Whew, I have health insurance for 2014 !!!!

[Cujet]

It's been a bit of a struggle with the recent uncertainties. I'm 50, in good physical shape, not overweight at all, however, I have some health issues and need insurance.

Background: I live and work in FL, but due to FAA regulations and that "operational control" of our airplane is a contract company in NY, the FAA requires that my paycheck and health insurance come from NY. (the FAA requires 2 out of 3 items pay, insurance and residence)

So, I attach myself to the NY based company and fully pay my premiums myself.

2011, Caddy plan, $16K.

2012, I purchased the best plan I could. Almost "Cadillac" plan, with total coverage, modest deductible, low max out of pocket and so on. Cost me $27,000.

2013, that plan was no longer offered. I purchased a PPO, with a $2500 deductible for both myself and each family member. $10K max out of pocket and so on. Cost me $24K and change. Plus nearly $9,000 in out of pocket additional health expenses. (20% co-pay and deductibles)

2014, my plan was canceled due to not meeting recent regulations. And I was going to be forced to go on the NY health exchanges. But, the company came through last minute and I have a modified version of last years policy. Premium went up 22+%! And the coverage is far worse, with fewer in network doctors here in FL. (remember, it's a NY plan and I'm away from the network) Premium is just shy of $30K.

I have NOTHING NICE TO SAY ABOUT THE CURRENT REGULATIONS. In 3 years time, my premiums have nearly doubled, my max out of pocket has quadrupled and my deductible has increased 10 fold. Affordable Care Act? I don't think so!!

However, the "platinum" on the NY exchanges would have topped $35K for my family. So, I'm doing a bit better in that regard.

Next year, I expect to be working a different job, with income in the mid 50's to mid 60's. I won't be able to afford good insurance. This is truly horrible.

 

[Turk]

Originally Posted By: Cujet
Premium went up 22+%! And the coverage is far worse, with fewer in network doctors here in FL. (remember, it's a NY plan and I'm away from the network) Premium is just shy of $30K.

I have NOTHING NICE TO SAY ABOUT THE CURRENT REGULATIONS. In 3 years time, my premiums have nearly doubled, my max out of pocket has quadrupled and my deductible has increased 10 fold. Affordable Care Act? I don't think so!!

I won't be able to afford good insurance. This is truly horrible.


All everyone needs to know.

- HOW are Americans going to come up with this much greater expense?

- Have wages gone up this much to compensate?

People will have to CUT BACK on discretionary spending and this will equal an economy that will TANK.


It's sad, but easy math.

 

[demarpaint]

Don't let me get started.

 

[Sayjac]

IBTL

 

[R80RS]

I'm going through the same challenges regarding renewing the group plan we offer at our company. The delay of the employer mandate to the end of 2014 has put off the day of reckoning for one more year, but if things don't change we will be forced to push our people onto the "exchanges", with a significant loss of plan benefits and increase in cost. This "reform" has been a disaster through and through.

 

[Cujet]

Originally Posted By: sayjac

IBTL


Well, I really did not start the post to be political. I was simply glad that I have coverage for 2014! I probably should have been a bit more careful in what I said. But as I wrote, the words just came out.

As I mentioned, I have some health issues. I had viral cardiomyopathy and other issues related to the Epstein Barr virus 20 years ago and the result was a long and difficult struggle with certain issues. I can't go without insurance. When things flare up, I need the hospital.

 

[R80RS]

Originally Posted By: Cujet
Originally Posted By: sayjac

IBTL


Well, I really did not start the post to be political. I was simply glad that I have coverage for 2014! I probably should have been a bit more careful in what I said. But as I wrote, the words just came out.



Says a lot about where we are as a society when an honest and civil discussion of the most significant health law reform in our lifetimes can be branded as controversial political speech and is in danger of being shut down.

 

[Turk]

This is not a political thread, imho, it's reality.

Reality that is negatively affecting us, significantly.

 

[JHZR2]

For now it is just the reality of the situation. Taking it political, or adding thinly veiled political comments will make the thread go away, and people may be banned.

That said, healthcare costs have been rising unsustainably for years. It's nothing new. And for someone who needs a hospital and has bad and lingering issues, they are an insurance liability, do cost society more and should pay more. It's no different than if you have auto insurance with a clean record or one with five speeding tickets and two accidents. The pricing is not the same.

But at least now some coverage is guaranteed, he won't just be dropped for making too many expensive claims should he go into the hospital... And his coverage is assured for many years until Medicare eligibility comes along.

The stupidity is still the market boundaries and less than optimal grouping of people into better risk pools. However I doubt that FL costs are much different than NY anyway.

Keep in mind that others have noted net cost reductions on their policies.

And at mid $50-60k, IMO the OP wouldn't have been able to satisfactorily afford the plan at 2011 cost levels either.

 

[Donald]

The OP is not the typical person the health car act was going after. It was the 7 million Americans who had no insurance and worked at Walmart or McDonalds. They will get a subsidy and finally have health insurance and can go and see a primary care doctor when they are sick vs wait until they are critical and go to the ER.

The full cost of an average health plan if you worked for a major company is around $7500 per year for one adult. Now in most cases the employer pays about 2/3 to 3/4 of that.

If the new health care act was not in place, what would the OP like to see, pay a lot for substandard plans? All the new health care act did for the OP was to not allow him to purchase a substandard health care plan.

I would guess the OP earns about $75K. Health care is expensive, so the full cost of the plans is expensive if you have to pay it all yourself.

I hope in the not too distant future we go to a single payer health care system. We are one of the few democracies in the world without a single payer health care system. And we get worse health care than most countries that do have a single payer health care system.

 

[d00df00d]

Originally Posted By: R80RS
Says a lot about where we are as a society when an honest and civil discussion of the most significant health law reform in our lifetimes can be branded as controversial political speech and is in danger of being shut down.

I agree, but I'm not sure it's for the same reasons.

Any time you light up someone's moral sense, the discussion becomes black-and-white, us-against-them. Political discussions ALWAYS light up our moral senses, so they usually devolve into bitter verbal punch-ups. This is why BITOG has board rules against discussing politics. BITOG is supposed to be a safe and family friendly site, so these kinds of punch-ups are a no-go.

Furthermore, the current political climate is EXTREMELY polarized. These days, any time someone gets a whiff of the other side of the political spectrum, they get spectacularly defensive and flip out. This is happening MUCH more on one side of the political spectrum than on the other, but the effect is the same: civil political discussions are getting harder to find by the day.

Lastly, very few people actually know and respect the line between "civil discussion" and "controversial political speech." People who want to lob political bombs often retreat when they are called on it, and say they were just trying to talk; at the same time, people who really were just trying to talk are often perceived as political bomb throwers. It's hard to have a reasonable give-and-take discussion under those conditions.

I share your wish that people could discuss these important issues safely. As always, the hard part is making that work in reality.

 

[Turk]

Originally Posted By: Donald


I hope in the not too distant future we go to a single payer health care system. We are one of the few democracies in the world without a single payer health care system.


"Just for clarification":

We are not and never were a democracy, we are a constitutional republic. Big difference.

Back on topic.

 

[d00df00d]

Originally Posted By: JHZR2
It's no different than if you have auto insurance with a clean record or one with five speeding tickets and two accidents. The pricing is not the same.

One crucial difference: It's hard to imagine how a person could be born into five speeding tickets and two accidents.


Originally Posted By: JHZR2
But at least now some coverage is guaranteed, he won't just be dropped for making too many expensive claims should he go into the hospital... And his coverage is assured for many years until Medicare eligibility comes along.

Yup. Easy for the bad stuff to eclipse the fine print.


Originally Posted By: JHZR2
Keep in mind that others have noted net cost reductions on their policies.

Right here. My wife and I are about to get into a policy that is a better fit for both of us (higher deductibles but better coverage), for only a hair more than my current premiums alone.

 

[JHZR2]

Originally Posted By: d00df00d
Originally Posted By: JHZR2
It's no different than if you have auto insurance with a clean record or one with five speeding tickets and two accidents. The pricing is not the same.

One crucial difference: It's hard to imagine how a person could be born into five speeding tickets and two accidents.


Unfortunately it doesnt matter. Insurance here is all about actuarial mathematical risk and a profit margin. Mathematics doesn't have a softer side that says that someone's condition that they were born with should give them a discount that others have to pay for.

That's where the problem lies. Sicker and older people are more of an actuarial risk, and cost us all more money. Sure, insurance is about pooling risk, but at some level it's all about the healthy/responsible/whatever for the circumstance subsidizing the care of the people more likely to make claims.

The treatment before was to not allow pre-existing conditions, and dump individuals if they make too many claims. Same deal for health and auto insurance, amongst others. The OP may be paying more now because he likely costs more, but he also has assurances that he didn't have before.

And I'm not trying to be harsh on the OP because of his condition. It's more a matter of thinking from the insurance company's angle, ACA or not. I'm no fan of the insurance industry and feel sorry for the op's situation. But there is likely some logic behind it that is sound in the pricing structure, unfortunately.

What would be interesting to know is if OP took the employer's standard plan like everyone else gets, what the full and employer subsidized cost is, this going across states thing seems to be a big problem still.

 

[supton]

Mine doubled, and I expect to pay more out of pocket on a high deductible whatever it is called; but thankfully nothing in that level of cost. I have to say, I'm not sure I could ever be self-employed now, not with the cost savings I get from my employer--I'd really have to be convinced that I would make that much more off my time and effort so as to make up the diff.

Ouch.

Looking at this a different way: should healthcare cost more or less than what one would normally pay for an automobile (or their entire fleet)? Just to put costs into perspective. Can't live if you are dead, but you can always live in a cardboard box, or thumb rides, or (egads!) drive old cars. I'm not saying a wellness visit (annual physical etc) should cost $200 for 10 minutes of time but no aspect of healthcare seems cheap.

Getting pretty expensive to live it seems, but I don't have the knowledge of what it cost decades ago.

 

[Turk]

Originally Posted By: JHZR2


The treatment before was to not allow pre-existing conditions



There are not too many insurance companies that will insure a home that is already partially burned down or, on fire.

If they did, they would not be in business for very long.

 

[JHZR2]

Originally Posted By: Turk
Originally Posted By: JHZR2


The treatment before was to not allow pre-existing conditions



There are not too many insurance companies that will insure a home that is already partially burned down or, on fire.

If they did, they would not be in business for very long.



Very true. Thing is, short of euthanizing anyone that has a medical cost above $x that they can't afford, those costs do become shared publically one way or another. Now it's just clearer what the costs truly are, instead of hiding them I the bills that the rest of us pay, and the tax losses that some claim.

 

[Turk]

Wait until late 2014 when the gap between the revenues & expenses gets announced.

Sticker shock (OUR out-of-pocket expenses going way up) will be in full force early in 2015.

This is worse then terribe, it's a debacle.

 

[SwampSurvivor]

Originally Posted By: Turk
Originally Posted By: JHZR2


The treatment before was to not allow pre-existing conditions



There are not too many insurance companies that will insure a home that is already partially burned down or, on fire.

If they did, they would not be in business for very long.



They were going overboard with pre-existing conditions.

Last year, I developed a health problem. I ended up in the hosptial because of it.

I had a 3 month fight with the health insurance company because the doctor said it was a "pre existing" condition.

Yes, it was pre-existing ... I didn't develop it while sitting in the ER ...

 

[Astro14]

Originally Posted By: JHZR2


That said, healthcare costs have been rising unsustainably for years. It's nothing new. And for someone who needs a hospital and has bad and lingering issues, they are an insurance liability, do cost society more and should pay more. It's no different than if you have auto insurance with a clean record or one with five speeding tickets and two accidents. The pricing is not the same.

But at least now some coverage is guaranteed, he won't just be dropped for making too many expensive claims should he go into the hospital... And his coverage is assured for many years until Medicare eligibility comes along.


That argument is specious - the rates are not varying because of claim history, they vary because of your income. Further, the new "requirements" for minimum coverage have required many to get coverage that they didn't previously have or need (glad, as a 50 year old man, that I have maternity coverage in my policy now, but not certain it's needed).

So, you get increased rates based on ability to pay and the addition of coverage that was not previously required. It's nothing like auto insurance...nothing at all...