Aa
How 'affordable' are Obamacare plans?
NEW YORK (CNNMoney) Many Americans browsing the Obamacare exchanges are finding the Affordable Care Act isn't living up to its name.
It's not just premiums that are bringing up the costs. Consumers are finding high deductibles, co-payments and other expenses that make the Obamacare policies seem more like catastrophic plans than comprehensive insurance.
Those picking a bronze plan, which carry the lowest monthly rates, may have to spend $5,000 or more before the insurance kicks in. The next highest level of coverage, the silver tier, can carry $2,000 deductibles. And once they hit their deductibles, policy holders still have to pay for doctor visits, lab tests and medication.
"All we ever heard about Obamacare is that it would lower our deductibles and premiums," said Jennifer Slafter, 40 of Mabel, Minn. "That's just not what's happened."
Slafter and her husband, Steve, are scrambling to find affordable care for themselves and their two children. The exchange's Blue Cross Blue Shield plan was $1,087 a month with a $6,000 deductible, while a Medica plan was $877 a month with a $12,700 deductible. Both are steeper than their current plan.
"Everything got higher," said Slafter, who is still waiting to hear whether they qualify for a premium subsidy. But even if they do, she said she'd still find it very tough to meet the deductibles.
Medical care under the bronze-level coverage is so pricey because it is designed to cover only 60% of a policy holder's expenses, on average. It's meant for people who don't use a lot of health care services.
Take a 40-year-old San Francisco resident who rarely sees the doctor. The cheapest plan on the Covered Cailfornia exchange would cost him more than $2,800 a year, without federal subsidies. But if he had to go to the doctor more often, he'd have to satisfy a $5,000 deductible and then pay $60 for each primary care visit and $70 for a specialist.
He'd have to pay 30% of the cost of lab tests and $19 for generic drugs or $50 for preferred brand name prescriptions. The exchange estimates he'll pay $500 in out-of-pocket costs annually.
Those who run up bigger health care bills may be better off going with a silver or gold plan, which have lower deductibles and co-pays but higher monthly premiums. They will have more peace of mind that their insurance covers more of their expenses.
Consumers will have to assess their likelihood of using the insurance, said Benjamin Sommers, an assistant professor at the Harvard School of Public Health. They can also talk to so-called navigators or counselors who can guide them through selecting a plan.
Some of the sticker shock stems from American's lack of understanding of health care. Those with employer-sponsored plans don't often appreciate how much of the tab their company picks up. And policy holders in the current individual market don't always realize what their plans cover, resulting in some nasty surprises if they do get into an accident or fall ill.
"Part of what people are discovering is that health care is expensive," Sommers said. "The big difference is how transparent this is. People might not be used to seeing deductibles that high."
Regardless of what plan you chose, individuals won't have to pay more than $6,350 and families $12,700 out-of-pocket each year.
And not everyone will have to fork over the full amount for premiums or cost sharing. Those with incomes up to 400% of the poverty line will get subsidies to defer premium prices to no more than 9.5% of annual income.
Those earning less than 250% of poverty are eligible for additional subsidies that will lower their deductibles and co-pays.
SOURCE: http://money.cnn.com/2013/11/21/news/economy/obamacare-affordable/index.html
It's not just premiums that are bringing up the costs. Consumers are finding high deductibles, co-payments and other expenses that make the Obamacare policies seem more like catastrophic plans than comprehensive insurance.
Those picking a bronze plan, which carry the lowest monthly rates, may have to spend $5,000 or more before the insurance kicks in. The next highest level of coverage, the silver tier, can carry $2,000 deductibles. And once they hit their deductibles, policy holders still have to pay for doctor visits, lab tests and medication.
"All we ever heard about Obamacare is that it would lower our deductibles and premiums," said Jennifer Slafter, 40 of Mabel, Minn. "That's just not what's happened."
Slafter and her husband, Steve, are scrambling to find affordable care for themselves and their two children. The exchange's Blue Cross Blue Shield plan was $1,087 a month with a $6,000 deductible, while a Medica plan was $877 a month with a $12,700 deductible. Both are steeper than their current plan.
"Everything got higher," said Slafter, who is still waiting to hear whether they qualify for a premium subsidy. But even if they do, she said she'd still find it very tough to meet the deductibles.
Medical care under the bronze-level coverage is so pricey because it is designed to cover only 60% of a policy holder's expenses, on average. It's meant for people who don't use a lot of health care services.
Take a 40-year-old San Francisco resident who rarely sees the doctor. The cheapest plan on the Covered Cailfornia exchange would cost him more than $2,800 a year, without federal subsidies. But if he had to go to the doctor more often, he'd have to satisfy a $5,000 deductible and then pay $60 for each primary care visit and $70 for a specialist.
He'd have to pay 30% of the cost of lab tests and $19 for generic drugs or $50 for preferred brand name prescriptions. The exchange estimates he'll pay $500 in out-of-pocket costs annually.
Those who run up bigger health care bills may be better off going with a silver or gold plan, which have lower deductibles and co-pays but higher monthly premiums. They will have more peace of mind that their insurance covers more of their expenses.
Consumers will have to assess their likelihood of using the insurance, said Benjamin Sommers, an assistant professor at the Harvard School of Public Health. They can also talk to so-called navigators or counselors who can guide them through selecting a plan.
Some of the sticker shock stems from American's lack of understanding of health care. Those with employer-sponsored plans don't often appreciate how much of the tab their company picks up. And policy holders in the current individual market don't always realize what their plans cover, resulting in some nasty surprises if they do get into an accident or fall ill.
"Part of what people are discovering is that health care is expensive," Sommers said. "The big difference is how transparent this is. People might not be used to seeing deductibles that high."
Regardless of what plan you chose, individuals won't have to pay more than $6,350 and families $12,700 out-of-pocket each year.
And not everyone will have to fork over the full amount for premiums or cost sharing. Those with incomes up to 400% of the poverty line will get subsidies to defer premium prices to no more than 9.5% of annual income.
Those earning less than 250% of poverty are eligible for additional subsidies that will lower their deductibles and co-pays.
SOURCE: http://money.cnn.com/2013/11/21/news/economy/obamacare-affordable/index.html
I, too, am happy that you got it all worked out and that your insurance expense will be less.
I, truly, hope it starts working better for those who struggle so hard to make ends meet.
I, truly, hope it starts working better for those who struggle so hard to make ends meet.
Ditto what Mike said:)
I'm happy that things are looking up for you.
Good luck,
Mike
Good luck,
Mike
http://www.inquisitr.com/974829/obamacare-exchanges-rates-explained-penalty-facts-pros-and-cons-affordable-care-act-bill/
If you want Obamacare exchanges rates explained, you need to know the facts, pros, and cons to the Affordable Care Act Bill.
As previously reported by The Inquisitr, Obamacare exemptions exist for certain groups, including religious conscientious objectors.
This article is intended to be an overview, highlighting different parts of the Obamacare plan. For more detailed information, click on the various links within each section to bring up the Inquisitr article.
Obamacare History
A brief look at the history of Obamacare shows heated debate from unions, concerns over the debt ceiling and delays for enacting the state exchanges. Even the origination of the Affordable Care Act bill was controversial. The bill started life as House Resolution 3590, which was then called the Service Members Home Ownership Act. After passing the House, the bill was stripped in a process known as “gut and amend” and replaced entirely with the contents of what became the Patient Protection and Affordable Care Act.
As we all know by now the Supreme Court passed Obamacare as a tax. In fact, the total cost over 10 years was originally projected at $850 billion but this has slowly grown to almost $2 trillion, which is why it became the center of the government shutdown debate. But despite many attempts to stop Obamacare it has become effective as of today.
Obamacare Penalty And Fines
The biggest point being buzzed about is the well-known Obamacare penalty. The policy forces individuals opting out of any form of health insurance to pay a “penalty fine”, which is more appropriately a tax. You must be signed up for health insurance by December 25, 2013 in order to Obamacare penalty. The original Obamacare penalty maxes out at $285 or one percent of the income for a family of four. In 2016, the Obamacare penalty maxes at $695 per person, $2,085 for the family, or 2.5 percent of taxable income, which amounts to $173.75 per month.
Obamacare Exchanges Rates
In general, the Obamacare prices are expected to average $328 per month. But that is just the tip of the iceberg. There is a lot to know about the Obamacare state exchanges, so gather up all your financial information and have a go at HealthCare.gov. Obamacare exchanges rates all depend on income, location, and the number of dependents. Income projections are required for the self-employed and employees with no health insurance offered at work, so be careful. Also, any raises you receive could conflict with originally reported income so be aware that if you miscalculate you will receive a tax bill for the difference.
Obamacare Exemptions
Many are clamoring for Obamacare exemptions and the group of exemptions currently includes the IRS, the religious, the poor, qualifying Native Americans, illegal aliens, criminals, those suffering “hardships,” and many other categories. Even entire states have attempted to gain exemption status, which created the rather redundant “state innovation waiver.” There’s also a political argument over whether Congress is exempt although that depends on how you define “exemption.”
Obamacare Pros
One of the major pros of the Affordable Care Act will be the creation of an Obamacare rebate system for qualifying individuals stemming from the 80/20 rule. This rule requires insurance companies to spend 80 percent of premiums on healthcare or refund portions of already paid premiums.
For the lower income tax brackets, those in need of health care will have lower premiums and will receive a tax credit and subsidized health care. In addition to the above, the government is talking about a Medicaid expansion for those below 133 percent of the poverty level, if your state provides it.
Studies have shown that preventative medicine can keep the overall cost of healthcare down. So Obamacare also provides genetic testing to women at a high risk for Ovarian and Breast Cancer. There is no co-pay and yearly mammograms are also offered (most insurance programs don’t offer yearly testing anymore).
Young people up to the age of 26 can stay on their parent’s health insurance as long as they’re living together. Small business with less than 50 people can apply for tax credits to help pay for health benefits.
Another pro is the discontinuation of insurance companies denying coverage for pre-existing conditions. But that can conceivably be viewed as a con since some people may choose to go uninsured and pay out of pocket until they have a medical condition which is too expensive. Which leads to…
Obamacare Cons
There’s much talk over whether health care spending will continue to increase at a great rate in America. There has been a slowing but it’s due to the economic recession, not the Affordable Care Act.
Businesses that have more than 50 businesses are required to provide health benefits. Unfortunately, this is both a pro and con since these benefits to full time workers. Under Obamacare, full time employment was officially defined for the first time as being more than 30 hours. But some businesses are responding by cutting worker’s hours to under 30 so Congress is considering changing the ACA definition for full time work to 40 hours.
Studies on the subject of insurance price changes claim that Obamacare premiums for many of the middle aged and seniors will go down. But in order for Obamacare to succeed the costs for the younger generation will have to see a dramatic increase.
The Supreme Court said the average healthcare cost per year for twenty-somethings used to be $854. In order for Obamacare exchanges to break even the the projected cost requires 2.7 million Americans in the 18-35 age range to spend $5,800 a year per individual.
Additionally, many are concerned about the effects Obamacare will have on Social Security, the national debt, inflation and the value of the dollar. In order to enforce the Obamacare penalty the IRS had to expand greatly, which comes at a cost. Obamacare is funded by $52 billion in business taxes as well as $27 billion on drug companies and $20 billion on medical device makers. Back in 2011 the Congressional Budget Office (CBO) estimated that Obamacare will result in an estimated 800,000 fewer US jobs. The Obamacare CBO job loss estimate has since grown to seven million jobs according to some results, but only time will tell for certain.
Obamacare Alternatives
Obamacare alternatives do exist for the State exchanges, including religious health care sharing groups and tax breaks for individually purchased health care for part-time workers, the self-employed and for small businesses. The Affordable Care Act does not specifically force anyone into the Obamacare exchanges so be sure to shop around for alternatives before making a decision for your family.
Read more at http://www.inquisitr.com/974829/obamacare-exchanges-rates-explained-penalty-facts-pros-and-cons-affordable-care-act-bill/#fCQMYlx3Q2Mixkqp.99
If you want Obamacare exchanges rates explained, you need to know the facts, pros, and cons to the Affordable Care Act Bill.
As previously reported by The Inquisitr, Obamacare exemptions exist for certain groups, including religious conscientious objectors.
This article is intended to be an overview, highlighting different parts of the Obamacare plan. For more detailed information, click on the various links within each section to bring up the Inquisitr article.
Obamacare History
A brief look at the history of Obamacare shows heated debate from unions, concerns over the debt ceiling and delays for enacting the state exchanges. Even the origination of the Affordable Care Act bill was controversial. The bill started life as House Resolution 3590, which was then called the Service Members Home Ownership Act. After passing the House, the bill was stripped in a process known as “gut and amend” and replaced entirely with the contents of what became the Patient Protection and Affordable Care Act.
As we all know by now the Supreme Court passed Obamacare as a tax. In fact, the total cost over 10 years was originally projected at $850 billion but this has slowly grown to almost $2 trillion, which is why it became the center of the government shutdown debate. But despite many attempts to stop Obamacare it has become effective as of today.
Obamacare Penalty And Fines
The biggest point being buzzed about is the well-known Obamacare penalty. The policy forces individuals opting out of any form of health insurance to pay a “penalty fine”, which is more appropriately a tax. You must be signed up for health insurance by December 25, 2013 in order to Obamacare penalty. The original Obamacare penalty maxes out at $285 or one percent of the income for a family of four. In 2016, the Obamacare penalty maxes at $695 per person, $2,085 for the family, or 2.5 percent of taxable income, which amounts to $173.75 per month.
Obamacare Exchanges Rates
In general, the Obamacare prices are expected to average $328 per month. But that is just the tip of the iceberg. There is a lot to know about the Obamacare state exchanges, so gather up all your financial information and have a go at HealthCare.gov. Obamacare exchanges rates all depend on income, location, and the number of dependents. Income projections are required for the self-employed and employees with no health insurance offered at work, so be careful. Also, any raises you receive could conflict with originally reported income so be aware that if you miscalculate you will receive a tax bill for the difference.
Obamacare Exemptions
Many are clamoring for Obamacare exemptions and the group of exemptions currently includes the IRS, the religious, the poor, qualifying Native Americans, illegal aliens, criminals, those suffering “hardships,” and many other categories. Even entire states have attempted to gain exemption status, which created the rather redundant “state innovation waiver.” There’s also a political argument over whether Congress is exempt although that depends on how you define “exemption.”
Obamacare Pros
One of the major pros of the Affordable Care Act will be the creation of an Obamacare rebate system for qualifying individuals stemming from the 80/20 rule. This rule requires insurance companies to spend 80 percent of premiums on healthcare or refund portions of already paid premiums.
For the lower income tax brackets, those in need of health care will have lower premiums and will receive a tax credit and subsidized health care. In addition to the above, the government is talking about a Medicaid expansion for those below 133 percent of the poverty level, if your state provides it.
Studies have shown that preventative medicine can keep the overall cost of healthcare down. So Obamacare also provides genetic testing to women at a high risk for Ovarian and Breast Cancer. There is no co-pay and yearly mammograms are also offered (most insurance programs don’t offer yearly testing anymore).
Young people up to the age of 26 can stay on their parent’s health insurance as long as they’re living together. Small business with less than 50 people can apply for tax credits to help pay for health benefits.
Another pro is the discontinuation of insurance companies denying coverage for pre-existing conditions. But that can conceivably be viewed as a con since some people may choose to go uninsured and pay out of pocket until they have a medical condition which is too expensive. Which leads to…
Obamacare Cons
There’s much talk over whether health care spending will continue to increase at a great rate in America. There has been a slowing but it’s due to the economic recession, not the Affordable Care Act.
Businesses that have more than 50 businesses are required to provide health benefits. Unfortunately, this is both a pro and con since these benefits to full time workers. Under Obamacare, full time employment was officially defined for the first time as being more than 30 hours. But some businesses are responding by cutting worker’s hours to under 30 so Congress is considering changing the ACA definition for full time work to 40 hours.
Studies on the subject of insurance price changes claim that Obamacare premiums for many of the middle aged and seniors will go down. But in order for Obamacare to succeed the costs for the younger generation will have to see a dramatic increase.
The Supreme Court said the average healthcare cost per year for twenty-somethings used to be $854. In order for Obamacare exchanges to break even the the projected cost requires 2.7 million Americans in the 18-35 age range to spend $5,800 a year per individual.
Additionally, many are concerned about the effects Obamacare will have on Social Security, the national debt, inflation and the value of the dollar. In order to enforce the Obamacare penalty the IRS had to expand greatly, which comes at a cost. Obamacare is funded by $52 billion in business taxes as well as $27 billion on drug companies and $20 billion on medical device makers. Back in 2011 the Congressional Budget Office (CBO) estimated that Obamacare will result in an estimated 800,000 fewer US jobs. The Obamacare CBO job loss estimate has since grown to seven million jobs according to some results, but only time will tell for certain.
Obamacare Alternatives
Obamacare alternatives do exist for the State exchanges, including religious health care sharing groups and tax breaks for individually purchased health care for part-time workers, the self-employed and for small businesses. The Affordable Care Act does not specifically force anyone into the Obamacare exchanges so be sure to shop around for alternatives before making a decision for your family.
Read more at http://www.inquisitr.com/974829/obamacare-exchanges-rates-explained-penalty-facts-pros-and-cons-affordable-care-act-bill/#fCQMYlx3Q2Mixkqp.99
Where there's bad news, there's Always good news
http://www.buffalonews.com/opinion/letter-affordable-care-act-is-helping-some-of-us-20131120
Affordable Care Act is helping some of us
With all the bad news we’ve been hearing about the Affordable Care Act, I’d like to share my very positive experience. When my husband’s professional group stopped offering health insurance plans, we knew we’d have to start shopping for an individual policy. Our only option was the Health Care Exchange under the Affordable Care Act.
After reading all the political hype and hysteria, I was pretty nervous. When we went to the website, we did have a bit of a problem setting up an account and filling in the application. But when I called the help number, I got a very nice, helpful and knowledgeable woman on the other end. She explained all the options and recommended the best plan for me and my husband.
In the end, we signed up for a policy that will cost us a fraction of what we were paying, with better coverage. It was easy, painless and we’re very happy with the result.
Shelly Kerker
Amherst
http://www.buffalonews.com/opinion/letter-affordable-care-act-is-helping-some-of-us-20131120
Affordable Care Act is helping some of us
With all the bad news we’ve been hearing about the Affordable Care Act, I’d like to share my very positive experience. When my husband’s professional group stopped offering health insurance plans, we knew we’d have to start shopping for an individual policy. Our only option was the Health Care Exchange under the Affordable Care Act.
After reading all the political hype and hysteria, I was pretty nervous. When we went to the website, we did have a bit of a problem setting up an account and filling in the application. But when I called the help number, I got a very nice, helpful and knowledgeable woman on the other end. She explained all the options and recommended the best plan for me and my husband.
In the end, we signed up for a policy that will cost us a fraction of what we were paying, with better coverage. It was easy, painless and we’re very happy with the result.
Shelly Kerker
Amherst
The worst part of this deal for someone as myself--self-employed, is having to flat out guess(educated) on what I will make in 2014. I finally just averaged the last 3 years of filed taxes and used that number as my income number. I will get some credit, so I'll take it.
Something to keep in mind
1) in the end your plan cost will get adjusted up or down based on what your true income ended up being.
2) inflation lesson , 1$ in Jan14. will be worth more than 1$ in Dec14.(almost guaranteed)--so take the max credit up front and as much of it as you can get.
3) business lesson --Use their money instead of letting them use yours.
Something to keep in mind
1) in the end your plan cost will get adjusted up or down based on what your true income ended up being.
2) inflation lesson , 1$ in Jan14. will be worth more than 1$ in Dec14.(almost guaranteed)--so take the max credit up front and as much of it as you can get.
3) business lesson --Use their money instead of letting them use yours.
Morning all, Quick update, after spending a lot of time on the phone and with state run exchange rep (CGI designed software crap)..I am officially enrolled.
While my coverage even with the platinum plan does have a few co-insurance pays ,,as opposed to the flat deductible on my current plan (we're talking major in hospital stuff ,$2000 out of pocket max)
Current BCBS plan $617.54/mo
Platinum BCBS plan on the state exchange $582.79 (without tax credit)
As Mike and Mastercard have said, when you need it-----priceless
While my coverage even with the platinum plan does have a few co-insurance pays ,,as opposed to the flat deductible on my current plan (we're talking major in hospital stuff ,$2000 out of pocket max)
Current BCBS plan $617.54/mo
Platinum BCBS plan on the state exchange $582.79 (without tax credit)
As Mike and Mastercard have said, when you need it-----priceless
I don't think you can let anyone in DC determine what is "affordable". These people have no sense of reality. Not too long ago, some senator (I believe) said paying taxes was optional....... Really?
If I was making $174 k a year I could handle any plan they are offering, even in this state.
If I was making $174 k a year I could handle any plan they are offering, even in this state.
I know someone whose daughter and grand daughter, both signed up and their premium cost, with subsidy is higher than either can afford to pay.. they will continue to go without.
Who's determining what "affordable" is? Obviously, not anyone who understands what it's like to live on minimum, or slightly higher wage and have to struggle to pay bills/buy food each month.
Looks like somebody needs to get real, here; when a person/family can't pay utility bills or buy groceries, how in he!! can they pay for mandatory insurance, or exorbitant deductibles/co-pays?
Who's determining what "affordable" is? Obviously, not anyone who understands what it's like to live on minimum, or slightly higher wage and have to struggle to pay bills/buy food each month.
Looks like somebody needs to get real, here; when a person/family can't pay utility bills or buy groceries, how in he!! can they pay for mandatory insurance, or exorbitant deductibles/co-pays?
You must join this user group in order to participate in this discussion.
You are reading content posted in the Current Events . . . Group
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.
