouldn't have taken thousands of pages to accomplish that. A good portion of ACA has nothing to do with insurance at all. I wish there was some scope restriction on bills. For example the latest highway bill contained passport revocation provisions for those with delinquent taxes. This forces politicians to reluctantly vote for something they don't like because the overall bill is important. Poison pill amendments are often not poisonous enough so we get stuck with a bunch of really bad laws.
MCRed 11y ago
The reason nobody could sell you insurance with your pre-existing condition before is that regulations prevented making plans for conditions. EG: You couldn't make a national diabetes insurance plan for people with diabetes (and the economies of scale that go along with a pool of all people with diabetes) because it was effectively illegal. If the ACA had merely fixed that, then your premiums would be going down more and you'd be getting better insurance.
- Frondo 11y ago
  You know what? My pre-existing condition was that I'd had my gallbladder removed in the early 2000s. That's it. Uninsurable for 10 years because of an operation which I recovered from fully in less than a week. Telling me it's "regulations" that had every insurer reject me? Pull the other one, it's got bells on.
  - HarryHirsch 11y ago
    Citizen Frondo, you don't understand. If the market says you must not be insured it is right because the market is always right. Why, on this board you had people tell with a straight face that one should not bother to eradicate schistosomiasis and malaria in the African continent because if the continent was meant to be productive people would be spending money in the project right now.
    - zo1 11y ago
      If the OP is correct, then it is not the market that is enforcing the insurance scheme to reject cover for him based on pre-existing conditions, but rather the state that is making it illegal for schemes to be tailor-made for specific (pre-existing) conditions.
  - facetube 11y ago
    My preexisting condition was "history of headache". I was denied by every insurer that did business in our state in 2010 and 2011. I wish I was kidding. Had I failed to mention the headache thing and sought treatment, I would have been vulnerable to rescission.
Turing_Machine 11y ago
" Here in the Pacific Northwest, my premiums have actually been going down and the plan offerings are getting better." You are in the minority. Every insurance company that provides Obamacare in Oregon is increasing rates for the average customer this year. http://www.oregonlive.com/health/index.ssf/2015/07/more_than_220000_oregonians_fa.html http://www.oregonlive.com/health/index.ssf/2015/07/more_than... In fact, the State of Oregon has actually ordered some of the companies to increase their rates more than they'd originally planned. http://www.cnbc.com/2015/06/22/oregon-dumps-cold-water-on-low-obamacare-rates.html http://www.cnbc.com/2015/06/22/oregon-dumps-cold-water-on-lo...
- mgkimsal 11y ago
  That seems really crazy, but then... Frondo just said the company he was with before went out of business. Why? Were they, in fact, not charging enough to cover their costs (supposedly the motivation behind Oregon raising prices)?
snatoeusntaoeu 11y ago
I feel bad for people in other states, in Oregon it was been a pretty sweet deal for me. I moved back to Oregon from California several years ago. I was astonished at how much more expensive insurance was in OR than in CA. I've been told that Oregon has had a lot of protectionism for local health insurers, so they didn't have to compete much. So perhaps you're just seeing Oregon coming into line with other states... (By the way, I had a pinched nerve in my neck when I moved. No insurer would take me, and one told me that they wouldn't insure me until nine years had passed without any symptoms)
rbritton 11y ago
Unfortunately, your situation must be specific to Oregon. I'm in Washington, and the closest plan we could get to what we had pre-Obamacare went from a $2500 deductible to $6300 with a premium increase of around 40-50%. In my opinion, the problem was never the unavailability of insurance. The problem was (and still is) the out-of-control pricing of medical care -- $5000+ for non-sterile gloves [1] is a bit extreme. [1]: http://www.rd.com/health/wellness/wildly-overinflated-hospital-costs/ http://www.rd.com/health/wellness/wildly-overinflated-hospit...
- cookiecaper 11y ago
  I agree with you. I wish more people would realize their quibbling over a treatment for a symptom when they're hashing out a regulated private insurance marketplace v. single-payer. Our existing insurance system allows a lot of perversions of the marketplace and contributes to the root cause, but having the government sign a blank check isn't the answer either. We need to return ordinary market dynamics to health care if we want something that's sustainable over the long term.
- briandear 11y ago
  The expensive gloves problem is due to cross subsidization and cost recovery. A good portion of the problem is due to under-market Medicare reimbursement rates; another part of the problem is that certain demographics that aren't eligible for Medicaid due to their lack of legal status incur expensive care (via the emergency rooms) that goes unreimbursed. This problem is especially accute in places like Texas. I would suspect that more free primary care clinics could take some of the burden off of emergency rooms in terms of cost and those free clinics could even be funded by insurance companies from the money their saving from not having to pay for $5000 gloves anymore. A cash-payment medical system would also solve some of these problems. With opaque pricing, hospitals get away with solving budget issues by overcharging. If you actually saw the menu of what things would cost and you were paying out of your pocket, nobody would ever tolerate $5000 gloves. Market forces would fix the cost overages very quickly. As it is now, very few people actually directly pay for their own care and thus are less motivated to care about price. "Insurance covers it," is all many people care about.
- 11y ago
SwellJoe 11y ago
It isn't ACA that has caused me problems, or at least the law itself. The description given matched my experience with insurers before ACA. My problem with ACA is Healthcare.gov (still). It is possible to go through the entire application process, make one mistake or fail to provide the right detail, and end up disqualified from buying insurance through Healthcare.gov (in my case, I used a mail forwarding service address, because I travel full-time). There is no do-over, no online process for correcting the problem with the application. You have to go through a protest process that involves mailing physical letters somewhere. Fuck that. I'd go back to the nightmare that is pre-ACA private insurance, before I beg some bureaucrat, by mail, for the privilege of paying too much for insurance. Healthcare.gov got a lot of flack in the beginning for costing too much, delivering too little, and being too flakey. All of those things are still true. It's also dehumanizing.
- briandear 11y ago
  The traveling full time "problem" affects me as wel. When some company or another asks, "Where do you live?" My response is preceeded by an audible shrug.. I seems that many companies actually plan to come visit me and are put out when I explain that my physical location is really of no concern to them. For example, banking. If I give a Texas address and agree to Texas terms and conditions, why would it matter that I spend 11 months a year in Europe. My mail arrives, I do my transactions online.. So what's the problem? Twentieth century thinking, that's what.
  - zo1 11y ago
    Those are most likely regulations enforced on to the banks. By the time it gets to the low-level employee that checks/asks/confirms your address, it's probably morphed a bit, and each employee has their own interpretation of what is "okay" when it comes to addresses.
- dragonwriter 11y ago
  The federal exchanges (for which healthcare.gov is the portal) were never intended to be a good choice (or even to have to exist at all), they were in the law as a minimal fallback to be applied for states that failed to implement their own exchangees.
akulbe 11y ago
Who's your carrier currently? I'm in Oregon as well, and I'm not impressed with the offerings here, at all.

by Frondo 11y ago

mgkimsal 11y ago

Yeah, it's pretty crappy in NC. First year of ACA we only had one company even offering any insurance in my county. And yeah, it's county-based for some reason - if I lived 2 miles in another direction I'd have had multiple options about 10-15% cheaper than what I had available. Second year we had another option in our county which was about 15% higher than BCBS (which had gone up about 25% from the year before). Apparently some/much of this has to do with our state choosing to opt out of dealing with increased medicaid funding, so... yay... I guess they get to show obama how bad ACA is by... digging in their heels while we all just pay insanely increasing pricing? We are > 100% from where we were wrt premiums from 2012. I expect some increase every year. I don't expect > 100%. Colleague of mine is now facing > $1800/month health insurance pricing. He's... early 50s, married, 3 kids. This is with a $10k deductible. Another colleague with just one spouse and a child was facing going from $1300->$1650 this year, again with a fairly hefty deductible. Given that this is effectively only something you'll get any benefit from if you're in a horrific accident of have a massive illness, this is now just really expensive catastrophic insurance. I might feel slightly better about some of this if I actually knew anyone personally (beyond Frondo now!) who's benefitted. In my social circles, this has not even been close to a win for anyone. Either insurance has gone way up for people who can afford it, or it's still too expensive for some of my friends who are still unable to afford it (because they don't make enough money to qualify for the 'subsidized' pricing). Bring on single payer...

zrail 11y ago
We started on a $1500 indv / $3000 fam deductible PPO in 2014 for about $800/mo for two people. In 2015 the premiums went down maybe 0.5%. In 2016 the premiums have gone up 6% and the out of pocket max went up $500 per person to $4k. ACA has absolutely been a net positive in my life. I had cancer in 2012 and so it would have been literally impossible for me to get health insurance outside of a group plan. With ACA I've been able to go independent, start my own business, choose my own clients, and fully control my destiny.
- ghaff 11y ago
  The ability to get insurance for an affordable price (the parameters of which I realize people differ on) with pre-existing conditions outside of group plans has been one of the big wins of ACA. It's at least reasonable to argue that particular problem could have been addressed outside of the massive and controversial implementation that was ACA as a whole.
  - briandear 11y ago
    I agree. The Federal subsidies should actually be limited to subsidizing pre existing condition coverage. I am willing to allow tax dollars to cover the difference of pre-existing condition coverage since it would be a net gain for everyone. The problem is that the subsidies are available for everyone, regardless of prior insurability, thus, just like student loans have accelerated college cost inflation, subsidies for almost everyone in the middle classes have resulted in price increases. Essentially, pre-existing condition insurability is where the government could have make a huge impact with minimal disruption to the overall system. Much like there are government mortgage guarantees available for higher risk borrowers, the same kind of system could have helped the pre-existing conditions people get coverage while not throwing the baby out with the bath water. The alleged goals of the ACA were to get everyone insured. However it shouldn't have taken thousands of pages to accomplish that. A good portion of ACA has nothing to do with insurance at all. I wish there was some scope restriction on bills. For example the latest highway bill contained passport revocation provisions for those with delinquent taxes. This forces politicians to reluctantly vote for something they don't like because the overall bill is important. Poison pill amendments are often not poisonous enough so we get stuck with a bunch of really bad laws.

MCRed 11y ago

The reason nobody could sell you insurance with your pre-existing condition before is that regulations prevented making plans for conditions. EG: You couldn't make a national diabetes insurance plan for people with diabetes (and the economies of scale that go along with a pool of all people with diabetes) because it was effectively illegal. If the ACA had merely fixed that, then your premiums would be going down more and you'd be getting better insurance.

Frondo 11y ago
You know what? My pre-existing condition was that I'd had my gallbladder removed in the early 2000s. That's it. Uninsurable for 10 years because of an operation which I recovered from fully in less than a week. Telling me it's "regulations" that had every insurer reject me? Pull the other one, it's got bells on.
- HarryHirsch 11y ago
  Citizen Frondo, you don't understand. If the market says you must not be insured it is right because the market is always right. Why, on this board you had people tell with a straight face that one should not bother to eradicate schistosomiasis and malaria in the African continent because if the continent was meant to be productive people would be spending money in the project right now.
  - zo1 11y ago
    If the OP is correct, then it is not the market that is enforcing the insurance scheme to reject cover for him based on pre-existing conditions, but rather the state that is making it illegal for schemes to be tailor-made for specific (pre-existing) conditions.
- facetube 11y ago
  My preexisting condition was "history of headache". I was denied by every insurer that did business in our state in 2010 and 2011. I wish I was kidding. Had I failed to mention the headache thing and sought treatment, I would have been vulnerable to rescission.

Turing_Machine 11y ago

" Here in the Pacific Northwest, my premiums have actually been going down and the plan offerings are getting better." You are in the minority. Every insurance company that provides Obamacare in Oregon is increasing rates for the average customer this year. http://www.oregonlive.com/health/index.ssf/2015/07/more_than_220000_oregonians_fa.html http://www.oregonlive.com/health/index.ssf/2015/07/more_than... In fact, the State of Oregon has actually ordered some of the companies to increase their rates more than they'd originally planned. http://www.cnbc.com/2015/06/22/oregon-dumps-cold-water-on-low-obamacare-rates.html http://www.cnbc.com/2015/06/22/oregon-dumps-cold-water-on-lo...

mgkimsal 11y ago
That seems really crazy, but then... Frondo just said the company he was with before went out of business. Why? Were they, in fact, not charging enough to cover their costs (supposedly the motivation behind Oregon raising prices)?

snatoeusntaoeu 11y ago

I feel bad for people in other states, in Oregon it was been a pretty sweet deal for me. I moved back to Oregon from California several years ago. I was astonished at how much more expensive insurance was in OR than in CA. I've been told that Oregon has had a lot of protectionism for local health insurers, so they didn't have to compete much. So perhaps you're just seeing Oregon coming into line with other states... (By the way, I had a pinched nerve in my neck when I moved. No insurer would take me, and one told me that they wouldn't insure me until nine years had passed without any symptoms)

rbritton 11y ago

Unfortunately, your situation must be specific to Oregon. I'm in Washington, and the closest plan we could get to what we had pre-Obamacare went from a $2500 deductible to $6300 with a premium increase of around 40-50%. In my opinion, the problem was never the unavailability of insurance. The problem was (and still is) the out-of-control pricing of medical care -- $5000+ for non-sterile gloves [1] is a bit extreme. [1]: http://www.rd.com/health/wellness/wildly-overinflated-hospital-costs/ http://www.rd.com/health/wellness/wildly-overinflated-hospit...

cookiecaper 11y ago
I agree with you. I wish more people would realize their quibbling over a treatment for a symptom when they're hashing out a regulated private insurance marketplace v. single-payer. Our existing insurance system allows a lot of perversions of the marketplace and contributes to the root cause, but having the government sign a blank check isn't the answer either. We need to return ordinary market dynamics to health care if we want something that's sustainable over the long term.
briandear 11y ago
The expensive gloves problem is due to cross subsidization and cost recovery. A good portion of the problem is due to under-market Medicare reimbursement rates; another part of the problem is that certain demographics that aren't eligible for Medicaid due to their lack of legal status incur expensive care (via the emergency rooms) that goes unreimbursed. This problem is especially accute in places like Texas. I would suspect that more free primary care clinics could take some of the burden off of emergency rooms in terms of cost and those free clinics could even be funded by insurance companies from the money their saving from not having to pay for $5000 gloves anymore. A cash-payment medical system would also solve some of these problems. With opaque pricing, hospitals get away with solving budget issues by overcharging. If you actually saw the menu of what things would cost and you were paying out of your pocket, nobody would ever tolerate $5000 gloves. Market forces would fix the cost overages very quickly. As it is now, very few people actually directly pay for their own care and thus are less motivated to care about price. "Insurance covers it," is all many people care about.
11y ago

SwellJoe 11y ago

It isn't ACA that has caused me problems, or at least the law itself. The description given matched my experience with insurers before ACA. My problem with ACA is Healthcare.gov (still). It is possible to go through the entire application process, make one mistake or fail to provide the right detail, and end up disqualified from buying insurance through Healthcare.gov (in my case, I used a mail forwarding service address, because I travel full-time). There is no do-over, no online process for correcting the problem with the application. You have to go through a protest process that involves mailing physical letters somewhere. Fuck that. I'd go back to the nightmare that is pre-ACA private insurance, before I beg some bureaucrat, by mail, for the privilege of paying too much for insurance. Healthcare.gov got a lot of flack in the beginning for costing too much, delivering too little, and being too flakey. All of those things are still true. It's also dehumanizing.

briandear 11y ago
The traveling full time "problem" affects me as wel. When some company or another asks, "Where do you live?" My response is preceeded by an audible shrug.. I seems that many companies actually plan to come visit me and are put out when I explain that my physical location is really of no concern to them. For example, banking. If I give a Texas address and agree to Texas terms and conditions, why would it matter that I spend 11 months a year in Europe. My mail arrives, I do my transactions online.. So what's the problem? Twentieth century thinking, that's what.
- zo1 11y ago
  Those are most likely regulations enforced on to the banks. By the time it gets to the low-level employee that checks/asks/confirms your address, it's probably morphed a bit, and each employee has their own interpretation of what is "okay" when it comes to addresses.
dragonwriter 11y ago
The federal exchanges (for which healthcare.gov is the portal) were never intended to be a good choice (or even to have to exist at all), they were in the law as a minimal fallback to be applied for states that failed to implement their own exchangees.

akulbe 11y ago

Who's your carrier currently? I'm in Oregon as well, and I'm not impressed with the offerings here, at all.