There seems to be a great deal of misinformation on the Affordable Care Act (ACA). MoneyTalk did a couple of excellent articles that are free on their website. I'll post a link to each article separately. The first one is:

Understanding Obamacare: Bronze, Silver, Gold and Platinum
September 20, 2013 MoneyTalks.com

(Excerpted) It’s less than two weeks before the state online marketplaces open for business as part of the Affordable Care Act, widely known as Obamacare. Have you decided which level of health insurance you’re going to buy? Your choices are bronze, silver, gold and platinum.

As the names suggest, bronze has the cheapest premiums and, as a result, the highest out-of-pocket costs among the four plans. On the other end, platinum has the highest premiums and the lowest out-of-pocket costs for health care.

First, keep in mind that if you get health insurance through a work-based group plan (and most Americans do), this will likely have no bearing on your life, unless your employer’s plan is deemed unaffordable for your income. The online marketplaces where the so-called “metal plans” can be bought are intended for those who are uninsured or who have individual coverage and may want to shop for a better deal. They’re also for businesses with 50 or fewer employees.

If you get your health care through a government plan like Medicare or Medicaid, you can also tune this out.

Second, the marketplaces are merely a way to simplify the process of buying health insurance. You’ll be purchasing insurance from many of the same companies that sell it now, plus perhaps some new cooperatives and nonprofits. This is not a government insurance plan.

Third, your premiums will vary not just by which metal plan you pick but also by your age and where you live. However, under Obamacare, insurance companies can no longer set higher premiums for women and can no longer charge someone more or refuse to sell them coverage because of a history of health problems.

Fourth, it’s important to remember that many of those who buy insurance through a state marketplace will be eligible for a subsidy in the form of a tax credit, which can be applied directly to the monthly cost of the premiums. You have to make a good income -- more than $45,960 for individuals and $94,200 for a family of four in 2013 -- not to qualify for some kind of help with the cost. You won’t know your actual subsidy until the marketplaces open, but we’ve provided the Kaiser Family Foundation’s calculator below to give you some idea. Depending on your income, the subsidy could substantially reduce what you pay for your premium.

Finally, regardless of which plan you pick, you’ll be provided with certain health benefits, like maternity care, prescription drug coverage and mental health care. In fact, the Affordable Care Act raised the bar for the kinds of care every health insurance policy -- both individual and work-based group plans -- must provide. Says HealthCare.gov: "All marketplace insurance plan categories offer the same set of essential health benefits. The categories do not reflect the quality or amount of care the plans provide."

However, you’ll need to examine the details of each plan to see if they meet your health needs. Says WebMD: "Plans differ by the services they provide for each benefit. For instance, one plan may cover more prescription drugs. Only some plans may include bariatric surgery under hospital care. And not all plans will cover in-vitro fertilization under maternity care."

Here is a link that might be useful: How to pick the type of policy under ACA

Despite many people thinking the penalty is "only" $95, this second article by MoneyTalk points out that in fact, the penalties can be much more severe:

What happens if I don't buy health insurance?
You'll have to pony up cash to the federal government if you ignore the requirement to purchase health insurance -- and you could face a pile of medical bills if you're injured or seriously ill.
October 4, 2013 Money Talks News to MSN Money

(Excerpted) "It may seem like a clever idea to save yourself cash by not purchasing health insurance, but with Obamacare kicking in, you'll have penalties to pay, which could cost you big bucks in the long run.

Not only are you playing financial Russian roulette -- you could be forking out tens of thousands or hundreds of thousands of dollars if you're injured in an accident or become seriously ill -- you'll also have to pay a penalty to the federal government for flouting the law, costing you hundreds or thousands of dollars more."

Here is a link that might be useful: The penalties for not being insured under ACA

People who didn't buy health insurance before Obamacare were playing Russian roulette and they didn't care then. Why should they care now? They usually don't have homes or good credit. What can the government do to them. You can't go to jail for debts in this country. If Obamacare changes that then we are in serious trouble regarding freedom.

A lot of people who didn't have health care before- not just those without homes or a good credit rating - will now have it either under the MEDICAID expansion or the exchanges with it either being free to them or subsidized to a fare thee well. It's a good thing and will be even better once people are "trained" not to use emergency rooms for their primary care.

Despite the unemployment figures, etc., there are a lot of younger people out there who are indeed gainfully employed and can afford to take advantage of the exchanges. It might cut in to their personal lifestyles a bit, but heck, no one ever said being a responsible human being was easy.

All the "yeah buts" just muddy the water. People will think it's wonderful once it evolves into a single payer system. It has its glitches, but what massive new program doesn't? Social Security was regarded as the end of civilization as we knew it when it was first introduced. There's a lot of good information out there if one only takes the time to read it.

^And, social security is nearly broke. I don't expect to see a single dime of it.

I don't think Soc Sec will fail unless the country fails like it did during the depression. It is a scare tactic politicians have used for years and years to get your vote.

The law says the policies must have maternity care and child wellness care. Can ANYBODY tell me WHY a single male has to have this coverage? I know of NO men who have gotten pregnant.

Just to clear some misconceptions - SS is not broke as it has been running at a surplus for a long period of time. However, each administration (on both sides) have borrowed from SS to fund other missteps in our government. So, what should be maybe 500 billion is now 200 billion with 300 in no-interest IOU from the USA..
Think of all the money spent on the Iraq War or wall between US/Mexico and we could restore the debt from SS back to normal accounting levels. Instead, SS has a bunch of IOUs which if not repaid eventually it will not have enough money to fund.

There is no plan to repay those IOUs nor is government capable so that is why the conversation of SS going broke relevant but not due to mismanagement or poor accounting practices of SS administration or aging population.

This post was edited by rooseveltl on Tue, Nov 12, 13 at 12:02

Reason why men are required to have insurance that covers maternity and child care is that men can have children which they are required to have coverage one. They may not carry them but without male sperm females normally do not become pregnant.

Unless they're married, the man's coverage cannot be used.

If a guy gets his girlfriend pregnant, his insurance his insurance cannot cover her. She uses her own insurance.

So again, why does a single man need maternity coverage? Why do women who have gone through menopause and live alone need maternity benefits?

I wouldn't matter if insurance companies wrote separate, specific policies for women (with maternity coverage) and men (without maternity coverage) ... the cost of it all is aggregate so everyone would "pay" either way.

Regards to the penalty, for 2014 it's $95 per adult, $47.50 per child or 1% of of the taxpayer's taxable income (maximum $285 per family) ... whichever figure is greater.

So a single taxpayer with taxable income (I assume that means after all deductions, exemptions, and credits) of $35,000 ... the penalty for 2014 would be $350, not $95. Or maybe $285 if the family limit also applies to an individual.

This post was edited by dadoes on Wed, Nov 13, 13 at 9:44

Christopherh,

Shouldn't you be asking HMO's the same question?

All HMO policies Ive ever had provide maternity care, alcohol and drug abuse treatment services, pediatrics, prostate cancer treatments, all kinds of things that I will never use or need. I assume there's some sort of cost benefit to the HMO and to the customers to lump them all together.

Maybe it is like a home owner's policy it covers more than I might have chosen, but it's a packaged deal. One time I had towing on on three different polices.

$285 is still one HECK of a lot less than insuring an individual for the year; let alone a family.

I agree. $285 is less than one month's premium in Vermont. And If someone gets sick, all they have to do is get coverage.

Now, all we have to do is get this same deal for auto insurance. No need to pay a monthly premium, and when we have an accident, then call Progressive and get insurance to fix the "pre existing condition" on my car.

As far as maternity benefits for men, that depends on the state you're in. many states do not mandate maternity coverage for single men.

I'm a small business owner. Our current plan doesn't meet ACA requirements, presumably because of lifetime maximums and pre-existing condition exclusions (excluded for 1st year, then included). So we're one of the many that got the notice of cancellation.

We're renewing our current plan ($2500 deductible HSA with 100% coverage after deductible) on 12/1 to postpone for a year the ACA requirements. The difference in the premium between what we've got and the closest equivalent ACA-compliant plan ($2500 deductible HSA with 90% coverage) is a whopping 30%.

Oh, and supposedly we can get a tax credit for up to 50% of our premiums. But to do so we have to sign up through the exchange, and the exchange isn't even working to tell us what rates and tax credits would be. And it's not expected to be working until the end of the month, which doesn't allow us enough time to evaluate it before we renew on 12/1.

BTW, I did look up rates from a local provider (their website, not healthcare.gov) and every one of our employees' individual rates are more than our small group rate if we renew on 12/1.

Yippee. Loving this Obamacare. :-(

But to do so we have to sign up through the exchange, and the exchange isn't even working to tell us what rates and tax credits would be. It worked for me a on 11/5 (I signed-up a user account a couple weeks prior), although it took a while and required several refreshes. I got the quotes and tax credit info. I haven't yet decided which plan to take.

Single payer anyone? AKA "medicare for all." Youd still have your options for Cadillac coverage through private insurers, who would have to reinvent themselves to profit in the new environment.

Yeah, I know, aint gonna happen anytime soon.

YOu have to find out this kind of thing by urself.

The people in the richest so-called democracy in the world ...

... haven't, until now, been able to arrange universal health care for themselves.

Or is that not a credible conclusion?

Doesn't one of the basic tenets of democracy require that we respect others and help care for them, especially if we have the good fortune to have had very little requirement for health care, while others have not had such good fortune?

That's not to suggest that there shouldn't be graduated premiums as e.g. life insurance costing more for smokers.

ole joyful

I have friends who reduced their premiums by almost $700 per month because of the Affordable Care Act. It's a good thing.

My Sis is very knowledgeable about the health care and she said it is a good thing. She also said people are judging it because of rumors they hear. Those people need to call and get the facts.

6.5 Million people have had their insurance cancelled. 3.2 Million have "enrolled" in Obamacare. And of that 3.2 million, only 15 to 20 percent actually have insurance. It seems the ACA is counting those who opened a shopping cart and never went to checkout.

The main people who are "enrolling" are those who have had their insurance cancelled, not young, healthy people who are the ones needed to support this whole thing.

The insurers are saying that until the premium is fully paid, there is no coverage. And since they are not getting the 7 million people they need, the insurers are looking at a government bailout.

Just last week Obama gave a reprieve to businesses with 50 to 99 employees.

It's... not.... working.

I signed-up via the ACA website to get better coverage at a better price, not because my existing policy was canceled (it wasn't canceled, and it was not compliant with the new coverage requirements).

Of course the policy isn't active until the premium is paid. You expect to get something for nothing? BCBS extended the payment due-dates to compensate for the delays in the system ... February payment for example isn't due until end of February per the note on my bill, but I paid it on 1/31 anyway.

It ... is ... working ... for me.

bump

The truth.

Of course we will pay for it. Great Britain has a health care plan and so does Sweden. London is the most expensive city in the world to live in. For what you buy in Sweden you pay 2 times what you pay in this country for the same item. Our taxes will go sky high just like theirs. We pay no inheritance tax here, in GB they pay 98% of their inheritance. We always pay for the the lazy. The poor and handicapped in this country are cared for through social services. The lazy are cared by us with higher medical care and insurance premiums.

London is not the most expensive city in the world. In fact, it's not currently in the top 10.

The US has an estate tax. The rate after exemptions is 40%, about the same as the UK rate.

The high prices experienced by American travellers abroad (especially in Europe) are mostly because of the weakness of the US dollar in recent years. Ten years ago, 1 Euro cost less than $1 US. Today it's about $1.40. If their prices stayed the same (which they haven't, like here) everything in dollars would be 40% higher.

Y'all ought to do some research to be better informed as you form your opinions. It might affect your views.

The guide on our London tour said it was and I saw a documentary years ago 20 20 or 60 minutes where they interviewed a man whose parents had died and he said he inheritance tax was 98% so he was drinking all of the expensive wine in his parents wine cellar he could before the government took it.

The inheritance tax top rate has been 40% in the UK since the mid 80s. For comparison, the US top rate in the 1980s ranged from 55% to 70%, so their tax was quite a bit lower at that time and for some years since.

Tour guides and film makers are in the entertainment business. There's no truth or reality standard that applies to either, which is why they're are not good sources for information.

The young and the healthy are the ones who will pay for Obamacare.

They need the premiums from those people who will not use insurance to pay for the ones who do.

The problem is, according to a survey released by Mc Kinsey and Co, only 27% of those signing up are previously uninsured. So 73% are those who had their insurance cancelled. and of those who signed up, less than half actually have insurance because no premiums have been paid.

Maybe the next President will just use his/her pen and modify it so it works. After all, we no longer need Congress to amend established laws.

christopher-
What's your point? Many social programs work along these lines. If we had had a coherent health care system in the first place we would not have problems with unaffordable care and millions of people with no insurance. And why do you assume -- if your numbers are correct -- that, if 27% of those signing up are previously uninsured, it means that 73% had their insurance "cancelled" (which generally means they previously had crappy health care that doesn't meet the modest requirements of the Affordable Care Act)? It's entirely possible that many people who had insurance that wasn't "cancelled" decided they could get better coverage or a better premium and switched.

Mudhouse,

Private insurance does not cover pre-existing conditions. And the part about being able to keep your plan if you like it-you can keep your plan but some don't 'count' and you must pay the fine as well as the cost of the insurance. Mine included.

whitelacey-
Unfortunately, private health care plans are grandfathered in under the Affordable Care Act, which means that they can continue to discriminate, and/or continue to offer inferior coverage. But that doesn't mean you have to stay with them. Have you tried to look at what might be available to you under the ACA?

Here is a link that might be useful: Pre-existing conditions

Everything is OK now.
The legislation had been amended by the White House again.

Up till now, in order to claim a hardship you had to be either homeless, or bankrupt and living in a 1980 Ford Fairmont. But now all you have to do is say that the premiums will cause a financial hardship and you can get an exemption. No proof is necessary.

So healthy young people, the ones who feel they don't need insurance, can now simply say the premiums are too expensive and will cause a hardship.

The young healthy people are the ones who are needed in order to make this thing work. They don't need insurance and therefore their premiums will go to pay for older people who do. And if they don't pay, Obamacare doesn't work. That's why there is a fine for not enrolling. Our government says you MUST purchase something at your own expense or face severe penalties.

Just what is the government going to do to them, put them in prison. The people who don't buy are people who just go to the ER and get help free. That has always worked before.

In reality - government says you need car insurance to drive a vehicle. Even if you never get into an accident or drive 3 miles a year. Why? Most of us pay for the uninsured loser who kills 3 people in a drunk driving incident.Whether it is the auto insurance lobbyist or other - we go along and typically pay higher premiums when a flood or earthquake occurs in another part of the country.

I see Affordable HealthCare in the same breath - we don't question car insurance so if you have ever been sick in you life- pay your share. I think a fine is similar to other laws which aren't meant to be broken.

"The people who don't buy are people who just go to the ER and get help free. That has always worked before."

Worked for whom? The people who have no regular health care provider who knows their history? The people who don't get routine care (e.g., mammograms, flu shots) but only go to the ER for illness? The rest of us who pay inflated prices to cover uninsured people who don't have the cash to pay their ER bills?

The ER-as-provider approach doesn't really work for anyone.

Of course they are not covered like those who pay for insurance and they don't care. When and if they go to the ER with a bursting appendix it is going to be fixed. People like that are not usually responsible people. They live their life for that moment in time, they do not worry about tomorrow.

While there surely are people who are irresponsible - you just can't paint all the ER "visitors" with the same broad brush. If some of the more recalcitrant states would accept the Medicaid expansion for their populations...

Yes, we all pay for it, but the burden would be greatly lessened all around if we had a single-payer system.

How about all the young Millennials, too old to be covered by parents, and who are working and making a living salary but think they're invincible and nothing bad will ever befall them. They're pretty irresponsible too. No?

We go through this ad nauseam on the Hot Topics forum.

I did NOT say all were.

Duluth, I'm not sure what you're advocating is such a good idea. I'm not aware of any single payer systems that work well and provide excellent care, are you?

In many European countries, coverage is mandatory but involves insurance companies and health care providers entirely in the private (non-governmental) sector. THAT works.

Emma, what I was challenging was your assertion that the ER approach "works." From a health care perspective and a financial perspective, it does not work.

Mary why do you have to be so picky about the wording of my reply, was it so important that I didn't say "for them". It does work for them, but it would not for you and I. We have money to loose if we have to pay for health care costs, so we buy insurance. The people I know that do that don't have any money or credit rating to loose. They don't worry about check ups, preventative meds, the only time they think about it is when are sick or hurting.

I don't mean to be picky, and apparently, I wasn't being clear. Emma, I'm saying it doesn't work for them. I'm saying not having a primary care physician who knows about one's history doesn't work. And not having routine exams/tests to detect conditions before they become serious doesn't work. Do you really think "they" don't worry about tests and preventative meds just because they don't get them?

Obamacare made it possible for me to give up my very expensive Cobra coverage. My pre-existing conditions prevented me from purchasing insurance on my own during the first two years out of three of my COBRA. I now pay about half the premium. The coverage is not as comprehensive but what I save in premiums will make up for the higher deductible in just a few months.

My young 30's daughter also applied and was informed that she would be eligible for Medicaid under the expanded coverage for her state.

I had no problems with the website at all.

I'm one of the people who aren't buying health insurance through Obama care. I'm not young, I'm 49, but I'm healthy. I couldn't afford health insurance before and even with the "government help", I can't afford it now. It's cheaper for me to pay the fine so far, then to get the insurance which we typically don't use. Next year when the fine goes up, then we might have to get insurance, but I don't know how we'll afford that. I'm self employed, and my husband's work used to have insurance but got to where they couldn't afford it either.

Well let's see. My parents and others I know have been lied to. Their insurance that they liked DID change. Now they have to pay more. Thanks Obama!

rooseveltl : Pay me share??? I've paid 500/month for healthcare for the last 5 years. I never get sick (organic only- no sugar, no meat,no precessed food, plenty of exercise and supplements). I think that qualifies for paying my share. F that! Socialized healthcare doesn't work. Just ask those in Canada how they like waiting months to see a specialist.

AND, it's not he same as an automobile insurance - where you risk killing someone. I take care of myself and shouldn't have to be forced to have insurance: OBAMA STAY OFF MY BODY!

I think I'm going opt out of my insurance and just pay the fee, way cheaper than the 500/month, especially since I don't use it. I'm tired of being forced to pay for others. Enough is enough.

This post was edited by kali2024 on Wed, Apr 23, 14 at 23:28

Opt out and the rest of us will be getting tired of paying for you if the unthinkable happens.

Kali2024, you've already been "paying for others" for the entire 5 years you've had that $500/month insurance policy. Your payment is part of the aggregate risk pool under which the insurance company operates for ALL of its policy holders. Obamacare didn't change anything in that regard.