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View Diary: Confessions of an Obamacare advocate with cancelled policy, facing 38% premium hike (463 comments)

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  •  What made your current plan so excellent? (6+ / 0-)

    When you say you lost your current "excellent, low cost coverage", was there something excellent besides the low cost?

    Given the difficulty in sorting through even the metals of the ACA, I'm finding it impossible to believe that anyone understood the implications of the pre-ACA least, until they got sick and tried to make a claim beyond their deductible.  

    "One faction of one party in one House of Congress in one branch of government doesn't get to shut down the entire government just to refight the results of an election."

    by Inland on Mon Nov 11, 2013 at 01:12:59 PM PST

    •  The excellence of the cancelled plan (14+ / 0-)

      My plan had a low deductible (2000) and low premiums for someone my age (400); the out-of-pocked maximum was fairly low (3000). So all in all this was great, especially compared to what I was facing in California.

      Ginny Mayer, Ph.D. Democrat CA State Senate Candidate - SD-35 (Orange County)

      by Ginny Mayer on Mon Nov 11, 2013 at 01:19:10 PM PST

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      •  Ginny - I notice your sig line and I'm confused. (13+ / 0-)

        Are you running for SD-35 in CA, or do you live in WA?

        The number of children and teens killed by guns in one year would fill 134 classrooms of 20 students each. (Chlldren's Defense Fund, 2013)

        by nzanne on Mon Nov 11, 2013 at 01:22:32 PM PST

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      •  I'm having a hard time (8+ / 0-)

        putting my head around why would you would see rates go up so much.

        The ACA introduced community rating on a national scale, which meant that insurance companies could charge, at most, three times more for their oldest customers as they do for their youngest. In the pre-ACA world, they could charge much more.

        So if anything, that should apply downward pressure on premiums for older folks. I'm in my mid to late 40s, and my CT individual policy would have been just over 25% less than what I was paying, also without subsidies. (I recently changed my employment relationship, though, and am now employer-insured.)

        Now, perhaps there's some quirk for WA state? Maybe it already required community rating in this way? I don't know. Just wrestling with how this could be...

      •  I can't tell what's covered, though: (5+ / 0-)

        All your saying is that it didn't cost much, either in premiums or limits.

        Did you ever get sick and make a claim?

        "One faction of one party in one House of Congress in one branch of government doesn't get to shut down the entire government just to refight the results of an election."

        by Inland on Mon Nov 11, 2013 at 01:33:40 PM PST

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      •  Did it ... (7+ / 0-)

        have an annual cap? a lifetime cap? Did it cover preventive care?

        Was it cancelled because of the ACA, or because the insurer cancelled that product? In some cases, insurance companies are doing the latter because they are not profitable, and blaming "Obamacare."

        Done with politics for the night? Have a nice glass of wine with Palate Press: The online wine magazine.

        by dhonig on Mon Nov 11, 2013 at 01:48:41 PM PST

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        •  ACA compliant plans in the last two years (6+ / 0-)

          have had to comply with those requirements. If you stuck with a grandfathered plan back in 2010, no.

          My understanding is that all policies sold after this next January (?) have to include additional things like maternity care, pediatric dental, mental health, etc.

          If you had a policy that didn't already cover those things, it can't be rolled over after January.

          •  Has anyone identified a "grandfathered" plan yet? (0+ / 0-)

            I haven't heard if a single person's plan got grandfathered; I suspect it's because no insurance company has offered any of these low premium plans without changing them in the last two years, and want to change them this year, too.

            IOW, the diaries thinks she's had the same plan for years, but hasn't; and assumes she would have had the same plan next year, but wouldn't.

            "One faction of one party in one House of Congress in one branch of government doesn't get to shut down the entire government just to refight the results of an election."

            by Inland on Mon Nov 11, 2013 at 02:58:24 PM PST

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            •  Mine did (4+ / 0-)

              See comment below by me. "My Story"

              Ted Cruz: The second coming of Christ, but not quite as good as Reagan (yet).

              by nuketeacher on Mon Nov 11, 2013 at 03:23:19 PM PST

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            •  Kaiser North. Cal sent letter last month grandfat (2+ / 0-)
              Recommended by:
              Inland, mrkvica

              hering my plan for 2014.   It was the individual coverage extension of a cobra policy I had some time back which I took out at about 450 per month, but kept increasing with increased medical costs as well as my aging into higher tiers.  Seemed like every year they increased co-pays, pruned away coverage for durable medical, substituted generics for any replaceable drugs or you paid in full for brand name,  didn't cover increasing lab tests/xrays/blood work etc.  costs.  Premium in one year increasing from about 960 a month to just over 1000 -- a solid 5% increase if I hold on to it this next year.  
                 I could never find any other coverage for myself, as I have a preexisting condition.   I paid really large out of pockets, high deductible -- premiums and payments on the plan last year were about $15,000, higher than my total annual income.   I pretty much ran out of money so I have put off/forgone some treatments I could use.  
                  I will be signing up for California coverage and expect I will be able to get a subsidy.  
                  However, I do worry that even though I sign up for what looks like a plan that will really meet my needs,  the actual delivery of services covered might very well be impacted -- am I going to have to deal with long waits for appointments,  less well trained technicians/physical therapists?   Will hospitals that treat larger numbers of previously uninsured be able to maintain standards of care?   Will I be shipped to Mexico or India for surgeries, or will more medical personell be shipped in from already medically deprived countries?  

      •  The key is (10+ / 0-)

        "someone my age." When you turned 62, you went up a level in the risk pool. Unfortunately,we will never know what the non-ACA premium would have been.

        In a sense, we are all now comparing apples to oranges. Even a "good" comprehensive policy before ACA cannot be compared to an ACA policy because the standards have changed. And we have no way of knowing what the premiums for the "old" policy would have risen to if ACA had not been enacted. I suspect that they would have been comparable to what you are being quoted now under ACA.

        One other point. The goal of ACA is to make coverage affordable to those who previously thought they were invincible, but, whom when ill or injured, tended to run up extremely high bills. Underwriting included paying for these bills, so premiums across the board were higher. By expanding the pool, the risk is being redistributed. You are in a group that is being hit hard by statistics - high income and a high risk group. But the trade-offs are as you said: no more risk of health caused bankruptcy, no lifetime caps, co-pays, and increased wellness services. And of course, no pre-existing condition exclusions.

        FWIW, you are only 3 years away from Medicare, so hang in there.

        The foolish and the dead alone never change their opinions. James Russell Lowell

        by Serendipity on Mon Nov 11, 2013 at 01:49:58 PM PST

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        •  Re: your third paragraph, (4+ / 0-)

          I'm not so sure about that. All things considered, an equivalent insurance policy for an older person under ACA should be cheaper than pre-ACA, as there are now limits on how much more insurance companies can charge based on age. Which has the effect of putting upward pressure on policies for younger folks and downward pressure on those for older.

          •  I think (0+ / 0-)

            that simple actuarial considerations would make the costs of an equivalent pre-ACA policy EQUAL to an ACA policy. The "limits" would prevent the latter from costing more.

            All I am saying is that if ACA did not exist, most likely, the cost would have gone up to what it is under ACA.

            For a certain group of patients, this will mean a premium increase. That's the "fix" that the administration is looking at. Mathematically, I don't see a fix.

            The foolish and the dead alone never change their opinions. James Russell Lowell

            by Serendipity on Mon Nov 11, 2013 at 06:50:36 PM PST

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            •  Not sure what you mean (0+ / 0-)

              If previously an insurance company charged 1000 per month for a 64 year old and 200 for a 20 year old, and now they need to reduce that to a 3:1 ratio, they'll likely increase the premium on the former and reduce it on the latter. Of course, the ACA requires additional protections and is intended to bring more people into the pool, so it's not as simple as that, but that price pressure is definitely there. It's why conservatives have been so focused on broadcasting rate increases on young men and discouraging them to enroll.

      •  Some things to check (16+ / 0-)

        Read the fine print of your cancelled policy. See if there was:

        1) A lifetime cap
        2) Certain treatments (such as chemotherapy) that had limited coverage
        3) A clause that allowed them to raise your premiums.

      •  I don't know what your policy looked like (11+ / 0-)

        In California there were a lot of weird carveouts in policies - like sure you're at a $3000 out of pocket maximum - but you might not be covered at all for some kinds of care that you might end up needing. Care that isn't covered doesn't count towards your OOP max.

        The example I use a lot is the California policy that I had that only covered, for example, X-rays, if you were admitted. Coming to the ER with a broken bone did not count, since it was outpatient.

        Certainly it sucks that health insurance is so freaking expensive, and I'm sorry you're seeing an increase. No matter what the reason, no one likes a kick in the wallet.

        Fry, don't be a hero! It's not covered by our health plan!

        by elfling on Mon Nov 11, 2013 at 02:04:53 PM PST

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