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View Diary: A Freelancer in Texas Applies for Health Insurance, by Jen Sorensen (152 comments)

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    •  Added one more. :) (17+ / 0-)

      Another important aspect of the free lance story, is how many are benefiting from Obamacare, but not counted in the official tally because they purchased directly from the Insurance company. If you didn't qualify for subsidies, this was faster and a lot easier.  Would love to know the tally here.

      "A typical vice of American politics is the avoidance of saying anything real on real issues." Theodore Roosevelt.

      by StellaRay on Sat Mar 29, 2014 at 09:27:27 AM PDT

      [ Parent ]

      •  This applied to me (0+ / 0-)

        I was insured through a group policy at work, but the premiums for me and my family were over $2600 per month. I shopped on the Exchange and ended up buying an individual policy for my family with monthly premiums of just over $900 per month. I wouldn't have known what my options were before the ACA came along, and I didn't have to worry about pre-existing conditions or any of that nonsense.

    •  So we love Jen. What about Commonmass? (12+ / 0-)

      I'm out of work and live in a state that won't extend Medicare to me though I have paid into it.

      Do I deserve to die? Because I REALLY need to go to the doctor.

      Pope Francis: the Thumb of Christ in the eyes of the Pharisees.

      by commonmass on Sat Mar 29, 2014 at 09:46:06 AM PDT

      [ Parent ]

      •  Did you try Medicaid? (5+ / 0-)

        All states have some form of Medicaid for people who have no income...the recent expansion of Medicaid through the ACA (Obamacare) was to include people who have some income who were previously denied Medicaid because of it.

        “When it comes to this, I shall prefer emigrating to some country where they make no pretense of loving liberty—to Russia, for instance, where despotism can be taken pure and without the base alloy of hypocrisy.” —Abraham Lincoln

        by Pragmatus on Sat Mar 29, 2014 at 09:50:15 AM PDT

        [ Parent ]

      •  We love Commonmass too. (20+ / 0-)

        Sorry to hear this. Without LePage you would be covered by Medicaid. I have friends in Wisconsin in a similar situation. It sucks big time.

        I want single payer, medicare for all. Even though we are saving $300 a month, it still costs $1200 a month to insure our family. It's a huge bite out of our income.

        However, the ACA made things much better for our family in several ways, and no need to apologize for appreciating that.

        I wish just one state---Vermont looks like the most likely---would get going and institute single payer.  If folks got a load of the benefits of it, other blue states would begin to fall like dominos. It would be incredible bait to businesses and job seekers, who would make those blue states more prosperous until finally, red states bring up the caboose of decency, as usual.

        This is how Canada got universal health care, province by province, and I believe it is the way it will finally come to America, state by state.  

        And unfortunately, not in time for many. And that makes me heart sick.

        "A typical vice of American politics is the avoidance of saying anything real on real issues." Theodore Roosevelt.

        by StellaRay on Sat Mar 29, 2014 at 10:09:00 AM PDT

        [ Parent ]

        •  Single Payer (8+ / 0-)

          The upside of the Affordable Care Act is that it will get more people covered who didn’t have health insurance in the past, both through cheaper individual policies and expanded Medicaid coverage. However, at the risk sounding like some conservative Republican troll, but I think that over the next few years the ACA will turn out to be too complex, with high premiums and limited networks and the public will demand something better. With the public demanding a better system and employers wanting to rid themselves of the responsibility of providing health insurance for their employees we'll start to see single payer legislation being passed by blue-state legislatures (in addition to Vermont) and then a few years after that the purple states will follow suit, and then finally the red states will have no other choice but to acquiesce because by that time the private health insurance companies will all be gone. I just hope that someday 10 years from now President Obama gets some credit for starting us down the road to single payer.

          "For all those whose cares have been our concern, the work goes on, the cause endures, the hope still lives and the dream shall never die." --Senator Ted Kennedy

          by Blue Silent Majority on Sat Mar 29, 2014 at 10:47:55 AM PDT

          [ Parent ]

          •  I just want it to happen (6+ / 0-)

            not picky about how. The ACA is still beholden to the insurance middlemen there is absolutely no need for, as proven by most of the rest of the civilized world that got rid of this useless link long ago.

            However, folks often forget, or don't know, that the ACA legislated the right for states to opt for single payer. That is huge, if far from what we all wanted and still want.

            "A typical vice of American politics is the avoidance of saying anything real on real issues." Theodore Roosevelt.

            by StellaRay on Sat Mar 29, 2014 at 11:21:42 AM PDT

            [ Parent ]

            •  Can't happen all at once. (2+ / 0-)
              Recommended by:
              worldlotus, Larsstephens

              There is a part of me that would love to have had single-payer immediately, but I think its good that we'll be making the transition slowly over time. Americans are going to have to adjust to the idea of not getting health insurance through their job, and while I don't like the big insurance companies, a lot of nice middile-class people work for these companies (the majority of whom are women) and I wouldn't want to see those people loose their jobs overnight.

              "For all those whose cares have been our concern, the work goes on, the cause endures, the hope still lives and the dream shall never die." --Senator Ted Kennedy

              by Blue Silent Majority on Sat Mar 29, 2014 at 12:06:30 PM PDT

              [ Parent ]

              •  You make a good point. (1+ / 0-)
                Recommended by:
                Blue Silent Majority

                None of us want to see yet more Americans out of a job, and even if it is those who hold jobs in the health care for profit insurance industry, a category many of us believe should be just GONE, it is good to hear about and consider the pain that will cause for some.

                Being progressive is not easy, and in its own way, it gets rid of as many jobs as it seeks to save. This IS a reality. And it sucks.

                However, whether we like it or not, change is always upon us, and so many have suffered due to changes, really, since the beginning of time.

                I don't like it. LOL, in my perfect world no one would ever suffer for too long due to inevitable change, and everyone would be whisked  along w/changes that need to happen, by a community smart enough to figure out how to celebrate the changes AND find a way to pay the least on the underbelly of that change.

                We don't have that in America today. We are not, imo, exceptional at all, just hanging on to our natural riches, much of which goes into the pocket of the 1%---and not doing a darn bit of thinking for the rest.

                SIGH. In the end, here's the deal. IF the middle class in America disappears, it is THAT, and exactly THAT first and foremost that will end our Democratic experiment.  

                We just aren't that special, and history should inform everyone of how quickly we can be humbled. But then again, high schools these days don't put much emphasis on history.

                I know , a rather long and about way of saying, we must find a way to re-employ those who are imo, working in a needless industry---that of health care insurance. Their skills should be very useful to a government universal health care program.

                I don't want to see folks put out of their jobs, but in some cases, as has been true since the beginning of time, it must happen.

                "A typical vice of American politics is the avoidance of saying anything real on real issues." Theodore Roosevelt.

                by StellaRay on Sun Mar 30, 2014 at 05:47:19 PM PDT

                [ Parent ]

          •  Single Payer (7+ / 0-)

            I'd like to add that I support single-payer and would ultimately prefer that to a system involving insurance companies. The ACA curbs their worst abuses, but a single-payer system would be more efficient.

            •  Have to say, (2+ / 0-)
              Recommended by:
              wader, Larsstephens

              the worst abuse is needless middlemen, but yes, the ACA did curb some of the worst abuses of those middlemen. But insurance CEOs and executives still make billions that a government run program could put back into decent health care for everyone.

              A single payer system would not only be more efficient, it would be more affordable, more to the point that healthcare in a country this rich should be a right not a privilege.

              Having said that, I loved your diary. Having been free lance for over 30 years, before the ACA I had given up on there ever being a better health care choice for us, and prices were escalating so fast, it was only a matter of time till we could not have afforded it. Not to mention the pre-existing condition clause that kept us tied for years to a plan that was not the best for us, but kept us imprisoned to rising rates with no choices.

              I believe the ACA is a fine plug for now in a dam that will eventually break without universal health care. It really does sicken me that enough Americans are satisfied with so much  less that it's been impossible to get there---because they've got theirs!

              I have long thought that the employee provided insurance model is the reason for this, and now finally, that model is showing its deep cracks. The employed are feeling it more with their much larger health care contributions, and the unemployed are feeling it with companies' reluctance to hire, every hire costs a lot more due to health insurance.

              "A typical vice of American politics is the avoidance of saying anything real on real issues." Theodore Roosevelt.

              by StellaRay on Sat Mar 29, 2014 at 04:14:56 PM PDT

              [ Parent ]

          •  We should have unhooked ins. from employment (3+ / 0-)
            Recommended by:
            Jen Sorensen, StellaRay, Larsstephens

            long ago.  With so many unemployed, and those who had ins. through employers being screwed by their employers who want to stop cost sharing... we should have bit the bullet and gone to single payer, private providers long ago.

            We are so S-L-O-W to get it right.  sigh....

            •  Another problem with health insurance from work: (0+ / 0-)

              Linking health insurance to employment is sexist because it assumes that the primary breadwinner in nuclear family, who is usually the husband/father, has a traditional full time job with health insurance with the wife and kids on his policy as dependents. That model just doesn’t work very well in today’s world.

              "For all those whose cares have been our concern, the work goes on, the cause endures, the hope still lives and the dream shall never die." --Senator Ted Kennedy

              by Blue Silent Majority on Sun Mar 30, 2014 at 08:50:26 AM PDT

              [ Parent ]

        •  IIRC, Vermont's single-payer experiment is set (8+ / 0-)

          to kick off in 2017. The ACA rules dictated the timeline, again iirc.

        •  CA is working on single payer but (3+ / 0-)
          Recommended by:
          debocracy, Larsstephens, StellaRay

          the R's are making it an uphill battle.  Why do they hate citizens who are not millionaires?

      •  commonmass (9+ / 0-)

        I hope you did an application, at least? That spares you the penalty, and you might be eligible for a catastrophic plan under one of the hardship exemptions, since Maine didn't expand Medicaid. (Since having an idiot Republican governor like LePage is a catastrophe.)

        And hopefully, a year from now, Maine will have a new Governor who will have expanded Medicaid.

        Support a Progressive Dem from Maine for US Senate! Bellows for Senate

        by Illegitimi non carborundum on Sat Mar 29, 2014 at 10:33:11 AM PDT

        [ Parent ]

        •  People should be aware that, if they're 55-64, (4+ / 0-)

          the state can seek recovery from your estate for all expenses incurred on Medicaid after you die.  

          In states where the administration of Medicaid has been farmed out to corporations, this can include monthly fees for being enrolled in Medicaid even if you receive no medical care.

          Medicaid has always done estate recovery for nursing home care, but now they can seek recovery for all care, ages 55-64.

          This is not an argument not to enroll in Medicaid, but fair warning.

          © cai Visit 350.org to join the fight against global warming.

          by cai on Sat Mar 29, 2014 at 12:02:33 PM PDT

          [ Parent ]

          •  I come under that from being on Medi-Cal in CA (2+ / 0-)
            Recommended by:
            debocracy, Larsstephens

            and I think it is fair.  I don't have dependents and once I'm done with my home, why should the Medi-Cal I received not be paid back so that the fund is replenished for someone else's use?  Assistance should not be windfall profit.  If I won the lottery I would pay back what assistance I received... gladly.  I'm just grateful to have had my medical bills paid during a time I would not have been able to do so on my own without becoming homeless.  A little gratitude would get this country a long way.

            •  What if you never used Medicaid, or yearly (3+ / 0-)

              physicals, but wracked up tens of thousands of dollars of costs in the corporations' administrative fees?  Would that still be cool?

              Furthermore, people who earn enough to qualify for subsidies don't have to pay back any of their non-nursing home care.  Why should you?  Why should only poor people be on the hook for what the government spends on them?

              Gratitude is what our "betters" want us to feel as they fleece us and rob us and argue for the abolition of the minimum wage.  I think we could do with a whole lot more "all for one and one for all" and a lot less dividing us up into subgroups of the underpaid to fight over scraps.

              © cai Visit 350.org to join the fight against global warming.

              by cai on Sat Mar 29, 2014 at 05:50:33 PM PDT

              [ Parent ]

            •  Please look at my other comment below (0+ / 0-)

              It is different if you choose to enroll, than if you are forced in it. Some people, like me, would rather have their dependents not become homeless than to have Medicaid coverage. That at least should be a decision for the person to make.

          •  I've never heard of that. Links? (1+ / 0-)
            Recommended by:
            Larsstephens

            I'm skeptical. Did you ever know anyone who was pursued for estate recovery for nursing home care? Never heard of that.

        •  I wish people would notice the problem (1+ / 0-)
          Recommended by:
          manyamile

          with expanded Medicaid. Some people are being discriminated by being denied participation in the Exchanges and the Federal Subsidy.
           Why, if I earned $100. more per month I would be offered a subsidy (money with no strings attached) for 95% coverage, and pay around $56. a month to get coverage that includes even dental, but since I fell short of those earnings I get NOTHING.
          I would like to raise awareness of the problem. A class of people: the poor are being discriminated. First, it is left to their governor if to give them coverage. Second, they are offered zero subsidies, when those richer than them are offered up to 95%, they could at least be offered that same amount. Third, instead of a subsidy they are placed in a system that recovers the expenses with their assets. I am glad to be uninsured (even though I am probably by now diabetic and have hypertension). My three kids (19 to 23) still live with me and are in college. If I got Medicaid, lets say I died this year, recovery would take the home and all assets, it would ruin their future. It is not letting me choose if I would rather go to the doctor or help my children's future - that I would loose that choice is unbelievable loss of freedom, is basically flawed.
          It is unfair to have no say and be forced into a system (Medicaid) that recovers the assets. When people talk about how great that now with insurance, an illness in the family will not mean financial ruin and loosing their home, they are forgetting that precisely that is now what we the poor are being set into, without even a say, and even if we plan not to use the coverage, just by being assigned to it we already lost what we own. Besides Medicaid doesn't even cover the same, it does not cover dental and other services that private insurances do.

          •  Overestimate (0+ / 0-)

            Couldn't you just "accidentally" overestimate your annual income when you sign up for ACA coverage and then qualify for the subsidy that way? I don't see how it would be considered fraud to say that you expect to make more money than you actually wind up with at the end of the year. Think about it this way; its not a crime if you accidentally overpay your taxes.

            "For all those whose cares have been our concern, the work goes on, the cause endures, the hope still lives and the dream shall never die." --Senator Ted Kennedy

            by Blue Silent Majority on Sun Mar 30, 2014 at 08:17:17 AM PDT

            [ Parent ]

            •  overestimating as well as underestimating (1+ / 0-)
              Recommended by:
              Poor in a Rich World

              are tricky and right now no one knows the consequences.
              the first time around ,for a lot of us who have irregular income (freelancers, self employed,etc.) , it is difficult enough to arrive at a reasonably accurate number/forecast.

              none of us know what the penalties are for underestimating , for example. i qualified for state medicaid, but if my income goes up ,will i be penalized? will the state want me to repay them? how often do i have to report? my state has been in an operating mode for regular medicaid where they want detailed info EVERY MONTH..they don't know what to do with expanded medicaid and i sure as hell do not want to have to support detailed reports to the state DES every month for health insurance. i live in a red state that begrudgingly went for expanded medicaid. our governor overruled the legislature on that one but the damn GOP legislature is trying to hack away at it. they are determined to use expanded medicaid as a way to 'punish' all the 'freeloaders' who qualify for it.
               i can earn six months of income in one month and nothing at all for the next  few months..and they do not know how to handle 'complex' cases like this. their heads are  exploding just like Scalia's in Jen excellent comic!!

              same for overestimating.  No one knows how the ACA will handle  income variances. i tried to appeal to ACA and all i got was 'sorry, our records show you do not earn enough money, our records show you qualify for state expanded medicaid'. if the ACA goes on tax returns that number will always trump any estimates right?
              no this should not  boil down to having to game the system to get in. and  this kind of roller coaster is possibly going to be a real nightmare for people right on the border between medicaid and ACA
              this needs to be fixed.
              on the bright side, i think these issues will lead us to single payer. All the more reason to elect democrats, who will be able to actually improve the system on the next few years.

              •  Sorry (1+ / 0-)
                Recommended by:
                manyamile

                I didn't intend to oversimplify you situation, I was just trying to understand this weird contraption called the ACA. Perhaps I shoud be more greatful that my wife and I both have traditional full-time jobs with health insurance.
                                                                                                                .

                Although, on a seperate note, I fully agree with the follwing statement:

                "on the bright side, i think these issues will lead us to single payer"
                Maybe the Republicans should be more careful when they say they want to "repeal and replace" Obamacare; they just might get what they wish for.

                "For all those whose cares have been our concern, the work goes on, the cause endures, the hope still lives and the dream shall never die." --Senator Ted Kennedy

                by Blue Silent Majority on Sun Mar 30, 2014 at 09:14:23 AM PDT

                [ Parent ]

            •  I have thought of that but... (0+ / 0-)

              if somehow (like because of writing it here) the IRS found out that I did it on purpose, then it is fraud, and it is a crime. My concern was not with my personal situation because I might improve my earnings soon and then actually qualify for the real ACA and thanks to manyamile's helpful comment below now I know I can go back in and file under "change of circumstances". My point was to bring to everyone's attention a problem that needs fixing because I know there are many people less fortunate than me who will not have that option of increasing their income to make it into the ACA. My point is that just changing a sentence in the legislation would improve many people's lives. Instead of saying "Those who earn X amount will receive coverage at 95%" it could say those who earn X amount OR LESS, and then you would have everyone covered. Granted for many the 5% remaining would be a hardship but some other form of subsidy for that portion could be looked into, or at least owing that amount to Medicaid would be better than owing them the total amount plus administrative fees, as it stands now. I hope we get enough people to notice so we can petition our legislators to tweak the law.

          •  i Agree. THIS is important (2+ / 0-)

            there's a whole layer of people  who are TOO POOR for the ACA marketplace but considered to make too much money for the wonky state calculations.
            (In AZ for example, the state counts a self employed  persons 'Gross receipts' as income, nt their 'adjusted gross income', i.e they allow for no business expenses whatsoever.

            this is leaving out a CRUCIAL demographic..basically a pretty  good swath of working poor, which is exactly the group that desperately needs affordable health care.

            this is a  huge oversight and a huge gap and needs to be fixed. I think the federal architects of the plan did no foresee the difficulties of working with 50 different states.  in my state the DES is so dysfunctional and inaccessible you can't even address the problem as an individual.

            •  one thing you can do if you get bumped (1+ / 0-)
              Recommended by:
              Poor in a Rich World

              from medicaid   or if you were denied by the ACA because your income was too low ,and you find your income is increasing,  is go back to ACA after the deadline and file a 'change of life circumstance'. this will reopen the door for you, even in midyear.
              a very helpful navigator explained this to me.
              i am very glad  to have  qualified for expanded medicaid, but here's what i mean about the gap

              if i make even $42 dollars a year more this year, i will make to much too qualify for state expanded medicaid.

              meanwhile over at ACA ,i need to make  anywhere from $3,000 to $7,000,(depending on who you ask), more per year to qualify for the ACA marketplace.

              that is a big, big  gap where no one quite knows what happens. even the navigator told me if i get bumped from medicaid but don't make enough for ACA,my option will be 'to find insurance in the private market'.

              right. same with all the folks in states with no expanded medicaid. poor folks looking for insurance 'in the private market'. again.

              i fervently hope that dealing with this gap is  one of the first orders of business after enrollment period winds down.

              •  Thanks for your comment (0+ / 0-)

                If possible let's write about this to raise awareness and have the law tweaked. Too many people I know are in this situation but I have not seen any of the media address it at all.
                My idea is to get that sentence in the law changed: "those who earn X qualify for subsidies at 95%..." change it to "those who earn X or LESS qualify for..." at least as a start. Then come up with ideas of how to fund the remaining 5% but at least that would be better than to be excluded as it is now, or to have to repay to Medicaid in full.
                Would like to know if you think we should go in that direction.  
                 

                •  yes! (1+ / 0-)
                  Recommended by:
                  Poor in a Rich World

                  I  and many like me, could afford  a subsidized plan and am very willing to pay it. i would MUCH rather do that.
                  'poor' people know how to wring a lot out of a dollar. and for those who really cannot swing it , medicaid could still be there, or 100% funding.
                  but i believe a large percentage of the people in this gap could absolutely afford the 95% subsidy.

                  also , i think this problem isn't do much with the ACA federal marketplace or the original idea,  but with the states, and with the huge disconnect between how the feds are implementing the program and how the states are interpreting it, (or flat out refusing to participate.)

                  but it does show just how big of a disconnect there can be  with the states..

                  •  You are right but (1+ / 0-)
                    Recommended by:
                    Sharon Wraight

                    I think it is a flaw in the actual law to leave some people to the will of the states. It also complicates things bureaucratically because Medicaid takes much more paperwork and checking for verification, and gives less services. To include the poor in the ACA would require just one change in the program: "Is your income X or less then go to..." I will try pushing for a petition of "Don't leave it to the states"... (because many times you can't trust your governor).

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