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View Diary: Fixing the ACA (12 comments)

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  •  the "coverage gap" (3+ / 0-)
    Recommended by:
    Sunspots, SingleVoter, JamieG from Md

    We have left the poorest of the poor behind in many cases. The exchange subsidies are only provided to those between 133% and 400% of the poverty level. Below 133% of the poverty level, the states determine the existence and/or amount of health care assistance. Many people in the states that are refusing the Medicaid expansion are excluded.

         In my state a person making $11,001 can bop onto the exchange and purchase fully subsidized insurance while a person making $10,900 is completely out of luck if they have no children. Not even Medicaid. Nothing.  

     Some of us have been working for and waiting for the ACA for a long time. This really needs to be addressed, if not by legislation than by litigation.

    To keep our faces turned toward change, and behave as free spirits in the presence of fate--that is strength undefeatable. (Helen Keller)

    by kareylou on Fri Aug 30, 2013 at 09:04:48 PM PDT

    •  There is that (1+ / 0-)
      Recommended by:
      Sunspots

      Although that's not a problem with the law so much as a problem with the people running the red states. We could remove the lower income limit so that people who would otherwise be eligible for Medicaid can get free insurance through the ACA, and I suppose we should, but it would really hurt to spend more money for worse coverage simply so that the insurance companies can have their profit.

      •  I understand your comment (0+ / 0-)

        up to this point.....

        but it would really hurt to spend more money for worse coverage simply so that the insurance companies can have their profit.
        Can you clarify that? How can people without coverage get "worse coverage"? I'm not sure what you're saying.

        To keep our faces turned toward change, and behave as free spirits in the presence of fate--that is strength undefeatable. (Helen Keller)

        by kareylou on Fri Aug 30, 2013 at 09:11:16 PM PDT

        [ Parent ]

        •  Sorry, I'll clarify (1+ / 0-)
          Recommended by:
          kareylou

          I meant that because Medicare/Medicaid are more efficient than private insurers, covering the same population through the exchange will cost more for worse coverage than they would get if the insurance companies weren't involved.

          •  Oh, thanks. (2+ / 0-)
            Recommended by:
            Sunspots, JamieG from Md

            Now I see what you mean. Yes, we should all be on Medicare. It is so much more efficient. It's awful to see our country wasting so many resources in an inefficient and cruel system, out of inertia and greed.
            After helping my sister navigate the Medicaid (not Medicare) system I would rather have private insurance. It is difficult for her to find many specialists who take Medicaid anymore. My sister lives in Ohio and has to drive many hours to get to a decent doctor who will take Medicaid. I think Medicare is different.
            I just don't want to be left behind. I loathe private insurance as much as anyone (read my early diaries) but that's the system we have and until we have something different I am just as entitled to medical treatment as the next person!
            So that's my fix.
            Now I'm going to bed. Good night.

            To keep our faces turned toward change, and behave as free spirits in the presence of fate--that is strength undefeatable. (Helen Keller)

            by kareylou on Fri Aug 30, 2013 at 09:21:10 PM PDT

            [ Parent ]

            •  Federal law requires (1+ / 0-)
              Recommended by:
              kareylou

              Medicaid provider accessibility be as least as good as typical private insurance.

              Of course the law and reality often differ.

              And I remember trying to find a provider still accepting HMO patients in the late 1980's. I finally found one guy 12 miles from home. Fortunately I never needed to see him. Most of the doctors listed in the HMO's book were no longer accepting new patients.

    •  Also, Medicaid over 55 is just a loan (2+ / 0-)
      Recommended by:
      kareylou, SingleVoter

      and it has to be paid back when you die, out of your estate, if any.  You're essentially just using up your savings or home equity.

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