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2013-10-04 1:24 PM

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Subject: Affordable Care Act for dummies version

I'm not much for politics, so I don't hang out here much. Excuse me if this topic has already been done to death. I'm really just looking for some info, feel free to send me to other websites to read it for myself.

My husband has health insurance through his work but a couple of years ago we realized that it is a lot cheaper for the kids and I to be on our own plan. I just received info from our current health insurance with the updated prices from the Affordable Care Act and for just the kids and I it will cost $850 a month for what they say is a similar plan. Huh?  I'm obviously missing something here. I thought this was supposed to be more affordable?

Feel free to set me straight.


2013-10-04 2:15 PM
in reply to: trigal38

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Subject: RE: Affordable Care Act for dummies version
I am also interested in a good explanation without the "Obama is a Socialist" or "The Republicans are Crazy" twist that seems to be put on every single article I find.
2013-10-04 2:20 PM
in reply to: dmiller5

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Subject: RE: Affordable Care Act for dummies version

Originally posted by dmiller5 I am also interested in a good explanation without the "Obama is a Socialist" or "The Republicans are Crazy" twist that seems to be put on every single article I find.

Obama is really a crazy republican who aspires to be a Socialist who an expert at doing the twist.  That's why your healthcare is so high.

 

2013-10-04 2:50 PM
in reply to: dmiller5

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Originally posted by dmiller5 I am also interested in a good explanation without the "Obama is a Socialist" or "The Republicans are Crazy" twist that seems to be put on every single article I find.

Yes, this. I'm sure I'm missing something. This increase doubles what we are currently paying.

And the letter says we must move to a plan that meets the law's "minimum essential benefits" with pharmacy or maternity benefits. Umm, we currently have a plan with no prescription coverage as none of us take any regular medications and I am 41 years old with 2 adopted children so I don't think maternity issues are something I want to be forced to pay for! 

How is this helping me?!

2013-10-04 7:55 PM
in reply to: trigal38

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Subject: RE: Affordable Care Act for dummies version
Originally posted by trigal38

Originally posted by dmiller5 I am also interested in a good explanation without the "Obama is a Socialist" or "The Republicans are Crazy" twist that seems to be put on every single article I find.

Yes, this. I'm sure I'm missing something. This increase doubles what we are currently paying.

And the letter says we must move to a plan that meets the law's "minimum essential benefits" with pharmacy or maternity benefits. Umm, we currently have a plan with no prescription coverage as none of us take any regular medications and I am 41 years old with 2 adopted children so I don't think maternity issues are something I want to be forced to pay for! 

How is this helping me?!

This isn't helping you, and it's not designed to help you.   You're one of the "young and healthy" people who is being forced into the pool with sick people in order to reduce their costs.

If you are poor and/or sick, ACA is designed to help you.   If you are rich and/or healthy, ACA is designed to force your money into the pool in order to help defray the costs for the poor and/or sick.

2013-10-04 10:32 PM
in reply to: trigal38

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Subject: RE: Affordable Care Act for dummies version
I wish there was an easy answer, but this is what millions of Americans are facing. You can't mandate insurance companies cover everything under the sun, including pre existing conditions without costs going up drastically. The concept was to force the pool larger with the individual mandate to offset the increases, but even the cheapest of plans are really expensive so nobody is able to afford them, even with the subsidies.

I just read this article talking about the same stuff. The ice is cracking and the ACA is quickly turning into the largest tax the young and poor have ever seen, it then hammers the successful as well so the economy gets crushed.
http://www.breitbart.com/Big-Government/2013/10/03/Obamacare-Facebook-Erupts-With-Citizen-Sticker-Shock
I apologize for the political statement, but AL Qaeda couldn't have dreamed up a more perfect storm to destroy or economy.


2013-10-05 5:48 AM
in reply to: tuwood

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Subject: RE: Affordable Care Act for dummies version

Originally posted by tuwood I wish there was an easy answer, but this is what millions of Americans are facing. You can't mandate insurance companies cover everything under the sun, including pre existing conditions without costs going up drastically. The concept was to force the pool larger with the individual mandate to offset the increases, but even the cheapest of plans are really expensive so nobody is able to afford them, even with the subsidies.

I just read this article talking about the same stuff. The ice is cracking and the ACA is quickly turning into the largest tax the young and poor have ever seen, it then hammers the successful as well so the economy gets crushed.
http://www.breitbart.com/Big-Government/2013/10/03/Obamacare-Facebook-Erupts-With-Citizen-Sticker-Shock
I apologize for the political statement, but AL Qaeda couldn't have dreamed up a more perfect storm to destroy or economy.

I couldn't sleep last night for wrestling with this information. It's very disturbing honestly. My husband tried to get on the exchange to look for cheaper insurance for us but he could not even get on. I guess it's either send your kids to college or pay for health insurance.

2013-10-05 7:56 AM
in reply to: 0

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Subject: RE: Affordable Care Act for dummies version
Originally posted by trigal38

Originally posted by tuwood I wish there was an easy answer, but this is what millions of Americans are facing. You can't mandate insurance companies cover everything under the sun, including pre existing conditions without costs going up drastically. The concept was to force the pool larger with the individual mandate to offset the increases, but even the cheapest of plans are really expensive so nobody is able to afford them, even with the subsidies.

I just read this article talking about the same stuff. The ice is cracking and the ACA is quickly turning into the largest tax the young and poor have ever seen, it then hammers the successful as well so the economy gets crushed.
http://www.breitbart.com/Big-Government/2013/10/03/Obamacare-Facebook-Erupts-With-Citizen-Sticker-Shock
I apologize for the political statement, but AL Qaeda couldn't have dreamed up a more perfect storm to destroy or economy.

I couldn't sleep last night for wrestling with this information. It's very disturbing honestly. My husband tried to get on the exchange to look for cheaper insurance for us but he could not even get on. I guess it's either send your kids to college or pay for health insurance.

I've been looking at ACA options as my employer coverage via COBRA will end soon. Like you, my costs will be significantly higher based on what I've found thus far - although I could only get to the calculators.  I've read that some major insurers have opted out of the state exchanges, at least for the first year.  It "may" be worth looking for other insurance providers outside of your state exchange to see if your family's "young, healthy, no maternity etc" needs are available at a lower cost elsewhere. At least worth a bit of internet time. 



Edited by kcarroll 2013-10-05 7:57 AM
2013-10-05 2:51 PM
in reply to: kcarroll

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Subject: RE: Affordable Care Act for dummies version
I posted this response on another thread, but just want to use my example to help bring a face and a name to the "poor and the sick". I consider myself neither, but I do have a condition that is very expensive to treat and will last my lifetime short of a cure.

There are certainly problematic provisions of the ACA. But I'm one of those "sick" people who has a pre-existing condition. I've had Type 1 diabetes for 20+ years...otherwise no health problems. However, that one strike makes me uninsurable on my own. I'm not overweight and no "eating too much sugar" did not cause it. No one knows why I got it. Short of a cure, I will always have it and will always need insulin to keep me alive.

I'm very fortunate to have excellent group coverage right now. I use that to take good care of myself, but my care is not cheap. Test strips, insulin pump and related supplies, insulin, lots of doctor appts. to check blood work, eyes, etc. Hopefully that prevents or delays complications that will be even more costly and allows me to be productive in life.

To many people, I guess I would be considered a "drain on the system"....you know....one of those "unhealthy" people who the young healthy ones don't want to pay for. And if I were to wind up with a gap in group coverage and left to look for insurance on my own, I would be automatically turned away by most if not all insurance companies. Yes, even though I'm healthy in every other way. Requiring insurance companies to cover the likes of me is something that I'm very glad is part of the ACA. Not pointing fingers at any individuals here, but if you think you don't have any worries along those same lines because you are fit, eat right, etc.....think again. I was diagnosed as an otherwise healthy, active 27 year old. Before that I thought I had no worries either.
2013-10-05 7:21 PM
in reply to: squirt

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Subject: RE: Affordable Care Act for dummies version

I agree, they system was broke before for sure.  My father had a large laundry list of health issues everything from cancer to heart problems, my mother in law had 5 eye surgeries. I don't need a face to go with the sick and poor - they are my family.  And I never voiced an opinion about anyone being a drain on the system. That is not the point of my post.

My household alone is looking at $15,000 to have basic insurance with no current medical needs. This is not affordable health care. Don't I remember someone stating that the middle class could expect to save $2,500 with Obamacare? Well that is not what I see happening.

I will be searching for something less expensive, which probably means it will cover only the basics with a doctor I do not know or get to choose and carry an incredibly high deductible. And maybe I will save 200 bucks.

 

2013-10-05 8:05 PM
in reply to: 0

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Subject: RE: Affordable Care Act for dummies version
Originally posted by trigal38

I agree, they system was broke before for sure.  My father had a large laundry list of health issues everything from cancer to heart problems, my mother in law had 5 eye surgeries. I don't need a face to go with the sick and poor - they are my family.  And I never voiced an opinion about anyone being a drain on the system. That is not the point of my post.

My household alone is looking at $15,000 to have basic insurance with no current medical needs. This is not affordable health care. Don't I remember someone stating that the middle class could expect to save $2,500 with Obamacare? Well that is not what I see happening.

I will be searching for something less expensive, which probably means it will cover only the basics with a doctor I do not know or get to choose and carry an incredibly high deductible. And maybe I will save 200 bucks.

 




Would it be cheaper to go back on your husbands plan?

Edit to add: Not an expert on ACA, but isn't there some provision about not being eligible for ACA coverage if you have access to group coverage, even if it is through a spouse?

Edited by buck1400 2013-10-05 8:08 PM


2013-10-05 8:12 PM
in reply to: buck1400

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Subject: RE: Affordable Care Act for dummies version
Originally posted by buck1400
Originally posted by trigal38

I agree, they system was broke before for sure.  My father had a large laundry list of health issues everything from cancer to heart problems, my mother in law had 5 eye surgeries. I don't need a face to go with the sick and poor - they are my family.  And I never voiced an opinion about anyone being a drain on the system. That is not the point of my post.

My household alone is looking at $15,000 to have basic insurance with no current medical needs. This is not affordable health care. Don't I remember someone stating that the middle class could expect to save $2,500 with Obamacare? Well that is not what I see happening.

I will be searching for something less expensive, which probably means it will cover only the basics with a doctor I do not know or get to choose and carry an incredibly high deductible. And maybe I will save 200 bucks.

 

Would it be cheaper to go back on your husbands plan? Edit to add: Not an expert on ACA, but isn't there some provision about not being eligible for ACA coverage if you have access to group coverage, even if it is through a spouse?

The open enrollment period has ended so I don't think so unless ACA makes them change that too? I don't know.

2013-10-06 7:16 AM
in reply to: trigal38

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Subject: RE: Affordable Care Act for dummies version
It will help my buddy who is self-employed and has a genetic disorder that precludes him from individual insurance. His prescriptions cost about $1200/month. Without it, he would die. He has been paying for his medication, doctors visits, labs, without assistance to the tune of about $20,000/year. ACA will allow him to start thinking about saving for his retirement as he expects to cut his annual medical in half.

But someone (you and me) will have to pay the difference.
2013-10-06 7:29 AM
in reply to: squirt

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Subject: RE: Affordable Care Act for dummies version

The name Affordable Care Act is misleading.  It has nothing to do with reducing the medical costs for the country as a whole, and it's hard to argue that it won't actually result in greater costs for everyone combined.  As others have said, it will allow people who had trouble getting insurance in the past to get it now.  That's about the only thing good I see about it.

IMHO, we need to find a way to make health care more affordable by addressing the actual costs, rather than just trying to funnel more money into the system like the ACA does.  Making it more affordable would actually help more people.  Forcing more money into the system just creates a drain on the economy.

My prediction is that as big of a mess as it appears to be now, it's going to get worse before it gets better.

2013-10-06 11:02 PM
in reply to: TriMyBest

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Subject: RE: Affordable Care Act for dummies version
Originally posted by TriMyBest

The name Affordable Care Act is misleading.  It has nothing to do with reducing the medical costs for the country as a whole, and it's hard to argue that it won't actually result in greater costs for everyone combined.  As others have said, it will allow people who had trouble getting insurance in the past to get it now.  That's about the only thing good I see about it.

IMHO, we need to find a way to make health care more affordable by addressing the actual costs, rather than just trying to funnel more money into the system like the ACA does.  Making it more affordable would actually help more people.  Forcing more money into the system just creates a drain on the economy.

My prediction is that as big of a mess as it appears to be now, it's going to get worse before it gets better.

I figured it would really help the poor and the preexisting condition folks, but it looks like it's only going to help the preexisting folks because it's too expensive for the poor, even with the subsidies.
2013-10-06 11:02 PM
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Subject: RE: Affordable Care Act for dummies version
Oops, cellphone double post.

Edited by tuwood 2013-10-06 11:03 PM


2013-10-07 6:21 AM
in reply to: tuwood

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Subject: RE: Affordable Care Act for dummies version
Originally posted by tuwood

Originally posted by TriMyBest

The name Affordable Care Act is misleading.  It has nothing to do with reducing the medical costs for the country as a whole, and it's hard to argue that it won't actually result in greater costs for everyone combined.  As others have said, it will allow people who had trouble getting insurance in the past to get it now.  That's about the only thing good I see about it.

IMHO, we need to find a way to make health care more affordable by addressing the actual costs, rather than just trying to funnel more money into the system like the ACA does.  Making it more affordable would actually help more people.  Forcing more money into the system just creates a drain on the economy.

My prediction is that as big of a mess as it appears to be now, it's going to get worse before it gets better.

I figured it would really help the poor and the preexisting condition folks, but it looks like it's only going to help the preexisting folks because it's too expensive for the poor, even with the subsidies.


I just ran a quick calc on the kff.org web site. For a family of 4 (2 adults and two kids) making 30,000/yr (125% of pov). where i live, the premiums would be:

$8600/yr before subsidy
$600/yr after subsidy.

Looks pretty affordable to me.
2013-10-07 8:01 AM
in reply to: buck1400

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Subject: RE: Affordable Care Act for dummies version
Originally posted by buck1400
Originally posted by tuwood
Originally posted by TriMyBest

The name Affordable Care Act is misleading.  It has nothing to do with reducing the medical costs for the country as a whole, and it's hard to argue that it won't actually result in greater costs for everyone combined.  As others have said, it will allow people who had trouble getting insurance in the past to get it now.  That's about the only thing good I see about it.

IMHO, we need to find a way to make health care more affordable by addressing the actual costs, rather than just trying to funnel more money into the system like the ACA does.  Making it more affordable would actually help more people.  Forcing more money into the system just creates a drain on the economy.

My prediction is that as big of a mess as it appears to be now, it's going to get worse before it gets better.

I figured it would really help the poor and the preexisting condition folks, but it looks like it's only going to help the preexisting folks because it's too expensive for the poor, even with the subsidies.
I just ran a quick calc on the kff.org web site. For a family of 4 (2 adults and two kids) making 30,000/yr (125% of pov). where i live, the premiums would be: $8600/yr before subsidy $600/yr after subsidy. Looks pretty affordable to me.

What's the deductible and copay?  There are "affordable" premium plans in the bronze area but they then have a very high deductible/copay that make them unusable.

2013-10-07 8:08 AM
in reply to: buck1400

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Subject: RE: Affordable Care Act for dummies version
Originally posted by buck1400
Originally posted by tuwood
Originally posted by TriMyBest

The name Affordable Care Act is misleading.  It has nothing to do with reducing the medical costs for the country as a whole, and it's hard to argue that it won't actually result in greater costs for everyone combined.  As others have said, it will allow people who had trouble getting insurance in the past to get it now.  That's about the only thing good I see about it.

IMHO, we need to find a way to make health care more affordable by addressing the actual costs, rather than just trying to funnel more money into the system like the ACA does.  Making it more affordable would actually help more people.  Forcing more money into the system just creates a drain on the economy.

My prediction is that as big of a mess as it appears to be now, it's going to get worse before it gets better.

I figured it would really help the poor and the preexisting condition folks, but it looks like it's only going to help the preexisting folks because it's too expensive for the poor, even with the subsidies.
I just ran a quick calc on the kff.org web site. For a family of 4 (2 adults and two kids) making 30,000/yr (125% of pov). where i live, the premiums would be: $8600/yr before subsidy $600/yr after subsidy. Looks pretty affordable to me.

BTW, on a side note I have seen a lot of these calculators before and figured it would be "affordable" for most of the poor and the obvious benefits to the folks with pre-existing conditions.  My contentions were mostly around the costs not being sustainable and the increase in demand will drive costs up and quickly bankrupt the system.

However, now that the plans are starting to come out the "calculators" don't seem to be adding up to the reality numbers I'm seeing.  I'm also just digging into it a little more now, but I read something last night that says the law is written so that any states who don't have their own exchanges are not eligible for any Federal subsidies.  Supposedly the President has committed to ignoring that portion of the law and paying them anyways.  Oklahoma apparently has a lawsuit going up about this portion of the law.

2013-10-07 8:17 AM
in reply to: buck1400

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Subject: RE: Affordable Care Act for dummies version
Originally posted by buck1400
Originally posted by tuwood
Originally posted by TriMyBest

The name Affordable Care Act is misleading.  It has nothing to do with reducing the medical costs for the country as a whole, and it's hard to argue that it won't actually result in greater costs for everyone combined.  As others have said, it will allow people who had trouble getting insurance in the past to get it now.  That's about the only thing good I see about it.

IMHO, we need to find a way to make health care more affordable by addressing the actual costs, rather than just trying to funnel more money into the system like the ACA does.  Making it more affordable would actually help more people.  Forcing more money into the system just creates a drain on the economy.

My prediction is that as big of a mess as it appears to be now, it's going to get worse before it gets better.

I figured it would really help the poor and the preexisting condition folks, but it looks like it's only going to help the preexisting folks because it's too expensive for the poor, even with the subsidies.
I just ran a quick calc on the kff.org web site. For a family of 4 (2 adults and two kids) making 30,000/yr (125% of pov). where i live, the premiums would be: $8600/yr before subsidy $600/yr after subsidy. Looks pretty affordable to me.

A family of 4 (2 adults) making 30K a year would equate to both adults making less than minimum wage?  Hate to sound like an azz but if you've got 2 kids and you make 15K a year as an individual maybe health insurance isn't your biggest concern.

2013-10-07 8:41 AM
in reply to: buck1400

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Subject: RE: Affordable Care Act for dummies version

Originally posted by buck1400  I just ran a quick calc on the kff.org web site. For a family of 4 (2 adults and two kids) making 30,000/yr (125% of pov). where i live, the premiums would be: $8600/yr before subsidy $600/yr after subsidy. Looks pretty affordable to me.

That's were the problem with the name comes into play.  AFAFBMEFM (Affordable for a Few But More Expensive for Most) just doesn't roll off of the tongue very well. 



2013-10-07 8:44 AM
in reply to: Sous

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Subject: RE: Affordable Care Act for dummies version
Originally posted by Sous

Originally posted by buck1400
Originally posted by tuwood
Originally posted by TriMyBest

The name Affordable Care Act is misleading.  It has nothing to do with reducing the medical costs for the country as a whole, and it's hard to argue that it won't actually result in greater costs for everyone combined.  As others have said, it will allow people who had trouble getting insurance in the past to get it now.  That's about the only thing good I see about it.

IMHO, we need to find a way to make health care more affordable by addressing the actual costs, rather than just trying to funnel more money into the system like the ACA does.  Making it more affordable would actually help more people.  Forcing more money into the system just creates a drain on the economy.

My prediction is that as big of a mess as it appears to be now, it's going to get worse before it gets better.

I figured it would really help the poor and the preexisting condition folks, but it looks like it's only going to help the preexisting folks because it's too expensive for the poor, even with the subsidies.
I just ran a quick calc on the kff.org web site. For a family of 4 (2 adults and two kids) making 30,000/yr (125% of pov). where i live, the premiums would be: $8600/yr before subsidy $600/yr after subsidy. Looks pretty affordable to me.

A family of 4 (2 adults) making 30K a year would equate to both adults making less than minimum wage?  Hate to sound like an azz but if you've got 2 kids and you make 15K a year as an individual maybe health insurance isn't your biggest concern.




Understand it is tough at that income level, but no health insurance for them would be very serious, IMHO. I used income numbers assuming 1 person working full time and making $10/hr and the other working part time making the other $10,000/yr. Not unusual for a young family at the lower income level.
2013-10-07 8:47 AM
in reply to: tuwood

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Subject: RE: Affordable Care Act for dummies version
Originally posted by tuwood

Originally posted by buck1400
Originally posted by tuwood
Originally posted by TriMyBest

The name Affordable Care Act is misleading.  It has nothing to do with reducing the medical costs for the country as a whole, and it's hard to argue that it won't actually result in greater costs for everyone combined.  As others have said, it will allow people who had trouble getting insurance in the past to get it now.  That's about the only thing good I see about it.

IMHO, we need to find a way to make health care more affordable by addressing the actual costs, rather than just trying to funnel more money into the system like the ACA does.  Making it more affordable would actually help more people.  Forcing more money into the system just creates a drain on the economy.

My prediction is that as big of a mess as it appears to be now, it's going to get worse before it gets better.

I figured it would really help the poor and the preexisting condition folks, but it looks like it's only going to help the preexisting folks because it's too expensive for the poor, even with the subsidies.
I just ran a quick calc on the kff.org web site. For a family of 4 (2 adults and two kids) making 30,000/yr (125% of pov). where i live, the premiums would be: $8600/yr before subsidy $600/yr after subsidy. Looks pretty affordable to me.

BTW, on a side note I have seen a lot of these calculators before and figured it would be "affordable" for most of the poor and the obvious benefits to the folks with pre-existing conditions.  My contentions were mostly around the costs not being sustainable and the increase in demand will drive costs up and quickly bankrupt the system.

However, now that the plans are starting to come out the "calculators" don't seem to be adding up to the reality numbers I'm seeing.  I'm also just digging into it a little more now, but I read something last night that says the law is written so that any states who don't have their own exchanges are not eligible for any Federal subsidies.  Supposedly the President has committed to ignoring that portion of the law and paying them anyways.  Oklahoma apparently has a lawsuit going up about this portion of the law.




I think there are some additional subsidies for deductibles and co-pays for those under 250% of the poverty level.
2013-10-07 9:05 AM
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Subject: RE: Affordable Care Act for dummies version
When do you get your subsidy back?

Do you front the $8k and get it back on your tax return? Because I can't imagine anyone who will get a subsidy has the cash to front the expense.

Edited by Jackemy1 2013-10-07 9:06 AM
2013-10-07 9:06 AM
in reply to: trigal38

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Subject: RE: Affordable Care Act for dummies version
Originally posted by trigal38

I agree, they system was broke before for sure.  My father had a large laundry list of health issues everything from cancer to heart problems, my mother in law had 5 eye surgeries. I don't need a face to go with the sick and poor - they are my family.  And I never voiced an opinion about anyone being a drain on the system. That is not the point of my post.

My household alone is looking at $15,000 to have basic insurance with no current medical needs. This is not affordable health care. Don't I remember someone stating that the middle class could expect to save $2,500 with Obamacare? Well that is not what I see happening.

I will be searching for something less expensive, which probably means it will cover only the basics with a doctor I do not know or get to choose and carry an incredibly high deductible. And maybe I will save 200 bucks.

 




So why not put that $15,000 into a savings account for when you do have some insurance needs? Pay the $100 penalty (that's what I heard it is) and call it good?

You said you don't have any current medical needs.

When I was in corporate America I had a High Deductible plan and loved it. They put money into my account every month and since I had no needs, it filled the gap when I did need it. People are all wrapped around the axle when they don't have health insurance yet they are the ones that don't use it. It's the specter of fear and the 'what if'.

I haven't had Health Insurance since I left Corporate America but put money into my savings account just in case. I've had some minor stuff happen and I pay cash for it. When I had dental surgery the pharmacy asked me for my updated insurance card, and when i said I didn't have any, they simply put in a 'code' and I paid the same for them. But I was prepared to pay 'full price' as well.

I have had full blood tests, just in case, and negotiate a cash price beforehand. It takes time upfront, but it works for me and I'll play my odds because the odds are in my favor.
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author : Ontherun
comments : 1
The first video in this series will go through some wetsuit basics: what is a triathlon wetsuit, different styles, rules for racing with a wetsuit and wetsuit care and fit.
date : November 28, 2004
author : sekhmet
comments : 1
I challenge all BT readers who want to shed the pounds to stay committed to their training during the colder months. Share this commitment with others.