ObamaCare Doesn’t Care – Story
This site is full of facts about ObamaCare. Facts based upon the theory of what ObamaCare would bring. I doubt that this will be published, but I am a REAL ObamaCare user. I received a significant benefit in subsidies by using the marketplace. Due to significant health problems and lack of income I pay a fraction of what I used to pay for healthcare. However, I support repeal of the law. Why?
As of April 30th, 2015 an untold number of marketplace users lost their subsidies without notice or explanation. I was one of them. I submitted the required documentation regarding my income. But according to the marketplace management, my documents were declined and then deleted from the website (leaving me no evidence of having submitted them). Without my knowledge, they contacted my healthcare insurance carrier and changed my policy. I now have a $7,000 deductible and out-of-pocket maximum. My premiums are over $800 per month. I’ve talked with numerous managers at the marketplace and received no explanation. I can only conclude that this is how the administration plans to make the law seem financially viable.
I am currently on an injectible medication monthly with a cost of over $2,500 per injection. I told the marketplace management that I could not afford to keep taking these injections without the subsidies. The manager admitted that “many consumers are in the same situation”. I asked her, what if this was chemotherapy? Her response was that she was sorry, but there was nothing else I could do and no one else I could speak with.
I’ve done nothing wrong. And without explanation or notification, my Federal Government has gone behind my back and cost me thousands of dollars in collaboration with my insurance carrier and force me to cancel my medical treatments. Affordable Care Act???? REPEAL OBAMACARE! OBAMA DOESN’T CARE.
Well we personally know a lot of people who are getting cost assistance, had the process work fine, and are using the credits and the Marketplace. Some of what we wrote before the law went into effect is theory, but the rest is based off of what is happening in practice post implementation of each provision.
$7,000 must be on a family plan or rounded up because it is illegal to have deductible or maximum that high on an individual plan.
What state do you live in? What insurer are we talking about? Was the old plan discontinued? This is the first we are hearing about this sort of thing, but would urge others who had this experience to discuss it below and to answer the aforementioned questions so we can help get to the bottom of what happened and why.
For the record, we would not support a repeal of ObamaCare or say that Obama doesn’t care based on your plan being changed. As many 20 million people now have coverage then before between all sources (employer, medicaid, marketplace) and many of those who had preexisting conditions are able to get care for the first time. $7000 is a lot, but being refused insurance is much more expensive.
“For the record, we would not support a repeal of ObamaCare or say that Obama doesn’t care based on your plan being changed. As many 20 million people now have coverage then before between all sources (employer, medicaid, marketplace) and many of those who had preexisting conditions are able to get care for the first time. $7000 is a lot, but being refused insurance is much more expensive.”
BALONEY!! Great, people who didn’t have coverage before now have it, big whoop….. because they can’t afford to use it. Rates are outrageous and the deductibles make it impossible to use your plan. People with serious conditions, like ME, cannot even use it because of the high deductibles. Sure, I can now afford to be told I need surgery, but can not actually afford the surgery. What a joke. Yeah, I am fired up… and so are many MANY other people.
My friend and her family just got Obama care. she was happy until she found out she had to pay 50% co pay for necessary surgery. The doctor won’t do the surgery because he said, what if something happens and she has to be hospitalized an extended time. She is paying $650 insurance for nothing. Can she upgrade to another plan and pay more for better coverage? Ty
By the way you are wrong, we live in NY and my friend is required to pay $12,000.
$12,000 for a deductible / out-of-pocket maximum is for a family plan. In 2015, your out-of-pocket maximum can be no more than $6,600 for an individual plan and $13,200 for a family plan before marketplace subsidies under the Affordable Care Act. (Deductible can never be more than the maximum).
No, your wrong, again! I have also seen higher deductible rates for single (not family) plans. I live in Oregon, and have seen them to 10,000 myself. You want people to open up and tell their stories, but you come here to argue with them… claiming they are wrong. Hey, I voted for Obama, and supported his health coverage. HONESTLY, I had better care before ACA. I just got my new rate estimate for 2016, and guess what, they have risen 290%. That puts me out of the ballgame as to being able to afford coverage. Your oversimplified “solution” of people appealing and fighting is unbelievable! Why should we, the people, have to fight to defend our rights when it’s ACA’s, the state you live in, and the insurance company’s fault?!!!! Don’t call me a liar either, because I am more than willing to provide proof of what I am saying. America needs to quit bowing down to insurance companies and drug manufactures. Why don’t you put out FACTS about how much more we Americans pay for these services vers any other country on this planet? Corrupt Government.
Oh yeah… and I fully expect you not to publish what I just said because it does not fit your rosy picture of how great ObamaCare is.
Just to be clear we are an unofficial facts site in no way associated with the Government. We live in Washington State and visit Oregon often. We can assure you that under the law major medical for a single person will never have an in-network deductible of $10,000. This is because limits are capped by the law. If an insurer charges more you are looking at short term or the insurer is breaking the law. https://obamacarefacts.com/health-insurance/out-of-pocket-maximum/
The point we were making above is that repealing the law isn’t going to fix the problems with our healthcare system, the ACA was a good start… but no one will argue that it was enough. We need to address the issues displayed on this page while keeping in mind that millions more now have access to coverage for the first time. We can’t let them end game be bring costs down for some at the expense of others, or give coverage to some by making coverage unaffordable for others. The answer needs to be a further focus on the underlying costs of healthcare and how we can afford coverage as individuals and as a nation.
Here Here my friend!!
Our friend Leigh-Ann must be young and naive. It will get repealed. Otherwise Texas will probably Succeed from the union. Maybe they will open their own state run Pharma company on regular wages. Maybe everyone will leave the US and move to Texas. Either way, I am fine with it. When the government becomes as corrupt as it’s worst citizens then it is time to make someone like Ron Paul president.
In our opinion: No one like Ron Paul is running, Texas has more uninsured than almost any other state despite rising costs. The ACA likely won’t get repealed in full (it’s technically next to impossible). And there is no way Texas would successfully succeed from the nation… Nor would it be a good idea logistically.
Instead we should work on finding common ground and that unity will give us the power to see more meaningful health reform that builds on what the ACA gets right.
It is pretty common to have a copay or coinsurance with insurance. The only plans that will essentially pay for all care in exchange for premiums are high premium plans. People can switch plans during open enrollment to one that works better for them, but can only switch outside of open enrollment if they qualify for a special enrollment period. The primary time it will make sense to have a high premium plan is when someone needs immediate expensive care, otherwise a lower premium plan may actually provide better value in the long run due to all the cost differences (not that $650 is low by any means). Her doctor shouldn’t be deciding whether or not he will perform necessary surgery based on her copays, if she is hospitalized her insurance should cover that too (she can check the cost sharing amounts and time frames with the insurer). You can never pay more than your out-of-pocket maximum in a year for covered in-network services (up to the allowed amount). So in short that means that the money she is paying out of pocket should all be going toward that maximum preventing her from spending more than the maximum in a year. None of that really makes the premium and copay easier to afford, but hopefully it clears up the situation a bit. Remember on Marketplace Silver plans people can adjust the amount of out-of-pocket cost assistance they get based on income by updating their income at the Marketplace. This can help make out-of-pocket costs more affordable.
I had to apply for healthcare in 2013 because my husbands place of employment closed. I still can’t believe how the cost of the premium is based. For the life of me how in the world can you use your MAGI income to base it on? Since when are payroll taxes spendable income in your pocket to pay bills with? The government includes them in you calculations as income to figure out what you premium is going to be and to see if you qualify for help from them!
I chose a gold plan because I don’t have &8,000 laying around to pay all the charges befor the insurance kicks in.
My premium increased over $100 a month from 2104 a 2015!
So now paying close to $700 a month, plus $260 a month for medication. This is not to mention copayment of $45, $60, up to $80 for a specialist. Which the cost is up $20 since 2014. My husband old insurance covered just about everything, including an injection required once or twice a year for a chronic condition. Now it cost $1,600 copayment for one treatment. So that adds another $3,000 a year.
Do the math…. it’s NOT AFORDABLE by any means!
I kept my doctors, but on the tier plan they are all tier 3. I found one doctor in the area that was tier one and wouldn’t send my worst enemy to him.
Can’t wait till the 2016 plans come out! Looks like a third job will have to be taken just to pay healthcare. So much for putting money away for retirement.
As things stand now..according to our retirement plan…without contributing anything to it due to having to pay healthcare now we can retire at 85.
I pray each night I don’t get sick.. Because I can’t afforded to pay copayments after paying my premium!
I was shocked that ObamaCare Screwed you over by going behind your back. On a facts sheet it said that “ObamaCare won’t keep costs down.” So that’s why it was $2,500 per dose. Since they screwed you over what did you end up doing about it, did it all work out in the end?
What facts sheet are you talking about? The ACA does a lot to keep costs down in many areas. That isn’t to say there isn’t a ton of overspending in healthcare under the ACA, there is. Just trying to understand what the comment is referring to.
Not that you would publish this, but it is obvious that you have been anywhere other than the state you live during your life yet. Otherwise you would know that the cost of medicines are so much cheaper in other countries. Are you a robot, or are you a real person? The internet costs 45.00 a month and it is included for free on your smart phone. Maybe you should do some research. We worked our asses off to get that freedom for you. I have worked more in 30 years than most people do in 60. I have an education, and I paid taxes so you could get one, even though I have no children. We had to go to the library when we were kids, and it is offensive that you do not do research when the conveniences we slaved over, and the wars we fought for your freedom, turned you into a lazy airhead! They put you guys in these positions with no brains and program you to say what they want you to. When you find out you are wrong and your belief system crashes you will leave that job because you will be afraid you are going to go to hell. Just like a drug dealer who kills innocents. I wouldn’t be surprised if you caught some new age disease for being so dumb!
You and your lovely comments. I actually run my own independent company which I started from the ground up after putting myself through school working three jobs. I spent most of my 20’s broke and paying back debt. Today I pay taxes, pay for my phone, pay for Internet, pay employees, and even pay for my health insurance! I’m grateful for every dime I reinvest back into this country even when things aren’t running as smoothly as i’d like ideally.
My team and I have studied the PPACA for about 4 years now. We worked hard on a daily basis to help people understand the law so we can move forward as a country with more meaningful change, instead of eating each other alive over “Obama”Care and ideology.
To be clear I find everything you are saying to be unnecessarily mean and offensive, but as the purpose of the site is to be an independent site unconnected from the federal government or health insurance that gives everyone a voice this is of course going to be posted.