Here's Great News About the ACA

[BoSoxGal]

I've decided after much contemplation to hang a shingle following the end of my term as County Attorney.

In the past several weeks I've been working on planning and preparing for that endeavour, and just this past week I looked into what I felt would be my biggest self-employment expense: healthcare.

Open enrollment is over for 2014, but I was able to use the calculators at the Healthcare.gov exchange to estimate my monthly premiums and coverage. I used this year's income of $100k+, because I have no idea how much I'll be making my first year in private practice, and thought I would see the 'worst case scenario'.

Given that income I don't qualify for a subsidy, but the platinum policy - comparable in benefits to the current (excellent) plan offered by my employer, with just a slightly higher deductible ($500, as compared to $350 under employer's plan) and out of pocket yearly limit ($1200, as compared to $750 under employer's plan) - is $377/mo., without subsidy.

My employer pays close to $1k/mo. for similar coverage!

ACA is doing exactly what it was intended to do, allowing folks to change employment and/or, like me, pursue entrepreneurial opportunities, without the fear of being uninsured or underinsured, and bankrupted by medical care costs.

ACA!

[Long Run]

You're welcome. The reason that you can be an ACA winner is that everyone who has an employer plan and other individual policies are subsidizing the Exchange plans through higher rates, and a myriad of taxes, significantly, the "risk corridor" assessments that protect insurers from taking losses. That said, how the ACA is doing is greatly influenced by each state's approach and participation of healthy folks; looks like Montana is doing a good job. btw, congratulations and best of luck on your decision!

[oldr_n_wsr]

ACA is doing exactly what it was intended to do, allowing folks to change employment and/or, like me, pursue entrepreneurial opportunities, without the fear of being uninsured or underinsured, and bankrupted by medical care costs.

How's it doing getting those 30-40 million of the uninsured into plans?
Off the cuff numbers I've seen thrown around that 8+million signed up. So far 7+million have actuall paid. 6 million were uninsured due to the ACA and the majority of hte 8 million who signed up. So I'll be generous and say 5 million were those newly insured (those who were not thrown off an old plan, aka those who nevr had HI before). So we have about 25-35 million still with no health insurance.
The feds are looking at a big windfall when those fines are due next tax season.

[Big RR]

BSG--one thing to check on the ACA policy is the deductible for drugs; when I looked at possible changing I found that the drug copay for the more expensive drugs was 30% of the total average list price rather than a fixed dollar amount. Things like that can sneak up on you, so be sure to check.

[Long Run]

That and making sure your doctor is in the network, though in a small, mostly rural area nearly all providers should be on every carrier's network.

[rubato]

You're welcome. The reason that you can be an ACA winner is that everyone who has an employer plan and other individual policies are subsidizing the Exchange plans through higher rates, and a myriad of taxes, significantly, the "risk corridor" assessments that protect insurers from taking losses. That said, how the ACA is doing is greatly influenced by each state's approach and participation of healthy folks; looks like Montana is doing a good job. btw, congratulations and best of luck on your decision!

Employer plans are being raped by the employers. Thank god I have HI through my wife (Kaiser Partner) because my employer has fucked their own employees so badly that they are actually recommending that some switch to the ACA exchanges. Most large companies are doing the same.


yrs,
rubato

[BoSoxGal]

Montana is one of those stupid states that refused to set up an exchange or expand Medicaid, but the feds have set up an exchange for us - so I guess the kudos go to Obama. The exchange, by the way, was super user-friendly.

My D.O., who I adore, is thankfully a participant in the provider network. The maintenance meds I take (migraine preventive, migraine abortive, SSRI) are all generic, so those costs should be manageable, too.

Here's some info on Montana's ACA participation, and continued rate of uninsured:

A June study by the Kaiser Family Foundation health care information organization puts the Treasure State in 34th place for health coverage.

This is despite the 30,018 people an analysis by the state Commissioner of Securities and Insurance counts as now covered who didn’t have insurance before ACA coverage first became available Jan. 1.

Those newly covered individuals reduced the previous number of uninsured, estimated at 195,000, by 15.4 percent. That dropped the percentage of uninsured in Montana from about 20 percent to 16.9 percent, according to CSI’s analysis.

A large majority of the newly insured found coverage through the Marketplace, with smaller numbers receiving Medicaid or finding policies through the private insurance sector, CSI estimated.

Kaiser puts Montana’s uninsured post ACA-implementation level at 17.6.

More:http://www.greatfallstribune.com/story/ ... /14711953/

I have a love/hate relationship with Montana, as you'll note I call it "Montucky" on my profile. It's one of the most fantastically beautiful places I've ever been or seen, and the quality of life here - and low cost of living - make it really great in many ways to live here.

BUT, there are a great many rednecks hanging about, and many of them HATE Obama with a passion that defies reason - it's bigotry, plain and simple. I've no doubt - because I've heard people say it in the small town where I live - that many folks in Montana who qualify for ACA (and probably for a healthy subsidy), won't sign up because the N----- President (I am quoting) shoved ACA down our throats and it's just more of the Feds trying to control our lives.

Ah well, you can't fix stupid. Since they won't have healthcare, they're likely to die off that much sooner.

eta: I would never be able to hang a shingle without ACA - the insurance offered to solo practitioners through the State Bar is hugely expensive, and I have pre-existing conditions - nothing horrible, but enough that before ACA, I could have been denied insurance or charged an impossibly high premium.

I'm especially excited because I'm at the State Bar's Annual Meeting right now and I just attended a CLE at which two of the presenters were these folks:

http://www.theatlantic.com/business/arc ... le/375717/

So, now I'm thinking about starting my own non-profit legal services program to serve folks between the poverty line and the place way above where you can actually afford a $200/hr.+ attorney.

[Lord Jim]

I have a love/hate relationship with Montana, as you'll note I call it "Montucky" on my profile. It's one of the most fantastically beautiful places I've ever been or seen, and the quality of life here - and low cost of living - make it really great in many ways to live here.

BUT, there are a great many rednecks hanging about...

BSG, that reminded me of something I saw a while back in a documentary about the Vietnam War...

A soldier who had just returned from Vietnam was being interviewed, and he said:

"Vietnam is a beautiful place, except for the people"...

[rubato]

http://acasignups.net/


Hispanic uninsured rate drops by 36% nationally

One of the bigger concerns about the ACA was that the reduction in uninsured rates wouldn't be felt among the Hispanic community in particular. Instead, that demographic appears to be outpacing the general populace:

The federal healthcare law has dramatically increased coverage among Latinos, according to a new report that provides a comprehensive look at the effects of the Affordable Care Act on a historically underinsured community.

Overall, the percentage of Latinos ages 19 to 64 lacking health coverage fell from 36% to 23% between summer 2013 and spring 2014.

That's a reduction of 13 percent points, or 36% among non-elderly adults.

By comparison, the overall reduction nationally has been from around 20% down to 15%...or roughly a 25% drop.

Annnnnnd another ACA attack point bites the dust.

yrs,
rubato

[rubato]

http://acasignups.net/14/09/25/darn-you ... llion-year

Darn you, Obama! ACA cuts hospital costs by $5.7 billion this year!

The Washington Post's Jason Millman reports:

The Obama administration is projecting that hospitals will face $5.7 billion less in uncompensated care costs than they otherwise would have in the first full year of the Affordable Care Act's coverage expansion.

Millions more people with health insurance means fewer uninsured patients are coming through hospitals' doors. That means fewer costs from bad debt or charity care from people unable to pay their bills, which amounted to about $50 billion for the nation's hospitals in 2012.

OK, so obviously the hospitals are thrilled about this, but what about the rest of us? Well, in theory, those savings should be in turn passed along in the form of lower premiums/co-pays/etc. (or at least a slower rate of increase, anyway)

y):

Five years ago, when advocates were still trying to build support for the bill that became the ACA, they saw the potential for reducing the costs of uncompensated care as a big selling point. That's because those costs were already getting passed along to the tabs of people who could pay. This "hidden tax" amounted to about $1,000 for family coverage, according to a 2009 analysis from Families USA.

Of course, whether the rest of us will actually see this "$1,000/year per family" savings is difficult to tell...but so far this seems to be yet another anti-ACA talking point (hospital costs will skyrocket!!) being shot down.:

yrs,
rubato

Another one bites the dust.

[rubato]

And then the cautionary tale about Republicans trying to fuck their constituents and piss away money once again:


http://acasignups.net/14/09/24/roundup- ... whospitals

Roundup: GOP still plans to kill ACA; Obamacare success story in TX; CVS joins forces w/hospitals
Submitted by Charles Gaba on Wednesday, September 24, 2014 - 11:34am.
Source:
Politics USA, 09/22/14: Paul Ryan Admits That The GOP Plans To Win The Senate and Take Healthcare Away From Millions
New York Times, 09/23/14: A Health Care Success Story
Kaiser Health News, 09/24/14: Win-Win? CVS Joining Forces With Hospitals, Doctors

Paul Ryan Admits That The GOP Plans To Win The Senate and Take Healthcare Away From Millions

"I’d go back to the pre-Obamacare baseline is what I would do. I think that’s the way to go. We shouldn’t assume we’re going to have an explosive entitlement then replace it with our own. I would start over again, quite frankly."

What Ryan was suggesting is that if Republicans take control of the Senate, they are going to begin the process of repealing Obamacare. The real target date that Republicans have in mind is 2017. If Republicans control Congress and win the presidency, they will be able to repeal the ACA and replace it with a voucher system.

A Health Care Success Story

IT may have been the most influential magazine article of the past decade. In June of 2009, the doctor and writer Atul Gawande published a piece in The New Yorker called “The Cost Conundrum,” which examined why the small border city of McAllen, Tex., was the most expensive place for health care in the United States.

The article became mandatory reading in the White House. President Obama convened an Oval Office meeting to discuss its key finding that the high cost of health care in the country was directly tied to a system that rewarded the overuse of care. The president also brought up the article at a meeting with Democratic senators, emphasizing that McAllen represented the problem that needed to be fixed.

Five years later, the situation has changed. Where McAllen once illustrated the problem of American health care, the city is now showing us how the problem can be solved, largely because of the Affordable Care Act that Mr. Obama signed into law in 2010.

Win-Win? CVS Joining Forces With Hospitals, Doctors

Neglected to pick up your prescription? Now, there’s a good chance your doctor will know and do something about it, thanks to a slew of new partnerships between CVS Health and various health systems.

One of the most recent, which is slated to begin by early next year, will integrate the electronic medical records from MedStar Health’s 10 hospitals and 4,000 doctors – located in Washington, D.C. and Maryland -- with CVS pharmacies as well as the chain’s 900 Minute Clinics located across the country.