2014 Healthcare a Vent!

[scrapquitler]

From your link:

The Affordable Care Act states that people who had health insurance prior to March 23, 2010 – the day President Obama signed the bill into law – will be able to keep those policies even if they don't meet the requirements of the new law. However, the Department of Health and Human Services tightened that provision, so that "if any part of a policy was significantly changed since that date -- the deductible, co-pay, or benefits, for example -- the policy would not be grandfathered," NBC News reports

So the ACA did not cause everyone to lose their policies... the insurance companies did deliberately.

Everyone who thinks the insurance companies did this on purpose so they could up their rates and blame the ACA raise their hand.

I have the same policy with the same benefits, coays etc as I did prior to 2010, and my policy is no longer 'compliant' and won't be available after December 31. So I don't get to keep MY policy. Nothing is different in it than before.

 

[leahjade]

Everyone who thinks the insurance companies did this on purpose so they could up their rates and blame the ACA raise their hand.

Of course we have to have someone to blame other than the creators of this monstrosity! Too bad the reason the insurance companies have to raise their rates is to meet the mandates of this "Affordable" Care Act.

Some customers of Regence Blue Cross Blue Shield, one of Oregon’s largest insurance providers say they are finding their health care plans are dramatically changing under the Affordable Care Act.

“Policy holders are seeing almost double their monthly premiums,” said a KATU viewer named Larry in an email. He said his wife’s premium will increase by $300 under the Affordable Care Act.

The Affordable Care Act mandates that the plans include ten essential benefits, from care for pregnant mothers to substance abuse treatment.

The issue, according to Regence spokesman Jared Ishkanian, is you’ll have to pay for those benefits even if you don’t use them all.

“The Affordable Care Act increases access to coverage and enhanced benefits, but these come with additional costs. For those members on individual plans that will no longer be ACA-compliant starting on January 1, it’s important to remember that these members are seeing new rates for new health plans with new benefits,” said Ishkanian in an email to KATU.

 

[AndyLL]

Of course we have to have someone to blame other than the creators of this monstrosity! Too bad the reason the insurance companies have to raise their rates is to meet the mandates of this "Affordable" Care Act.

You didn't read either the link or the posted article did you?

 

[johde]

So the ACA did not cause everyone to lose their policies... the insurance companies did deliberately.

Everyone who thinks the insurance companies did this on purpose so they could up their rates and blame the ACA raise their hand.

Then why when I got my letter I was given 3 options.

1)Keep my current policy and current premium of $179 until the renewal day (April 1, 2014) before being switched to an ACA compliant plan.

2) Renew my policy early (Dec. 1, 2013) for a $182 a month until Dec 1, 2014 when I would get switched to a new ACA compliant plan.

3) Switch Jan 1, 2014 to an ACA compliant plan either on or off the exchange.

The closest ACA compliant plan available on the exchange has a $2,000 deductible instead of $2,500 deductible and costs $486 a month before subsidy. My premium after subsidy depends on how much money I make. If I make over about $23,000 a year I'll be paying more or getting less insurance than now. If I make under about $22,900 I can get better coverage for less money thanks to my fellow tax payers.

The company didn't need to offer me early renewal. They did it to keep me premiums as low as possible for as long as possible. They are also actively advertising to get customers look at buying before Jan 1, 2014 to avoid the potential higher premiums.

Some state governments didn't allow insurance companies to do early renewals. Those people are getting the notices to change insurance effective Jan 1, 2014.

 

[A_Princess'_Daddy]

Then why when I got my letter I was given 3 options.

1)Keep my current policy and current premium of $179 until the renewal day (April 1, 2014) before being switched to an ACA compliant plan.

2) Renew my policy early (Dec. 1, 2013) for a $182 a month until Dec 1, 2014 when I would get switched to a new ACA compliant plan.

3) Switch Jan 1, 2014 to an ACA compliant plan either on or off the exchange.

The closest ACA compliant plan available on the exchange has a $2,000 deductible instead of $2,500 deductible and costs $486 a month before subsidy. My premium after subsidy depends on how much money I make. If I make over about $23,000 a year I'll be paying more or getting less insurance than now. If I make under about $22,900 I can get better coverage for less money thanks to my fellow tax payers.

The company didn't need to offer me early renewal. They did it to keep me premiums as low as possible for as long as possible. They are also actively advertising to get customers look at buying before Jan 1, 2014 to avoid the potential higher premiums.

Some state governments didn't allow insurance companies to do early renewals. Those people are getting the notices to change insurance effective Jan 1, 2014.

My understanding, in a global sense and not particular to your situation, is that while the insurance companies COULD grandfather their plans, they did not HAVE to grandfather their plans. If an insurer determined that it was in their best interest to end a plan and roll out a new one, I don't think anything in the ACA could compel the company to maintain the plan. That doesn't mean that is what happened in your case, or even that I am correct in my understanding, but again in my reading of the regs, it seems like the issue stems from that loophole and I have no doubt, from direct experience, that the finance teams quickly proceeded to figure out what was in each company's best interest, which may have included terminating plans that were less favorable to their bottom line.

 

[daughtersrus]

Then why when I got my letter I was given 3 options.

1)Keep my current policy and current premium of $179 until the renewal day (April 1, 2014) before being switched to an ACA compliant plan.

2) Renew my policy early (Dec. 1, 2013) for a $182 a month until Dec 1, 2014 when I would get switched to a new ACA compliant plan.

3) Switch Jan 1, 2014 to an ACA compliant plan either on or off the exchange.

The closest ACA compliant plan available on the exchange has a $2,000 deductible instead of $2,500 deductible and costs $486 a month before subsidy. My premium after subsidy depends on how much money I make. If I make over about $23,000 a year I'll be paying more or getting less insurance than now. If I make under about $22,900 I can get better coverage for less money thanks to my fellow tax payers.

The company didn't need to offer me early renewal. They did it to keep me premiums as low as possible for as long as possible. They are also actively advertising to get customers look at buying before Jan 1, 2014 to avoid the potential higher premiums.

Some state governments didn't allow insurance companies to do early renewals. Those people are getting the notices to change insurance effective Jan 1, 2014.

How will you be getting less insurance? What coverage do you have now that you will no longer have?

 

[Arielle22]

From your link:

The Affordable Care Act states that people who had health insurance prior to March 23, 2010 – the day President Obama signed the bill into law – will be able to keep those policies even if they don't meet the requirements of the new law. However, the Department of Health and Human Services tightened that provision, so that "if any part of a policy was significantly changed since that date -- the deductible, co-pay, or benefits, for example -- the policy would not be grandfathered," NBC News reports

So the ACA did not cause everyone to lose their policies... the insurance companies did deliberately.

Everyone who thinks the insurance companies did this on purpose so they could up their rates and blame the ACA raise their hand.

Assuming it is insurance through a company, it is the company that made the changes not the insurance company.

I am in HR and currently waiting for my 2014 renewal rates. A company gets a quote for the next year based on current year's selections. The company can negotiate with the insurance company to tweak the plan to bring the cost down. Things such as raise the emergency room deductible will save you 1% or raise the deductible to this level and save 3%.

My company talked about grandfathering a couple of years ago but it would be costly with increases running 15% at that time.

So my hand will not be raised that the insurance company did this. It is a cause and effect of multiple moving parts. To say that an entire industry did it just to make the ACA look bad shows you don't understand how health insurance renewals work.

 

[manning]

Grandfather.

I heard a debate the other day. Of course arrows were fast and furious so things got confusing. If I understood it correctly even if premiums went up the grandfather is lost.

If correct you know they will. They have to.

 

[lauradis]

I'm just throwing this out there bc I am wanting an answer! How do we know that all these employers and insurance companies raised our premiums because of "Obamacare"? I'm not trying to get political by any means, I just tend to be skeptical!

DH has employee based healthcare, as he works for a large publisher, and our health insurance increased $4,000.00 for premiums for 2014 ! We could have dealt with that but our kicker is our Rx coverage will not kick in until our higher deductible is met! This was deal breaker for us. Now I am nurse and I work for non- for profit hospital, who DID NOT raise our rates for 2014! I will have to get moved from a per diem position to at least part time so I can pick up my insurance from my employer.

My point is: my employer didn't raise their insurance rates and they are a small non for profit but my husbands huge employer doubled ours. This seems so shady to me!

I Agree with you employers are taking advantage of ACA because they are now allowed to charge you up to 9.5% of your household income for health insurance premiums and still call it a benefit.

Basically what ACA did was shift the cost of insurance from
employer to employee
Over 94k income family of 4 to help pay for everyone below them.

 

[johde]

My understanding, in a global sense and not particular to your situation, is that while the insurance companies COULD grandfather their plans, they did not HAVE to grandfather their plans. If an insurer determined that it was in their best interest to end a plan and roll out a new one, I don't think anything in the ACA could compel the company to maintain the plan. That doesn't mean that is what happened in your case, or even that I am correct in my understanding, but again in my reading of the regs, it seems like the issue stems from that loophole and I have no doubt, from direct experience, that the finance teams quickly proceeded to figure out what was in each company's best interest, which may have included terminating plans that were less favorable to their bottom line.

In my case, I did know I would most likely be changing plans eventually. Because of issues with networks, I changed companies after the ACA was passed into law. So, my plan is not grandfathered. The best they could do for me is letting me keep my current plan until Dec 1, 2014.

How will you be getting less insurance? What coverage do you have now that you will no longer have?

The less coverage for slightly more money is in a different plan.

Gold plan $2000 deductible, $2000 OOP max $486 a month w/o subsidy quite a bit more than I'm paying not w/ subsidy depending on income.
Silver plan $1,500 deductible $5,000 OOP Max $400 a month w/o subsidy right about what I pay now w/ subsidy (Income above $22,900)

Silver plan $500 deductible, $2,100 OOP max same plan as above (Income below $22,900) because of additional Cost sharing.

 

[sookie]

I feel your pain, OP.
Ours went up by $6,000 for 2 of us. I really feel for those with children at home who are getting hit with these costs and new parents just starting out.

Our policy was also a "cadillac" policy before being downgraded to avoid the 40
% tax. Employers are being punished for providing top notch coverage. It makes no sense at all. This law is such a huge tax burden on the middle class.

Mine will be cancelled as well. I have paid the highest premium possible for a good policy with my employer. It will be cancelled as a cadillac policy - I had a lower deductible policy and I had a lower copay.

I'm pretty sad about this. I feel that when we were told that if we had coverage we liked, we would be able to keep it, that this was not true.

I'm looking at a pretty radical jaw surgery sometime within the next year. Further, we wanted to have another baby sometime within the next 2-3 years.

I don't know how we will swing either. Both of these things seem impossible. Everyone will be on a high deductible, high copay plan from now on.

This seems more like a punishment to those of us who have been carrying insurance rather than helping. I have a dentist friend who will end up paying the tax - they bought their insurance through the state group plan and it is being cancelled as well. They don't know what they will do either as the plans offered through the exchange are outrageously expensive. And they are dentists!

 

[wendow]

This seems more like a punishment to those of us who have been carrying insurance rather than helping.

I agree. We've never been without insurance in the almost 19 years we've been married. But we are seriously considering dropping it and going without or doing a med share due to the cost. I agree with those saying this bill is actually going to increase the number of uninsured. What a mess this whole bill is

 

[njcarita]

I agree. We've never been without insurance in the almost 19 years we've been married. But we are seriously considering dropping it and going without or doing a med share due to the cost. I agree with those saying this bill is actually going to increase the number of uninsured. What a mess this whole bill is

we have been paying our insurance for 18 years ourselves too............ 1300/ month right now............. this is the first time we also considered going uninsured....... website is a mess........... we have been waiting for
obamcare people to call us back now for over a week........... my present plan is also not being renewed......... I HAVE NO IDEA what my costs will be in jan..... total mess.........

 

[Gumbo4x4]

You didn't read either the link or the posted article did you?

I've read the article and also some that dispute it. As I understand it, the only way out of compliance is for insurance companies to opt out of the exchange COMPLETELY.

Not that that really matters. My policy is newer than 2010, so it wasn't eligible for grandfathering anyway. And we're getting dinged an extra $120 a month to cover things we couldn't possibly use - example, better post birth care when I've already had a vasectomy.

Bottom line is this: the ACA does not benefit people who already had insurance. So one has to question why exactly such people were included in the bill. There are any number of possible reasons, and none of them are honorable.

 

[Gumbo4x4]

This seems more like a punishment to those of us who have been carrying insurance rather than helping. I have a dentist friend who will end up paying the tax - they bought their insurance through the state group plan and it is being cancelled as well. They don't know what they will do either as the plans offered through the exchange are outrageously expensive. And they are dentists!

This is precisely what it is. It's a punitive tax, and on those of us who can least afford it: namely, those of us paying 100% out of pocket for what were already VERY expensive plans outside our employer plans.

 

[A_Princess'_Daddy]

Mine will be cancelled as well. I have paid the highest premium possible for a good policy with my employer. It will be cancelled as a cadillac policy - I had a lower deductible policy and I had a lower copay.

I'm pretty sad about this. I feel that when we were told that if we had coverage we liked, we would be able to keep it, that this was not true.

I'm looking at a pretty radical jaw surgery sometime within the next year. Further, we wanted to have another baby sometime within the next 2-3 years.

I don't know how we will swing either. Both of these things seem impossible. Everyone will be on a high deductible, high copay plan from now on.

This seems more like a punishment to those of us who have been carrying insurance rather than helping. I have a dentist friend who will end up paying the tax - they bought their insurance through the state group plan and it is being cancelled as well. They don't know what they will do either as the plans offered through the exchange are outrageously expensive. And they are dentists!

I have tremendous empathy for you, I truly do. That stinks for you and your family! But, and I realize this isn't easy to hear and please understand it's in no way a criticism of you, you also sound like you were/are planning to be a high utilizer of your insurance, which is a major part of what is pushing everybody's insurance costs higher.

My family and I are extremely high utilizers as well, due to my son's special needs which require a slate of physicians and medical professionals that rivals the phone book, and I have no doubt that our medical costs far exceed what we pay in each year. Look at it in this way: If you and your company were paying $1,500 per month, combined, for your health insurance policy, and you have a $5,000 out of pocket maximum for the year, your total contributions to the risk pool would be $23,000, which would likely not even cover the cost of your upcoming surgery and post-op care, leaving other contributors to the pool, i.e. your colleagues, to cover your other care for the year. The same goes for a pregnancy, or any major care. The issue is those other contributors are also using medical care for their own surgeries, babies and routine care, and there's not enough money to cover the medical payments, so costs rise, either through higher premiums or through cost-sharing devices such as deductibles and copays.

The challenge is that the solutions are things nobody wants to consider, including me, because they are distasteful solutions! The amount of money spent on end-of-life care is astronomical. Billions of dollars are spent each year to prolong life a few days, a week, a month, but the alternative grates at our sense of humanity for obvious and fair reasons. Expensive tests are ordered, not only to generate revenue for the physicians and medical device manufacturers but also because we, as patients, want no expense spared to save our lives. Case in point: my daughter had a low WBC count at a routine test that involved three follow-up tests and a few trips to a pediatric hematologist at a specialty clinic to make sure it wasn't leukemia. I would have accepted nothing less, but what was the cost of that, to conclude she just had a slow recovery from a harmless bug? Part of the economic theory of covering everyone with insurance is a larger insurable pool, which spreads the risk, but some people chafe at the mandate. Single payor puts everybody in the pool, but chafes at some others who oppose it. Every solution has detractors, and so we have to come together to find a solution.

So what is the solution? It's complicated beyond my ability to solve...

 

[Gumbo4x4]

I have tremendous empathy for you, I truly do. That stinks for you and your family! But, and I realize this isn't easy to hear and please understand it's in no way a criticism of you, you also sound like you were/are planning to be a high utilizer of your insurance, which is a major part of what is pushing everybody's insurance costs higher.

My family and I are extremely high utilizers as well, due to my son's special needs which require a slate of physicians and medical professionals that rivals the phone book, and I have no doubt that our medical costs far exceed what we pay in each year. Look at it in this way: If you and your company were paying $1,500 per month, combined, for your health insurance policy, and you have a $5,000 out of pocket maximum for the year, your total contributions to the risk pool would be $23,000, which would likely not even cover the cost of your upcoming surgery and post-op care, leaving other contributors to the pool, i.e. your colleagues, to cover your other care for the year. The same goes for a pregnancy, or any major care. The issue is those other contributors are also using medical care for their own surgeries, babies and routine care, and there's not enough money to cover the medical payments, so costs rise, either through higher premiums or through cost-sharing devices such as deductibles and copays.

The challenge is that the solutions are things nobody wants to consider, including me, because they are distasteful solutions! The amount of money spent on end-of-life care is astronomical. Billions of dollars are spent each year to prolong life a few days, a week, a month, but the alternative grates at our sense of humanity for obvious and fair reasons. Expensive tests are ordered, not only to generate revenue for the physicians and medical device manufacturers but also because we, as patients, want no expense spared to save our lives. Case in point: my daughter had a low WBC count at a routine test that involved three follow-up tests and a few trips to a pediatric hematologist at a specialty clinic to make sure it wasn't leukemia. I would have accepted nothing less, but what was the cost of that, to conclude she just had a slow recovery from a harmless bug? Part of the economic theory of covering everyone with insurance is a larger insurable pool, which spreads the risk, but some people chafe at the mandate. Single payor puts everybody in the pool, but chafes at some others who oppose it. Every solution has detractors, and so we have to come together to find a solution.

So what is the solution? It's complicated beyond my ability to solve...

It's definitely a complicated situation. But to me, that makes it all the more frustrating that we have put so much effort into a program that doesn't even address ANY of the reasons the costs are spiraling out of control.

Back when you & I were born, it wasn't unusual for a blue collar family to send the mother into the hospital for childbirth followed by a full week stay. And at the end of the week, the family would write a check for the entire bill. That's something the average family couldn't possibly afford today. Why is it SO much more? And why haven't we done anything to address THAT as opposed to trying to force more people into what is already a broken system?

 

[ceemys]

For years and years I have complained about the high cost of my companies insurance. It went from awesome to everything is OOP. I just received our 2014 benefit schedule. The deductibles and co-pays are the same. My premium is going up $15 per month.

Monthly premium - $269.00
Calendar year deductible - $3750.00
After that, it is 80/20 until the maximum OOP is reached.
Maximum OOP is $7500.00

The only time I used everything up is 3 years ago when my little one fell down one step and broke her jaw in 2 places and had her mouth wired to keep 6 teeth in place. I paid everything OOP. I was ticked off at my insurance company because all they 'discounted' was $500 out of a $7500 bill. They didn't even pay the 80% on the part over the $3750 because even though the surgeon takes CIGNA medical, her type of injury was covered as 'dental'. Even though a dentist would not touch her. sigh. So I had to meet the $7500 OOP versus the $3750.00.

I do like my HSA now. I am contributing enough that I should have my deductible covered by end of next year.

After hearing about others premiums and health insurance, I will definitely say the grass is not greener on the other side and I will not complain.

 

[bethy]

It's definitely a complicated situation. But to me, that makes it all the more frustrating that we have put so much effort into a program that doesn't even address ANY of the reasons the costs are spiraling out of control.

Back when you & I were born, it wasn't unusual for a blue collar family to send the mother into the hospital for childbirth followed by a full week stay. And at the end of the week, the family would write a check for the entire bill. That's something the average family couldn't possibly afford today. Why is it SO much more? And why haven't we done anything to address THAT as opposed to trying to force more people into what is already a broken system?

These are my feelings in a nutshell. I wish there were an option to utilize insurance strictly as something that covers catastrophic events. But the costs of every day stuff is so high now that practically everything is a catastrophic event for the average family.

 

[Gumbo4x4]

^^^^ Little intricacies like dental vs medical & such drive me nuts ceemys.

Somewhat similar situation, my wife needed a little cyst removed from a finger many years back. The Dr. suggested the outpatient clinic as it would be much cheaper than the hospital. Well, turns out our insurance would only pay $1,000 toward the procedure at the clinic, but would have covered it in full at the hospital (even though the hospital was WAY more expensive). So, the following Saturday, we get a $2,800 bill from the doctor for the amount the insurance wouldn't cover. We call the doctor's office on Monday and explain that we shouldn't have to pay that since the doctor chose the clinic. They agreed and waived the fee. In the end, the doctor was perfectly happy to get the $1,000. The bill would have been close to $10,000 at the hospital.