Skip to main content

One of the big draws of Obamacare was that at least - at the very least - expenses would be capped. No longer could someone run up a catastrophic $100,000 bill. As the President said

"We will place a limit on how much you can be charged for out-of-pocket expenses, because in the United States of America, no one should go broke because they get sick..."
Or so we thought. But that is not to be for some this year.
...some group health plans will not be required to impose any limit on a patient's out-of-pocket costs for drugs next year. If a drug plan does not currently have a limit on out-of-pocket costs, it will not have to impose one for 2014, federal officials said Monday.
In other words: Yet Another Exception For The Benefit Of The One Percent.

In other words, should you be so unfortunate to be one of the lucky ones to fall under "some group health plans" you can still go very, very broke, very very quickly...

The American Cancer Society... noted that some new cancer drugs cost $100,000 a year or more.
Multiple Sclerosis drugs are also exceedingly expensive:
Theodore M. Thompson, a vice president of the National Multiple Sclerosis Society, said: "The promise of out-of-pocket limits was one of the main reasons we supported health care reform. So we are disappointed that some plans will be allowed to have multiple out-of-pocket limits in 2014."
If you're not quite so unlucky, your out-of-pocket expenses will only be double what the law is written to allow!
Under the policy, many group health plans will be able to maintain separate out-of-pocket limits for benefits in 2014. As a result, a consumer may be required to pay $6,350 for doctors' services and hospital care, and an additional $6,350 for prescription drugs under a plan administered by a pharmacy benefit manager.
And why did this insanity come about?
federal officials said that many insurers and employers needed more time to comply because they used separate companies to help administer major medical coverage and drug benefits, with separate limits on out-of-pocket costs.

In many cases, the companies have separate computer systems that cannot communicate with one another.

Oh, no!!!  Not that.  Separate computer systems?  Separate computer systems that health care providers have known need to talk to each other for almost FOUR FUCKING YEARS NOW?????

And this is just bullshit anyway. If the systems really can't talk to one another this year but will magically be able to do so next year, then why not demand at the very least that the two different insurers provide reimbursements at the end of the year, insisting that the two balances be reconciled?  Explain to me why people making $30,000 a year have to cough up a possible extra $6350 a year because the government is too stupid to figure out a way to deal and so gullible as to believe insurance companys which make $300,000,000 / yr. claims?

But the worst of the worst is those who will still be caught in hell - a total non-cap on out-of-pocket expenses. What in the name of the Affordable Care Act were they thinking?

Originally posted to jpmassar on Mon Aug 12, 2013 at 07:34 PM PDT.

Also republished by Occupy Wall Street, Single Payer: The Fight for Medicare for All, Healthcare Reform - We've Only Just Begun, and Single Payer California.

EMAIL TO A FRIEND X
Your Email has been sent.
You must add at least one tag to this diary before publishing it.

Add keywords that describe this diary. Separate multiple keywords with commas.
Tagging tips - Search For Tags - Browse For Tags

?

More Tagging tips:

A tag is a way to search for this diary. If someone is searching for "Barack Obama," is this a diary they'd be trying to find?

Use a person's full name, without any title. Senator Obama may become President Obama, and Michelle Obama might run for office.

If your diary covers an election or elected official, use election tags, which are generally the state abbreviation followed by the office. CA-01 is the first district House seat. CA-Sen covers both senate races. NY-GOV covers the New York governor's race.

Tags do not compound: that is, "education reform" is a completely different tag from "education". A tag like "reform" alone is probably not meaningful.

Consider if one or more of these tags fits your diary: Civil Rights, Community, Congress, Culture, Economy, Education, Elections, Energy, Environment, Health Care, International, Labor, Law, Media, Meta, National Security, Science, Transportation, or White House. If your diary is specific to a state, consider adding the state (California, Texas, etc). Keep in mind, though, that there are many wonderful and important diaries that don't fit in any of these tags. Don't worry if yours doesn't.

You can add a private note to this diary when hotlisting it:
Are you sure you want to remove this diary from your hotlist?
Are you sure you want to remove your recommendation? You can only recommend a diary once, so you will not be able to re-recommend it afterwards.
Rescue this diary, and add a note:
Are you sure you want to remove this diary from Rescue?
Choose where to republish this diary. The diary will be added to the queue for that group. Publish it from the queue to make it appear.

You must be a member of a group to use this feature.

Add a quick update to your diary without changing the diary itself:
Are you sure you want to remove this diary?
(The diary will be removed from the site and returned to your drafts for further editing.)
(The diary will be removed.)
Are you sure you want to save these changes to the published diary?

Comment Preferences

Subscribe or Donate to support Daily Kos.

Click here for the mobile view of the site