This Obamacare story is just plain sad...

[jaeger19]

She makes almost $50k/yr and has one child. She can afford the Bronze plan

I agree.. the vast likelihood is that she could afford a bronze plan if she is making 50k a year and has one child. Now.. she may NOT be able to afford it because of past indiscretions in her borrowing or her choices.. but that would be more her deal.

I see such a lot in my medical business. People I see on auto insurance or workers comp.. who are making 40 to 70 thousand a year who have opted to NOT buy insurance.

I have an employee right now.. and she is opting to not pay for health insurance (even though I make up more than half) because she cannot afford it... but she can afford a 200 dollar a month smoking habit. (we argued about it because I am willing to pay for her medicine to help stop smoking)

 

[sangha]

If she's making $9500 a month, she's making a hell of alot more than "a little less than 50K". I know you guys have difficulty with advanced algebra, but basic math?

How about basic reading comprehension?

from the article in the OP:

As a freelance court reporter, Sanford, 48, doesn’t make a lot – a little less than $50,000 a year.

 

[sangha]

So you are responding to a quote that have a glaring inaccuracy without comment on that inaccuracy? Interesting, and yet your claims of attention and knowledge... hmmm.

What glaring inaccuracy? As far as I can tell, that $9500/month figure was pulled from thin air

 

[Grim17]

:roll:



No, I don't. She makes enough money to pay for health insurance.

Again, you are assuming this... This woman is not some conservative plant. She is a registered democrat that voted for Obama and was a staunch supporter of the Obamacare legislation. So until you come up with a comprehensive report showing that the woman did have enough money to afford up to $400 dollars a month for insurance, then I'm going to take her at her word.

 

[sangha]

Again, you are assuming this... This woman is not some conservative plant. She is a registered democrat that voted for Obama and was a staunch supporter of the Obamacare legislation. So until you come up with a comprehensive report showing that the woman did have enough money to afford up to $400 dollars a month for insurance, then I'm going to take her at her word.

The proof that she can afford it has already been posted. it's in the article linked in this thread.

 

[Grim17]

The proof that she can afford it has already been posted. it's in the article linked in this thread.

What article? I started this thread and it was a video report from CNN.

 

[Summerwind]

How about basic reading comprehension?

from the article in the OP:

Taking my quote out of context does look that way, doesn't it.

 

[specklebang]

To answer and clarify some of the points in your post....she didn't expect it to be free. She could afford $200 a month for a plan that doesn't have a high deductible (meaning that she'd get help paying for regular dr. and hospital and prescription bills through copays, and there would be a reasonable out of pocket amount for the year).

It turns out that the amount would be $350-$400 a month AND a high deductible, meaning she would have no coverage for regular bills until the amount reached $5k or $6k or something along those lines.

So she would be out the, say, $5,000 she regularly pays for medical during the year AND an additional $4,800, totaling $9,800 (vs. $5,000 before). The extra $4,800 is NOT for coverage for regular medical bills. It is for coverage ONLY if her bills go over a certain amount. If they don't...she doesn't have coverage. Even if they do, it won't pay that much, since it would have to go over the deductible or out of pocket amount by a LOT in order to justify the $4,800 she paid in premiums.

I get it. I get it, because that's similar to my situation. I can only afford the cheapest plans, which don't even have certain kinds of providers in my area, and VERY limited primary care physicians and hospitals in my area (there is only one gynecologist within ten miles of me who will accept the bottom plans available to me...might as well not be any).

As for her making too much for a subsidy, that's probably the case (meaning she makes at least $46,000 a year and supports a teen son with health issues...easy to see why she can't afford $9,800 a year, half of which is for catastrophic insurance). But it could also mean that she doesn't make ENOUGH to get a subsidy. You have to earn a minimum of $12,000 a year (in my state...I think it may vary from state to state).

There are a lot of people who fall in that hole...they don't qualify for Medicaid for income or other reasons, but they don't make enough to qualify for the subsidy.

Now, $400 a month for insurance for a FAMILY, which I assume is what she would be buying, because of her son, is VERY reasonable. But if you don't have the money, you don't have it. It's pretty simple.

My policies available to me (for just one person) START at $400 and go up from there to $600 I think for the BRONZE (lowest, high deductible). To get a plan that actually has doctors and hospitals that will accept it...those start at about $550 a month, which I can't afford.

First time since my late 20s that I will be living without insurance. Thank goodness I'm healthy (I work at it). I just hope I don't get something I have no control over, like cancer.

As for the penalty, I can't stop them from taking it from me, I guess. But I can't spend $400 a month for policies that don't have care providers. And I just can't pay $550 a month. Those are the cold, hard facts.

I'm going to re-read this until I comprehend it completely but I wanted to thank you for this detailed reply. No partisan anger, just information. This is the kind of response I always hope for but rarely get. My SINCERE thanks.

 

[sangha]

What article? I started this thread and it was a video report from CNN.

post #47

 

[sangha]

Taking my quote out of context does look that way, doesn't it.

No, you took Specklebang's question which wrongly assumed that the woman makes $9500 a year out of context. She doesn't make $9500/month.

She makes a little less than $50K/yr

 

[specklebang]

Read it carefully. Listed events cost a $20 co-pay, but I doubt that a one week hospital stay for surgery is listed as a $20 item.

You are right. I was completely wrong about this. I can't even read my own handwriting. All I can make out is $147 deductible. $20 co-pay. $50 ER co-pay. 15% co-pay for doctors that don't take Medicare. I know there is a Hospital stay co-py but I can't quite figure out what it is but I think it wasn't very much. I'll return with better info tomorrow after I talk to the agent.

 

[specklebang]

She makes a little less than $50K per year. The state of Washington's exchange has been feeding incorrect information to the ACA site. It specifically has been sending people's monthly incomes in as their annual income for purpose of getting the quote. Rude Awakening for Federal Way Woman Who Got Shout-Out From President

I misunderstood an earlier comment by ??? which said $95 was 1% of her income, thus the $9500 figure was inaccurately calculated by yours truly.

Its the deductible that bothers me. Do we think you must pay all the deductible BEFORE it goes to co-pay or is there a limit per event. I'm pretty sure that when I have a percentage co-pay it still can't exceed the $20 but I'm pretty confused now and I obviously need to re-discuss this with my agent.

If you really have to pay the entire original $6000 amount, then I would agree this insurance is "junk" and I can't imagine what ACA thinks "junk" is.

 

[Grim17]

post #47

I don't doubt that she make a little less than $50k per year, but as I said before, you don't know what her expenses are... Until you know what her monthly expenses are, you are in no position to say whether she can afford Obamacare or not.

 

[specklebang]

She makes a little less than $50K per year. The state of Washington's exchange has been feeding incorrect information to the ACA site. It specifically has been sending people's monthly incomes in as their annual income for purpose of getting the quote. Rude Awakening for Federal Way Woman Who Got Shout-Out From President

If she's making $9500 a month, she's making a hell of alot more than "a little less than 50K". I know you guys have difficulty with advanced algebra, but basic math?

It seems that my $9500 figure is a complete noon-reality and that her income is $49K. That's just about my income by coincidence.

I found what my plan covers (if anyone still cares): PLAN N COVERAGE and it seems that I do have t pay the entire deductible up front but it is very little. So the issue about the $6000 deductible is very significant. Sounds like terrible coverage and not at all "affordable".

 

[sangha]

I don't doubt that she make a little less than $50k per year, but as I said before, you don't know what her expenses are... Until you know what her monthly expenses are, you are in no position to say whether she can afford Obamacare or not.

Actually, the article does mention her expenses.

 

[mak2]

And it really doesn't have to. If healthcare is available that moves up the priority list.

Actually, the article does mention her expenses.

 

[specklebang]

She makes a little less than $50K per year. The state of Washington's exchange has been feeding incorrect information to the ACA site. It specifically has been sending people's monthly incomes in as their annual income for purpose of getting the quote. Rude Awakening for Federal Way Woman Who Got Shout-Out From President

What glaring inaccuracy? As far as I can tell, that $9500/month figure was pulled from thin air

Hey. That was my figure which I got from a comment about 1% of her pay for the $95 penalty. My fault, nobody elses.

Maybe at 50K she can "afford" insurance but if there really is a $6K deductible and $400 a month, that can be $900 a month. I don't know what your check looks like at $4K a month after deductions but it isn't a fortune. Looks like about 30% of take-home which is not very nice.

 

[sangha]

And it really doesn't have to. If healthcare is available that moves up the priority list.

Agreed. It's like not paying rent to your landlord because your other expenses are too high

BTW, the article says that her kid, previously uninsured, is now on Medicaid for $30/month. She had been spending $250/month just for his meds, plus more for doctors visits so she now has at least $220/month to spend on getting coverage for herself.

 

[sangha]

Hey. That was my figure which I got from a comment about 1% of her pay for the $95 penalty. My fault, nobody elses.

Maybe at 50K she can "afford" insurance but if there really is a $6K deductible and $400 a month, that can be $900 a month. I don't know what your check looks like at $4K a month after deductions but it isn't a fortune. Looks like about 30% of take-home which is not very nice.

You're assuming that her health care expenses (for herself, not the kid) meets or exceeds the deductible. It's not clear from the article, but that doesn't seem to be the case.

The article says that her kid, previously uninsured, is now on Medicaid for $30/month. She had been spending $250/month just for his meds, plus more for doctors visits so she now has at least $220/month to spend on getting coverage for herself.

 

[specklebang]

You're assuming that her health care expenses (for herself, not the kid) meets or exceeds the deductible. It's not clear from the article, but that doesn't seem to be the case.

The article says that her kid, previously uninsured, is now on Medicaid for $30/month. She had been spending $250/month just for his meds, plus more for doctors visits so she now has at least $220/month to spend on getting coverage for herself.

Well, it is confusing but if you look at the worst case scenario, if the plan costs $400 then there goes the $220 and if the deductible really is $6,000.00, then technically it would be $900 a month.

I'm not trying to be difficult and I'm actually afraid to choose sides because its hard to understand the concept. Can you enlighten me about the $6K deductible and how that works?

 

[Grim17]

Well, it is confusing but if you look at the worst case scenario, if the plan costs $400 then there goes the $220 and if the deductible really is $6,000.00, then technically it would be $900 a month.

I'm not trying to be difficult and I'm actually afraid to choose sides because its hard to understand the concept. Can you enlighten me about the $6K deductible and how that works?

That means that she has to pay out of her pocket, the first $6,000 of medical expenses every year and anything after that is covered by Obamacare.

So let's say she starts coverage on January 1st... If she breaks her arm on February 22nd and goes to the doctor, and for the xrays, doctor visit, the cast, medication and everything else is $2600, she has to pay that out of her pocket... If she reaches $6000 during the year, then everything after that is free... Until January 1st rolls around again, then it starts over.

 

[Fisher]

So you are responding to a quote that have a glaring inaccuracy without comment on that inaccuracy? Interesting, and yet your claims of attention and knowledge... hmmm.

She makes a little less than $50K per year. was the very first line of the quote. Attention deficit Order got you down or are you just one of those people who refuses to admit you are wrong when you are wrong and have to engage in personal slights because it somehow makes you feel more righteous in your wrongness Don't bother answering as I ask rhetorically because I am sure your answer will be wrong for the third time in a row.

 

[specklebang]

That means that she has to pay out of her pocket, the first $6,000 of medical expenses every year and anything after that is covered by Obamacare.

So let's say she starts coverage on January 1st... If she breaks her arm on February 22nd and goes to the doctor, and for the xrays, doctor visit, the cast, medication and everything else is $2600, she has to pay that out of her pocket... If she reaches $6000 during the year, then everything after that is free... Until January 1st rolls around again, then it starts over.

If that is true, then I consider that a junk policy. I wish I could remember how the Medicare plans work....but I think© it is a 20% limit until you reach the deductible then 100%. If you have to pay the first $6K FIRST, the plan is nearly useless.

Earlier today I asked what was the definition of junk - no formal answer - but this sounds pretty junky to me.

 

[sangha]

Well, it is confusing but if you look at the worst case scenario, if the plan costs $400 then there goes the $220 and if the deductible really is $6,000.00, then technically it would be $900 a month.

I'm not trying to be difficult and I'm actually afraid to choose sides because its hard to understand the concept. Can you enlighten me about the $6K deductible and how that works?

That's the thing about worst case scenarios - they're seldom pretty

I know you're not trying to be difficult. Basically, you pay for your care (with exceptions for some specified things which are covered 100%, and others which have a co-pay) until you hit the deductible. Then the insurance kicks in and pays at the co-insurance rate which is, I believe between 40%-100% depending on the level of coverage.

When it comes to hitting the deductible, there's two main situations. One is where a person has a "one time" expense that is unusual, in which case, they are on the hook for it. Sure, it's going to be unpleasant, but what are you going to do? **** happens.

On the bright side, most doctors will let you pay it off over time. Depending on your circumstances, that may take a while, but it's not catastrophic. It's $6K - not pocket change, but not a king's ransom either.

The other situation is for people who have high medical costs year after year. Though I don't know the exact figures, I suspect that a higher level plan (ie Silver or Gold) would have a lower deductible and higher co-insurance rate making the higher premium worth it.

Basically, I'm all for higher deductibles. One of the reasons for the increase in health care spending is because once people meet their low deductibles, cost is no longer an issue. They have no problem getting more and more care because it doesn't cost them anything. I know that's how I saw it.

Now they (myself included) will have to reach into their pockets and believe you me, that will make them think twice about it.

 

[sangha]

If that is true, then I consider that a junk policy. I wish I could remember how the Medicare plans work....but I think© it is a 20% limit until you reach the deductible then 100%. If you have to pay the first $6K FIRST, the plan is nearly useless.

Earlier today I asked what was the definition of junk - no formal answer - but this sounds pretty junky to me.

I disagree. While it certainly is not pleasant to get a large medical bill, the purpose of ACA isn't to ensure that no one gets a large medical bill. It's meant to ensure that people don't get stuck with six-figure bills.

A $6K debt can be paid off over time, and most doctors will go along with that. A $200,000 debt is another story. That's the kind of bill that results in people not being able to get treated unless they can pay. Doctors will treat someone for a $6K bill; very few will do that for a $200K patient