Skip to main content

Health insurance is a hot topic these days. It seems everyone woke up one day and realized they had a stake in our national health care system, which is a good thing. Sadly, figuring out the best way to deliver health care to all Americans has almost turned into a contact sport.

The logistics alone are staggering. Even so, the ACA set up a system that works in all 50 states while setting standards of coverage and setting boundaries for insurance company behavior. The latest dust up is over the minimum standards for a health care policy and "grandfathered" plans. These plans do not meet the ACA minimum standards but since they were in effect in 2010, they could continue as long as the plan doesn't make major changes. Well insurance companies being what they are, changed these plans to where they lost their grandfather status. This means people who have these plans would no longer qualify for subsidies or exemption to the fines under the ACA. Let me clarify, these plans don't even qualify as catastrophic care policies under the ACA. That should be a clue. A $54 a month health insurance policy for a 56 year old woman is going to cover next to nothing. The fact that Republicans are defending their constituents right to own a nearly worthless policy certain to drive them into bankruptcy or kill them is crazy.

About 5% of America's population get individual medical insurance policies that cost more and cover less, but neither CBS nor NBC covered that aspect of the story. About 15.8 million people out of about 317 million people had nearly no protection before the ACA and a much higher chance of being screwed over by their insurance company. Does either CBS or NBC cover the atrocity of taking money for insurance coverage that leaves you all but bare? Oh, no they go for the sensational bullcrap story line. According to NBC 40-67% and possibly up to 75% of people with individual policies will not be able to keep their insurance that doesn't insure them against much of anything. If you need numbers, anywhere from 6.3 million to 11.9 million people will need to make a change, because what they have now no longer qualifies as insurance. Yes, the ACA forces people to change from junk insurance to something that offers real security.

Up to 75%!

That's huge!

Until you put it in the context that we live in a country of 317 million people

75% of 5% is is 3.75%

3.75% of 317 million is about 11.9 million people.

Maybe we should flip this around.

Wow! Nearly 12 million people courted bankruptcy or death for years! and didn't know it!

Too dramatic?


Ok, here's a question. How many people have the same individual insurance policy today that they had in March of 2010? Answer, not many. Most people take individual policies until they can get something better.

A real investigative report would have looked at the bankruptcies filed last year in Florida and noted how many of them had people with junk policies like Florida Blue 91.

A real investigative report would have shown how much revenue Florida is going to lose because their bone headed state legislature won't expand Medicaid.

The current story line that Obama lied and a story about a whole lotta lyin' going on about Obamacare is far more interesting than a headline that states 2010 Projections Are Proving True. Anyone following the ACA storyline from the beginning knew about half the individual policies were toast under ACA rules. Yeah, but these people are losing their insurance! and you said, (insert wailing 8 year old here) I could keep my insurance! Except, you can't keep insurance that doesn't qualify as insurance anymore and expect to receive subsidies for it or avoid the fines because those soon to be phased out plans aren't insurance anymore.

How we get our insurance says a lot about how we see the ACA. Employers provide insurance to about 49% of our population, Medicare takes care of about 16%, Tricare covers 2.6% and Medicaid covers 13%. For around 80% of Americans, nothing will change come January. That is still true. Except maybe a Medicaid recipient could face a change if their income increases and that would be good for them...probably. Oh, and, except when your employer decides to change plans and then, well, that never was up to you in the first place. Except, maybe your employer decides they can't afford to offer insurance at all.... Except... except our nation's insurance situation isn't very secure at all and everyone except the media seemed to know that.

Most reasonable people realized Obama's promise had some disclaimers and he should have said them, but he didn't. So, Deal. About 250 million Americans this January will see seamless change, but up to 11.9 million people on the junk insurance market will be ...expensively inconvenienced. Some will find getting a real policy to be sticker shock, but that's what the subsidies are for and the new plan will be insurance they can afford to use.

What's more, that "inconvenience" could save their life. It certainly will help prevent medical care caused bankruptcies.

Junk Insurance

Consumer Reports did an extensive article on these inadequate plans back in 2009 before the ACA and listed 7 warning signs of what would indicate a junk insurance policy. Analyses like this paved the way for the ACA.

Do everything in your power to avoid plans with the following features:

Limited benefits. Never buy a product that is labeled “limited benefit” or “not major medical” insurance. In most states those phrases might be your only clue to an inadequate policy.

Low overall coverage limits. Health care is more costly than you might imagine if you’ve never experienced a serious illness. The cost of cancer or a heart attack can easily hit six figures. Policies with coverage limits of $25,000 or even $100,000 are not adequate.

“Affordable” premiums.There’s no free lunch when it comes to insurance. To lower premiums, insurers trim benefits and do what they can to avoid insuring less healthy people. So if your insurance was a bargain, chances are good it doesn’t cover very much. To check how much a comprehensive plan would cost you, go to, enter your location, gender, and age as prompted, and look for the most costly of the plans that pop up. It is probably the most comprehensive.

No coverage for important things. If you don’t see a medical service specifically mentioned in the policy, assume it’s not covered. We reviewed policies that didn’t cover prescription drugs or outpatient chemotherapy but didn’t say so anywhere in the policy document—not even in the section labeled “What is not covered.”

Ceilings on categories of care. A $900-a-day maximum benefit for hospital expenses will hardly make a dent in a $45,000 bill for heart bypass surgery. If you have to accept limits on some services, be sure your plan covers hospital and outpatient medical treatment, doctor visits, drugs, and diagnostic and imaging tests without a dollar limit. Limits on mental-health costs, rehabilitation, and durable medical equipment should be the most generous you can afford.

Limitless out-of-pocket costs. Avoid policies that fail to specify a maximum amount that you’ll have to pay before the insurer will begin covering 100 percent of expenses. And be alert for loopholes. Some policies, for instance, don’t count co-payments for doctor visits or prescription drugs toward the maximum. That can be a catastrophe for seriously ill people who rack up dozens of doctor’s appointments and prescriptions a year.

Random gotchas. The AARP policy that the Clausens bought began covering hospital care on the second day. That seems benign enough, except that the first day is almost always the most expensive, because it usually includes charges for surgery and emergency room diagnostic tests and treatments.

The ACA eliminates the above 7 point check list. Limited benefits are gone. There are 10 essential benefits every plan has to provide: "ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including dental and vision care," according to There will be no more caps on coverage or caps on care you will use like the ER, hospital in-patient care a diagnostic MRI. There will be a cap on your out of pocket costs. You can probably keep your doctor, but you can't keep your stingy, bare bones limited liability plan.

Let's dive into that CBS story of the Florida woman forced out of her $54 per month health "insurance" policy. Florida Blue has a Consumer Directed series of plans where the policy is cheap, but the coverage is hit and miss...mostly miss. They also have a medical discount program that won't offer much help for cardiac catheterization (should you need it). The soon to be defunct GoBlue 91 pays a maximum of $50 per date of service per provider for covered services only (and those services are very limited), $0 for hospitalization (unless you are experiencing complications due to pregnancy and then it will pay $50), it pays a $15 discount on prescriptions. That's junkier than most junk insurance. Credit goes to Greta Susteren, of all people, for almost calling out how bad this $54 per month policy is, Susteren called it "bare bones". I call it faux insurance. Susteren also got Dianne Barrette to admit she qualifies for a fair amount of subsidy and has 10 other plans to choose from and her subsidized premium falls to about $209 per month for real insurance. Not the fake stuff, the real deal.

10:36 AM PT: I just read this from my Huffpo link in the diary:
Still, we are left with Obama's phrase,
"If you like your plan, you can keep it,"
that probably should have come with a bit of fine-print reading,
"Some restrictions apply, void where prohibited."

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

  •  Tip Jar (28+ / 0-)

    If a nation expects to be ignorant and free, in a state of civilization, it expects what never has and never will be. Thomas Jefferson

    by JDWolverton on Tue Oct 29, 2013 at 10:10:59 PM PDT

  •  I'm not surprised we are here (9+ / 0-)

    with NBC news doing their "we were hard on the GOP during the shutdown, so, we have to balance that out by being hard on the Democrats via the ACA roll out" thing.

    This is the same media that lumps people who were critical of the ACA because they wanted a more liberal outcome in with people who are fine with 30 million people having no access to affordable care and don't care if sick people die in pain to sell the idea that everybody just hates HCR.

    I'm coming to the conclusion that the ACA becomes accepted when the next Democratic President comes in and gives it a new brand identity that has nothing to do with Obama.

    We see it in the Kentucky roll out, divorce it from Obama's brand and the Teahadi like it.

    I have had Tea Party people here in Nevada, after ranting about Big Gubmint in my face, tell me that they would swap Medicare for All for ObamaCare.

    It's about Obama, not Big Gubmit.

    He's black, the Teahadi don't get how we won, hate that he won twice, and would trade Obama losing his legacy over actually getting rid of the ACA.

    Again. We see it in the Kentucky roll out, divorce it from Obama's brand and the Teahadi like it.

    It's hard not to see that as the ultimate statement of racism being a foundational issue of where we are with HCR and the fuel feeding the anti-ObamaCare fire.

    I am a Loco-Foco. I am from the Elizabeth Warren wing of the Democratic Party.

    by LeftHandedMan on Tue Oct 29, 2013 at 10:25:35 PM PDT

    •  Yap. They would accept it if not for the black (5+ / 0-)

      Dude behind it. My mother is a real Obama hater but she has found out that Obamacare will help her. She has since toned down her anti Obama rants.

    •  funny thing is that this "even handed" type (3+ / 0-)

      of equivalency does not exist anywhere else.  For example, I enjoy asking Fox devotees why is it the preacher never has anything nice to say about Satan?  After all, if religion were fair and balanced, then it seems ministers would point out God's failings along with Satan's good points since that is what is demanded of political media coverage.  So far no one has any answers for me.  (same for cops and robbers.  No media story ever covers the good side of bank robberies)  

  •  hotlisted, rec'd, tipped ... (2+ / 0-)
    Recommended by:
    JDWolverton, Trix

    ... all while hopping on one foot to type with the other foot, so i'm real glad i dint fall and fracture my other hip.

    Addington's perpwalk? TRAILHEAD of accountability for Bush-2 Crimes. @Hugh: There is no Article II power which says the Executive can violate the Constitution.

    by greenbird on Tue Oct 29, 2013 at 10:39:57 PM PDT

  •  Greta / surprising (4+ / 0-)

    I watched the interview with the Florida woman. I was really surprised to see someone on Fox taking a serious look at how little this poor woman got for her $54/month.

    My impression is that Greta was being quite restrained and low-key out of respect for her guest. I think Greta wanted to convey the points about how bad this coverage was, but without humiliating her guest in public.

    The guest is a low-information person--not unlike a whole lot of other people when it comes to insurance--and probably fairly low income. She did the best she could when she signed up for insurance she could afford way back when.

    Since Greta said, more than once, that it would be good for her guest to get some advice from someone knowledgeable about insurance, I hope that Greta took the next step, after the show, to put the guest in contact with someone who can help her. Greta clearly recognized that she would be eligible for a subsidy to help her get some decent insurance.

  •  That Consumer Reports link is excellent (4+ / 0-)

    laying out all the reasons in one tidy package that these alleged health insurance policies were not what people thought they were buying.

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

    by elfling on Wed Oct 30, 2013 at 12:27:35 AM PDT

  •  Libertarian Friend: "Obama Lied" (4+ / 0-)

    I got the front edge of the Frank Luntz storm two or three weeks ago, and saw this whole line of attack coming.

    My response? OK, sure. Obama said you can keep your insurance if you like it. But even more fundamentally, ACA says that everyone has to have insurance.

    If the plan you have no longer meets the definition of "insurance", then too damn bad. Your faux-insurance is fucking banned, like lawn darts and neodymium magnet toys. No, you don't get to keep that.

    No apologies. Deal.

    "They let 'em vote, smoke, and drive -- even put 'em in pants! So what do you get? A -- a Democrat for President!" ~ Faster, Pussycat! Kill! Kill!

    by craiger on Wed Oct 30, 2013 at 01:15:53 AM PDT

    •  funny thing is most of these folks who are (3+ / 0-)
      Recommended by:
      OooSillyMe, JDWolverton, KayCeSF

      complaining about losing their lousy policies are upset because they are being saved from their own rotten judgement. Human nature never changes; no one appreciates from being saved from himself

      •  And no one appreciates the Federal government (0+ / 0-)

        telling them their choices are not right for their particular circumstances, about which the Federal government knows nothing.

        •  it depends; they may be like the guy we had (0+ / 0-)

          years ago with 5 Medigap policies.  The problem was he was convinced he had to have all these policies though only the first one was ever billed as it paid 100% of balance of MC allowed charges.  The other 4 policies are superfluous.  Sometimes people don't know what is best for them

  •  daughter's friend complains about ACA constantly (4+ / 0-)
    Recommended by:
    theran, OooSillyMe, JDWolverton, KayCeSF

    Daughter called her out as she has state employee insurance at which point she said she was going by what members of her church were saying.  When my daughter tried to pin her down, she had to admit that most of the members either had MC or MCD or else worked for the local utility.
    There were a very few who had private coverage with $10K deductibles who are claiming that their insurance now costs more.  However, both parents work in sales positions (real estate) and have some very profitable years.  Another owns a construction company where he buys a private policy to keep from covering his workers and so on.

    It appears most of them complaining have not even gotten termination letters or have actually gone to see what their premiums would be but are using Fox estimates to apply to their own situations.  

  •  What these people had was in (2+ / 0-)
    Recommended by:
    JDWolverton, KayCeSF

    name only.....and now they are crying about it to trash the ACA and Obama instead of getting educated.  MSNBC had hours of programming saying "Obama shouldn't have said.....fill in the blanks.....  They should, as Ed Schultz and Chris Hayes did, have an explanation.....but no, they had to do the hand-wringing, pearl clutching, fainting couch version instead.....

  •  Hear me out... (2+ / 0-)
    Recommended by:
    JDWolverton, smileycreek

    It's disingenuous to say that we are all crazy. My husband and I had a Humana policy that was not crap. Yes, it had a $22,000 family deductible, but we are healthy, and if you have cancer or a bad car wreck, you can pay off the 40K max out of pocket, but not 3/4 of a million. Lifetime caps and annual caps were OUTLAWED in 2010 so those do not apply. We had co pays for Dr visits.

    We were paying $230 per month. We got our letter that it was going up to $860 in 2015. Now, I know what you are thinking, she's, new, she's trolling, but I am long time lurker, and this is the first time I have ever been moved to post. I support health care reform, I support this President. I hope that there will be tweaks and market adjustments and maybe even further subsidies down the road that will shake out in the next couple of years that will mitigate my costs.

    I am also a licensed insurance agent. If you are not sick, a deductible is not HIGH if you're NOT PAYING IT. 95% of people don't reach their deductible in a given year. It's the premiums that kill you. Over the course of 5 years if the projected premiums hold, I will pay more than $30K more in premiums, which is more than my deductible if one of us were to have a major event in that 5 year period. Yes, we could have more than one, but actuarially, it's not likely.

    So, like I said, I'm not running around with my hair on fire, I think the solutions will come, but please don't knee jerk and tell us all we had "crappy plans" when you don't know what you are talking about. It hurts your credibility and our solidarity.  A lot of us were informed and had plans that were right for us, and now we'll have to see where we will be landing.

    •  Aaaand... (2+ / 0-)
      Recommended by:
      JDWolverton, smileycreek

      I checked my policy, it turns out my deductible is $7500 per person maxed at $15,000 per my 2 person family and an additional 10K for a maximum out or pocket additional. So, I was overstating it above. And just to be sure, Yes, it covers things like ambulances, and doctors, and you know, cancer.

    •  I'm sorry you are losing your grandfathered plan (1+ / 0-)
      Recommended by:

      I've shopped for health plans for myself and for businesses I worked for (one business had 40 employees). It's hard to make choices for 40 employees and their families. Weighing higher cost sharing with lower premiums and all that is not easy. I get it. I understand why you don't want to go shopping for another health plan.

      You are right that not all of these cancelled policies are the Consumer Driven High Deductible/Limited Benefit plans. Some have over the limit deductibles or out-of-pocket caps. Some exclude one or more of the required elements and raised premiums over $5 per month or cut benefits further to stay within the $5 dollar limit. I take it you don't qualify for the catastrophic plans and Humana doesn't have a QHP (Qualified Health Plan) that you like. Again, I'm sorry you are one of those affected by this part of ACA, but I'm sure you'll be able to find a plan you like. It might not be from Humana.

      I understand you are healthy today, but that can change any day. The Consumer Reports article I referenced also said this:

      If you are healthy now, do not buy a plan based on the assumption that you will stay that way. Don’t think you can safely go without drug coverage, for example, because you don’t take any prescriptions regularly today. "You can’t know in advance if you’re going to be among the .01 percent of people who needs the $20,000-a-month biologic drug," said Gary Claxton, a vice president of the nonprofit Kaiser Family Foundation, a health-policy research organization. "What’s important is if you get really sick, are you going to lose everything?"
      I've known people who were underinsured and watched them die.  Correction, watched them suffer, saw their family in anguish, then watched them slowly die.

      I also have been the point person who had to tell the indestructible 30 year old father the out-of-pocket costs (over $50,000 it was a severe case) to close the cleft palate his baby has that his policy didn't adequately cover. (It went poorly.)

      I've been the point person who had to explain to the rheumatoid arthritis patient their monthly prescription was going to cost $2,000. (Also went poorly and those drug company assistance programs are way too few and far between.)

      The worst was explaining to an ardent anti-abortion crusader their daughter's pregnancy was an uncovered service. That their daughter had a high risk pregnancy and the costs would be higher than a usual pregnancy (the predetermination estimate was $15,000 and I didn't know what the hospital fees were going to be).

      I wouldn't say I don't know anything about it. From where I sit, I've seen some bad, bad health insurance policies that need the boot. This diary was specifically about Florida Blue 91 and why policies like this are no longer acceptable.

      If a nation expects to be ignorant and free, in a state of civilization, it expects what never has and never will be. Thomas Jefferson

      by JDWolverton on Wed Oct 30, 2013 at 10:28:42 AM PDT

      [ Parent ]

    •  Here's my question for you: (1+ / 0-)
      Recommended by:

      We also just had our high deductible Blue Cross plan cancelled. The premium kept going up 25-30% a year so we kept dropping coverage and going for a higher deductible, because we were both healthy and had never used it.

      Then 2 years ago statistics caught up with us and we needed it. We were $10k out of pocket before full coverage kicked in.

      You said, you can pay off the $40k max out of pocket. Well, being self-employed in practice together and losing one practitioner for 8 months to cancer treatment meant that $10k was a devastating hit. $40k would have been impossible.

      BUT-- here's my question (and I do appreciate the reasonable tone behind your comment): Have you checked on the Exchanges to see if you get a tax subsidy yet? I'm assuming you have, because you don't seem like a hair-on-fire type, but I've seen people freaking out over their cancelled policies and higher premiums without seeing what tax credits they are eligible for.

      Our Blue Cross plan that was cancelled would have been replaced with a bronze-type plan that would have increased our premiums from $493 a month to over $900. I gulped pretty hard when I read that.

      BUT-- on the exchange we qualified for a Silver plan for less-- for $400 a month.

      So--crap plan gone, better plan and lower premiums in place as a result. And we have real health insurance now, not just "mortgage insurance."

      If, however, we were much higher income, the tax credits wouldn't have helped. So yes, some higher income people will have to pony up for real insurance. I'm just not sure how many people that will add up to yet. Most higher-income people I know already have decent insurance.

      Welcome from the DK Partners & Mentors Team. If you have any questions about how to participate here, you can learn more at the Knowledge Base or from the New Diarists Resources Diaries. Diaries labeled "Open Thread" are also great places to ask. We look forward to your contributions.

      Oh, I used to be disgusted
      Now I try to be amused
      ~~ Elvis Costello

      by smileycreek on Wed Oct 30, 2013 at 10:43:20 AM PDT

      [ Parent ]

      •  Thanks for the reply- (1+ / 0-)
        Recommended by:

        I have checked the website--a lot depends on what we make next year. We have our own business. So, again, we'll see how it shakes out. A bronze plan with a higher deductible looked like it would run about $360. Which is more money for less coverage. Again, Humana said it would match our current plan with ACA provisions, for $860. I have scoured our policy and honestly the only difference I can find is that we did have a 1 year waiting period for pre-existing conditions and metal health, (neither of which applied to us) and no maternity care (and being 50 and owning no uterus, does not apply either)

        Again, I am hoping that that some other age-based options appear without maternity (which is sooo expensive) or the subsidies are expanded) In any case, we'll be okay. I am optimistic!

    •  $40,000 OUT-OF-POCKET?!? CAN NOT!!! (1+ / 0-)
      Recommended by:

      Not if I stay healthy and strong enough to make it to 120 could I pay of an out-of-pocket expense so huge.  Having a wage so enormous is one big whopping privilege.  One I never had, and at 62, guess I never will have.

      I figure you must be pulling in mid-six-figures ("licensed insurance agent" - wife's dad was one, too, I've seen the house);  you really ought to spend some time familiarizing yourself with the realities of life in the other 99.5%.  WHEN WAS THE LAST TIME YOU COULD AFFORD NO CARE OF ANY KIND?

      I, for example, had CRAPPY insurance that cost me more than my mortgage in return for catastrophic & office co-pays but nothing else - so it had to go (fortunately "healthy enough" so far...but no medical care for me these last 12 years has been an emotional strain, to say nothing of the TEETH it cost me);  when my retirement investments crashed and burned in what's laughingly called the 'mortgage' crisis, I lost my bank account & what was left of my credit.

      I currently keep house for my wife (whose training I was able to pay for before all the money got sucked up) during the week, and I work as hard as I possibly can on the weekends;  I make far less than I could if I could afford an office, but it feeds us and stretches just enough to let me pay professional fees, and keep my truck running.  Sometimes, though (say, this Aug/Sept - or last Nov/Dec) I make just enough for us to not-quite-starve...and nothing else.  Happy holidays!

      $100/month health insurance WILL BE A BURDEN FOR ME.  Add in co-pays and a deductible, and ta-daa!  I'm right where I was:  same lack of health care, and  EVEN LESS MONEY than I had for no-coverage before..

      If being a well-paid insurance agent gives you insights into how to help people in similar positions to mine, I know we'd all love to hear it.  In particular, I'd love to know.

      Not out to beat you up, welcome to DK, looking forward to your contribution,  but the let-them-eat-cake bit really hit me on my last nerve...this is what keeps me up at night, now that I've lost everything but my marriage.  Something to do with being anxious / sleep-deprived for a decade.

      Some weeks are better than others, but THIS IS NOT A GOOD WEEK.

      Welcome, really.  Not your fault.  I'd talk it out with my friends and relations, but they're all dead.  I don't blame you.

      I see you've amended the 40k to 25k.  I'm sure that will seem significant to some...but AFAICT my ONLY CHANCE is to stay alive one way or the other until I can get Medicare.  Hell, I'm probably fooling myself on that, but it IS the only hope I have left.

      I'll probably regret posting this, but I don't think I'll be able to stop crying and get back to work if I don't.  Sorry.

      trying to stay alive 'til I reach 65!

      by chmood on Wed Oct 30, 2013 at 10:48:27 AM PDT

      [ Parent ]

      •  chmood, what is available to you on the exchange? (2+ / 0-)
        Recommended by:
        smileycreek, JKVaughn

        I think you qualify for subsidies if not Medicaid coverage. Are you in a state that didn't expand Medicaid? You also might end up exempt from the fines. Best of luck.

        If a nation expects to be ignorant and free, in a state of civilization, it expects what never has and never will be. Thomas Jefferson

        by JDWolverton on Wed Oct 30, 2013 at 11:03:47 AM PDT

        [ Parent ]

      •  I got laid off in 2012 (1+ / 0-)
        Recommended by:

        I have kept my license up, but I am not what you think I am. I needed a license for my work. My husband and I have a small business. If you saw my note above, My max out of pocket is 25K for the family, which would be a big hit, but is a whole lot better than 38K in premiums EVERY YEAR. If our household of 2 makes more than 62K a year then there is no subsidy. We don't know if that will happen, and my unemployment ran out this month.

        There was nothing "let them eat cake" about what I said. I hope you didn't mean me.

        That's when $860 a year becomes serious. I can a bronze plan for $360 but the coverage is not as good as what I have now. Again, I think that as these issues surface, solutions will arise. I know that this legislation is in it's infancy and I think it will only get better.

        I hope you will be okay.

        •  your math isn't holding up (0+ / 0-)

          If your premium is 860 per month, your total is $10,320 per year.

          If your premium is 360 per month, your total is $4,320 per year.

          You will not pay 38k in premiums in a year either way.

          If a nation expects to be ignorant and free, in a state of civilization, it expects what never has and never will be. Thomas Jefferson

          by JDWolverton on Thu Oct 31, 2013 at 07:11:56 AM PDT

          [ Parent ]

        •  Triggered by the gap between your reality & mine (0+ / 0-)

          As I tried to say (and not well, either) I was not triggered by you, nor did I feel attacked or targeted by you individually or as a member of any group.  I am genuinely sorry to have had a strong reaction of that kind;  I am genuinely sorry I could not (apparently) keep my reactions to myself.  Last week was not a good week, but then they mostly haven't been good weeks these last 5-6 years

          You simply live in a different reality than I do:  I have NEVER BEEN in a position to weigh one five-figure expenditure against another - much less to consider such a thing 'business as usual', and entirely reasonable.  My wife OTOH is the daughter of an insurance agent:  our definitions of what 'poor' means are very different (example:  in her world, 'poor' means not being able to keep ALL the lights on ALL the time;  in my world it means having nowhere to sleep and nothing to eat).  Going by your post, and not judging the content of it, I suspect you and I have similar variations in our definitions.

          Had I been less fragile that day, had the days before them been less rocky, had the deaths of so many not hung upon me as they did, I'm sure we would have had a different interchange entirely.  As I cannot undo it, I acknowledge my fault and move on.

          trying to stay alive 'til I reach 65!

          by chmood on Mon Nov 04, 2013 at 07:05:28 AM PST

          [ Parent ]

Subscribe or Donate to support Daily Kos.

Click here for the mobile view of the site