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Affordable Care Act Question

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  • Republican
    Portland, OR
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    Hi I am not sure if I can post this question here. If not, please tell me where is a good place. My question comes from something someone posted in another forum and I am curious if it is true. They basically say that by 2015 Doctors and Hospitals will have to report all patient records to a federal government medical database. Does anyone know where I can look that up to see if it is true?
  • Strongly Liberal Democrat
    Democrat
    Portland, OR
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    norwaymills Wrote: Hi I am not sure if I can post this question here. If not, please tell me where is a good place. My question comes from something someone posted in another forum and I am curious if it is true. They basically say that by 2015 Doctors and Hospitals will have to report all patient records to a federal government medical database. Does anyone know where I can look that up to see if it is true?
    Hello norwaymills. You are more than welcome to post that question. I have not found any credible information that would point to this happening. There are discussions in the United Kingdom of creating a national health database, but those are just in the discussion phase and have no impact on American medical practices. There is still doctor-patient confidentiality and that won't be changing.

    With regards to the IRS and verification of coverage--It is true that the IRS will be able to verify if an individual has coverage, but they will not have any access to patient records. Here's a good link with a few more myths about Obamacare that have been debunked:

    Obamacare Myths
  • Liberal Democrat
    Democrat
    Colorado Springs, CO
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    Thanks Jared for posting the ObamaCare myths. I do believe that many of these myths are part of an orchestrated campaign by those that want to undermine or sabotage the Affordable Care Act. They rely on the ignorance of the American people to accept these facts.

    And they appear everywhere, and not only on the Fox News daily rants. Derogatory false comments are added by saboteurs to the end of articles posted by the media and to Facebook pages featuring Obama. Even the Democratic Hub gets its share of trolls targeting Obama, and I wonder how many are paid to do this. There are legitimate criticisms on ObamaCare and other issues that are worthy of real discussions, but it's hard to separate these out sometimes from the shrills that don't care about facts.

    Then there was the so called "veteran" that called into the Ed Schutz radio show claiming that 171,000 vets were thrown off their health care insurance because of ObamaCare. The story was false from the get go as the Veterans Administration has not thrown anyone off of VA health care. Ed, of course, took the bait and immediately called out the caller for his outrageous lie. However, now the right wing blogosphere is full of complaints about Ed treating a vet so poorly...never questioning that the story was bogus...and that the guy was probably not even a vet. A true vet would no better. Vets are largely happy with their VA insurance, except for those affected by the backlog of claims.

    I noticed that a similar post was made on this website and I am glad to see it was removed.
  • Other Party
    Nebraska
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    Schmidt you say that ..."They rely on the ignorance of the American people"...

    And I say, why wouldn't they? It's pretty good strategy, because there's LOTS of ignorance out there. Your first two paragraphs are pretty much right on but there's probably even more. I would be surprised if there are not people trying to hack into the web site and doing their best to crash it, or do as much as they can to mess it up.

    There is so much hatred of Obamacare that some people will go farther than just spreading lies and conducting a smear campaign in the media.

    There's enough bad stuff that is TRUE about Obamacare that the opponents should just stick to the facts. The thing I am hearing more and more in the past few days about Obamacare is the sticker shock of huge deductables that people are being faced with. Their premiums going way up is bad enough, but the deductables are where the real bad news is.

    I didn't see the vet call to big head ED but since Ed is prone to uncontrollable explosions at times, I hope to see it reviewed this evening.
  • Liberal Democrat
    Democrat
    Colorado Springs, CO
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    jamesn --

    Yes you are right about the high deductibles. I personally don't have any problems with high deductible plans, and in fact that is the trend for even employer based plans.

    Bloomberg, October 13, 2013: Patients Pay Before Seeing Doctor as Deductibles Spread

    "Employers are following suit as they push workers to share more financial responsibility for health care. The percentage of insured workers with a deductible of $1,000 or more for single coverage jumped to 34 percent in 2012 from 12 percent in 2007, according to a study by the Kaiser Family Foundation and the Health Research and Educational Trust."

    "Overall, the number of people with high deductible plans rose to 15.5 million in 2013 from 1 million in 2005, according to America’s Health Insurance Plans, the industry’s lobbying group in Washington. The Internal Revenue Service largely defines high deductible health plans as those with an annual deductible of $1,250 or more for individual coverage."


    For those that cannot afford health care coverage at all, the high deductible plans will not be of much help. But then they probably qualify for Medicaid in some form...if you live in a state like Oregon without a Republican Governor blocking the new Medicaid provisions attached to the Affordable Care Act.

    I know some young people that didn't have insurance prior to the roll-out of the Affordable Care Act that are now considering it mainly because they want the catastrophic coverage in case of a major accident or health problem. They really don't want to be a "Terri Shivo" burden on their parents. These high deductible plans are very cheap...under $100 per month in most states.

    As one who has had a past experience (a few years ago) in dealing with Anthem to get single coverage for my daughter in Connecticut, I can say that process was extremely onerous and costly, and we never felt comfortable that they wouldn't pull the plug on her insurance for any reason. As a part of the process for enrollment she had to fill out pages and pages of health history, and they initially turned her down for a preexisting condition. She had went to a chiropractor once for treatment and that was determined to be a disqualification. Her doctor had to write a letter to the insurance company explaining the routine nature of the treatment and that she was fully "cured." After a couple of months they finally approved her policy back dated to the day she applied. In other words she had to pay for the month plus they say she was denied coverage. Bunch of crooks.

    If I compare that ordeal to signing up on the exchanges for a policy with one of the ACA participating countries, there is no comparison. I'll take the ACA, even with it's glitches, any day.
  • Other Party
    Nebraska
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    Schmidt it must be nice to ..."not to have any problems with high deductible plans"... but apparently many Americans are not as well off as you. One lady I talked to said her deductible will be $12,000 so now, as she put it "I'm forced to buy this insurance but now I can't afford to go to the doctor" because she didn't have the $12,000 to pay for anything other than the visit to the family doctor. If she was referred to a specialist, she could not afford to go. Oh well, if a few Americans like her will die younger, maybe all our health care costs will come down.

    She was considering visiting an emergency room and telling them she was an illegal alien so she would be treated for free. Problem solved! Thanks Obamacare!
  • Liberal Democrat
    Democrat
    Colorado Springs, CO
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    Regarding the high deductibles, it is just a matter of economics. Consider this from the Agency for Health Research and Quality:

    "Half of the population spends little or nothing on health care, while 5 percent of the population spends almost half of the total amount."

    I'm part of that 50 percent of the population that spends little or nothing on health care. So opting for a higher deductible makes economic sense regardless of my economic circumstances.
  • Other Party
    Nebraska
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    Schmidt that's good info but it really doesn't help my friend who is being forced to buy insurance for a much higher premium, with much higher deductibles who soon will no longer be able to afford to go see a specialist.

    Like I said, it must be good to be in your position. Not all are so fortunate.
  • Democrat
    Texas
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    jamesn Wrote: Schmidt it must be nice to ..."not to have any problems with high deductible plans"... but apparently many Americans are not as well off as you. One lady I talked to said her deductible will be $12,000 so now, as she put it "I'm forced to buy this insurance but now I can't afford to go to the doctor" because she didn't have the $12,000 to pay for anything other than the visit to the family doctor. If she was referred to a specialist, she could not afford to go. Oh well, if a few Americans like her will die younger, maybe all our health care costs will come down.

    She was considering visiting an emergency room and telling them she was an illegal alien so she would be treated for free. Problem solved! Thanks Obamacare!
    BTW, from 2000 to 2008 almost 10% nationwide employers dropped health insurance for employees adding millions to the uninsured numbers and this trend WAS continuing to increase. Emergency room care , the most expensive care available when unpaid increases costs for all paying customers but contrary to popular belief not all hopitals will take non-payers they will send them to the nearest hospital that get's federal funding for treating uninsured that can't pay. Most illegals from Mexico actually go back to Mexico for most medical needs and I do think quite possibly there are enough illlegals working paying taxes that are NOT eligible to collect SS, disabilty, and are helping fund these hospitals that get federal funding to cover the cost of the few that have to take a child to the emergency room or go themselves.


    The limit on individual for TOTAL out of pocket costs is a little over 6 K not 12 K and deductible counts against that limit. 12K is the limit of out of pocket for whole family. I don't know what policy this lady was talking about but I am considering either a silver plan with 2, 500 deduct or a gold plan with 500 deduct, and there are various options for various deducts etc for all levels bronze, silver , or gold just depends on what a persons wants to pay.

    Even without subsidy, I can get better insurance for less cost thru the healthcare exchange and most people will be able to do the same. The vast majority of people that can not get employer provided insurance and have to purchase individual will benefit GREATLY.

    The vast majority of employer ensurance will not change and will not be impacted by ACA other than insurance can no longer refuse to pay for needed medical care after it reaches a certain amount because they are no longer allowed to set that cap which has required them to increase premums. The good thing is that due to the ACA , some prefer to credit recession lol , the increase in premiums even with this is much smaller than it has been in the past. Average yearly increase in cost of health insurance since 2000 up to 2009 was 10% a year. Has been 4% increase since and next year is estimated to be 6.3% increase which is still cheaper than the 10% increase that was digging deeper in our pockets every year.

    But like all laws and pretty much all things it is impossible for everyone to benefit there are always some that don't. Build a new lake for a town that over 5,000 people badly needed required the city to use eminent domain law to force my grandparents to sell their land. They got a fair price and they also benefited from the new lake just by the town surviving which is closet to their ranch.

    We must always respect individual needs, rights, etc , but we have to use common sense and when something is needed from which millions wo;; greatly benefit and will help them to stay alive , there are times when the few that will not benefit financially just need to understand like my family and my grandparents had to do. If we deny everything that is going to benefit large numbers of people because it does not benefit a few then we get nowhere and eventually civilization must stagnate, numbers of people that suffer continue to increase, and/or we die out. Just like out town would have died without the new lake.


    LOL. sorry for the length, but it barely scratches the surface much more needs to be said on the subject if you are interested , If not I will leave it at this.
  • Democrat
    Texas
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    SChmidt Employers are following suit as they push workers to share more financial responsibility for health care. The percentage of insured workers with a deductible of $1,000 or more for single coverage jumped to 34 percent in 2012 from 12 percent in 2007, according to a study by the Kaiser Family Foundation and the Health Research and Educational Trust."


    Do you know if there was any jump in deductible in 2008, 2009, 2010, 2011 prior to ACA and also did deductibles ever increase prior to 2007 ?
  • Democrat
    Philadelphia, PA
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    Companies are for the most organized to supply a demand and of course to make profits, when profits are threatened these same employers must find a way to eliminate the risk to their profits, as so many of people are now finding out the medical /health care costs to a company are one of the highest expenses a company can assume, given the chance to now reduce this risk, via the ACA, towards their overall profit picture becomes a no- brainer. This is the way of a capitalist system, even if one were to go the way of a single payer system ,the politicians will always find many different ways to avoid the chance of sharing a medical facility with the common folk.
  • Libertarian
    Syracuse, NY
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    While I am not for Obamacare I don't think the IDEA of deductibles is a bad one. The problem is the threshold for a lot of people. We can go back and forth about what we think is acceptable limits but that is up to the individual.

    Our family has been on a high deductible plan for a few years now (although the deductible was $2,500 before Obamacare and now it will be $4,000 at the silver level or $6,000 at the bronze level-in NY). We were uncomfortable with it at first. I had always worked and got health coverage through my employer-very good coverage. The most I ever paid was $440 a month with no deductible and no co-insurance. Everything was paid for except the copays-$20 a visit and $50 for specialist. RX coverage was $5,10 or $20 depending on RX.

    When we went to the high deductible we had an option to have RX coverage or not. The difference each month was about $610. We chose the no RX option. Luckily we were healthy at the time.

    It really made us change our health care habits. With employer coverage we went to the dr whenever we wanted and as soon as the kids had a fever we took them. Everything was covered. No big deal. Now we are extremely careful. We don't need to take the kids each time they have a fever, etc (you get the point). I also started checking each and every one of our bills. Since we have to come out of pocket before insurance kicks in I had many a battle with drs about what they charged.. And on most occasions I won. We also found that since we didn't have RX coverage we had to be careful with any RX that we got from the dr. They were fantastic and so was the pharmacy. Both the drs and the pharmacist went out of their way to research low cost options and gave us coupons. I would recommend everyone find a local pharmacist. They are worth their wait in gold! Nothing against big chains but I find they are so busy they don't have the time to really help to try and save us money.

    When you have to pay at first you really do a lot more research about alternatives. Now that's just our example. I know there are people out there who make have to make tough medical decisions now and after Obamacare.

    I tend to think having deductible might, in some way, lower the COST of healthcare. If people have to pay attention to what they are being charged, challenge the doctors and drug companies and look for alternatives it will help the whole system.

    Just a side note, when we had healthcare through our employer I had back surgery. I was supposed to stay in the hospital for two days. I did well and got released the same day. When I got the bill from the hospital, they charged the insurance company for two days. I called the insurance company and told them they should only pay for one day. The response from the insurance company was, "That's ok. We have an agreement worked out with the hospital. Don't worry about it." I let it go because I wasn't paying. You can bet if we had to pay there would have been a battle!
  • Libertarian
    Syracuse, NY
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    oops I misspelled wait. I meant weight!
  • Democrat
    Texas
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    frazerisland Wrote: While I am not for Obamacare I don't think the IDEA of deductibles is a bad one. The problem is the threshold for a lot of people. We can go back and forth about what we think is acceptable limits but that is up to the individual.

    Our family has been on a high deductible plan for a few years now (although the deductible was $2,500 before Obamacare and now it will be $4,000 at the silver level or $6,000 at the bronze level-in NY). We were uncomfortable with it at first. I had always worked and got health coverage through my employer-very good coverage. The most I ever paid was $440 a month with no deductible and no co-insurance. Everything was paid for except the copays-$20 a visit and $50 for specialist. RX coverage was $5,10 or $20 depending on RX.

    When we went to the high deductible we had an option to have RX coverage or not. The difference each month was about $610. We chose the no RX option. Luckily we were healthy at the time.

    It really made us change our health care habits. With employer coverage we went to the dr whenever we wanted and as soon as the kids had a fever we took them. Everything was covered. No big deal. Now we are extremely careful. We don't need to take the kids each time they have a fever, etc (you get the point). I also started checking each and every one of our bills. Since we have to come out of pocket before insurance kicks in I had many a battle with drs about what they charged.. And on most occasions I won. We also found that since we didn't have RX coverage we had to be careful with any RX that we got from the dr. They were fantastic and so was the pharmacy. Both the drs and the pharmacist went out of their way to research low cost options and gave us coupons. I would recommend everyone find a local pharmacist. They are worth their wait in gold! Nothing against big chains but I find they are so busy they don't have the time to really help to try and save us money.

    When you have to pay at first you really do a lot more research about alternatives. Now that's just our example. I know there are people out there who make have to make tough medical decisions now and after Obamacare.

    I tend to think having deductible might, in some way, lower the COST of healthcare. If people have to pay attention to what they are being charged, challenge the doctors and drug companies and look for alternatives it will help the whole system.

    Just a side note, when we had healthcare through our employer I had back surgery. I was supposed to stay in the hospital for two days. I did well and got released the same day. When I got the bill from the hospital, they charged the insurance company for two days. I called the insurance company and told them they should only pay for one day. The response from the insurance company was, "That's ok. We have an agreement worked out with the hospital. Don't worry about it." I let it go because I wasn't paying. You can bet if we had to pay there would have been a battle!
    New York healthcare exchange must be vastly different from the Federal healthcare exchange that my repub state defaulted to because there are several options in the silver plans with deductible ranging from 1500 to 2500 and there are no 4,000 deductibles in the silver plans you would have to go to the bronze plans I am sure to have that high a deductible which I did not even look at because I am going with a top level silver or bottom level gold plan have not quite decided yet which one. The only tough choices the people I have talked to so far have had o make are the same as me, they can get better insurance for LESS COST and our tough decision is how much better to we want. btw AND THAT IS BETTER INSURANCE FOR LESS COST EVEN WITHOUT SUBSIDY.
  • Libertarian
    Syracuse, NY
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    I understand why you might not believe me because of all the misinformation reported in the media. Please google NY State health exchange, go on to the website, click small business (because the individual side makes you "sign up" before you can shop-the rates are the same-I called), choose Excellus-that's the plan we want to keep because as of now our doctors are not accepting the cheaper plans, choose employer + family then silver. Shop the rates. Then shop the bronze level.

    I did post a correction on the other thread relating to Obamacare. We received a letter from Excellus. Our family deductible actually went down to $1,200 for the silver. That's the good news. I am not sure why but the letter we got from Excellus lists rates that are not comparable to the website. Our premium is $820 (up from $483) but the website lists it at $1,125. The letter states we are going to have cost sharing but they only list an average for the silver plan at 30%. I have a call into Excellus to clarify a few things. The bottom line is it is not better for us.

    I also stated that there are going to be many people who benefit from this law but for each success story you will be able to find one that is not so good. Your example of someone making 16K is not very good. While they may be able to afford $30 a month I can't imagine that they can come out of pocket $2,500 before their benefits kick in and then be able to afford 30% of health care bills after that.

    I like the bill that is being floated around now by a Republican that allows people to keep the plan they have if they like it. It will be interesting to see if Harry Reid even lets it go to a vote. If he doesn't, who isn't helping the WORKING class now?

    By the way NY is a democratic state and we have always had the most expensive insurance because they required a lot of the "essential benefits" Obamacare is now requiring. And while Sally Kohn's article was interesting I don't think it helps the cause. First of all she already had insurance. Those are not the type of people this program needs to sign up. I certainly am not begrudging her, I would as do it as well.

    I would have liked to see the federal government, first, pass a law that says health insurance companies can go across state lines and sell insurance. Give that a couple of years to see if that does anything to lower the cost of insurance. Again, the bottom line is this is going to do nothing to lower the COST of healthcare (not insurance) in this country.