High Deductible Plan Too Expensive?
I have job based coverage. My workplace offered three plans bronze silver and gold.
I am getting coverage for me and my family (I have a 4 year old son my wife works part time). The premium is similar to what I paid in the past (a little higher but not by much). but the deductibles make all the plans just unaffordable. Not with taking into account dental expenses and medical expenses.
I cant afford my health plan because of the deductible. I already gave up on looking for a doctor or treatment for my chronic conditions. trying to save money for when my son is sick. I did not take my son to his doctor for regular check ups. I know that I cant afford thees deductibles. I am afraid of what will happen to my health since I am not going to the doctor and what will happen to my sons health.
I tried going to the market place but I was told that since I work I will not get any help from the market place and it will probably end up costing more. I don’t know what to do I am worried and feeling my health deteriorating.
I am not a political person and I voted democratic and I am for the health plan changes. But I cant afford anything anymore. the next time I see a doctor will probably be in the emergency room. Who can I turn too?
Under the ACA cheaper plans typically have high deductibles, the ACA limits what these can be, but it can still be costly. Here are some tips and tricks.
- Get an medical savings account. A health savings account (HSA) for individuals, or flexible spending account (FSA) offered by employers, is a tax preferred savings account that allows you to spend tax free dollars on care. You can have both, but can only fund one in a year. If an employer offers an FSA go with that, if they don't go with an HSA. For those who get cost assistance, this can help lower MAGI. For those who don't, it can still help save money on care.
- Remember you get free preventive services and all covered in-network services go toward your cost sharing. Even with a high deductible you'll get some "free" care on your plan. Any care you do pay out-of-pocket goes toward your deductible.
- You'll always have catastrophic coverage. People may put off important health services due to cost, even with health insurance. That being said, when things get really bad your coverage will kick in and you'll never owe more than the maximum. All those in-network services you paid for in-full over the year will still have counted toward your maximum.
There isn't much consolation to give to an employee on a high deductible plan. The truth is those with low-and-middle incomes get a better deal from the Marketplace than they do from employers (in general, this depends upon region and employer contribution). There are ways to make high deductible plans more useful, but even these tend to favor the self-employed and those without access to employee health plans. The best bet would be to looking into medical savings accounts.
I just want to point out the silver plan which is the only one that you can have an HSA with. The Silver plan has a deductible of 6500 for the family. Thats six thousand for the year before I get any help with my expenses from the insurance company. This is on top of the premium that I pay every month. and after I hit the 6000 only 80% is covered. So this means I need to cover 6000 for the year even though I pay a premium every month. I saw this and almost had a heart attack just from that. And then I am told that I will not get any help from the market place because I have a job that offers health care that meets the minimum threshold required by law. So I have to take my job health insurance I have no choice. I also want to mention that none of this includes dental expenses. If I need to pay 6000 for the year why am I paying a premium. And there is no one to complain too about this. I called for help in the market place and they say its my employer fault and nothing to do with the ACA. I called my health insurance company and they cant help. I even tried to talk to my employer and they blamed the ACA. So I am left frustrated cant see a doctor and no one to complain too.
We very much sympathize with your situation. The group hit the hardest by the ACA is in many cases employees. They don’t get cost assistance, and are left to choose from employer selected plans, that means if the employer didn’t do a good job shopping around or if the employer offers coverage in a region with high costs many employees suffer.
The $6,500 deductible for a family may seem steep, but your HSA contribution limit (assuming you don’t have an FSA from your employer) is $6,650 (or $7,650 if over 55).
This means you can lower your Adjusted Gross Income by $6,500 by maxing out an HSA, you don’t pay taxes on HSA money, and you can use this to pay all out-of-pocket medical expenses. The math works like this. Fund your HSA, then when you need to use coverage you are paying tax free. If you pay out the full $6,500 your insurer is now paying 80% and you’ll never pay a dime over your maximum over the year.
So the coverage may be lackluster without the HSA, but when used to it’s full potential the HSA can actually provide better value than a higher premium plan with better cost sharing limits (when taxes are taken into account).
Imagine lowering your tax bracket by using an HSA with a silver plan, then paying tax free for your care, if you need the money before retirement you can pay a 20% penalty to withdraw money in a bind too.
So with all factors considered, minus you not having Marketplace cost assistance, you are actually in a really good place to take advantage of some awesome tax benefits.
You make good points about the tax benefits. The only way you can take care of that benefit though is if you actually can afford to put that money away into the HSA.
Right, that is the caveat. The math is there to show that it pays off over the short and long term in tax savings, premium savings, and medical savings. So if a person can plan things out to fund an HSA it will almost always pay off, it’s just figuring out how that works considering the other costs of living which can be a struggle.
All this would be a very good, if we all worked for the government, as you know, the private sector will not give low wage employees an HSA account when they have cut our hours and give us part time benifits. And now we have to pay at the end of the year on our taxes for medical insurance that we can’t afford. Once again, thanks for screwing us!
The HSA’s are a goof thing, but realistically after premiums of $16K per year for my wife and me and huge annual deductibles, and the cost split after the deductible is met, the 25% tax savings on my HSA account is almost insignificant……… and it sits there drawing very low interest year after year. I find the greater benefit from the HSA is avoidance of an infrequent large expense from my current year’s income.
I agree. The best thing about an HSA is the tax savings. That said, if and when you do need to use it, it helps.
Certainly there are a number of problems in healthcare that an HSA doesn’t fix, and one of those is most certainly the insanely high $16k.
Healthcare is expensive, no way around that, but of course this is why we should be addressing it in a smart and centered way. In the meantime, maybe the Senate can pull off a miracle.
Your statement is very true. The only thing one can do, is actually borrow 6000, and put it into an HSA. More importantly—don’t touch it until you need it. You can deduct the full amount from your taxes, for a tax savings of 1500 dollars, but if you are in that low of a bracket, chances are your federal tax payments are minimum.
The higher deductible plans, are mostly when you have catastrophic problems. heart Attack. Cancer. Things which could run up into the hundred thousands. And don’t forget, that there are a lot of free things in the ACA designed to be perventative. Finding polyps that may turn cancerous. Or Mammograms and MRI’s designed to diagnose a problem in its early stages.
There should have been a lower deductible ( out of pocket expenses are different than deductibles ). And most plans have a co pay for the doctor, so you usually pay between 15 and 40 dollars for an office visit, and no more.
The problem with HSA account is that you have to use the fund by year end or lose all. Than start everything all over again at the beginning of the year again. The maximun that carry over to the next year is only $500. We and our family members don’t plan to get sick so we can plan ahead to fattening that HSA account so we can use it. Illness come at its own terms and unexpectedly so how is this HSA account benefit us?
At time I wonder how regulators got this HSA passed, knowing that if employees didn’t use the entire amount, it will NOT be carry over to the next year. This is more like robbing people right front of their face. HSA must paid some lobbyists somewhere to push this program through. What a shame.
I tell you, the public just got f*ck by Obama care and HSA period.
NO YOU ARE THINKING OF FSA. HSA you can roll over each year and then roll over into a retirement account. You never loss funds from an HSA.
So yes, FSA’s are lame… but HSA’s are pretty, pretty, pretty, pretty, sweet.
I am a healthcare provider and I see a lot of working people who are avoiding various kinds of essential healthcare because they cannot afford it under their high deductible plans. They don’t have a spare $6,600 lying around after paying their insurance premiums and other fixed expenses every month (rent, food, gas, utilities).
What research has been done to document the number of people who have acquired ACA plans who cannot afford actual healthcare? At what income level do people need to be to meaningfully benefit from the kind of tax deduction HSAs represent?
People who previously couldn’t afford either health insurance or doctor’s visits now have to pay for health insurance but still can’t afford doctor’s visits. Doesn’t this seem like a really bad idea? There are a lot of people who weren’t given access to basic healthcare under ACA, but were given the illusion of access. The reported numbers of newly “covered” people hides the fact that a lot of those people are not actually getting their basic healthcare needs met.
I’m a supporter of the ACA in principal, but it seems like the cost of the program is once again disproportionately hitting low-income working people, and perhaps also young people who are often also saddled with high levels of student debt.
People who have good full-time jobs are more likely to have employer-provided plans with lower deductibles (or employers who pay into FSAs and HSAs) AND are more likely to earn enough to be able to pay for actual healthcare costs.
The working poor (of which we have an ever growing number) are getting the raw end of the deal all around. What are we doing to document and address their lack of access to healthcare under the ACA?
Well we can start by phrasing it like you have and posting it to the site. I would assume we will find that insurers are paying out a lot more to sick people while absolutely benefiting from the new high out-of-pocket costs. Ultimately this needs to be addressed because it will result in putting off care which will give us a sicker older population which puts a burden back on insurers and Medicare.
Couldn’t agree with you more! The sooner he’s gone the better!
yes, I agree.
Me and my husband has $12000 deductible.
How are we going to met the deductible, at least we both got paralyse
You are wrong. I have had an HSA for ten years and it carries over. You are confusing it with a flexible health care.
That said, although I have saved almost $20,000 in this account, my monthly insurance premiums are eating me alive. For 2017 I will pay $2000 a month for a policy which is useless to me. Once again, when government gets involved in the free market system it always makes everything worse. Our legislators and government workers should be forced to participate in this mess as well.
You are absolutely right. Health Savings Accounts are different, but often confused with, other types of medical savings accounts. The money saved in an HSA (even if it is contributed by an employer or a family member) is yours. It never goes away and can go with you even if you no longer have the required High Deductible Health Insurance because it is only required for making additional contributions. You can always spend any saved funds in your HSA on eligible expenses and in most states you can also roll it over into a retirement account after age 65. This is one of the reasons that Republicans find HSAs so appealing. There have a ton of tax benefits and flexibility, but you must trade in a low deductible and administrate more of your own early out-of-pocket medical expenses in order to get it.
Imagine everyone keeping money in special accounts, so the investors can live off the profit they made flipping in stock market. There is no end to the profit they can make on healthcare, lol
Well that is true. One can argue savings accounts are safe, but it’s hard to argue that they have a good return, are tax advantaged, or aren’t used for someone else’s profits.
Sure – you can lower your adjustable income by the deductible but that doesn’t help out the middle class that is still taxed at 28%, now has to pay $650-800 a month for a family of 3, and then pay a deductible for 13,800 for Aetna 15 dollar co-pay bronze. Not to mention, none, exactly none of my son’s doctors were covered. Cancelling now as we speak – choosing to pay the tax and pay cash – which is less than the deductable.
I haven’t been to a Doctor appointment in 2 years and I am an RN working too hard for the money I earn. I refuse to pay these high rates bi-weekly and then high deductibles. I chose to pay the fine’s. Struggling to pay the bills and feed a family of only 3. The cost of food is ridiculous. Healthy food is another topic. Imagine going for a procedure and owing thousands?! No, I won’t do it. Putting off a mammogram and other important preventative tests and hoping this will be abolished before I end up in dire need. If not, I choose to lose. Some understand but some may see this as irresponsible. The choice is simple, I leave it all up to god because there is no one else helping but him. Thanks ACA. Oppose the ACA, Medicaid will still exist.
EXACTLY! I am also an RN . Have not been to a doctor in over 6 years, still healthy at 62 and practice holistic ways to maintain my health.
After getting totally scre… by ObamaCare in 2015 I dropped the insurance-which there is nothing insuring about it. I had not carried insurance for approx. 10 years prior to 2015 and I survived just fine.
This is a silly response because at the end of the day, an individual still needs to give their insurance company $6500 AFTER their monthly premiums to access healthcare. And even then, they are responsible for their coinsurance. HSA’s are just ways to guarantee the insurance company can get their deductible. What if you cant afford and HSA? I am helping someone who makes 15 an hour, 30K per year, and their employers sponsored plan has a 3000 deductible? Even that is high. When stats were entered into AcessHealthCT the monthly premiums average 250-300 a month, with deductible of 6-8k?? Do you really expect Americans to believe Obama wasn’t in bed with the insurance companies when this was agreed on?
He can’t afford the HSA, can’t you read? We are now in the same boat for 2017. Free Preventative care is BS. If the doc finds anything wrong with you, you need to make a second appt and pay in full for the visit and any prescriptions. This after 40 years of dedicated service to a company. We are in our 60’s, a HSA is not going to help us. We cannot afford it either.
This is like saying “I can’t fund my 401k, I don’t have enough money”… look WE ALL get that. The financial advice isn’t for those who truly can’t afford it, but people get raises and cut back spending, and when they have the few extra bucks then they should know about tax-advantaged vehicles to help them save on their net costs. We didn’t invent the system, we are trying to help.
Imagine you weren’t already forced to have car insurance and home owners and then I tried to sell you on both, you would tell me there was no extra funds (and i’d understand), but certainly we could agree I was better off telling you than keeping it a secret.
All your responses go back to being a penney pinceher. while the poverty line in america is lower then $30grand.your answers are again to pay into a hsa acc.no matter what the problem is the high paying ceo politicians in bed with lobbyists. While squeezing the american citizen for every dollar he makes …imagine living in new york making 30000.
Rent food premiums ..for god sake he doesnt have a comp… to see aca
Obamacarefacts.com didn’t write or pass the law known as the Affordable Care Act. They are trying to provide the best information about the law and how to navigate it that they can considering it is a complex law and many elements make people frustrated. Sometimes that means an answer that isn’t something everyone is going to be happy with. What good would it do for Obamacarefacts.com to spend all of its time and resources focusing on whose to blame for specific failures of the ACA? Does that help people figure out their individual situations? Would that help anyone figure out how to get a better deal under the law? Would it inform them of their rights under the law? Help them file their taxes correctly to follow the law?
This is an informational site and it attempts to provide people with the best information and advice given the circumstances (the bounds of the law). But it also spends time discussing alternatives to the law and trying to get debate and discussion going on how to improve it.
You must be from Colorado. …home owners and car insurance aren’t cutting me out of 12% of my net income either…..and NO, after paying that, there is no more expendable income to pay off deductible. This is one of the most oppressive taxation policies to date. Sadly, this in itself should get TRUMP elected.
So i have a job where i bring home 500 dollars a week. I have 6 kids at home im 38 years old. After rent, heat, electric, water, gas to get to work, groceries, and car insurance there is no money for a hsa.. Now i find out i need care that’s going to cost me an extra 350 dollars a month out of pocket because my deductible is 6000 dollars that i don’t have.
Where is the help for me? Tax deductions do nothing for me. My condition if not treated is going to cost me my job. No job = welfare.
My auto insurance is $82 a month with ONLY a $500 deductible!
My homeowners insurance is $54 a month with ONLY a $1,000 deductible!
This is a total different ball game than what you mentioned about selling me auto/homeowners insurance. My new Healthcare plan under the ACA is now $1,560 a month with a $7,150 deductible! That is a 2nd freakin’ mortgage. My mortgage is
$1,735 a month!!! My healthcare is a complete joke. My wife and I are only 33 years old with 2 small kids. We used to pay under $750 a month for $1,000 deductible just 3 years ago. This is the only time I will say “I miss them good ol’ days”. Thank you President Obama and congress for helping us out. I didn’t need that extra money in my bank account…it is too stressful to hold on to it!
You are in denial making excuses for this monstrosity. This debacle called the affordable care act is just another social welfare program for the poor, many of whom made life decisions to make and keep themselves that way, paid for of course by the working middle class. I am 57 and my wife is 37. We have a five year old daughter. I own a small business and for the very first time in my adult life I will go without health insurance in 2017 and pray to god no one gets sick or hurt. What was the tipping point you ask? Bronze plan 2016, $759 a month. Up from $572 in 2015. This year? Down to one choice here in rural oregon and I’m asked to pay $1296 a month for a bronze plan with a max out of pocket for my family of over 30K this year. That’s over a 70% increase. I’m just not buying it. Obama and all his big government liberal do gooders can go straight to hell. I thank Jesus every day that man is leaving and someone who actually loves this country is taking his place.
“people get raises”. What economy are you living in? Wages haven’t increased in at least a decade, unless of course you’re a health insurance company executive. ACA is a joke, and just another way for insurance companies to financially screw the public.
So what they are saying is we should all quit our jobs and go on welfare because that will be the ONLY way we will get covered for anything.
So, generally, your response shows that you have never been on welfare. It isn’t that easy, and it certainly has little glory for the user.
Also, for the record, you should not quit your job. We want more people working and pulling themselves up, not less.
Just saying put away money is not the answer. Clearly the premium costs or network limits are also factors in not taking his employers insurance. Ariel’s point is well taken; the deductibles makes this a double hit on household income. Not sure how many children he has but one sick child is enough strain for anyone. Ariel, curious to where your family receives care? Is it at a hospital or clinic?
Oscar, are you serious with these comparisons? Why not add it earthquake and tidal wave insurance too. I guess in your world, insurance is insurance.
So….Come up with money that our abysmal wages don’t cover in the slightest? Do you think Americans are that f-ing stupid?
Your only solutions seem to be find more money that doesn’t exist. We do not have it.
That’s all well and good, but after paying a monthly premium of $900, for a couple, who has the funds to put in an HSA? This whole thing is a joke for the working people of America. Thanks Obama, NOT
Oh yes Obama-NOCARE, every American just has an extra 6500 laying around for HSA, on TOP of the premiums and no care at all deductibles. My family HAD insurance with NO mandate for many years when we could afford it. Then this “law” goes into effect to screw the people and the stupid Sheep that voted for this president. I cannot wait for Trump to REPEAL every bit of this mess, maybe I can get my life back before I die.
Trump’s entire ‘healthcare’ plan is to encourage everyone to have an HSA. That’s it. Won’t do a thing about spiraling healthcare costs, premiums, etc. While the current situation is a mess, it goes well beyond the HC exchanges. I have private employer-provided insurance and it’s the same crappy deal as the exchange plans. Healthcare needs a major overhaul, but it ain’t gonna happen with Trump! Thank God for medicare in a few years- maybe Clinton will get the age lowered for the many who got dumped from their jobs too late to get another, but too soon to be able to afford to retire.
Pat, you’re wrong. The price plan would eliminate the mandates for not having insurance which has had a significant impact on small employers? The fact is that the majority of people who are in the exchanges work for small businesses or are self-employed; 180m Americans receive employer coverage; the poor qualify for Medicaid or higher tax subsidies in not expansion states; seniors are on Medicare.
The only way to fix this is to allow small employers to get tax subsidies based on annual revenue vs. one based on low wages. For example, the 50% max tax credit is limited to 10 employees who make less than $25k. So if an employer has 24 employees, they don’t have to meet the employer mandate for coverage and the tax credits are scaled for the other 14-not 50%. Plus they are only good for two years. The premiums for the average individual/family are a backstop for insurers. Just enrolling in a HSA even if’s tax deductible has an impact on the cash flow of the family. Easier said than done.
Good luck with that. Let’s not make the mistake thinking that Obama or Trump have anything to do about this. Every time we hear these names just say billionaires instead. Obama and Trump were not elected, they were placed where they are by billionaires cheating the system. Elections are a scam, just read BlackBoxVoting. This insurance system did NOTHING to address the exorbitant costs of medical care. It never will if we allow billionaires to stash their profits offshore. If we don’t address these two issues we are headed for a lot of people dying unnecessarily. We have to scream loud and bloody SINGLE PAYER! EXPAND MEDICARE. It is highly immoral to make healthcare a profit vehicle for the already rich. But morals are not a word that the rich are familiar with. The lesson here: Don’t expect the insanely rich to care about anyone. Sociopaths are built to not care about anyone but themselves. Keep screaming SINGLE PAYER UNTIL YOU DIE! Maybe if enough of us scream it the next generation of workers will get a square deal. I don’t expect to see anything get better for the next eight years, and I expect to see way worse. The only difference between Obama and Trump are manners.
Obama had some while he screwed us over. Trump will screw us over and make lame excuses. I appreciate his ugly transparency.
Sorry but this is just your way of shifting blame!! The government is to blame for this crud because even if you try to refuse health insurance you are penalized!! So you push something through that’s free for people who fraud the government and who choose not to work and you penalize working people. I’m literally going to go to my job go part time and get free health care that way. Screw this. I’m sick of. Ring screwed by the government. You want to keep people poor and you want bums I will give you it. I sit here and pay my real estate tax only for it to be mismanaged I work overtime each week only for more taxes to come out I pay my friggin interest on my mortgage to my greedy bank I am so sick of being royally screwed while I see friends that are lying to the government about their income so they can get free health care. Immigrants having babies to get free healthcare and welfare I am so sick of it. I’m done trying. I’m done!!!
Keep your spirits up. It is too easy to blame another struggle person, blaming government is probably a more appropriate response than blaming some poor struggling American or a baby who is being born. So, my advice: I get the frustration, but tone down the attack on your fellow citizens.
The tax benefits help but are grossly offset by the monthly premiums. I’m single and have to pay $800 a month with a $6500 deductible. My yearly check-up with insurance is the only thing I get by paying $9600 a year (with no insurance the cash price is $250). Add $6500 deductible on top of my monthly premiums ($16,100) before my insurance kicks in, HOW IS THAT AFFORDABLE? I don’t smoke, I don’t have any prescriptions and no pre-existing conditions. There is something very wrong with the ACA. I’ve decided to pay the penalty and drop my insurance.
I fully get the situation. I can make lots of cases for why healthcare reform is a good thing, and I can offer many tips and tricks, but I’m not going to sit here and rationalize large expenses. I’m not a fan of rationing care based on cost, no matter what form it is in.
We really need real reform soon. My only concern is the AHCA (TrumpCare, 1.0 at least) essentially solves none of the problems people are having.
To say the situation has become complex is an understatement. The healthcare crisis has been a problem longer than the ACA, but now with us all faced with it, it is all pretty real. Hey, maybe that was Gruber’s point, but its like “OK, we get it now, can we please do something about it.”
we are screwd, obamacare was supposed to make health insurance cheaper, instead its plans are unreasonable and too expensive for anyone to afford, truth is obama lied Nd screwed us all we did not get any help affordable instead we get fined every year for not being able to affors insurance, i hope the next president repels and festroys obamacare and help us out more than what they have done to us
This thinking is like cutting off our noses to spite our faces. We don’t want a president who is running on repealing our new rights and protections. We want one who runs on keeping them and fixing the broken parts. Right?
We want coverage for preexisting conditions, coverage for our poorest, appeal rights, cost curbing measures, rules that crack down on insurers, and really large employers (whose owners comprise Forbes top billionaires lists)… Then we also want affordable premiums and low cost sharing. We don’t want a full repeal because we will be left with high priced coverage, sure no mandate, but the prices won’t go down. No way, no how, will prices ever go down without some arm bending.
That’s exactly what we want! A staunch conservative to repeal this worthless junk and actually REFORM healthcare, but not at the cost of us actually not being able to afford it! I have a family of 4 on an income of $65,000/yr, I get a subsidy, and even with that the cheapest plan for 4 was $600 with a $6000 deductible and a $15,000 max out of pocket! That is worthless insurance barely worth having! How in the hell do people think that’s a good insurance policy?
A fiscally responsible conservative who cared about the future of the country would reform and not repeal the law. This is just due to the logistics of our current healthcare industry and the way legislation works. I think in general we need less polarization of the parties and more of them working together for the people. I think people on both sides want this judging by the comments we get.
Your site is very biased in favor of ACA-Obamacare. We have an employer policy. We have to have it. For our family it has a $7000 deductible before they pay anything! Plus, we have to pay premiums. Obamacare SHOULD be repealed, and instead of forcing insurance, provide healthcare. Without all the extra paperwork, bailouts for insurance companies, high prices for website creation, and pr campaigns to to try and get us to like Obamacare, prices could have come down. Every American could have been given a free checkup complete with necessary tests once a year. What a concept! Actual healthcare instead of insurance no one can use. Instead, my family has a policy that costs a quarter of our income. Our health is now failing since we can’t even get our medicines. Way to go Democrats! BTW- Republicans DID bring numerous versions of healthcare fixes, but the Democrats refused to discuss or bring any to the floor. Then claimed the Republicans didn’t have any ideas. http://rightwingnews.com/democrats/not-the-party-of-no-gop%E2%80%99s-offered-many-healthcare-bills/ If ANYONE knows how I can get my husband’s insulin I would appreciate it. We are told it’s our problem. There is no help for us. Only illegals.
That article was hard to follow and lacking details. I agree that the GOP does have some ideas, and it should be noted that ACA changes have happened in congress. That said, they haven’t offered many meaningful fixes to the law and almost all bills are repeal centered and centered in ideas like re-instating pre-existing conditions. If I’m missing something i’d love someone to show me a smart healthcare bill of GOP origin. All I hear when Republican politicians open their mouths is repeal, but maybe i’m missing something.
Try making 30 thousand, premium 400 per month with a 12 thousand deductible.
Yep got the problems as all the people here
Go fudge yourself.
Everyone who sneaked this through Congress in the middle of the night need to be publicly flogged.
I hope I see the day!
We need a partial repeal because health insurance that does not cover you when you are sick is not insurance. I have to avoid medical care because I cannot afford the 6,000 individual deductible for each member of my family. Check ups are pointless if you cannot afford any follow up treatment.
I was shocked too to find out of the mandatory healthcare, I thought it would be free like many other less rich countries! I cant afford the penalty nor the premium – that’s a fact, but will be fined for not affording….? The real question is can the USA afford to pay its citizens? With a $700 billion in military budget (the same Canada, Russia, France, Italy, Spain, UK, Korea, China, put together…), $2 million/ minute to maintain nuclear weapons…I thought we could.
How come the other countries can afford it? Less on war, more on health, but regardless of democrats or republicans, THAT is not in the American culture. Too bad.
Yes I agree, we are paying over 1200.00 a month and we are healthy , thank god but it is way too high of a premium and the deductible is over 6,000 dollars. If we don’t have it they tax you and we are paying for the coverage Obama changed with all having insurance. The people that are not working are getting my same plan for half the price and jaking up all the cost for us. This is not making any sense, they need to find a way to make this reasonable for the middle class. We may drop our plan. Contacted rates are much higher even when going in network, my doctor charged two visits for my routine because she discuss bloodwork, the doctors are getting less for that preventative visit so they are trying to rip you off , by changing another level 4 visit. I work in the medical field and this is outrageous. You should be able to discuss bloodwork and vitals at a routine visit.
Personally I dont like that everyone is blaming Obama for this. This was NOT the bill that Obama originall proposed. He originally proposed a public health insurance much mike the NHS is in the UK. However, he couldn’t get the support of the republican party to get it passed in Congress. The republican party tore apart the bill a number of times and basically changed it into Romney Care (whom is a republican). This was not Obama’s fault he just got stuck with the name.
Obama passed the bill with no content . It’s like sitting at the bar with a friend and saying . Lets make a law . Ok what will it be ? Lets just pass a law and we’ll fill it in later . This was ALL Obama !!! He gets all the blame on this . When you back door a health care system that takes money and offers nothing . That’s what you get . Over priced junk !
Alex, you forget that Obama would not negotiate on the bill. Remember Nancy Pelosi said; we have to pass the bill before we know what’s in it.
If you remember, Obamacare was supposed to be free. But the always obstructive Republicans made him compromise Obamacare to the point of where it is now. But it has helped 20 million more people get health care. Being that I’m not an a-hole Republican, I’ll pay a little more for now, in order to help those people to finally have Healthcare, until the Healthcare System gets overhauled. It would have been overhauled properly by Hilary, who is a Democrat, and who is corrupt like every other politician ever in history, but also cares about more than just herself. A Democrat.
Alex, et al, you are absolutely out to lunch if you believe ANYthing you’re saying.
Republicans had NOTHING to do with the debacle we call Obamacare. They were excluded from giving input, the final legislation was slipped through on a technicality (created by democrats) in a midnight Christmas session.
Who can forget Nancy Pelosi’s immortal words, “well pass the bill THEN you’ll find out what’s in it.”
The only thing slightly truthful is that Democrats really wanted socialized health care aks NHS in the U.K. Knowing the country would not go for it, not being socialists why would we? they alone created this disaster probably with the intention that health insurance would become SO MESSED UP that most people would swallow socialized health care in desperation.
amen – i was helping my sister and she makes 20k a year so 300 + dollars a month then you need a 6500 deductible hi what is is living off after that -this is insane and an insult to the working poor of of America
At $20,000 it should be less after cost sharing reduction subsidies. Some websites show you the non-subsidized cost until you actually sign into the account. Not to say insurance can’t be expensive anyway, but is to say that math-wise tax credits cap what you can pay. Via this logic the numbers you quote seem high.
Why are prices of healthcare so expensive anyway? Why aren’t insurance companies made to reform their greedy pockets? Do you realize that medical providers inflate their prices for claims to insurance companies because depending on the contract with insurance companies some of them will pay more than others, so when the medical provider codes the claim incorrectly the claim is denied and the patient is stuck with the full billed inflated amount and is forced to fight while most likely sick to get the claim corrected where both the medical provider and insurance company blames the other. How does a normal person who isn’t familiar with medical terminology or medical billing expected to deal with these issues? Insurance companies need to be made to reform not the citizens. Yes, having to pay premiums taken out of your paycheck plus the high deductible and coinsurance is highway robbery. In a country that is supposed to be civilized this is a ridiculous practice. Then say you do see a doctor and you have multiple issues, the doctor only wants to concentrate on only one issue at a time because the insurance company may deny the whole claim if too many things are billed at a time so that means more back and forth to doctor visits for testing and follow ups. Come on, doesn’t anyone see there is a problem here? If Obama sees there are flaws then why isn’t it being addressed already? This is a serious problem being forced to pay for something and not being able to use it. Tax credit programs work well for people who have time and understanding of the loop holes, the average worker is drained from work and most likely doesn’t have the luxury of sitting in their Human Resources department to go over such details. Such a legalized scam. Who benefits?
I completely agree!! I have health insurance through my job, which I thought wouldnt be to bad since I am employed through a hospital. Needless to say my premium is $198 dollars a month for just myself, if I were to include my daughter it is an extra WEEKLY cost of $183.00. My deductible is $6550 and once that is met than my insurance will kick in their portion of 70% and I cover the additional 30%. This makes me extremely upset as I make the same amount yearly that I did last year however my coverage last year was a $2300 deductible with a monthly premium of $118 with 80/20 coverage. My job also only offers one plan, that is reasonably priced. The other plan is the same 70/30 coverage after your $2900 deductible is met with a premium monthly of $398 for one person, to add a child the month premium is $837.20. Ridiculous!
Iam having the same problem now. 6500 deductible for my wife and I and iam paying 170 a month for health insurance. I recently had to go to the E.R. and my total bill came out to almost 3000 dollars. Guess who is paying that bill. Not my insurance company. They won’t pay one cent until I pay up to 6500 dollars for the year. Who the heck can afford to be ripped off like this. Thanks to our stupid president for not thinking this through. This is bull crap. While all the unemployed black people in America get food stamps and Medicaid and don’t have to pay for nothing. The working man who struggles to pay his bills but supposedly makes to much to qualify for what all the sorry bums do has to pay a monthly insurance premium and 6500 dollars of all medical expenses before the insurance companies help at all. And we are being forced to this crap or pay a tax penalty. This is straight up hwy robbery from President Obama. Can’t wait for him to be out if office. I hope we don’t get another idiot in office like him.
I am an employed white man, and I am on Medicare. I do not appreciate your stereotyping of me.
To qualify for that in my state you would need to, as a McDonald’s employee at the average pay of 9.01, work no more than 7.08 hours a day. Full time as a Walmart associate would be 4.77 nours. Part time Walmart is 6.03.
The point being there is really nothing you could be doing with a full work day and still qualify for Medicare.
To qualify for that in my state you would need to, as a McDonald’s employee at the average pay of 9.01, work no more than 7.08 hours a day. Full time as a Walmart associate would be 4.77 nours. Part time Walmart is 6.03.
The point being there is really nothing you could be doing with a full work day and still qualify for Medicare.
This what happens when you have liberal politicians trying to fix something that was not broken. They changed 100% of a program when only 15% needed adjustment. It was a coupe for government to take over 18% of our GDP
Yes. Something needs to be done. This is scary!
I’m so upset. Obamacare does nothing for the middle class. It makes having health insurance so expensive. And if you don’t have it, you get fined. This is crazy! Obamacare was supposed to help people, but still, insurances are making money on us who can’t afford it.
If you remember, Obama originally wanted health insurance to be totally free, for all. But the other “side” wouldn’t have it. So now we’re stuck with this compromise, which I agree, isn’t great. I pay too much but.. at least I have insurance, and at least people who couldn’t get insurance at one time, have insurance. And the no preexisting condition rule is good.
I need to put my two cents worth in.
It urks me when I hear people say “Obamacare was supposed to be free!” Ha! you really think so? Nothing is free! Where the heck do you think the money would come from to pay your insurance bills? Yep TAXES! Its welfare in sheeps clothing. we ALL pay for it now. So instead of bringing the less fortunate up to a higher standard, Obama has dragged us all down to a lower standard all in the name of “equality”. I am sick of that word. Hey, life is not equal! It never was and never will be! Get over it. Survival of the fittest.
This next year 2016, my employer is changing to a new HSA plan from our current PPO. Why? Because the government is forcing them to. They are considered a “premium” plan and we can’t have that because then we would be better than those poor unfortunate individuals who could not afford to have a better insurance plan. My premiums won’t change much, but my deductibles skyrocked and my out of pocket expenses blasted off too! However, I will not get a pay raise to compensate for this increase. So you see, I get penalized as a result and have to have crappy insurance just so I can be “equal”. This is not the way it should be, and the government should NOT be in the insurance business!
I have a daughter, her husband is self employed and can not afford insurance for them or their 2 kids. Not even Obamacare. You really think that is equality? What really needs to happen is to get those insurance companies out of the pockets of the congress. And also get government out of the insurance business. Make insurance affordable by competition. Free enterprise! Not by force.
Well said, Jim. I hope that ACA is trashed and we go back to what we had. On Obamacare, if you are unemployed your insurance is free.. If you work for minimum wage, it costs at least $200 a month with a $6,500 deductible.
What it boils down to is-I am being forced by the government to buy insurance to cover the unemployed and those that choose not to work. I working 2 jobs to pay for them, while I pay my $200 a month, yet can’t afford to go to the doctor. My previous insurance was $179, $30 co-pay and $1,500 deductible for any hospital stay.
So we have one vote for pushing those with no active income and those who are sick out of the insurance market and hoping the insurers drastically cut costs for everyone else as a result. What do you think the chances that insurers would respond this way are?
Everyone seems to forget that going backwards is not going to solve the problem. People who are unemployed will still be feeding off the system with or without the ACA. Except without the ACA the cost will continue to eat up GDP. It will eventually bankrupt the nation and going backwards won’t help. Is the ACA perfect? Hell no! Are insurance companies going to be nice? No way! People mention a free market place like it won’t become corrupted. It is already corrupted weather is health insurance or the Telecommunications Industry. You cannot have government out our business because business is in government! Quit believing what utopia they are selling on the radio. Its a fantasy it will not happen! What will work is an educated active populace engaged in our democracy. Use your brains people!
I so agree with many people on this subject. OBAMA unAFFORDABLE do not really CARE ACT! My husband & I DID NOT go to the Dr in 2016, not once! To become a new patient at a Family Physician Office, that accepts the plan you are on, was $100.00 out of pocket. WTH? Yearly deductible per person was $6300.00. Just received packet for 2017. Deductible per person $7500.00 per person & monthly premium up over 200%. YES, you read it right…200%. Holy crap..was living paycheck to paycheck then and now???? I don’t know what to do. Fined if you don’t pay. What happens if you don’t pay because you CAN’T afford to pay? Fined doubled? I just don’t get it. I was fine before…….Government officials really don’t care because they have US, the taxpayers paying for them. The get round the clock medical care and protection. I can’t even afford to move out of country if I wanted to, although I don’t have an interest….but just saying…. At a total loss of what to do. No wonder there is such depression in the world. Can’t even afford to live. I’ve downsized considerable, no police record, no loans, pay my taxes, try to stay healthy, don’t rely on government hand outs and still get screwed in the end. This idon’tcare unCare Act makes people get on government assistance because they can’t live with their minimal pay. Land of the free. I love this country BUT it is truly going downhill when it defies the people who pay for it. The taxpayer……
Jim also add deregulation to that list. EU and Canada benefit from having a fairly deregulated pharmaceutical market. Hell some of the products are better than US products. I would rather take my chances with an unknown brand than no brand of medicine or treatment at all. The only reason healthcare is cheaper and manageable through taxation in other countries is because medicine and care is cheaper. To make things really affordable get gov out of healthcare,pharma and insurance!
The other side is more Democrats who still haven’t read the bill nor.will they allow themselves to be included in coverage which is all one needs to know about “quality”.
Who do you think is going to pay for this “free” insurance? The people who work, with more and more taxes! People are always looking for a handout, because they don’t understand that nothing is ever free! Who is going to pay the Dr’s, when they can’t make money because the insurance companies are not making enough money to payout benefits, who’s going to pay for all of this? I’m going to assume you’re a liberal voter, who has absolutely no clue how the world works! You’re in a group of entitled free loaders who thinks they deserve everything given to them while because I have a job, I’m going to end up paying for it…out of touch liberals!!!
“Free” is probably not the best solution. It would perhaps be more sustainable to have the scale slide a bit more at both ends. Ask a little more from the 50 – 100% FPL and a little less from the 400% – 500%. Always gonna be some unhappy people, but at the heart of all good programs should be a fairness and justice.
You are in denial making excuses for this monstrosity. This debacle called the affordable care act is just another social welfare program for the poor, many of whom made life decisions to make and keep themselves that way, paid for of course by the working middle class. I am 57 and my wife is 37. We have a five year old daughter. I own a small business and for the very first time in my adult life I will go without health insurance in 2017 and pray to god no one gets sick or hurt. What was the tipping point you ask? Bronze plan 2016, $759 a month. Up from $572 in 2015. This year? Down to one choice here in rural oregon and I’m asked to pay $1296 a month for a bronze plan with a max out of pocket for my family of over 30K this year. That’s over a 70% increase. I’m just not buying it. Obama and all his big government liberal do gooders can go straight to hell. I thank Jesus every day that man is leaving and someone who actually loves this country is taking his place.
Re-writing history aren’t you. Not one single Republican voted for that Pig of a bill. It was passed by only Democrat votes. They built this system they own it.
You are right, they didn’t vote for it. That is fact. What they did do was get their ideas in it though (from putting their ideas out there or pushing back against other ideas). It’s just a compilation of ideas that are rooted at least in the time of Nixon and Kaiser, but in reality likely stretch back much further. I mean this is even to the extent the Heritage foundation suggested the individual mandate in the 80’s.
Also, all the repeal lawsuits have come from the right and that has changed the way the law works. So yes, they didn’t vote for it, but they did affect it.
Credit where credit is due, but the GOP didn’t have “nothing” to do with the law.
Not true. I know 4 families who still can’t afford it and this was never anything but a scam to benefit insurance companies and convince people who wanted a handout to vote in favor of these jerks.
I think though it is a concession. Like a deal with a necessary evil to advance a social program. Some people make out really well, some in the middle get shafted. Anyone who invested in healthcare in 2008 made out darn well. Ok though, let us not look to the past for anything more than a history lesson, we need to ensure the next move is the right one.
No one likes being jerked around, but I personally want stand for repeal, so we need a socially conscious solution that isn’t a handout to big business, as it seems that is the only thing that will satisfy the majority.
How the F would he have obtained free health care for all?. Even if “the other side” would have agreed?
The other side did agree, thats how he was able to pass it in the middle of the night.
Youre a liberal idiot who supported this A-hole, and deserve what you get, just brought others down to your demise who hate the bastard in chief.
I hope we shi#-can this A-hole and avoid a civil war, hopefully get this mess fixed.
In times of turmoil, libtards need to stay on the bench and let the problem solvers fix the problems they create. Its the only way to regain public sanity.
Mote than likely a nonproductive liberal getting it free. Anyone paying what I do is not going to be light hearted about this crap they pulled on us!!!!!!!
Debbie I completely agree with you! We’re looking for a new plan because WE HAVE TO, our current plans are no longer accepted which has now happened past 2 years. The differences though that have happened are the plans got more expensive and covered less. And getting coverage through work has gone up as well that it’s almost unaffordable after taxes are taken from paycheck and then medical coverage…how the heck do you live off of what’s left? The insurance battle is just ridiculous and it’s not helping anyone at all, and is honestly one of the most frustrating things.
It’s helping the sick and the poor. There are many hurdles and many who are struggling with out-of-pocket costs or rising premiums, but it helps many. Also the non-coverage provisions of the ACA are helping the healthcare industry to reduce a lot of costs. So lots of good here, even when there feels like it is not.
“It’s helping the sick and the poor.” and hurting EVERYONE ELSE in the process. Our options have become more limited, premiums higher, deductibles astronomical. The working class who USED to have healthcare have now had it stolen (3 ways – increased premiums/deductibles, increased taxes and loss of healthcare options) to provide for those who are “more likely to have chronic medical conditions like HIV, Hepatitis C and diabetes than the customer based they served before Obamacare”
Costs are just going to go up and up and up (March 2016): http://www.huffingtonpost.com/entry/obamacare-enrollees-are-sick_us_56face7be4b0143a9b497571
And for those who stated that our standard of living has gone down to help bring up the standard of living of others and that this is really just another form of welfare….amen.
I’m a single, sole proprietor who used to have a pretty good PPO. Now my only option is an HMO, I have lost access to my Dr’s of 20+ years, whom I love, my premiums have doubled ($6K year), deductible is $7000 and I’m paying for everyone else’s healthcare while losing my own. In NY State, any plan offered to any individual must be offered to all individuals, so those of us who used to value health insurance, and purchased it voluntarily without the law demanding it, have now lost our options. I’ve been forced onto Obamacare as it is the ONLY plan offered to individuals. I live in Manhattan, where almost all the good MD’s and hospitals specifically say, “we don’t take any plan with a metal in the name.”
I don’t care about party politics at all – and I was all for everyone having coverage before I knew the President was lying ‘If you like your health care plan, you can keep it’ but now…it’s clear it’s not working, Obama LIED about what was he was doing…and the only thing anyone in gov’t cares about is the sick and unemployed and not the working class who don’t have $13K a year to put towards one PCP visit.
Well I think you point out a lot of the sticking points that a lot of us in the center agree on. A very real problem in America is that education and healthcare reform are battled tooth and nail by congress and lobbyist. This results in things like the ACA and Common Core, which despite good intentions still need work. I think one side is hesitant to shine a spotlight back on the program, or criticize it for fear it will be repealed, and the other side is using it to drum up support against. This is sad because one could say it is the job of the other side to temper and help reform policies. Instead, we get a very polarized and slow moving congress and lots of people caught in the crossfire.
ACA needs reform, not repeal, and certainly not a multi-year standstill and standoff over ideology (to be fair congress has passed a handful of minor fixes, but not major ones).
This law will make more people sick and bring more us down to poverty and welfare. What happens when the takers out number the producers? Look at Greece….
I think there is real danger in that. We shouldn’t just fund welfare willy nilly.
I bet you don’t pay anything. Obama and the liberals have you convenienced everyone should share their money? Right?
I actually co-own the business who runs this site and have worked with other small businesses for years. Many of my friends and family are conservatives. I’m not sure where you are going with this, but certainly my healthcare isn’t free. Although, I’m personally happy to pay a little more to help the sick and the poor, but that is a moral choice, not a political one.
it’s cheaper to get fined !!!
Only if you don’t need medical services. I worry a bit about this, as statistically some of the people making this claim will wish they had coverage. Consider all the angles, I know it can be very expensive, but it’s not without value.
But, you’re making the assumption that medical need equals available cash. What we are all saying is that if you don’t have $650 per month in a premium, plus $6000 per year in a deductible, plus $12,000 max out of pocket, then medical need won’t change that. Stop injecting your political bent (I’m neither major party), instead acknowledge the math.
Ok, to be clear, we acknowledge the math and one of the focuses of our site is how to reform costs so insurance is affordable for everyone. We tend to offer counterpoints here, we aren’t just providing an echo chamber.
$650 per month in a premium, plus $6000 per year in a deductible, plus $12,000 max out of pocket implies you make over 400% of the poverty level. That implies that, unless you are in debt, you do have that money in a catastrophic accident (but just barely, maybe) and/or you have the money to choose a plan with better cost sharing. You also likely have the money to fund an HSA. I mean, I crunch the numbers and see this is going to be really sticky in some situations, especially those who are close to that 400% FPL line. When you consider all the debt that most have in reality, it gets stickyer. When you consider someone not wanting to spend all their savings this way, it gets even stickyer.
I think it is clear that the law, and general legislation, tends to make life a little easier for the poorest and a little harder for the healthy middle class who only need bare bones coverage. I think it is very clear who it favors and who it doesn’t, but this is why we spend so much time on the site focused on pushing for reform of the underlying system rather than focusing on how to move money around between the middle-class and poorest while others profit.
This is a difficult decision. I am far more likely to get treatment for moderate health concerns if I am not paying high premiums every month. It would also allow me to pay for medication. With insurance If I had a major health problem I couldn’t not pay the deductible without going bankrupt so why bother.
Our family of 5 would have had to pay over $1500 per month for a plan (and that was WITH a subsidy) that would have even OFFERED coverage for lab tests and screening like mri’s (but only about 60-70%). We make around $70,000 (my husband is the sole breadwinner as I stay at home with the kids) and if we wanted the “cheap plans” we literally wouldn’t have had ANYTHING covered, not even doctor visits until we met about an $8500 deductible with out of pocket of $14,500. Not to mention that only a few hospitals in our area would take the insurance, and NONE of the 29 plans offered were in network for the doctor I wanted to see. We weren’t even able to get a silver plan, which we were told was the best option. Most of the plans offered were with companies who received scathing reviews, talking about not having customers medical bills paid, never receiving their health care cards and lying about receiving monthly payments, even tho customers had proof the payment had been withdrawn from their accounts. I’m needing some blood work and tests done…but I’d rather put any money I might pay for insurance in a bank account, pay cash to see the doctor *I* want, and take the fine, than pay for the insurance and not be able to use it. I was hopeful that we could finally get insurance this year…but we’ve decided not to throw money away every month on insurance that doesn’t benefit anyone.
Or if you go to walk in clinics or find Doctors that help the uninsured. I am in the middle of trying to enroll for this monstrosity and it is horrible. Covers nothing but wants almost $400 a month. Copays and preventive care don’t count towards the deductible. What an absolutely useless plan. 5 stitches cost me less than 1/4th of my premium at the closest walk in. Looks like I’ll be paying the fine again this year
This is a giveaway to insurance companies–they get the premiums and no one can afford to get the care so they get it for free. Great profit making plan Obama care turned out to be for medical establishment. Like always all the money is funneled to the top from the rest of us. Who can afford to go to the doctor and get a prescription after paying thousands in premiums and have thousands in deductibles to meet before one red cent from the insurance kicks in? The insurance companies give jobs to people overseas to be “customer service” for the healthcare plans who know nothing and can do nothing for you and are hard to understand just for fun. They won’t even pay Americans to do the work. Very patriotic and caring for their own ridiculously high salaries and perks. We are all putting off care even more than the past just paying more to do so. How droll. But the insurance companies profits are wonderful and executives get humongous bonuses and give a bit to all the Washington “representatives” and regulators to keep them in thrall. The rest of us don’t matter one whit to any of these high rollers. The US is a great place to be one of the very wealthy and a third world country, banana republic for the rest.
sadly, that sums it nicely.
This doesn’t help me at all either. The plans offered through my employer are far too expensive, do not include HSA options and while they barely fall into the affordability guidelines, my employer chose to only offer the most expensive plans-no silver or bronze tiers, because they are benefits brokers and make the 40% commission off of each plan their employees sign up for. So they get a pretty sweet cut and have no incentive to make the plans affordable to the employer. There’s only one plan I can even think about signing up for and it’s over twice as much as better coverage costs on the Marketplace. I’m actually better off taking a penalty for no insurance. How is Obama care supposed to be a better place for me to be covered? I used to get full coverage at no cost to me. Obamacare has turned out to be an incentive for my employer to give us less coverage and charge more for it.
Wow, that is pretty evil on your employer part… selling their own company plans and getting commission. That is shameful. You can reject employer coverage and get private coverage that does qualify for an HSA. You could also potentially wiggle in some tax deductions that affect MAGI and technically qualify your self as not being offered affordable coverage and then get cost assistance. That would take just the right set of circumstances, but could be of benefit for you.
Our premiums and deductibles have doubled in our transition to the marketplace. We have lost our insurance, our hospital, our doctor and our out of network coverage. My wife and I now pay $9600 yr premiums and $12,500 yr in deductibles, we do not qualify for subsidies and our provider has been approved for a double digit percentage increase for 2016. We have an HSA which is hardly much of a buffer and still keeps us in the non subsidy category. This plan is far more expensive than we had, it is the cheapest in the marketplace, unaffordable by the marketplace definition of affordability and in reality pays for less than our old plan did. It really isn’t a 60/40 and ALL of the 60 is consumed by the deductible. The irony of this whole mess is that all we use is wellness and that the affordable plan isn’t affordable. This new policy is really nothing but a lottery ticket or an extremely expensive discount card.
You have to make an additional $6,000 a year to take advantage of the HSA.
You have to be able to set aside up to the HSA limit (but you can fund less). The limit is different form families and individuals ($1,000 more for 55+). A person could, say needing to drop income by $1,000, just contribute $1,000 to an HSA. Whether or not you can contribute is based, mostly, on the type of plan you hold.
I feel for you. Im self employed. I had health insurance that i paid $90 per month before. $20 doctor visits.
Now i pay $230 per month for the cheapest plan. I cant afford to go to the doctor about a mole that is has changed because of my outrageous deductible. Im struggling. i have no idea what to do. This health insurance is killing me and im truly scared its going to ruin me financially and health wise.
Im so tired of people that do nothing getting handouts. While i worry every single day about the health and financial stability of me and my family. The wife and i make $80,000. Have 3 kids, live very conservatively and are struggling to make it work. It kills me when i see people that dont work living better than me.
The worst answer ever. Very political sounding as it offers no practical answer at all. You still have to fund a health saving account (with money you don’t have) and in the meantime, you are without any money for health care.
The thing is, we feel it is appropriate to offer solutions even in the face of negativity. When someone says they have little options, and are being burdened with a high deductible, there isn’t much to say. We could say “sorry”, we could say “we feel for you and offer you our shoulder”, or we can offer solutions. We gave the only practical solutions we could come up with to try to help this person who was struggling. We just felt that was way cooler than complaining.
What people are saying is that the math does not work for most people and it is having devastating consequences on their health and finances.
Unfortunate, obamacare deductibles are too expensive, my sister quilified for the federal help, sje pays $32 for the family, but the deductible its $20k , making impossible he them to go to the doctor, we live in the border, so we just cross the border to get afortable health care, instead of getting into debts. Best choice will be to get an insurace with your company. I pay around 60 a month without deductible and no out of pocket with my company’s insurance.
To clarify: A deductible can’t be more than the out-of-pocket maximum. The 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.
Here’s an “ObamaCareFact”… many insurance plans have unlimited out-of-pocket maximums (in the case of out-of-network care). Read the fine print on these ACA plans. Many insurers are switching to “narrow network” plans, which means they’ve only contracted with a small percentage of available healthcare providers, so very often people seeking health care are pushed out-of-network. Out-of-network deductibles, at least on my family plan, are $45,000 for my family and the out-of-pocket maximum is UNLIMITED (Blue Cross Blue Shield of Illinois Preferred Bronze PPO plan 106) http://www.bcbsil.com/PDF/sbc/36096IL0990006-01.PDF Families are still going broke and losing their homes to pay for medical care because they can’t find appropriate care within these constrained narrow network plans – and the most unfortunate have unwittingly signed up for plans with large coinsurance percentages (health care cost sharing). People that have signed up for narrow network plans combined with coinsurance are the most vulnerable to this out-of-network insurance scheme. The ACA is criminal and has only succeeded in offering care to some at the expense of care to others.
Yeah you are right. Narrow networks can bridge on criminal. Not sure how we can directly equate the ACA with insurers choosing to skimp on networks. I can see the relationship, costs up, insurers cut costs, but I personally see this is the ACA not regulating enough. No?
The Affordable Care Act itself is criminal in that it was sold to the American public on little more than a bunch of lies. The worst of which is that having health insurance is the same thing as having access to healthcare. It most certainly is not. The two biggest problems with healthcare were, and still are: (1) healthcare cost control and (2) open access to providers that encourages consistency of care. I had high hopes for the ACA. Unfortunately, I now believe that the ACA was purposefully constructed in order to spread the misery and collapse the insurance system thus forcing a solution which was politically unpassable back in 2009: single-payer. In the meantime, my son, my family and millions of other Americans will suffer for lack of choice regarding medical care, remain subject to premium increases that far outpace inflation and remain subject to irrationally high deductibles. Under the ACA, Americans are still financially vulnerable and losing their homes in the event of significant illness or injury. My son has lost his cardiologist, access to the children’s hospital that has been caring for him since birth and his pediatrician all while our family premium has doubled and our deductible has quadrupled since the advent of the ACA. We couldn’t keep the plan we liked, we couldn’t keep our doctors and we certainly aren’t saving any money – all of those things were promised by our President, and they were all lies. I see it as inevitable that our family will have to drop health insurance, sign up with an Obamacare tax exempt healthcare sharing ministry, and save the money we would have spent on premiums & deductibles to pay for our healthcare – the amount we could save would total nearly $25,000 per year. That’s $25,000 per year of MY hard earned money that I can spend on healthcare for MY family, rather than sending it into the void of the insurance system which offers my family little in return. And because I have a conscience, I’d be happy to donate some of that savings to a needy family that is being screwed by the ACA – my own community and gofundme.com is full of them. And, as a self-pay healthcare sharing ministry patient, we will spend far less on doctor visits (because we can negotiate rates) than we would if we visited that same doc as an out-of-network insured (because we would be obliged to pay the full price per insurance rules) and in some cases save even more than if we were in-network. What our President, our congress and the insurance industry has done to healthcare is not only criminal, it is morally corrupt.
Its over regulation that got people in this mess in the first place!
What ever happened to being able to purchase health care across states? Human hearts beat and organs work pretty much the same in all states. I can buy other insurances at great prices from other states…not health care. So, the insurances commissioners along with insurers flexed political muscle…Obama and Co. drank their KoolAid, and, here we are.
I have young healthy clients who are waiting tables…many of them…with $2K and up deductibles. This amounts to having to do paperwork and pay premiums to use one’s own money for healthcare. Are people going to wake up and figure out that voting has direct consequences to their own financial health. It’s not because of criminal activity, just ignorance of the marketplace, and playing checkers with people who play chess for a living.
We now see that in 2017 many areas…like mine..will be severely limited in the number of companies that serve it. The Lt. Gov. of Minnesota actually said that lack of competition will improve things for the consumer.
So your saying it’s better to be unemployed. If you can’t afford the deductible what makes anyone think that someone has extra money to put into a savings account that just screams nonsense.
It’s not better to be unemployed, sometimes tax brackets and safety net programs incentivize utilizing tax breaks or being smart with how much income you make, but it’s never better “not to work”. The thing with an HSA and a Hight Deductible Plan isn’t that it doesn’t sound pretentious, it’s that if you do the math the extra money you pay in out-of-pocket costs and taxes is outweighed by the benefits of an HSA and increased subsidies.
I 10000% understand how it sounds to tell someone struggling with money to fund an HSA… but it’s actually good and sound advice. Do the math, you save more over time this way than you do paying out of pocket for low deductible plans and paying into high deductibles. Consider HSAs lower MAGI and HSAs can be used to spend tax free dollars and high premium plans only pay off when you access medical services.
Chuchi- that is exactly what they are saying. It is better to be unemployed, then it is free.
If you live in one of the states that expanded. If you don’t then you have no coverage, but individuals and families can still have expensive coverage (think Texas or Florida). Also think about this: You can work hard your whole life stashing away a few thousand a year, living paycheck to paycheck supporting your family, paying for college, being the breadwinner. Now you get sick or lose your job to manufacturing in China, or they cut teacher jobs, etc. Now you have no income. Now you are unemployed. Are you now “less than”, or are you a hard working American in need of that safety net you have paid into your whole working life.
With house debt, student debt, and the cost of living there isn’t much of a buffer for the middle class when the unexpected happens. Don’t confuse this group with “lazy people who don’t want to work”.
Really, really, think about that. This describes millions.
It is not a safety net for the unemployed because benefits are based on your yearly salary not your current income while unemployed. If you didn’t or couldn’t save (because you were paying high premiums) you can’t afford the ACA premiums or deductibles.
I have done a bit of research on ObamaCare. Why is this the case, that…….1/2 the states ObamaCare is run by the federal government, 1/4 of the states it is run State & Federal in conjunction and the remaining states it is solely run by the state. This has to cause huge monthly price premiums differences from state to state. In Massachusetts (solely state run) where I live it is run by “The Massachusetts Health Connector”. My wife and I paid $1120.00 per month. I have heard people in other states paying a fraction of that. Why was this not standardized in all 50 states? It should have been solely run by the federal government?
Really good question. Right in the text of the law they give the option for the 3 ways to run an exchange. We are obviously advocates of state’s rights as Americans, but the framework should have done more to equalize the experince for each state. Still don’t understand why 50 websites, rather than just HealthCare.Gov was needed. Premiums needed to be capped regardless of cost assistance, cost controlling measures are great and all, but in practice we can see it wasn’t enough. The market desperately needed more control, we can see the effects of the lack of control in the outcries of those who don’t qualify for cost assistance and are in expensive regions / states. We always have to remind ourselves that other people are having different struggles than we are due to the disparity of costs and support for the ACA around the country.
Ps. $1,120 a month in premiums is brutal by any standard. Assuming you have good cost sharing at that price.
what did you mean when you said to me…..”assuming I have good cost sharing?”
Not sure what you meant
Obamacare is the worst care ever. No other country has deductibles and out of pocket maximums.
No other country has this high payment for universities and schools.
After paying for your mortgage, student loans, children schools, children university savings, retirement savings, now you are ask to pay thousands of dollars before you can see a doctor.
There seems always enough money to invade another country and destroy it, but for the citizens of the USA there is only left fast-food and drugs to make the pharmaceutical industry rich and the big corporations.
Think you summed things up well, although to be fair, with the free preventive care you can see a doctor for the basics for free on all plans. Also, this IS America. so we have to compare pre ACA to post ACA. Pre ACA millions didn’t even have the choice of getting costly coverage. We like to do things in small steps in the US, we all just gotta make sure we are stepping forward every chance we get and that means taking a closer look at “mortgage, student loans, children, schools, retirement, and healthcare… and a few other things.” This things are important so they should comprise a chunk of all spending for the family and the country (and they do), but the balance seems to be a little off all around at the moment.
How is it free preventive care? We are paying hundreds a month first of all. Second, preventive care isn’t preventive if blood tests aren’t run, imaging isn’t done, etc. etc. A doctor listening to your heart and looking in your nose isn’t preventive. Bloodwork will go toward deductible, if doctor hears something off with your heart, and ekg goes toward deductible. So not right and definitly not free!
Simple solution get gov out of all these sectors. Student loans are sky high due to federal student loans. When you are always guaranteed an income why would you keep your prices low. Its just common sense! Went to the bank and asked for a private loan to go to school. They told me, “sorry sir the bank isn’t in the business of school loans, go see FASFA.” Insanity when this is a viable option in the rest of the world. The over regulation that you love so much created lobbyists that abuse the system and regulate the market to death. while increasing the cost of living exponentially.
I just saw my 2016 Health Plans – HSA Individual $6,500 deductible 20/80%. I guess textiles, cars, steel, …, I never thought I’d see the day when we’d see un-affordable healthcare be done offshore. Hello Canada. Hello Mexico. Thankfully, my 2017 rates will appear before the election. And think about, so many people will be putting off procedures that when they finally turn 65, the sky’s the limit as far as fixing what was so pro-longly left undone. Unless, it’s our government hoping, plan, and device for yours and my early death. No, that wouldn’t happen; but, the Death Panel, did I say Death Panel; no, I meant … or … what I should have said was, The Medical Review Board advised against my cancer surgery.
I am in a similar situation as the writer, and will not be able to gain access to healthcare that I desperately need for the same high deductible reason. It is a completely defeating feeling to know that since you aren’t rich, you will suffer – or maybe even die – with unaddressed health problems. Your answer to this? Too bad; so sad. Really?!! To answer that “You’ll always have catastrophic coverage” is to say “Let them eat cake.” Your suggestion as to HSA’s of FSA’s completely miss the boat. If we are struggling to meet the deductible, that struggle is just the same to fund the FSA or HSA. In addition, for someone like myself, who was once on SSD many years ago, the Medicare Part A stays with you automatically, and therefore you do not qualify for an HSA or FSA. To add insult to injury, if I try to cancel the Part A so that I will qualify for FSA or HSA, I sacrifice all future Social Security benefits, including retirement, upon which I now depend to make ends meet. Truly, Obamacare has plunged this country’s healthcare crisis into a deeper one; and I am a Democrat. So now, this man, and people like myself, have to live day to day hoping and praying that the lump growing larger, or the pain growing greater, does not take our life, because the ACA missed the boat in a BIG way.
Thanks for pointing that out. We will make sure we provide better information on how an HSA affects those who have gotten Medicare early. Of course, the vast majority of people aren’t in that situation and thus the HSA suggestion makes more sense.
It’s not like we don’t understand the challenges of a high deductible plan and premiums. We do 100%. And I would argue not having health insurance and doing nothing as a society is like saying “let them eat cake”.
Teasing aside, we are people just like you. I have a high deductible plan that I use as catastrophic coverage, I fund an HSA to offset the deductible should I ever need it (those dollars will be tax free, saving .25 – .39 or more per dollar depending upon income). I do this because I crunched the numbers it makes sense to my wallet with my medical needs. I don’t love HDHP’s with premiums and cost of living considered, but consider the country as a whole is having the same problem as the people in regards to healthcare. I think we can do better as a society, but pairing a HDHP with an HSA is a solid strategy for dealing with where we are at today.
I keep seeing “free preventative care” stated, but what a lot of people don’t know is that if you go to your provider for a well check and something is considered “abnormal” on the exam and they code for that, the insurance in turn says, ” hey, that’s a well and a sick code”, then tells the office you owe for the sick portion. I work in a doctors office and have seen this all too frequently. Patients come in with no copay for their preventative and when something is found at their visit they in turn get billed their copay for the sick portion as well as their deductible for that charge. Another tricky way insurances scam their money. So for my family that is scraping by to afford our $836/mth premium, we ha e put off those free preventative checks mostly because of our preexisting conditions that will be noted on the exam causing us to have an out of pocket cost after all!
Thanks for the insight. I don’t like how this works in practice much either. The essential benefits in general are great, how it’s getting coded in practice is too confusing for everyone. One of the parts of the ACA that needs further work.
That will teach the S.O.B’s not to see a doctor. Gotta protect those company insurance company profits!
Terrible illogical fallacy based answer. Mddle-class singles and families would consider a $6,000+ “low” obamacare deductible to be a “high” deductible. As a single individual on a teacher’s $32k annual salary, I’d have to put at least $10k (31.5%) of my “before tax” annual income into an HSA/FSA to reduce my income enough to qualify for a subsidy/tax credit. And I’d have to pay out of pocket for my prescription: approx $960/yr. And eye care: approx $250/yr. Approx Obamacare monthly health premium with $75 estimated tax credit applied monthly: $180.
Salary reduction to qualify for tax credit: $10k (31.5% of annual gross from $32k to $22k).
Out-of-pocket *basic* health expenses: $1210.
Estimated annual health care premium: $2100.
Total est. annual health care cost: $10,310.
Effectively, to receive any discounts/subsidy/tax credit I have to reduce my annual take home salary by $10k to “save” $960.
If I don’t take a 31.5% salary reduction, then my monthly healthcare premium will be $233-255/month. My annual health care costs will be estimated $4006-4270.
Roughly 13% of my annual $32k salary will be spent on healthcare. And this is still too much, way too much.
Subsidy or not, on any Obamacare plan, when and if I need a diagnostic test it won’t fall under “preventive” care or “screening,” and I’ll get a whopping bill for say an x-ay or ultrasound.
So, NO, NO, NO! This answer absolutely does *not* help middle-income families.
Reduction of “gross income” by contributing to HSA/FSA accounts does not add up – advising those who fall into the “Obamacare Gap” to “utilize the HSA/FSA tax reduction strategy” signifies idiocy in basic accounting and budgeting.
Obamacare is crippling middle America. I can’t afford to spend 13% of my salary on healthcare let alone $31%.
If you make $32,000 you qualify for a subsidy (it’s less than 400%). So you don’t have to put money in your HSA to qualify for tax credits. You would need to put money in an HSA to qualify for cost sharing reduction to lower your high deductible (which $6,000 certainly is).
Your out-of-pocket spending is tax free through the HSA (as long as you spend it on medical it doesn’t get added back in).
Max HSA contribution is $6,650
Out-of-pocket basics are deducted from that $6,650 – total of say $5,000 left in HSA
Total annual cost way less than what you quote. At your income say $2,500 in premiums plus $6,500 in HSA, plus tax benefits (paying taxes on $6,500 less dollars), plus you still have $5,000 in your HSA for next year, it’s more like $3,000 a year or so for healthcare (maybe a little less or more as we made up some numbers here) which is less than 9.5% of MAGI.
Also HSA’s reduce MAGI and AGI, not just GI (LINE 29 under AGI on your 1040). (they reduce AGI and then aren’t added back in for MAGI, there are no special instructions on 8962, used to claim the tax credit, that signify that this can’t be done). So we would never suggest this to someone who is struggling to make 100% FPL, but would suggest it to someone just over the 400% level. We’d actually simply suggest all things that reduced MAGI to ensure they get the tax credit if they are on the line. https://www.irs.gov/pub/irs-pdf/f1040.pdf
So yes expensive, but it’s not as drastic as you say.
I have a family of five we pay nearly $800.00 per month for an insurance that basically covers nothing. My husband makes over 100k so we don’t qualify for any of the subsidies which are a joke anyways. We actually funded and FSA last year and the fiduciary actually said that none of our medical expenses qualified and took 3k that we had funded. Btw all the medical expenses that were submitted were for the labor and delivery of my daughter. It is less expensive for us to buy insurance in Central America buy a plane ticket and do all our major medical procedures over there. I have a growth on my ovary that is the size of a golf ball in order for me to do the lab work to rule out cancer it is costing me 1k insurance isn’t paying anything. We just had our second baby and nothing for the labor and delivery was covered. Also some of the procedures that are done at the doctors or hospitals don’t qualify for part of the deductible . I also feel that your responses to these people are a bit condescending. We have 3 small children and we literally can’t afford to make sure their mother doesn’t have cancer. This is the most ridiculous remedy for the healthcare system. It’s the same as not being covered it’s actually cheaper to be a cash pay patient so it almost as if you don’t have health insurance.
Thanks for sharing. The FSA thing though doesn’t seem right look at the changes to the use-it-or-lose-it rules and eligible FSA expenses. How would you get stuck loosing $3,000 without having a chance to do anything about it?
We said the same thing to the fiduciary we even sent them was is stipulated in the tax code. They said they our expenses didn’t qualify and that our money would essentially be going back into the pool. Our only action would be to take legal action. We did call an attorney but in order to take them to court we would be spending more in legal fees. Also we would be suing the my husband employer. So we had no course of action. Lose your job, spend $ on an attorney, or just move on. They took our money and there was nothing we could do about it since it is up to the fiduciary to approve medical expenses. Again what do I do about all these medical expenses that my insurance doesn’t cover? And you keep saying that you can go for wellness check ups but they are limited to only three per year. And you didn’t answer my question about the insurance companies being allowed to decide what is an approved procedure for a deductible. I am not exaggerating when I tell you I had 2 pregnancies almost back to back and I only had $480 towards my deductible how is this even possible? We are paying an exorbitant amount to basically have only emergency coverage. It’s 1k to do lab work with my insurance and it costs me $200 to say I am uninsured. How does this make sense. My husband and I are actually flying to Central America to do blood work, colonoscopies, and general check up because it’s less expensive for us to plan a trip then to use the medical system here.
So sorry to hear this. Seems like you are getting a raw deal in a few places. All the rules for what insurers cover and what FSAs cover are written out as laws, rules, and regulations. There really isn’t a grey area for us to interpret something more than there is a grey area for the insurers of fiduciary. So not sure how to answer your question. Certainly covered services should be covered and covered expenses should be covered. If your insurer isn’t crediting your out-of-pocket spending you need to contact them and find out why (sometimes it’s the way the doctor coded something). You can appeal any insurer decision. https://www.healthcare.gov/appeal-insurance-company-decision/appeals/
Gruber said it himself. Obamacare was meant to “even the playing field” and force a single-payer system (Marxist socialism) on anyone who actually works hard, tries to save their own money, and has tried–until now–to pay their own way. We who are middle-aged, middle-class Americans are shouldering the extremely high price. Obama, Roberts, Pelosi, and Reid, didn’t have to destroy the current choices of coverage to put people on Medicaid. Just because some have never discovered their options that were already in place doesn’t mean that had to ruin the health insurance coverage system for the rest of us. It was just a politically convenient way to tighten the screws on those who would comply with their plan to fundamentally change America. Tear down and rebuild the Soros way. Bring us to our knees financially in order to impose their “superior”, “positive” ideology on us all.
Last year, I paid out of pocket for two MRIs plus specialists $7000. I CANNOT do that, fund an HSA, pay for premiums, a property taxes, a mortgage, gas to work, braces, and my son’s college, too. It’s IMPOSSIBLE! And oh, by the way, I don’t have cable or a smartphone. I drive a car that’s 18 yrs old. I may have to quit my job at a non-profit because I can’t afford it. This current system pushes us all into no real healthcare, poverty, and no way out.
Oh, but as a 45 yr old I have pregnancy coverage, and as a person who’s never done drugs, smoked, or drank, I can go to rehab–for free! That so kind of Obama to tout the greatness of his imperial plans that do nothing to actually solve the problem of high costs for honest, hard-working middle-class families. (We think THIS is bad, just wait for the full government system. It will do exactly what it was meant to do: give complete power into the hands of the few elites and their useful idiots, with a complicit, ignorant, indigent, and fully-dependent public with no will of their own. Obama said he’d turn us into Europe. He just didn’t say it would be WWII Poland and Germany, or modern-day Greece.)
In the last five years, my premium went from $450/mo, to $680, and now almost $1000! My wages are frozen indefinitely. I can’t take the gov’t subsidy since my employer gives some toward the premium. (They had to drop their employer coverage four years ago–thanks to declining economy and Obamacare.) Even if I get a tax credit, I can’t afford $550/mo. The deductible was originally $3500/100%/$6000 max and it would now be $6800/70%/13,000 max.There’s just NO WAY.
WE are the ones who’ve always been working to pay for the unemployed and uninsured. We try our best, but as Someone said, “The poor will always be with you.” WE are the ones who give more in charity than most millionaires do. WE are the ones who balance our budgets and look for ways to survive on our own and don’t ask for a single dime. These are the true FACTS.
With these REAL numbers in mind that we’ve all shared here, what is the solution? MORE burden? MORE decrees? MORE talk? WE will still continue to survive financially somehow, or die trying. As long as those who think they have the “facts” believe that Obamacare is a good thing for those who work hard to support themselves, we will never get out of the grave that’s been dug for us.
The solution is FREEDOM. Let every person, employer coverage or not, choose only the coverage they NEED. Individualize plans, get rid of coverage some don’t need or want. Give freedom to buy across state lines, drive competition between insurers. Simplify billing and insurance procedures. Every cost charged by a doctor, hospital, or drug company is evaluated for effectiveness and true cost. Give incentives for cures, not a temporary fix and more pills. Everyone pays up front, nothing hidden, out of their own healthcare fund that cannot be raided for any reason. Get people off of expensive drugs, not a lifetime of drug dependence and more expensive tests that have a worse outcome than if the person stayed at home and never went to the doctor. Coordinate care, not passed from one specialist to another, one ER visit to the next. This is real healthcare reform.
So, the to be honestly compassionate, and not just sound like it, we must find and put the TRULY sick into Medicaid without destroying us all. Prevent people from chronically abusing the health and welfare systems. Require able-bodied people to work for assistance. Let charities do the job of educating and distributing to the poor, not government. Close failing systems that promote corruption. It should start with the billion-dollar Obamacare website that doesn’t even secure your personal information.
If we have real healthcare alongside true competition between private insurers, we will lower costs and solve this problem. Politicians, and those who believe them, won’t fix this. Ordinary, working Americans will have to try to fix this, too, just like every generation has had to do when times got really tough. I’m going to start by opting out of this imploding system until they say I can’t. This is my only choice, unfortunately. For those of you who have to buy coverage that covers next to nothing, may you work to change the failed system that have brought all of us to this place to vent our frustrations. Thanks for your time.
I have been told to look into liberty health share caring ministry since I was forced to take employer health insurance which dosent cover anything except a physical once a year until the deductible is met. The typical monthly premiums for me are about $107 a month with an unshared amount of $500 but everything else will be covered @ 70% unless u opt for a higher plan. Im still looking at reviews myself before I switch and its complies with the ACA .
I’m afraid I wasn’t very clear in my previous post and, based on the response, it’s clearly my previous was also not clearly and carefully read.
In addition, I’d caution responders from using too acronyms and fragmented thoughts in the parentheticals – remember people need “clear language” – at first the intended meaning in the second last paragraph is difficult to decipher.
Okay, yes, thank you for clarify that I qualify for a subsidy without having to contribute to a HSA. Still let’s go back to this thread’s original question ‘High Deductible Plan too Expensive?’ and answer.
Obamacarefacts.com original answer (in the green shaded box) contends that the HSA, FSA and tax credits is “helping” middle-income singles and married couples.
*[Contributing to an FSA or HSA account] helps can help lower MAGI. For
those who get cost assistance, [an FSA or HSA] can help lower MAGI. For
those who don’t, it can still help save money on care.either
Here’s a snapshot (for simplicity I’m using round numbers):
36yr old healthy, female
Annual Gross Income: $32,000
By the way – Healthcare.gov states I don’t qualify for a tax credit.
Cost of Obamacare Bronze Plans in my area:
1) Optima FitBronze (High-Deductible) Plan:
Estimated monthly premium: $255
Estimated Individual Total Out-of-pocket maximum: $6,850
2) Optima FitBronze (Low-Deductible) 6850 Plan:
Estimated monthly premium: $263
Estimated Individual Total Out-of-pocket maximum: $6,850
3) Optima FitBronze 4850
Estimated monthly premium: $263$284
Estimated Individual Total
Estimated Individual Total
The monthly difference between a “low” and “high” deductible plan is $8.00/month.
The difference between the two plans is that
Estimated Individual Total
I 10000% understand how it sounds to tell someone struggling with money to fund an HSA… but it’s actually good and sound advice. Do the math, you save more over time this way than you do paying out of pocket for low deductible plans and paying into high deductibles. Consider HSAs lower MAGI and HSAs can be used to spend tax free dollars and high premium plans only pay off when you access medical services.
account] can still help save money on care. has and continues to cause a negative financial (and ironically health) impact on educated “middle-class” single taxpayers:
Single, healthy (non-smoker), 36yr old woman. I’m a teacher.
I earn $32,000/yr before taxes.
The question was answered correctly, but the problem can not be solved by any of the above suggestions.
Working people simply do not have any excess income. A silver plan (like mine) with a $6,500. deductable reflects nothing more than a predatory enviornment.
We do not have the time nor the inclination to negotiate what is a seriously and poorly micromanaged healthcare system.
Fill out an application, get a card, pay a bill, healthcare covered! Am I dreaming?
I have been paying about 200 a year for health insurance. I buy a flu shot for 20 and go to a doctor once a year. Now if I buy the “affordable health care” it will cost me so much more. I won’t be able to afford the 200 I have been paying because my extra money is tied up in premiums. The deductables are so high I won’t be able to afford to go the doctor at all. How is this right? Or fair? We were promised the majority of health care costs would be lower. Now they are astronomical. Thanks President Obama!!!!!
I was happy with my health care before. Now I can’t afford to go to the dr. I thought if you like your plan you can keep your plan period. that was a PROMISE. That was a LIE!
it beautifully describes how middle class people can’t afford to take care of themselves, even though they have insurance. How is this even possible? I am in the same position, and I don’t understand how this is helping normal working people?
Well I will start by saying that this answer is unacceptable at best. This is basically saying “yep, your screwed, sorry about that!”. I want a real solution to this issue not a standard response from someone who works customer service.
As a small business owner with a family (3 kids), the cost for a lower deductible 80% copay coverage with a family (gold plan) is $18,000 per year. (not including the deductible of another $2000). No dental for adults, no vision, no orthodontics. I was vocally in support of the Affordable Health plan. I can no longer afford to be in favor of this plan. $20,000 for one family for health coverage is unbelievable. I understand I can drop down to a much more “affordable” Silver plan where I have a $14,400 premium with a $6000 deductible and only 70% coverage. My plan from last year went up another 20% and dropped the value by adding to the deductible and copay.
High premiums and excessively high deductibles make the Affordable Health Care Act sound like Jumbo Shrimp or Military Intelligence. It is NOT Affordable. And it is NOT HEALTH INSURANCE.
I would have to pay $700 per month premiums, with a $6750 deductible. That’s over $13000 per year. That’s more than I pay for my house!. And I have to pay 100% of all costs until I get to $6750. I would have to go to the Dr. every week to achieve that. That is not affordable.
Also, Wellness visits and checkups are free, but who really needs a physical if you don’t feel sick? You are more likely to get sick going to a Dr.s office for a physical,where people are spreading germs. Then you have to go back to the Dr., and pay 100% for the office visit, and get a prescription, which you pay 100% for.
And can everyone please stop saying Health Savings Accounts are a solution? It’s still MY MONEY! I’M STILL THE ONE PAYING!!!
So basically, it is ONLY catastrophic insurance. It is mathematically better off to NOT SIGN UP FOR INSURANCE AND PAY THE PENALTY! $13000 for insurance or $2000 for not getting it. That’s an $11000 savings to be uninsured.
I’ve read the responses below, and Obamacare facts can spin all they want, MATH DOESN’T LIE!
I HATE THE AFFORDABLE HEALTH CARE ACT AND THE INSURANCE COMPANIES WHO ARE RIPPING OFF MIDDLE AMERICA!
Math doesn’t lie. So health insurance is expensive, no one should be paying $700 for a $6750 deductible (average is less than half that, some regions and ages mean you pay more, but thats a lot more), and an HSA is tax free dollars in and tax free out. So the dollars you put in are worth more and lower your taxable income… which actually saves you money. No other way to say that. Remember FSAs are use it or lose it, not HSAs.
IF you truly are really paying costs like that shop around. If there are no cheaper plans i’d be curious to know what region this is?
I am in the same boat! Basically we will be paying $500 a month just for the premium and then there is a $12,000 deductible. Office visits aren’t covered until you reach the deductible. What is the point of having insurance if nothing is covered. My kid gets strep throat and we don’t go to the doctor because we have no money to pay the bill after paying the $500 for the premium. I am so stressed out by all of this. I wish we were like other countries where you get free health care. Tax me all you want. I hate ObamaCare! It is stupid. Mrs. Obama wants kids to be healthy and active but when we have to pay $500 a month for insurance that doesn’t cover anything, that takes away from my kids being able to join sports. For my son to play soccer it costs $250, for my daughter to do gymnastics it costs $170, for my older daughter to join cheer it costs $600. They can’t do any sports because we don’t have any money after paying for an insurance plan that we can’t even use because it is TOO EXPENSIVE! I am ready to move out of this country. It is not the best country in the world. Moving to a better country would insure we all get health care and a lot of countries have free college. Living here just doesn’t make sense anymore. Obamacare doesn’t even take into consideration how much money it costs for housing, food, transportation, clothing, and all that. I guess we are going another year with NO health insurance. Thanks Obama!
Only in America do the rich profit on healthcare. Shaking my head. I have insurance because my union sold our souls, luckily, but I looked at the market plans out of curiosity. Mandatory 90 bucks a month for my kids dental? She has one cavity a year, so, I would basically pay 1000 bucks for that. On top of 600 a month for insurance that I would never use because of the insane deductible. But hey, don’t sorry when you die of the illness you didn’t see the doctor for, your family won’t owe more than the 6 grand deductible. Now that our oligarchy has determined our health care to be simply a means for the rich to get richer, as we get sicker, I am working on a way to get my family out of here. Watch the overall IQ of this country drop, as those who actually have the capacity to think, do the same.
It is sad because you are describing an end result situation that we can see does happen, but this isn’t the end goal. There are good people out there who actually want to continue to see healthcare reformed to an efficient and morally respectable thing. Without knowing your income and region and plan I can’t make a judgement call on price, but generally 90 for dental and $600 a month for a $6k deductible sounds a bit like a racket to me.
Since it seems like your coverage is coming from an employer you should be able to get exempt if it’s unaffordable. So make sure to look into that. https://obamacarefacts.com/affordable-employer-sponsored-coverage/
The reply shown is nothing but spin. It almost would have been better if you just replied, ” eh, what you gonna do? ” I am for a single payer system. Now we are forced to pay money we don’t have, for premiums of a plan that doesn’t kick in until you spend even more money you don’t have. ??? Seems like the insurance companies still get to get their cake.
“eh, what are you gonna do?” 😀
obamacare is a joke, get with the rest of the world USA
So your answer to high health cost is SAVE SOME MONEY TO PAY FOR HEALTH COSTS! Just brilliant! Why didn’t I think of that!
Here’s an idea, if you want to be a millionaire, first, get a million dollars, and then….
Sorry, I get my business advice from Trump. So literally, my answer is just “get a small loan of a million dollars”.
Seriously though. I’m saying by using tax advantaged investment vehicles you can end up paying less over time. I don’t think coming up with the money each month is easy. Actually I think it’s an uphill battle and not doable for some. Still I want people to know this is an option!
This is just too expensive period. I have no assets, an 18 year old car and low income. I don’t “qualify” for benifits and I can not afford to pay out the ridiculous premiums let alone the deductible. Funding another medical account is not an option if I choose to pay for health insurance. It’s a damn shame that I was one of the ones that was insured every single year I worked prior to this law passing. Now I can’t afford to pay it.
My solution is easy, as someone with no assets, a car so old nobody would want to take it and a low paying crap job that somehow pays just enough to not qualify for help. If I find myself under a mountain of medical debt, I’ll simply file bankrupcy and be done with it. It’s not my fault that everything in this country is based on pure greed and insanely ridiculous costs are charged for everything since absolutely everything here is a for profit cause. Even non profits are such for tax purposes to be allowed to maximize their income while operating. I could care less if they keep the penalty against my tax returns, I never get them anyway.
And I don’t care what anyone says, these insurance companies are death panels. My Dad needed an LVAD device for his heart, the insurance approved everything, EXCEPT the wires for the device that are required for it to operate. Why the hell can they nitpick over components of a part that was approved? Especially if those components are essential to the operation of that device?! At least you know this is mainly the insurance companies themselves and not the actual doctors. My dad has survived because his doctors keep playing along with the pharmacy drug pushers that always visit them and get free samples of the medicine my dad needs. They feign interest just to get the free samples and they don’t charge my dad. The for profit at any cost agenda in this country makes me so angry.
Ok just to be clear you qualify for an exemption based on income. The frustration is shared by many, but as a plus for you you are (likely) exempt based on what you explained.
Talk about a political answer that doesn’t really answer anything. The actual answer is much simpler: Deductibles are too high and having health insurance in no way guarantees access to healthcare except in the event of medical catastrophe. Then you will be expected to cough up close to seven thousand dollars which for many people is a significant chunk of their yearly income.
The answer was tongue in cheek. Was just taking a break from giving the following response:
So yes high deductibles are too high and they are one of the biggest problems for people. Not cool and not super justifiable. But, by utilizing things like HSAs and tax credits and other tax deductions one can typically improve their situation, personally, given where we are today, without simply leaving it at “deductibles are too high”.
HSA’s are pointless if you are not going to the doctor. We spend so little on actual medical expenses that the math doesn’t work if any of us had chronic illness maybe it would matter but none in my family have prescriptions or anything we don’t even get sick that often. To answer an earlier question our company offeres insurance and as of Jan 1 that required me to go on it. They pay for none of it. I know they probably legally can’t force me to buy but they would simply let me go if I fought them on it. It’s so expensive what do you do my only option is finding a different job. We are trying to be a traditional family with my wife being a stay at home mom. I get the feeling that all of this is designed to make it so hard for people that they both spouses are forced to work leaving the raising of children to the government child care and the school system. Just my own opinion thought.
This is absolutely ridiculous. My family is in a similar boat. Prior to the change in the laws, our deductible was $1500.00 per person with a $350.00 monthly premium. Now that the law has changed, our premium is over $500.00 per month with a $4,000.00 per person deductible for 2015 and is slated to increase to $6000.00 per person in 2016!! We would have to pay over $6000.00 per year in premiums and additional $6,000.00 per year before 1 person in my family would have coverage. In order for all of us to have met our deductible we would have to pay $12,000.00 for the group in addition to $6,000.00 yearly premium. Thats $18,000.00 PER YEAR before the insurance kicks in!!!!!! Who benefits in this scenario? Certainly not my family! We also make too much to qualify for assistance and an HSA is out of the question for us.. it would actually cost us more per monthly premium in addition to trying to come up with the money to fund the account. This is affordable care? I was well able to pay for my premiums, deductibles and out of pocket expenses prior to the changing of the bill but not now. Now, I dont want to go to the doctor, my daughter needs braces and dental isnt covered in that mess I described above, my husband and daughter both wear glasses and vision isnt covered in that mess I described above. This is beyond tolerable. No use in saying at least I have coverage, because I would actually have more money in my pocket if I didnt… About $18,000.00 per year more. Lets just call this what this is… a TAX. I get no benefits from my “coverage”.
You, me, and the supreme court agree it’s a tax. It’s a tax we can feel good about when the cost point is right… but when we get jerked around with prices, and cost sharing is too high, and we get accidentally dropped and owe the fee, or in other similar cases, how can anyone feel very good about that tax. And that is the problem.
How we spend money affects happiness, and i’ll be darned if America was really ready to pay another 10% of their income in taxes for something that doesn’t feel like it has value.
That said, our whole country has a healthcare spending problem. So really, all we are doing is feeling at a personal level the burden we the people have and we are leaving our children.
What is infuriating about this thread, and commentary, is the inability of the Obamacare Facts respondent to acknowledge the failings of this legislation. I get it, tow the party line come hell or high water. Here are facts for you to contemplate:
1. The pool of healthy prospective insured individuals participating in this plan has not met expectations.
2. People are forgoing insurance and paying the penalty due to affordability.
3. The pool of premium paying participants who are adverse actuarial risk payers are too high. Translation, most participants are lower income, have pre-existing conditions, older, etc..
4. There is a profit component built into this plan by the insurance companies.Signed off mind you by the executive branch. To maintain this profit component insurance companies are spreading the cost, and profit, expectations to a smaller group of healthy premium payers. Thus, the ever increasing deductibles and premiums.
5. Larger government outlays to subsidize health care will continue to put upward pressure on premiums and deductibles.
I can go on. The bottom line is this is a failed piece of legislation and there is an argument that people are forgoing healthcare because of this. Yes, more people who haven’t had healthcare are receiving healthcare, but at the expense of middle america. Tax paying middle america mind you. These middle Americans who are not seeking healthcare because they have to support the people who can’t afford it. These middle Americans going overseas for healthcare. These middle Americans skipping appointments and medical procedures due to cost. Choosing between groceries, electric bills, school clothes, taxes, etc… Comical really. Obama alienates one class of people to take care of another. Sorta like rearranging chairs on the Titanic. Lastly, this legislation wasn’t voted on. Make no mistake, this abomination is all Obama, and the Democrats. Spin it all you want. This is a failure at improving the welfare and quality of life of most Americans.
Offer Medicare as an option to everyone.
Obamacare is useless. I am making $16000 a year. They say I have to pay premium 250$ a month. I am a fit and strong man. The last time I saw a doctor was 2009, 7 years ago. I never need insurance in my life. So, instead of pay this stupid 250 $ a month, I will just pay my $700 fee on my tax refund each year. is much better. Obamacare suck !!!
At that income you should be getting coverage for about 1/10th of that on the Marketplace. Do you have employer coverage? Or are you filing with other people and thus you are below the federal poverty level and not qualifying for Medicaid because your state didn’t expand? Seems like it may be one of those.
Your $700 fine you will pay “each year” is going to $2,000 this year. I’m willing to bet alot of people will just change the way they pay taxes so they don’t get that “large” check at the end of the year since it will get absorbed by the “fee”.
At $16,000 a year, you probably have no assets. Don’t get any insurance and claim bankruptcy if you get a huge medical bill. That’s my attitude and it was fostered by this bill being forced on all of us at unaffordable prices. I used to be insured at every job I ever had before this came into play. Now I can’t afford it at all, it really is a complete ripoff.
Exactly! Both the questioner and the answer point out the issue! Obamacare is useless — the high deductible makes the “affordable care act” plans UNaffordable for those who can only afford the lowest cost plan. So Americans at the lowest income levels are forced to purchase a plan that is virtually useless and do not benefit from it. Worse yet, as stated above the best recommendation is to ADDITIONALLY get an HSA plan! Wasn’t that what Obamacare was for? Employer-based HSA accounts with catastrophic coverage existed before Obamacare, the only thing was that you weren’t forced to throw money away on a plan that does nothing for you. Obamacare is simply an additional penalty for being poor!
I am sickened by the way health insurance operates now. My husband & I both work full time jobs, hardly ever get sick and our deductible is $3000.00 and then the insurance pays 90% on top of the high premiums we have have to pay to have this lower deductible. I am 10 weeks pregnant and am paying $400 every doctors visit to go towards my deductible. That’s high! Not to mention any lab work done is based on a 75%/25% scale. You tell me how this is fair to people who work hard for their money but lazy asses can get everything for free after paying a small premium every month.
So you getting short change NOT FAIR, 100% agree.
Lazy people getting stuff for free isn’t fair either, but this isn’t generally what is happening in the US. What is happening is that wages rise slower than inflation and the rich get richer while everyone else gets poorer. That is the root cause, but I don’t think we will get around to addressing it. We are simply too busy blaming poor people for taking all the money.
If poor people had the money… they wouldn’t be poor. Can we curb the hate a bit and just agree to focus on solving the problems for the working and middle class without blaming this “lazy poor boogyman?”
The rich get richer because they work hard. They are the ones who provide jobs to people. They are the ones who pay for our salaries. They are the ones who pay most tax. The real issue here is government spending way too much tax-payer money to make unnecessary regulation/program and complicated taxation system. If the government can reduce their spending we can channel those tax-payer money to help poor people instead of taxing ‘hard-working’ people more on top of federal tax, state tax, FICA.
What a joke. You clearly have never worked in upper management or executive leaders. In america, the harder you work the poorer you are. The more you take advantage of individuals the more you make. I’ve learned this in the 10 years in the workforce. Every job I’ve had has gotten easier and more rewarding at the cost of others. That’s the american way.
What you say rings true, but, At the same time, that is an old way of thinking. It’s up to the new generations forming companies to cement in a new way of doing business in America by setting examples. I think we have seen this work fairly well if we trace a line from the birth of silicon valley to present day.
The root cause is people like you, demanding for the expansion of government and regulation. You will always blame everyone else except for yourself and those you vote into power. Your no better than the dults who vote for Trump. I bet you think that Sanders mass expansion will stop all this insanity. When its government, the lobbyists and their crony capitalist friends that has created it through mass expansion. Minimize government, deregulate the market, get government back to basics, make the system more manageable.
EH, actually i’m for a centered approach that mixes small and big government, heavy on state rights, lots of checks and balances, a strong sense of morality and justice, and a conservatively balanced budget. Think I’d go with, lets say, Sanders with a Vice President Kasich and a real goal to bring down tax burdens on businesses without sacrificing any of our social programs (although i’d reform them to empower people and get rid of some glass ceilings to make moving up the ladder easier). I have lots of ideas, none of them involve blindly slashing important government programs and agencies. When we talk rather than yell and grandstand, we will I think, find we agree on a lot.
Hi I have a family of 6 wife and 4 kids I was making ok money with my job, but as of Jan 1 2016 my employer is forcing us on their plan. Their cheapest option is about 1400 a month right now my only recorse is to take a lower paying job that will allow me to get the subsidy. This unaffordable care act has now cost me my 2nd career change my first was in 2013 the company I worked for closed their doors saying they didn’t think they could comply with the new ACA rules and now this with is financial hit I’ll only be able to make it another 3 months before I default on my home. This is a for real instance I’m distraught and stressed out and not sure what I’m going to do. Thing is me my wife and kids are in good health we rarely go to the doctor yet this thing is bankrupting us and there’s nothing we can do about it.
I still can’t afford Obamacare. I’m not a Republican! It’s seems the “Un-affordable Healthcare Act” written by the insurance companies. I guess i’m one of those that still falls through the cracks. And I will be punished for not being able to afford any of the super high deductible plans offered to me. I make about 31,000 per year. yeah. Not much. Singe person household. 35yrs old. I have college loans. they want 15% of what I make from Income based Repayment. Obamacare wants me to pay around $200 per month plus pay out of pocket everytime until I reach $3500. I’m fairly healthy. I don’t go that much. But WTF! I’m paying $200 for nothing. to Just keep spending out-of-pocket to see my doctor. #&$*(#&(*#^(! Thanks alot Obama!
Hi, I’m 25 married and have a child. My husband I make $35000 this year. Coverage at work was $500 a month for the 3 of us and there just was no way because every Dr visit was 100 plus Co-ins of 30%. Also urgent care was 100 and it covered no med or lab test. I grow up without insurance and no government assistance of any kind. I didn’t know what social services meant. Anyways over the years I’ve learned that, if you pay upfront with cash the Dr prices goes down quick. Medical prices in my area-
$75- urgent care (25 less than plan)
$35-75- a Dr office (over $100 less)
Blood work is cheap at all health departments
prescriptions- are for the most part easy, I use goodrx discount cards. They are free and they have an app to price out pharmacies and give you the price before you go. Also almost every company gives out discount cards for popular meds.
Also Aflac is a great company for pennies a day i cover 3 ppl on an accident policy that pays 125 every time something unexpected happpens.
My issue is its unreasonable for the 3 of us to pay out premiums to plans that hurt us more than help. I would like something like state minimum car insurance that Is 150 for the 3 of us that covers nothing until we hit a max of 10,000 or more. Then I want it coupled with a HSA that I can max out and use. I already save for stuff like this but it would be nice to deduct it from income. We barely have used $500 in a year of all our medical expenses so how does ACA help us. Health insurance should be more like car insurance have base rates like my state concludes that state minimum is $27 and I have what I need, if I need more I can purchase more at any time. I also get incentives with car insurance like my deductible drops every year, I can call and switch if another company offers me better. We need to utilize the HSA from early on and not pay such high premium s when we are young and let the HSA grow so when you need more coverage you can pay the premium without fear of facing high deductibles. Also it’s a bunch of bull that ppl have to pay a penalty that can reach as high as 2.5% How is your youth, poor and middle class suppose to survive.
Obama Care is worthless. I’ve had health insurance all my life. I can no longer afford health insurance and get fined for not being able to afford it. This is senseless. Obama Care needs to be appealed as soon as a republican president is elected. They’re was nothing wrong with my old health insurance. It had a high deductible but I could afford it. My insurance would be 4 times the price (if I could afford it).
You are an MEAN ONE O BAMA! HOW DARE YOU! claim you are giving people AFFORDABLE HEALTHCARE!!! WE CAN’T EVEN MAKE THE PAYMENT SOOOOO HOW DO YOU PAY THE DEDUCTIBLE!!!!
DONT REVISE IT GIVE IT TO HIM!!!!
I have 2 choices.
Either have money to go to school and save for a house or have health insurance.
I am foolish either way.
I do not qualify for ANY subsidies and my most affordable plan doesn’t cover anything.
I did the math. If I am LUCKY I I will pay $26,900 for a $50,000 procedure.
In no way is that financially viable.
Is this the kind of math that our politicians are doing? Do they actually think the public would buy this “affordable” monstrosity?
I love how Obama is constantly touting the numbers of people who signed up for healthcare.
If you force them to get healthcare you cannot brag about the numbers.
My country upsets me.
Obama care is no care. So I have to pay a monthly premium for insurance add money into an has account and pay a 4000 dollar deductibl. So almost half my pay to insurance so how do I pay my bills
We don’t need fricken “tips and tricks.” Do you not realize that Americans like me can not afford medical services?? And I found this answer insulting, you basically told us you know we can’t afford the actual care, but hey, when your kidneys go, we got one hell of a catastrophic plan. That first “a” in ACA was supposed to stand for “affordable” not “a$$-reaming.” Insurance co’s now have us by the short and curlies, and I am absolutely terrified. What’s worse is as I am researching each plan, I can’t find any that even cover some of my medications. My husband’s plan drops spouses in couple of months and I honestly do not know how we are gonna make it.
LOVE YOUR COMMENT
I don’t have anything against Obama, but these health insurance marketplaces are just crazy. The LOWEST cost plan for me still includes a $6,000 per year deductible, but I only make about $11,000 per year. There’s no way I could ever afford to see a doctor or get health care. So I’m supposed to pay a premium, PLUS $6,000, before the insurance company will do anything? Why bother paying the premium?
Obamacare sucks. Im in the same situation and my monthly premium would be the same price as my rent. Incredible!!!
Yeah, that is wrong and unfair. Typically this means you are in a state that didn’t expand Medicaid or are getting a raw deal on employer coverage. The Marketplace typically doesn’t result in this, and if you have income over 400% FPL then rent would have to be very expensive for this to be true.
Such a lack of compassion coming from the “Answer” folks. I just spent HOURS comparing plans that are available through my state’s exchange. My husband and I are both self-employed and aren’t eligible for a subsidy. If we went with the cheapest Bronze plan we would have to pay a $611/month premium with a $13,100 deductible. With the exception of an annual health exam, the plan covers virtually NOTHING until the deductible is met. That adds up to just over $20,000 that we would have to pay out-of-pocket BEFORE ANYTHING IS COVERED! Please tell me how this is considered insurance! The government conveniently left out the insane deductibles when it mandated that we all should shell out 9.5% of our income for health insurance premiums. I lost my health coverage early last year and have put off all of my routine health screenings and mammograms because I CAN NOT AFFORD IT. PERIOD. Looks like I won’t be able to afford it again this year too. All I can do is pray that neither one of us get sick at this point.
Sorry you had that experience, 100% on your side that premiums and deductibles are a problem.
In 2016, your out-of-pocket maximum can be no more than $6,850 for an individual plan and $13,700 for a family plan before marketplace subsidies.
So insuring just two people on a catastrophic plan, with no subsidies, is not the best deal typically. You have to share the maximum deductible, and it’s not like two people are going to get catastrophically sick at once ideally.
Keep in mind that higher premium plans have the bonus of costing less net if you do need to use them. Also HSA’s help make high deductibles make more sense.
I understand that. However, I get NOTHING for my premium dollars until we cough up that ridiculous deductible. This is NOT health coverage at all. What am I getting for $600+ a month then? I HATE THIS LAW! We were lied to about being able to keep our plans or enjoy what Congress gets. Oh yeah, that’s right those SOBs are EXEMPT from the law. On my old plan I paid about $500 for my family (4 at the time) and the deductible was only $6000 for the entire family. Also when we went to the doctors we had co-pays and were billed reasonable fees for extras like lab work and imaging. Now you have to pay in full 100% for everything until you meet the impossible deductible. I guess I won’t be insured again this year, because I will NOT pay for something and get NOTHING out of it.
Just remember, it’s mandatory and you will get fined if you don’t have health insurance 🙂 I have no pity for any of you that vote in people like Obama or potentially Sanders. My healthcare costs are the price of a plane ticket back to Europe and my dual citizenship takes care of the rest!
I’m a single parent of one. I make more money than most ($100K); unfortunately $20K of that goes to taxes and $35K goes to student loan ($20K in interest alone!). I live very conservatively. For about 18 months I’ve been looking into health insurance but each time I go to the exchange website I just can’t stomach the costs. The cheapest plan (an HMO??) for my child and I is $350/month with a $5000/person deductible. The cheapest EPO is $375/mo with $6000/person deduct. The cheapest PPO is $475/mo with $5200/person deduct. These prices are just stupid. With all the living expenses, licenses fees and professional insurances I already cover, paying these prices for health insurance is beyond reasonable. Obamacare was the dumbest idea and worse written law to come out of this administration.
Yeah, as has been expressed by many others, between interest and debt “affordable” takes on a new meaning for those without access to cost assistance.
My only comment would be, ObamaCare is much more than just subsidies it’s 1,000 pages of provisions. We could tweak the subsidy system and fix a lot of the issues by only changing a few provisions.
I have read the law in its entirety. First of all it’s a Columbus document with confusing language that contradicts what is actually taking place in practice. Secondly, law maker DID NOT READ the text probably because they had no real interest in what it really means. The law in effect would not affect politicians since they are on the government dole for healthcare with no deductibles and of course all the best possible services.
You voted for him. hahahah
“Obamacare premium costs will soar 20.3 percent on average in 2016 instead of the 7.5 percent increase claimed by federal officials, according to an analysis by The Daily Caller News Foundation.”
I am not on Obamacare just yet. My Insurance company BCBS is dumping me because it is less expensive than Obamacare and doesn’t meet the Obama Criteria. I have an HSA account, 7000 deductible with 7000 out of out of pocket, and 11756/yr premium,100% after. That is borderline Respectful.
To replace with Obamacare, it will cost 15600/yr premium, 13000 deductible, and 13900 out of pocket, and 80% after. That is insane!! That is a 32% increase in premium, 85% increase in deductible, and 98% increase in out of pocket, and 20% after. Where does Obama get off on this being the Affordable Care Act. It ought to be called the RYNO ACT (RIP YOU A NEW ONE ACT). Nobody is paying for my healthcare or giving me subsidies. The tax incentive will not reach the out of pocket( on new Obamacare plan) not to mention the obscene increases in other charges.I would rather have low cost, across the board, than a tax incentive that will do very little for me. I need to close my business, go on welfare, like 60% of the voting socialist democrats are, and let the Government and people like me, pay for my healthcare. Or, I just need to drop health insurance altogether and pay the penalty; savings will start at 30% and go up. Unless you have a government related job with paid health insurance and retirement or an Employer/Provider Plan, you are screwed by Obama and his Cronies.
I am and will be paying for all those who get their premiums subsidized, if I continue with Obamacare.
ACA keeps saying you get “FREE” services. Free care only means free screenings for those leading unhealthy lifestyles. Out of the list of services for adults only colonoscopy (over 50), chol screen, blood pressure, mammogram and pap smear benefit healthy lifestyles. The long list of others benefit the smokers, drinkers, promiscuous, unhealthy eaters and pregnant women. It’s a pretty expensive “free” pap smear and I can check my BP at the drug store. Why should I pay for others bad choices??? I still need to pay a ton toward a deductible if I do need to go to the doctor. I’ll pay around $7000 in premiums and deductibles before my insurance kicks in. How is that insurance? I’ll pass.
This thread is a monstrous repeating snake of a trail expressing the frustration of a populace that is experiencing the first effects of a slide into a socialistic takeover of our countries value system. This all brought on by our elected President Obama pushing a “freebie” system that increases rewards for those who have no understanding of the belief that only those who produce a positive product for the society can be rewarded over the long term. Obama style politicians do this to increase their voter base and for no other reason. All this in the case of Obama done by a man who has never held a job that produced a single tangible product that added value to the food chain. A perpetual “community activist” adds little value to an economy or the food chain other than perpetuating a voter base loyal to the welfare system which adds zero value to an economic system. It does keep the socialistic politician in office until the system fails under the drag of the forever increasing numbers of voters realizing taking the free ride is much easier than working for their livelihood. And so the economies of Greece and other European governmental systems recently failed bringing on severe austerity programs. The ACA (Obamacare) is the first step down the same socialistic slide, which history shows us will end in austerity adjustments and failure of the system. What else would you expect from a person who has never held a job adding a single penny to the GDP of the country?
We come from a company that once had the Cadillac Plan – the salaries were lower but the health benefit helped offset this.
Now that the company has switched over to ACA to avoid the 40% excise tax, we need to meet close to ~10K out of pocket before deductible kicks in (very painful with an already lower salary over the industry); – it’s very very expensive now, and many of us are avoiding doctor visits and finding some of the needed medications aren’t covered (things like pain or diabetes medications go from $100/month to +1800/month – so its better to shop in Mexico)
We’re also finding that services we needed to maintain our health problems are no longer covered and only covered when there is an actual health problem. (Chiro or Acu for example to manage pain is not covered unless there is a real event that requires it)
I just hope no emergencies will happen – I will easily go broke – also the HSA’s don’t allow many of the eligible items that were in the FSA, and there are fee’s to using the HSA that I’m just learning about compared to the FSA. Strangely the HSA allows investing into the Market – which is quite risky when that is made for medical purchases.
I feel less certain the health care system is helping – it’s one thing to say people have coverage, it’s another matter to have it working for the covered.
What would be some options that could help offset the high deductible besides the HSA? The way the medications costs – I will burn through the HSA so fast and the deductibles are so high I’m not sure if there are other ways to lessen the burden – are there installment plans available in the ACA provisions for out of pocket payers?
Some people just don’t matter and their children don’t either. The insurance companies say we need “skin in the game” since “too many goddamn people go to the doctor or hospital when they get sick and we need to stop it to control costs and increase profits”. The high deductibles are by design
You’re basically just saying, yeah it’s expensive and probably not worth it, but you have no choice. We’ll take your money one way or the other. Obamacare is extortion.
The ACA was never about providing actual healthcare to Americans, it was about politicians who took advantage of an American public that is ill-prepared to critically think about such things and far too hesitant to criticize a black president. If protesters had shown up in the hundreds of thousands before the bill had passed and members of congress had been put on notice that their re-election was in doubt we wouldn’t have this mess. The ACA is NOT AFFORDABLE for millions of people, who simply cannot afford the deductible–and therefore will not see a doctor until it is an emergency. BTW, saying the people still have ‘catastrophic coverage’ is not a rational argument in favor of the ACA, it is just the opposite. This is NOT the way insurance is supposed to work and in fact is NOT insurance by definition. Before the ACA millions of Americans could not get coverage and millions more couldn’t afford hundreds of dollars to see a doctor for 5 minutes after waiting 2 hours. Even with pre-existing conditions covered, this situation remains largely unchanged, as few exchange-covered participants can afford to spend 6 to 15 thousand dollars of their own money to ‘take advantage of’ the ACA. As premiums skyrocket, projected to go up 40% in 2016, more insurers will bail out. This combined with steeply rising fines for not signing up for coverage and vanishing subsidies are a formula for a healthcare nightmare for millions of people–who the government couldn’t care less about. However, the good news is that millions of lower middle class Americans will still be forced to subsidize lower SES Americans–so the latter will have free healthcare. This is disgusting exercise in unprincipled hubris and hypocrisy. I am ashamed of the US for becoming a culture where charging just as much as possible for fundamental goods and services has become the political and economic norm, and for so many policies that favor special interest groups, to the tune of hundreds of billions of dollars, over millions of decent hard working Americans, who can no longer afford to actually live in the US. Finally, I give a 1 or POOR to this response for almost seeming like an apologist for the ACA, but give it a 4 for at least being honest, if circuitously so.
As for my family, there is no such thing as completely free well care checks anymore. Anytime my children, myself or my husband go to the dr. it seems as the routine tests that my dr. has always done aren’t covered under our insurance. I have a family of 5 and we put the max we can in our HSA every year in addition to what we pay monthly to our health insurance company. We have had no major health problems this year. My husband and myself take some meds and one of my children has had problems with kidney stones since she was in kindergarten but she is 16 now and the medication she takes seems to work for her. We still seemed to wipe out our HSA by the end of the year from routine dr. visits. I will do anything for my children, but now we have to wait until I know we’re really sick before we go to the doctor. I think the problem is when they started making MNCARE available the doctors offices, urgent care and hospitals started charging more for everything they do. If something should happen to more then one of my family members we would be in big trouble because we can only put 6700.00 into our HSA each year and our family out of pocket maximum per year is double what we can put into our HSA. Not that we can afford to put anymore anyway. Since they started doing Obama Care this is the first time in 22 years of marriage I am worried about affording my families health care needs.
As for my family, there is no such thing as completely free well care checkups anymore. Anytime my children, myself or my husband go to the dr. it seems as the routine tests that my dr. has always done aren’t covered under our high deductible insurance plan. I have a family of 5 and we put the max we are allowed to in our HSA every year in addition to what we pay to monthly to our health insurance premium. We have had no major health problems this year. My husband and I take some meds and one of my children has had problems with kidney stones since she was in kindergarten but she is 16 now and the medication she takes seems to work for her. We still seemed to wipe out our HSA by the end of the year from routine dr. visits and medication. I will do anything for my children, but now we have to wait until I know we’re really sick before we go to the doctor. I think the problem is when they started making Obama Care available the doctors offices, urgent care and hospitals started charging more for everything they do. If something should happen to more then one of my family members we would be in big trouble because our families out of pocket max per year is double what we can put into our HSA per year. Not that we can afford to put anymore in to it anyway. Since they started doing Obama Care this is the first time in 22 years of marriage I am worried about affording my families health care needs. I know a lady who has received government assistance for 10+ years and she gets way better health care then my family does, and she pays next to nothing for her meds and when she goes to the doctor. It is really not fair that people on assistance and don’t work for one reason or another, get better health care then people that work. I’m really worried about the future of health care.
This is a somewhat misleading answer. If you put money into a Medical Savings Account, all you’ll save is the tax dollars and you’ll earn tax free maybe a quarter of a percent on your money. Let’s see, if you’re making $85,000 a year, and your taxable income is $70,000, your tax rate might be about 20% (assuming this is for a family of 4). If you put $5,000 into a Medical Savings Account, you’ll save about 20% in taxes, about $1,000 (you’ll earn about $12.50 tax free on the account). That’s $1,012.50 in savings. It helps but not a whole heck of a lot.
I receive social security and have Obamacare but my premium and deductible is so high I cannot afford it. I am a widow and live from month to month. Can I find a cheaper premium at this time since it has passed the date to change my mind.
I looked into Short term health insurance, which isn’t subject to all the BS rules/regs under ObamaCare. The premiums and deductibles are very low – office visits, preventative, emergency room coverage vary in terms of payment after the deductible, but if you only need to shell out $500 to $1000 before coverage kicks in, why not? You’ll need to pay the idiot non-coverage tax, but if you add a premium of $150 a month (for a family of four) to the tax, it sure is less than the crap that’s being peddled on the marketplace.
I’m a life-long democrat, but I’m rooting for Kasich to pull a miracle and help us all out of this nightmare.
I had my fingers crossed for Kasich too. I’m sorry.
What a boat load of crap! this system does not work and has ruined our insurance plans across the country. You basically told this man that when you get really sick you won’t have a big debt. That is the worse answer and really NOT a solution. so just say to his daughter, “we aren’t going to help your daddy, but when he is nearly dead and goes to the hospital then your bill won’t be as high as it could be”. And when you say that some deductibles may be high..you mean all deductibles offered through jobs are high I haven’t heard of anyone with less that $4000. And the cheap plans cover so little and you still can’t afford medication. I say to the US government, “What are you thinking? HELP!
I lost my job, no income, affordable care still cost me $500 a month. How can I afford it.
I can’t afford my 6,000 deductible from employer provided health plan. So I will not go to doctors. And while paying monthly premiums with work related contributions to my health coverage, my question is: how is this affordable..yet mandated? I am a Healthcare practitioner, treating people with health issues. And I can’t afford and ‘expected’ to have to save or contribute to HSA. I don’t have $6,000+ laying around to save for this. What do we do? when our government takes advantage of us tax payers and helps insurance companies profits? This is in reality, unconstitutional! And everyone knows it.
Something needs to change. This health coverage demand makes insurance companies more profitable. A survey will be demanded by us working poor that shows health insurance rate profit increases by the mandated health care program. This program is NOT affordable, and is only a profit for health insurance companies. Prove otherwise. We as working class pay our taxes all our lives. Help us pay for our health, since we can’t and we pay our government. Help change this to help us with health needs and not the big buisness profits. We are as nation that is to help the people, for the people and by the people! Stand up and we can make change!!!
I am retired and receive $988 a month. I am not old enough for Medicare nor is my wife. We went though the Obamacare Marketplace and the cheapest insurance we could get was $900 a month. How is this affordable? Oh…and no…we don’t have a cell phone we can get rid of to pay our premiums. This is truly disgusting.
I’m a single divorcee who has had to purchase my own insurance. Unfortunately I not only pay a high premium but my $6000 deduct prevents me from ever going to the doctor because I do not have any extra funds to pay for my visits OOP. I have had to stop taking my blood pressure, depression & one other med due to the fact that one is quite costly & I have to meet my deduct before insurance will pay anything, & the other two are only prescribed if you see your doctor on a regular basis, which I cannot afford to do. My plan doesn’t offer vision & I wear glasses, so I have no vision coverage, my vision is changing but again I can’t afford to go to the eye doctor, I do have dental but I have to pay on a separate plan for this. I have hereditary back & neck issues, for which I’ve already had back surgery in the past & now my back, legs & neck are causing me restless nights, for which I cannot do anything about since I don’t have extra funds to see my doctor. I was unfortunately left with marital debt which I am still digging myself out of. Between rent, utilities & other bills, making that high insurance premium on my budget is killing me. I am suppose to see my specialist because of a possible cancer scare but I can’t afford to pay the cost of the visit and there’s no way I will every meet that $6000 deduct for my insurance to pay a thing. I had to cancel necessary visits such as mammograms because although most plans allow for these visits, my benefit booklet does not say it includes this. The point is I’m nearing age 60 and I have a lot of issues going on and am not able to see a doctor because of such a high deduct. I my as well take that money and be throwing it out the window for all the good it’s doing me….I have insurance but can’t afford to see a doctor. Thus I pay and get nothing in return except a card that says I have insurance.
This is nonsense. That answer is a rub around and didn’t address the question. For me on a self employed Obamacare marketplace plan it’s $450 a month and a $10000 deductible with nothing covered before the deductible. Nothing is preventive care, nobody goes to the doctor for that, only check ups with nothing done at the office count as preventive. This is a huge scam. My neighbor is self employed and their family pays $1600 a month. That is so far from affordable that it’s absurd to call the act affordable care. My private insurance before this wreck was $160 a month with a $3500 deductible and EVERYTHING was covered except major medical before the deductible. Lies and lies. I can’t avoid this and I will vote for anyone at this point who would fix it. This didn’t benefit the hospitals sushi ask, that was a lie and their staff is quitting in droves over it. This was just a way to buy votes from poor uneducated people whofeel for this scam and a way to force the middle class to pay double to cover them so the insurance companies wouldn’t lose their profits.
I hear your points, I really wish people who expressed this view didn’t combine it with a prejudice tone. And “This was just a way to buy votes from poor uneducated people who feel for this scam and a way to force the middle class to pay double to cover them so the insurance companies wouldn’t lose their profits.”…
Honestly I can’t even tell what party you are talking about. The one whose strategy is to defund education (the far-right)? Yes they have. The concessions made to big business on the left and right (yep).
Or the Democrats who really do want to see everyone have health insurance, and the Republicans who really do want a strong middle class… wait… why are these groups even fighting… Unless!?
Anyway, the trick is to utilize all deductions when self employed to get yourself in the sweet spot where you can use tax credits. If you work for yourself you must begin to master the tax system to benefit. That is the only advantage you have aside creating your own freedom.
So job the system to make it work?! What kind of advise is that? And I see you saying we need to “tweak”‘the ACA but you have never offered any solutions. I simply want to opt out! I want no one, not even the government, to pay for any of my family’s health care. I will pay 100%. Why must I pay for others as well. This act is little more that a distribution of wealth that could not be accomplished through regular means.
This site has plenty of suggestions and opportunities to discuss improving the ACA and possible new approaches in the news archives. The main focus of this site, however, is to provide the best information that is available on the law that legislators passed in Congress and that is subject to 50 different state’s individual guidelines for administration of medicaid. Yes, sometimes being honest and trying to provide the best advice given a set of rules that someone else came up with means the best answer is not always one you like. The Affordable Care Act is the law, Obamacarefacts.com didn’t write it. If you feel the law is unjust, write your legislative representatives. They are the only ones that can change it.
Nothing is FREE. Coventry says preventative care covered but not paid by them. They state it only qualifies as a part of the deductible. I can’t even afford wellness checkups or any preventative care. Even Pap smears and mammograms just count towards deductible. Either the insurance company is not abiding by obamacare or Obama is lying
The free preventive services are really free, but additional testing isn’t always. The details are a little more complex than was circled around through talking points. But you should talk to the insurer and they will explain.
If need be, you can appeal!
We should probably focus on addressing healthcare costs in general. If you break your leg, it shouldn’t cost thousands to get it set and fix it up, especially when treatment for such a procedure hasn’t changed much since the mid 20th century. Perhaps it is past due to audit the system to figure out what operations and basic healthcare are really costing. If I may interject my ideas on what a real reform should do continue reading: In my opinion, insurance should really only be there for catastrophic stuff. Going to the doctor for a lab on a mole shouldn’t cost you your arm and legs, and most of us should be able to pay reasonable prices out of pocket to cover these things. We could reduce premiums to very low levels and keep deductibles high so insurers aren’t overburdened yet we as the insured have a safety net. The savvy person would save that money not paid to a premium into an HSA and use it for their out of pocket expenses. Of course, all of this could only work assuming healthcare costs in general get audited and lowered to reasonable levels.
Amen. I am all for focusing on the underlying cost. For me, once we all agree repeal and replace with nothing or tax cuts for big business isn’t the answer, then we can focus on making the ACA better or replacing it with single payer. For me, there is nothing to replace it with that isn’t going to expand coverage and address costs. To be clear, the bill is about 1,000 pages long and a lot of it works well (and is actually reducing underlying costs). Don’t want to act like that isn’t happening.
The healthcare is a big rippoff. I am going to have to file bankruptcy to pay medical bills. I pay 363.00 a month for nothing. I have never been in debt because os medical bills but now I’m screwed.
People not working are getting great healthcare and eat way better ! Also now offer free phone service ! Quit your job!
That is actually just right-wing propaganda meant to divide the country so we don’t notice they are taking all the money… But hey, whatever, hate your neighbor while the corporations pass laws in backrooms. It IS one solution.
Dear ObamaCareFacts person,
I actually feel sorry for you because it’s your job to address these legitimate issues from frustrated people who work hard so they and their families can live decently. Unfortunately, the only thing you’ve accomplished is to reinforce the fact that this law is anything but affordable and has caused misery rather than relief. How anyone can justify our premiums going toward illnesses we don’t have, while not being able to afford the outrageous deductibles to receive care for the illnesses we DO have is mind boggling, to say the least. I read through every one of your responses to these comments hoping to finally read an answer that would make sense of this law, but I am convinced that the ACA is just not working, in particular for the middle class working people. In fact, it is literally crushing them financially! I’m all for helping others, but when those helping get hurt in the process it seems that some one has to admit there is something radically wrong with this system.
Thanks for the kind words. There isn’t really any good advice outside of “get an HSA” and “shop around” for those who don’t qualify for marketplace cost assistance or Medicaid/CHIP, but yet don’t make enough to simply eat the costs. We have tried to be consistent in praising what works with the law, calling attention to the millions getting a fair shake, and the many good provisions while remaining critical of provisions that hurt the middle class.
“I will sign a universal health care bill into law by the end of my first term as president that will cover every American and cut the cost of a typical family’s premium by up to $2,500 a year.” 6/23/2007 speech; “A Politics of Conscience”.
Someone who doesn’t know what they are doing, won’t apologize for the screw-up and won’t fix the overbearing burden they created is the definition of an World Class LIAR and A-Hole politician. Can’t believe a word he says.
Here is a typically higher deductible…..
Just lost job w/ BCBS Bronze Family insurance $420/mo, $4000 deductible.
Individual rates just quoted from exchange for me, wife and 4 kids with BCBS Bronze is $1500/mo premium, $13,700 family deductible! That’s $31,000 /yr before any medical costs are covered. Is this what Obama’s vision was for the $2500 reduction?
Right wing propaganda? You must be working with the corrupt politicians who passed this law. Welfare recipients get free food, as much as 500 dollars per month., many get section 8 subsidies to pay their rent, they get Meficaid which is completely free to them paid by my tax dollars. And now, yes welfare recipients qualify for free cell phones. I know this for a fact because I work with the Medicaid population in my community and they often come to me to verify their healthcare status which is required as part of reporting they must do to keep their services active.
God forbid we go feeding the poor and healing the sick on the tax payers dollar… Still, as someone who supports charity (including state-funded charity) and assistance programs, I too want to see welfare reform to cut waste and ensure people are getting what they need and are able to bounce back via the safety net, not get caught in the safety web.
FREE CELL PHONES!
[X website I won’t promote on here, but was confirmed as real]
Here is a really great web site that gives details on eligibility for government sponsored cell phones. 100% FREE!
NOT RIGHT WING PROPAGANDA.
This is how the Democrats expand their voter base. And guess where the money is coming from? You guessed it , tax dollars slotted for social services.
Fair enough, but it IS still essentially right wing propaganda as you are talking about the longstanding lifeline program (started by Ronald Reagan in 1985) for low-income people to get discounted phone service. There was an update to this in March 2016 and yes it of course today includes cell phones (do you suggest we give the poor rotary phones instead?).
I’m personally happy to pay a bit in taxes to help someone who can’t even afford a dang phone. Here is a description of the actual program: https://www.fcc.gov/general/lifeline-program-low-income-consumers
And guess how much of our budget is in “obama phones” anyway (its a little under $2 billion). Take a look for yourself: https://www.nationalpriorities.org/budget-basics/federal-budget-101/spending/
I have been looking at health insurance company’s 1,500 a month with a deductible so high I will never meet it. I can’t afford to pay even more money out to yet another insurance company. Car, life, health.
Make our politicians pay for their insurance without a pay increase.
When everyone pays fairly then and only then will something be done with the high cost of health care.
Put a cap on the cost of medical care.
Here is an idea make all political people live with 75,000.00 or less for a full year. Before they can even run for office. Things would change.
I am unemployed and have looked the “affordable” plans available on the healthcare. gov website. The most affordable premium is 700.00 plus a month with a 10,000 dollar deductible per year. That would probably exceed one fifth of my household income this year and would start over again at the first of next year. This could only be considered affordable if I neglected other expenses like my mortgage, utility bill, or vehicle insurance.
I have made the mistake in life of being one of the people who has worked. I spent 18 years in the military, and have worked municipal utility jobs as a civilian.
My health insurance went from great, to decent, to horrible with the passage of the ACA. This is all while employed with the same job. I am terrified of getting sick, because my current health insurance is garbage, and won’t pay anything.
My son’s pediatrician used to be a $20 copay, now it is a $40 copay, plus $205 per visit, because my insurance company has deemed pediatrics a specialist.
So thanks, Mister President. Thanks from all of the working stiffs who pay their taxes and decided to make enough to not need assistance from the government.
To those who are using the Obamacare system: Be a little humble, okay? There are millions of us who cannot afford healthcare anymore so that you can get it for free. We pay our taxes, and always have, and we are getting screwed now.
I have been a liberal all of my life, but this is one of the issues that I can’t help but agree with a lot of conservatives: we are getting the shaft to provide for Americans who refuse to support themselves.
My co pay to see a specialist is $50. I have chronic arthritis pain among other annoying conditions. Do you even realize how much this is adding up? I had to refi my house just to try and get out of debt. Man, if I knew back in the 90s that health care would be so profitable, I would have switched professions! It’s especially frustrating because the specialists I see, do nothing to help me! I’ve never, ever had to pay this much. Can we just go to single payer already?
High deductibles do not make care “affordable.” The fact that high deductibles exist at all contradicts the very reason this law went into effect. Only individuals on Medicaid benefit, as they do not pay at all. As a healthcare Administrator I speak from professional and personal experience when I opine that this law is an absolute failure.
My employer was required to offer ‘insurance’ to it’s employees this year because they employee an average of 100 employees. However, it would seem that they are only ‘required’ to offer their employees is minimum essential coverage. For those that do not know, minimum essential coverage does not include any hospitalization coverage. Well, my question is, since my employer offers this so called minimum essential ‘insurance’ and I still need hospitalization insurance, is there anything out there similar to medigap insurance that I can purchase to bridge the employer sponsored plan and what I actually need as a 55 year old employee? I can still purchase an individual plan and disregard the employers plan, because the existing employer sponsored plan does not meet the minimum value guidelines. I have shopped till I’ve raised my blood pressure (which I might add, isn’t good for my health either). What I a have found is that my annual single premium will be approximately $6,000, plus another $6,000 deductible, for a total of approximately $12,000 per year before I can even benefit from any sort of insurance. What I would like to find is some type of coverage that would bridge the gap of benefits (or lack there of) from my employer’s sponsored minimum essential plan and what I would actually consider insurance coverage at minimum value, without paying for a plan that duplicates what the employer is already offering. In conclusion, this current administration drastically failed this plan. They are penalizing married, working class people, but it’s not the first time we’ve been the loosing end.
That not actually true. For your employers coverage to be considered “Minimal essential coverage” it is require coverage for things like hospitalizations. However, only preventative coverage is required to be covered before the deductible is met. For an insurance to counts as minimal essential coverage, it must cover hospital stays and must have an annual limit on the amount of out-of-pocket costs that you would be responsible for in the event you needed costly care (like a hospital stay). Find out more here.
Obamacare is nothing but being forced into something that is not affordable. What should of happened is some regulation of what hospitals and doctors can charge for a procedure. The government even stopped people from buying scipts from Canada and Mexico, Its government mafia!!
This is a total disaster
Our out of pocket before we meet the minimum is in the thousands
Pre existing conditions will not be held against you, everyone will be insured
They may not be held against you to get health insurance but they will effect your care
so suck it up if you have pre existing conditions with deductibles in the thousands at least we will insure you
While I am a devoted Democrat and generally support most party initiatives, we got screwed by the ACA. As I am self-employed, we get health insurance through my husband’s company for our family of three. I had my daughter and I on a separate plan, but once the ACA passed, the cost for the exact same plan shot through the roof – doubling in cost. We moved to his plan, but the only one we can afford costs over $600 a month – basically 1/3 of his income – and has a $5,000 per person/$10,000 family deductible, making it pretty worthless. We now have co-pays for every visit, and the little money we manage to put in our HCA ends up covering those, prescriptions, tests, and dental /eye doctor visits. As a result, when my daughter had to have orthopedic surgery two years ago, we had to pay almost the entire $7,000 out of pocket. She now needs follow-up surgery to the tune of $4,500; once again, out of our empty pockets. I just finished paying off the docs from two years ago. We never have anything left for savings, vacations, or extras, all because of our medical costs. My husband and I are ignoring some medical issues because we don’t want to run up any more debt. And we’re generally healthy! I can’t imagine what unhealthy people are doing, other than going bankrupt. This country is a huge failure as far as offering decent affordable medical care, and there’s not a darn thing we seem to be able to so about it, no matter who is in office.
Editor comments on ObamaCare insurance that try to make this farce sound sensible are merely insensitive attempts to keep their editor’s jobs !! ObamaCare is ultimately a TAX, it is how it was originally presented, and then the chief justice of SCOTUS illegally rewrote it so it could be voted thru SCOTUS and not Congress. THERE IS NO UPSIDE TO THIS ECONOMIC ATTACK AGAINST AMERICAN MAINSTREAM !!
Well, i’m the editor and the co-owner of the site. So disagree, this site is meant to help America understand the ACA from a centered perspective. Yes, I agree that the whole tax or mandate thing was finicky politics, but the core of the program is a needed step in the right direction. Things were spiraling out of control before, we now have a platform with which to plug holes. Some holes have been plugged, more holes are springing up, and more work needs to be done. There are tons of upsides and healthcare isn’t an X-box, we can’t really treat it like a purely economic issue. Its too complex for that. We have 320 million Americans and a $3.8 trillion system to deal with. It can’t be boiled down to a YES/NO absolutist stance.
I have to agree with most of the people posting here. The cost of health insurance has soared since the passage of ACA. I have employer based health care plan. I work for a public school district. I pay for coverage for my wife, 2 children and myself and my employer pays some of my cost but just on me not my family. 8 years ago, I used to be able to afford the Gold plan but now I can barely afford the Sliver plan. I make $72K annually but it cost me 1,176 a month for health insurance premium with a $1,500 deductable and max out of pocket of $10,000 and 20% co-insurance after deductable.
I pay $10,584 per year in premiums just to say I have insurance and that is the least I pay assuming no one in the family needs to see a doctor, or medicine, or has an emergency. The cost just goes up from there. There needs to be a major overhaul of the system. A start would be if the premium cost was a tax credit not a deductable.
I have quit going to the Dr. as it has just gotten too expensive
I have the solution for every posted plea on here, that can not medically risk or afford to put their deductible on freaking “lay-away”.
First…too bad you wasted your vote on the p.o.s. responsible for the deaths of MANY Americans not considered “viable” enough to receive life saving procedures while hospitalized.
This November, you may want to reconsider your affiliation to a political party.
The method I suggest for satisfying unaffordable medical needs may not be acceptable by all & to the rejecting, I say, “oops…I’m all out of effs to give you.” Part of me believes this post won’t even make it through the left-sided, media manipulating machine. We’ll see….
The answer to this medicinal train wreck we’re stuck in is to,
A. Gift or transfer all assets to your spouse or s.o.
B. Get a divorce.
C. Quit your job/get fired.
D. Apply for welfare.
E. Bask in ALL necessary,(heck, even some you just WANT)gratuitous medical procedures.
G. Seek employment.
It’s a fairly involved manner in which to protect and sustain a life, in a nation so failing, you pause to wonder if she even warrants compromising the patriotic values of an idea on injustice.
I am a full-time student, my wife works full time and makes a little under $25,000 a year. The best plan I was offered in the Bronze category was a $368 premium with $13,500 deductible. I get no assistance for school and now I have to figure out how I can get my wife insurance. Her work offers insurance and it’s worse than the “healthcare.gov” insurance. It is so ironic how the democratic party says they want to offer help and assistance and they believe in CHANGE. Really? Was the CHANGE they were referring to a change in the oppression the American citizens were going to feel under the thumbs of the superior Democratic party?
It would make more sense to keep the premium that I pay each month for insurance and use that money for office visits. I have had to stop doctor visits and deal with illness on my own. I can not believe that we are in this situation today. It is a total waste of money for the average family to pay these ridiculous amounts monthly and then have the huge deductibles on top of that. What is the benefit?? Most people don’t normally have hospital stays, we depend on office visits to keep us from them! Too bad we can no longer afford them.
Oh my what a horrible answer. I’m thinking of just paying the penalty because the per year with the premium and deductible I’ll shell out over $17k for a family of 4 before the insurance company pays a dime. I have read and written multiple papers on the Affordable Healthcare Act at the graduate level and know that this was the worst thing to happen to America.
Basically for $6,800 a year I get coverage for an annual physical, colonoscopy (every 10 years as recommended), a mammogram and routine lab work. Terrible compared to what my coverage was prior to the ACA. MY son paid $12,600 out of pocket last year for his cancer care prior to his employers insurance paying much and that is with his premium of $400 a month for coverage.
NO one should be fined who cannot pat this exorbitant insurance plan/
not 1 cent of cost savings was added, and not mentioned too much from year to year less plan choices are offered, theirs only 2 co in my county and the offer only HMO and edo
either high premium and high ded for HMO or higher yet but somewhat lower ded EDO. but no PPO and the edo and hmo offer absolutely no out of network coverage unlike last years ppo with a slightly higher co pay if out of network. also if you do have care out of network it does not count to deductible and in my case 913 ss that i had to take early due to disability that was rejected i have a offer of almost 700 monthly and a 6850 ded and 70% coverage so in the long run i pa pos cash to facilities that offer cash discounts.and have never had to skip a appointment if i had ins i would not go to dr
If you don’t have the funds to pay the deductible, or are barely able to keep up with the standard cost of living, how is anyone going to be able to set aside money into a health savings account? I make around 70k a year, pay around $600 in health insurance, for me and my wife, each and every month through my employer. Both of us are in our late 50’s and have been trying to get by for the past 3 years with some form of walking pneumonia, coughing and wheezing with no energy to get up and do anything. I have been trying to put aside $40 so that I can see a doctor, but know that there’s going to be additional costs, medications, follow-ups, etc. The funds aren’t there. I’m sitting on thousands of debt from the last doctor’s visit from 5 years ago, no credit here, and also had to already give up on my 401k. The only solution that I see in bankruptcy, but won’t be doing that until after we’ve received all of the needed medical care. It’s a shame, to be insured, still not able to get medical care. When people report these issues, please provide workable solutions, not additional spending.
The best bet is quit your job and go on Welfare.
Well, while I do think this is true in some select cases, it irks me to see people taking that attitude even jokingly. If the rich pay zero in taxes and those struggling give up and “go on welfare” then there is no money, and thus there is serious problems for America.
Screw it, I agree, I cant get ahead in life and perhaps the only way to get ahead is to do nothing. No wonder why business is leaving this damned country I fought so hardddddd to protect, huh? WTF did I protect?
I think this healthcare is ridiculous. I can barely pay the monthly payment plan let alone meet a $5,000 deductible for myself and 2 children, my husband is disabled and thank goodness he is covered by medicare along with my youngest who has chronic health issues. but my other daughter is on my plan and her one medication is $700. NOT COVERED!!! This is a medication for her bleeding disorder. outrageous! not to mention multiple ER visits also havent met deductible just got a bill for over $2000! I am the only worker in he house and they say I make to much money for help! I cant even pay my bills. I am paycheck to paycheck. affordable health ins my ass, maybe for rich People.
The real answer is to untie our healthcare from our insurance just like our auto insurance. You buy what you want on your own without involving your employer. When your premiums and deductibles start going up you shop around. It works everywhere else in the world. My daughter lives and works in Amsterdam in the Netherlands. She pays 85.00 a month and that covers everything from hospitalization to prescriptions. We are fools if we keep letting our employers and the insurance companies dictate what we pay. Neither one has our best interest at heart. With Obamacare there are problems. From what I see the problem is that the insurance companies do not like have the regulations put on them. In other words the regulations from Obamacare are demanding that they actually take care of sick people. This is cutting into their bottom line. It is time we start demanding the care we deserve from the insurance companies. Unitedhealthcare pulled out of the market places because it was costing to much money to take care of their sick subscribers. On a personal note I worked for Paramount healthcare and at one of the staff meetings the toic was “how do we get our subscribers to pay higher premiums when we are cutting their benefits”. I left shortly after that. Your anger should be directed at the insurance companies. OT the regulations that have been put on them.
obama care is a attack on the middle class something that the goverment does all the time with their tax system from federal taxes to local taxes. the middle class is getting smaller and smaller.between the goverment and the corporations this country is going down hill and will continue to go down hill with the type of people we have in charge’
With obamacare my premium and co-payment have gone up, and the deductible has quadrupled. Your solution is to start a savings account to pay for medical expenses, and to not worry, because even though I can’t afford to go to the doctor the way I could before our brilliant president inflicted this disaster on us, I’ll be able to get treatment “when things get really bad.”
Just got my new blue shield enrollment forms for 2017. Monthly premium going up from $280 to $340. I guess cuz I got a dollar raise at work? Working 40 hrs/week for buck more than minimum wage and married but no kids. I make 18,144 after taxes and gotta pay 4,056 annually just to keep this insurance. That’s about 22% of my income and the silver plan doesn’t even cover that much! I couldn’t go to a specialist my doctor recommended… They don’t accept insurance through coveredca. So basically I pay a huge cost for something I can’t use???!!! Typical federal gov logic, but oh lucky me, I save $35 a month on my medication. Why are you hammering the working responsible people while giving free coverage to those that sit on their a$$ all day smoking weed, selling drugs, making babies? Say it aint so. How about free, GOOD, healthcare for those of us that work and pay our taxes? Wife and I joke it would be cheaper to get a divorce and have a few babies out of wedlock. Then quit our jobs. Get free food, healthcare, smartphone, housing… What a great country we currently live in! Oh that’s right, don’t be angry just smile and accept this blatant screwing over???
Really stuck here. Just got my renewal notice for 2016. It’s just my husband and I. He lost his job in 2013, hasn’t been able to get another job- employer’s think he’s too old- he’s 51. I am working two part time jobs, earning around $38,000. So, our bare bones plan is now going to cost $868 a month with a $10,000 deductible and a $14,700 max out of pocket. We get a small subsidy bringing the plan down to $535 or so a month. So, we have to pay $16,420 before the plan covers anything other than an annual visit for each of us, and a mammogram for me (I will be 49). My income after taxes is $28,500. This doesn’t leave a lot of room for much of anything. I still have to cover property taxes, house and car insurance, food (which we try to keep to around $50 a week), utilities. We try to limit water usage as much as we can because it’s expensive- so we are down to 1-2 showers a week, and I cut my own hair. I don’t have anything left to cut out.
Understand that u are stressing the middle class and if u politicians and the 1% keep pushing eventually we will stand up and push back.
I have a family of 3. My husband has a small business and we don’t get the break that employers with over 50 employees get. I just got my new Obamacare rates. YIKES!!!!!! Our monthly cost will be around 1700-2000 with a 6000 per person deductible. How in the world will we be able to pay this??? If you do the math we will be paying around 21,000 for a year of coverage then if we all meet our deductible (which we did this year) that will add up to 42,000 for health care. What was the Obama administration thinking when they passed this? It will sink us!!!!!
I just got a letter saying that our health insurance is going up 40% this next year. It is getting to the point that it is way less expensive and a better idea to not have health insurance and just put the money that I would be wasting in premiums in a bank account and just pay for my own bill’s. It is worse than highway robbery the amount that we have to pay for health insurance. It is almost more than my house payment.
I am paying 390 a month. 26 year old single male and my deductible is 5500 a year. I feel like Im getting ripped off as I go to the doctor for the first time in like 3 years the other day and I had to pay everything out of pocket. What a f**king scam.
This makes no sense to me. I wanted to know why after Affordable care my insurance through my husbands work has become unaffordable and our coverage has become horrible. Yet we can’t go anywhere else for insurance. What the heck? This act was suppose to make things better and that is not what has happened at all. I’m very sick and there is no help for me.
Yes the HSA/flex does not even come close to the $6800 per individual deductible. Which if you have a chronic condition will still cost you $6800 on top of an average premium of $17896.80 for a family of five. Employer will pick up a minimum of 50%. So Insurance company will take 29% of $60,000 salary. Then you have 20% fed/state tax and an average sales tax of 7% before you get to car payment auto insurance and mortgage you don’t even have enough money to feed your family.
I was pro- Obamacare but not anymore I may need to vote republican
The suggestions are not help. We need to get rid of this insane law. My employer only offers high deductible plans. The lowest premium for a family is $884.31 monthly with a $7,000 family deductible. So before the first claim is paid, I have to come out of pocket $10,611.72 in premiums plus the deductible. So I’m out $17,611.72 for the year. Our household income is $62,000 gross. Take out my taxes and the insurance, my bring home is now a little over $33,000. So tell me how this law made things better for us?
Do u realize!!!!!!!!! this will cause sick people not to go to doctors, get there medication because u have to pay full price for medication until u hit the deductible!!!!! what are u doing as someone who relies on medication to keep my panic attacks in check im now burdened with having to pay 85$ a month for my medication and have had to cut out another. because the deductible is so high. why am i paying monthly for a insurance that does not kick in until the deductible is payed your double dipping!!!! Whats worse is that money does not even go toward that deductibe. Your literally going to kill people with these type of plans and its only a matter of time before someone who has severe depression hurts themself or worse. What about a diabetic who need meds has a Son who need medical help but he can only afford for his son so your happy about letting someone father die. POLITICS AND GREED HAVE NO PLACE IN HEALTHCARE!!!!
Do u realize!!!! this will cause sick people not to go to doctors, get there medication because u have to pay full price for medication until u hit the deductible!!!!! what are u doing as someone who relies on medication to keep my panic attacks in check im now burdened with having to pay 85$ a month for my medication and have had to cut out another. because the deductible is so high. why am i paying monthly for a insurance that does not kick in until the deductible is payed your double dipping!!!! Whats worse is that money does not even go toward that deductibe. Your literally going to kill people with these type of plans and its only a matter of time before someone who has severe depression hurts themself or worse. What about a diabetic who need meds has a Son who need medical help but he can only afford for his son so your happy about letting someone father die. POLITICS AND GREED HAVE NO PLACE IN HEALTHCARE!!!!
Wow! How I am I supposed to afford my coverage, putting away for health issues and paying for actual health issues that my insurance will not pay because of their huge deductible?
Premiums have gone skyrocketing high for 2017. Here in PA a friend just got their premium amount and it’s $1600 for two healthy 45 year old couple! Can’t stand Obamacare. It’s destroying us even the name is a lie
“I am not a political person and I voted democratic and I am for the health plan changes. But I cant afford anything anymore. the next time I see a doctor will probably be in the emergency room. Who can I turn too?” —— Your last sentence says it all. The Democrats & the people that voted for them created this mess and you are now living with it. The real solution to health care costs is Capitalism (a dirty word with Democrats & Socialists). If there was a free market ACROSS STATE LINES, there would then be real competition.
“You’ll always have catastrophic coverage. People may put off important health services due to cost, even with health insurance. That being said, when things get really bad your coverage will kick in…”
So the answer is yes you’re supposed to end up hospitalized and unable to live. You have to sacrifice your health for the health of those who are unemployed or too poorly educated to work anywhere other than a grocery store.
“I voted democratic”
Then don’t be a cry baby, you did it to yourself and to the rest of us, GOOD JOB!!!
The crux of the situation is I can’t manage budgeting $6000 for an HSA on top of a premium $300 after my living expenses. The affordable care act is a crock. I have been let down. Not everyone works for an employer. I am an entrepreneur and there is not a plan that is “affordable” with my level of income. Even the lowest level catastrophic plan is $250/mo and a $7150 deductible. That’s $10,150 a year in a worst case scenario!!! If I had that kind of disposable income a year there wouldn’t be an issue with the $300/mo premium.
Who ever made these decisions is so far removed from your average persons cost of living and income that it is insulting.
This website is a biased piece of garbage; clearly left-leaning and COMPLETELY OUT OF TOUCH WITH REALITY.
I am a small business owner who is not under the MANDATE to maintain a healthcare plan. I have always provided a healthcare and retirement package for my employees simply because it is the right thing to do. As a result of this horrific tax-grab disguised as healthcare reform, I have been forced to discontinue my company sponsored plan. While we covered our employees, we could no longer afford to cover their families. The premiums for the families were at obscenely inflated prices and did not qualify for any subsidies because the plan was considerd ‘affordable’. As a result, people were faced with either making their rent or putting off getting their medicine on a regular basis.
To the talking heads say that this mandate is not hurting job growth and that the economy is actually growing, I have an announcement: STOP DRINKING THE KOOL-AID!!! When small businesses (the very BACKBONE OF THIS ECONOMY) cannot hire due to this quagmire that the ‘progressive’ left has foisted onto us, we all pay the price.
Study finance / economics and history, people.
I am an independent who has voted for Republicans, Democrats, and Libertarians in the past. However, I will NEVER EVER vote for another Democrat again because of how badly they have screwed up healthcare in this country. I am a healthy, self employed, working citizen, making close to $100k a year, and I will tell you that having health insurance is getting to the point where it is no longer financially feasible for me. My insurance costs for me alone are close to $9000 a year; add my $6,500 deductible to this, and I’m out of pocket over $15,000 a year before I see any benefits, plus I still have to cover a sizable chunk of any expenses over those costs. So what do I get with my upsized insurance mandated by the Affordable Care Act? A free checkup every year – for which I used to pay under $50 for with my old, very affordable health insurance.
I have no doubt that Obama will be judged by history to be the worst president ever just because of the ACA. The problem was never health insurance, it was health care costs. Honestly, how stupid do you have to be to try to solve the problem of affordable health care by mandating that everyone needs to purchase a product from a third party that does not provide health care and in fact actually ADDS TO THE COST of health care? And then to add to that stupidity, also require that health insurer’s policy must cover offer free birth control, 60 days of addiction treatment, and an annual checkup as part of the base policy? For those of you who think health insurance is the answer, please try to use your brain for just a few seconds: your insurance company inserts themselves into the transaction between you and your doctor, or the hospital; they insure the doctor gets paid, but the insurance company takes money for their services as well. And for those of you who want to point out that the insurance company negotiates lower rates with the doctors and hospitals, that is just another display of stupidity: the rates would be far lower if the insurance companies did not have their own interests at the forefront of all transactions.
If you really wanted to solve this problem, you would need to understand the problem and work to attack it in a logical manner. So what is the problem? Health care costs are high. Why? There are many, many reasons. Here are the some of the biggest reasons:
1) Malpractice insurance / malpractice lawsuits / malpractice awards
2) The U.S. has just under two doctors for every 1000 people (and bear in mind that among these doctors never see sick patients at all; they are in purely admin roles). A 2014 Survey of American Physicians found that 85% of physicians reported that they are over-extended, and that only 19% said they have time to see more patients.
3) The vast majority of these doctors are not allowed to practice medicine, per se. They are allowed to do testing and diagnosis, but when it comes to prescribing treatment, they have little to no discretion; they MUST follow treatment guidelines mandated by insurance company actuaries based on past treatment resolution rates.
Given these facts, how does requiring people to purchase health insurance fix anything? It doesn’t, of course. It only increases costs.
To fix the system, you need to have a multi-pronged approach, and sadly, I do not believe Donald Trump and the Republican majority currently elected have the courage to tackle this problem in a manner that makes sense. The backlash in terms of campaign and PAC contributions from lawyers and insurance companies would be staggering. Ift is far easier to say something like ‘we need to open up healthcare insurance across state lines’ than to deal with the multi-headed monster that is this problem. But here, in my opinion, is what it would take to start to fixing this:
A) There needs to be huge changes in malpractice law; awards need to be limited, and serious financial consequences need to be applied to complainants AND THEIR COUNSEL for bringing losing malpractice actions before a court of law.
B) The number of doctors in this country needs to be increased. We need some sort of program that puts students through medical school, and forgives that debt over a period of years for their service in an area where health care professionals are already strained. Create a doctor, pay them a decent wage for 7 years while they serve out the terms of their agreement in an inner city hospital or some rural area, and after that time, they owe the program nothing and can move on. (As an aside, go talk to some doctors. I promise you it will not take you very long to find several who are very unhappy with their jobs and wish they could do something else, but they have huge student loans that they need to repay, and they need to keep their jobs in order to stay afloat. There is a reason the suicide rate among physicians is double the rate of the general population.)
C) Let doctors doctor. Part of the solution needs to be getting the insurance companies out of the doctor’s way. I’m all about data, and believe that there is a lot to be said for playing the percentages, particularly when it comes to things like poker. But poker involves 52 cards – all of which are known, understood, and cannot change. Even with the use of wild cares, there is a finite number of possible outcomes for every round of poker. Medicine deals with people, and there is no way that any amount of data can determine the best treatment option for each and every person. Don’t misunderstand me here: the insurance companies’ data is valuable, and we still need this data, but we need to allow doctors the use of their discretion and training to determine how to best treat a particular patient. Given the huge advances in technology and our ability to access and update information at almost real time, this approach should increase both patient care and doctor morale.
Oh – and I think everyone in power who voted for the Affordable Care Act should be required to be covered only by plans offered on the government exchange.
I see that only the disgruntled have come here to complain. I am 60 had cancer and pay $255 per month for my plan, I needed surgery and if I hadn’t had my ACA plan I would have died–end of story. Believe me, all thought of how expensive it is to provide health insurance for yourself flies out the window when you hear the word “cancer.” If the law is repealed I become uninsurable. Before the law my partner’s sister was paying $30,000 a year for insurance because she had multiple issues, finally she was diagnosed with lung cancer and soon hit her 1 million “cap,” if she hadn’t died she would have had to have been destitute to get any care at all–this is what we are looking at going back to. That and junk policies that basically cover very little. I dare any of the complainers to get back to us in a couple of years after the law goes bye-bye and then tell us what you think of the health insurance industry in the country, I sincerely hope that none of you get really sick–if you do, the cost will be an eye opener believe me.
Affordable Care is anything but affordable. I am not sure that everyone realizes this but we are the only industrialized country in the world, and the only country in the western hemisphere without universal health care for all. Why? Answer: Because we are being told, and apparently believing, the lies about all the terrible longs lines and appointment delays presented by universal healthcare. Who is providing us with this faulty information? Answer: Our politicians who are being paid off by the lobbyists who are paid by the large insurance, healthcare and pharmaceutical companies. We seem to be willing to spend more than $600 billion a year on defense..which is more than the next 7 countries combined and more than 2X the amount spent by Russia and China combined. Why can’t we afford to help with healthcare? Americans now spend 2X yearly the amount for healthcare as do the most “healthy” countries in world, and we ranked #32! Yes, we have the greatest medical care in the world “if you can afford it”; sadly we have millions who can not afford it….thus…our #32 rating in the world.
Just wonderful, I had my new born son last month and now the bills are rolling in for my son and my wife. I’m going to have to sell half of what I own to pay this BULL****!!! 3500$ deductible each.. But… nothing I can do about it.. have half a mind to say the hell with my credit, buy a van and live by the river and never pay that over paid doctor a DIME!! Now my new born has check up appointments every few weeks and I cannot afford it!!!!!!!!!! What a team of IDIOTS we have voted into office!!
You voted Democrat. Elections have consequences. Enjoy your new health coverage.
My husband and I are self employed, and make about $5 K more than would qualify us for any discount. I don’t know where they got the idea that someone who makes that much can afford to pay the premium, and high decuctible. We can not afford to go tot he doctor. And yes, we have an HSA, but it doesn’t really help. We ended up paying more taxes in the long run, not less. We are basically paying a lot of money for health insurance we can not use. Help!
I’m writing this 26 December. All the posts on this site are heartbreaking to read. The fact is we’re all in the same boat. The answer is to get ourselves as informed as possible by the correct, actual facts–not by opinion or “news analysis” or “Fakebook” or by politicians or by what an angry neighbor told us! Anger won’t fix this mess.
Some of the respondents here do mention the appalling culture of our country. We spend more on prisions and the defense complex than any other country in the world. Our legislation favors the profits of the financial sector, not the profits of our good citizens, their children, and their small businesses. I am a history teacher sorting out my own healthcare mess, and wondering how I’ll survive. But I know this much about our country: this exact mess, this exact conflict, of favoring the worries of the wealthy over the daily poverty of the people has been part of our country’s history since the Declaration of Independence was written. What fixed it? People set aside anger for compassion. We’re all pretty darn screwed no matter who we are or where we live or who we voted for IF we remain passive. People got themselves informed by facts, by research, by the nobody scientists that big media and the well-to-do wants us to ignore.
You and I both are the bottom 90% and we hold almost 75% of all debt, meaning neither of us have earned enough in last 70 years to get anywhere financially except wrack up more debt. If you draw the line at Obamacare…you may be missing the bigger picture. I say this to everyone–my students or strangers in the grocery checkout line–think about it & do some homework. A vote…your single vote is just the starting point.
I am just going to pay the penalty. I have several chronic conditions and no more meds to take. I cant afford the doctor, meds, or insurance. My husband makes too much money according to healthcare.gov and the cost of the employer plan is too much. I hope something changes soon. I guess if I get sick enough I will go to the emergency room and take what ever relief i can get from them.
Please at least apply for a hardship or affordability exemption from owing the fee for not having insurance. If you are unable to afford insurance, experienced other hardships in obtaining insurance, or have current unpaid medical bills you can qualify for an exemption and avoid the tax. You can apply for those at Healthcare.gov.
So just pay out of pocket… To cover deductible to pay for others… Sure ok…. Well im 14K from the hospital and havent payed my deductible… Not very affordable care….. Now im in collections still hurt and have huge debt……
That’s how every kind of insurance works (car, home owners, life, and health). Everyone pays in and the funds are payed out based on the actual expenses of covered benefits of those insurances. Out-of-pocket costs (including for hospital care) on covered benefits are supposed to count towards your deductible. If it’s not, you may want to find a different insurer or contact your state’s Insurance Commissioner for help. If you have unpaid medical bills, however, you can qualify for a hardship exemption from the requirement to have insurance or owe the fee. You must apply through healthcare.gov. That is not likely to solve all of your financial issues, but I hope that information helps.
$1000 a month for premiums for a bronze plan with high deductible is ridiculous!
How can a family of 4 afford $450 per month premium & $516 per month towards their deductible. No matter how I figure this, if a family is going to get any medical care whatsoever, in a given year. They are FORCED to pay the premium & HAVE (already saved) enough to pay 100% of all medical needs per year. So basically this new insurance costs a minimum of $1000 per month. A worker making $15.00 x 40 hours x 52 weeks makes $31,200 GROSS. So insurance costs them 38% of their GROSS INCOME. How can anyone think this is ok?
It’s not okay and this theoretical family is likely eligible not going to be forced to pay anything. To be clear a family of that size and income level and family size would qualify for Medicaid coverage for the entire family if they live in a state that agreed to expand Medicaid. The would still qualify for CHIP coverage for their children even if the state didn’t expand Medicaid to cover low income able-bodied adults. Having employer coverage doesn’t prevent people from being eligible for Medicaid, but many people don’t realize they can still qualify for Medicaid or that CHIP has higher income thresholds.
If the family is not offered employer insurance in a state that didn’t expand (the children would qualify for CHIP) the parent’s would be eligible for Premium Tax Credits and Cost Reduction Subsidies (which lower deductibles and copays) on insurance purchased through the Marketplaces. If they are offered employer coverage, then they’d only need employer insurance for the parents.
Lastly, if for some strange reason that family lives in a region of the US which has such a limited number of Marketplace plans that the plans are still too expensive (even with cost assistance) or their employers insurance option is still to expensive they can apply for an exemption from the requirement to have minimal essential coverage or pay a fee for not having it. It the insurance you are eligible for costs more than 8.13% of your income in 2017, you can apply for an affordability exemption through healthcare.gov.
i pay for my own insurance a single plan with a $5,500 deductible, negotiated rates that i pay, and preventative care. $313 a month, which they say is good, but i feel i pay for only a disaster insurance, kinda like car insurance. If you dont use it, you still pay for it. I could have gotten obama help a bit, but then i’d pay like $356 or so. anyhow, what will happen to people that pay for their own like this. am i paying more for a individual plan cuz obamacare is paying for people that have no way to pay for insurance. Like my friend, she gets medicaid Molena free cuz her income is poverty level. she has no kids. am i paying for things like that with my insurance, maybe they tax the insurance companies to pay for them? I dont know. just wondered. I cant get medicare yet like my husband does, but he pays united heathcare plan and scripts. it is more expensive to live without a job as he had. I used to think seniors didnt pay as we are now. how the heck can people live with the expense of health insurance. And what will happen to my friend getting medicaid being a single woman, low income. will they just take it all back from people like her?
Painful reading this as a Canadian.
For the last 25 year’s I’ve been considered low income, under $42,000 a year.
I had my appendix removed, been hospitalized for a month for chron’s, had to have dialysis done for 6 months and had a kidney transplant.
Guess how much my healthcare has cost me?
Zero dollars. Sure I paid 20% income tax like everyone else who makes under $42 000 a year, but for some of those years I was on government disability because I was so sick. If you’re thinking the service must be sub par, it’s not, I wait between 10 and 30 minutes to get into my appointment at the nephrologist and am out quickly. Hell my kidney transplant took 6 months to arrange.
Not hard to figure out that these insurance companies are taking people for everything they can. I’m surprised folks are not rioting in the streets.
My husband is from a family from immigrants who were blue collar workers. We paid off my husbands college bills at age 31. We are thin, active, eat healthy, but are now entering our 50’s. Four years ago we had a bad stretch in business and went for six months with out pay. (Not to worry, we always plan and used our savings.) Three years ago my husband started his own business which employs just the two of us and it is doing well, placing us in middle class. When it comes to Obamacare our cost is $2,000.00 a month and a very large deductible.
I believe the real problem is the obesity epidemic.
Go “Red, White and Blue” LOL! Is there any wonder why our country has deteriorated into a tremendous mass of polarized apathetic zombies? Most having to work harder and longer hours like indentured servitude , just to make less money and that’s even taking into effect that our inflation rate is very nominal. Hey, but the good news is that our nations GNP is growing – Yippie! Also, so glad that we’re seeing the DOW Jones and Nasdaq pushing upward….. hmmm? Somehow I’m not sure that all of that is working to make my (or anyone I know) life any better or more affordable.
Sure, I see so many here blame Obama. Isn’t it great that we’re such a gullible and ignorant society that we’ve all gotten snookered into yelling “damn Libs” or “stinking Republicans”. It doesn’t matter if its Hillary or Obama – Bush or Tramp. We the people DO NOT control our monetary system, and are fooled into thinking that we can affect change by voting in someone less likely to rob or lie to us (that includes Congress just as much). Industry lobbies control our our legislative branches and this only serves the rich and elite.
Whats the answer? Bad socialized medicine? Free market (robbery) market? I think I know the answer but guess what – it doesn’t matter what I think. As long as we are a brainwashed society who will die to protect a false sense of freedom and democracy, dead set on protecting “Team Blue” or “Team Red” rather than intelligent enough to SEE what or who actually controls our cost of living and that good ‘ol quality of life that us Americans are so proud to banter about (joke). But enough about all that – lets just make damn sure that we keep our eye on the prize! Lower those taxes and eliminate big government out of our homes and lives. Good news folks, we now have a Republican President and Congress…. AND soon to be a far more conservative Supreme Court. No way we can fail now, right? Oh wait, I suppose if there’s any chance that we do though, we can all go back and just blame Obama hehe 😉 That’ll certainly guarantee I work fewer hours, spend more time with my family, afford that boat I once dreamed about, actually buy a car that’s under 10 years old, maybe buy a house, afford health insurance, and never never lose my paltry 401K investments or retirement funds. Just so long as no one tries to tax me more, I’ll be A-Okay and “free as a bird”!
There are a number of ways to make this work in a free market. First, recognize that primary care is the key to healthcare. Second, federal govt should allow primary care clinicians whether nurse of physician practices receive tax payer subsidies-as right now they are only provided to insurers, this isn’t about insurance anymore it’s about having a medical benefits plan that meets your need, is affordable and accessible. Third, allowing this will automatically cut healthcare costs; I am of the opinion that no one goes to the doctor just to go. Fourth, allow concierge and direct primary care clinics to receive tax subsidies; this means for between $100-$150 you/family have unlimited access to primary care-maybe a cost share which is ok. Fifth allow hospitals to accept direct subsidy payments for ER and hospitalization whether you use it or not-who goes to the hospital-no one unless they have too. Sixth set up catastrophic insurance plans financed by state and federal government for people who chronic illness/and disease. Seventh, reestablish the risk corridor program which will provide a backstop for insurers, clinicians and hospitals independent of one another. Eighth, there are a number of global insurers who do nothing but reinsurance or travel emergency care; remove the barriers to them bringing these models to the US. Ninth, this would mean you could cut in half the premiums for everyone receiving obamacare and it would be worth it for the emergency care/hospitalization; Tenth, expand the definition of wellness to include dental and vision; this is where there is a need for universal coverage from young to seniors; Eleven; block grant Medicaid to the states and allow them to manage their funding for the poor; my guess is that most will do what IN, IA and few other states have done, with the exception of people with severe mental and physical conditions mandate a co-pay for Medicaid recipients; don’t tell me they can’t pay nor will go to the doctor if they have a $5-10 copay but they can pay $100+ month for a mobile phone. Twelve, change the subsidy plan for small business from one based on low wages to one based on revenue and number of employees; the federal government should not penalize startups or say you can only receive a tax subsidy if you’re employee makes less than $25k; what if I hired one person who has real value at $30k, I can’t get the max credit. The goal should be towards everyone having universal care through employment and economic growth.
Most conservatives have listened to so many lies about the ACA that they don’t know anything about it. First, premiums have gone up because they convinced younger people not to join. That’s a mistake. A young, healthy person making $20,000/yr can get a bronze policy for practically free, but with a higher deductible. and which still includes some medical services exclusive of the deductible. A silver policy has higher premiums, lower deductible, and is geared to an older population that goes to the doc more often. My wife is 64, she has a silver policy with a $4300 deductible and premiums of around $320/mo. She pays $40 to see a doc. That’s on a gross income between the two of us (small business owners) of around $36,000. I am on Medicare. Our medical care udner the ACA is costly but managable. The key is to select the plan based on your anticipated medical needs.
When will this train wreck of a healthcare program be put out to pasture? Horrible website, horrible plans, horrible service. Round up all the goons who made this happen and fire them in my opinion and hire some new people who will actually make something that works for the people.
FUCK YOU blue cross blue shield, my fiancé has a 1700 dollar deductible, and his monthly bill went up, AND his co pays went up, and he is just above the poverty level. FUCK YOU
I am 25 and cannot afford health insurance. I make 40000 a year with not kids, but student loan debt of 90000 and I pay rent, for food, car insurance (another scam) and the clothes on my back.The government site wants me to pay a minimum of 300 a month for health insurance not including dental or great coverage. There are many people who are in my shoes and these premiums are just too high. You make health insurance mandatory and a monopoly, then spike up the price and capitalize off of people.
This is a load of horse shot and I hope Trump abolishes it. Why? Because “affordable” care act isn’t affordable at all!! I just tried to sign up for your “affordable” care because you people will not leave me alone, calling me texting me emailing me. So I finally gave in. And what did I find? Oh I get a stipend, yippee for me. But the plans? Are you freaking kidding me??!! Who can afford that high of a deductible?! Oh start a HSA or flex spending account. Gee, why didn’t I think of that?? Oh, right, maybe because my net income for the month is 1500? And that’s it! Gee sounds like a lot, right? Yeah, until you count in rent, car/renters insurance, gas, food, etc etc etc plus 3 children. I am the epitome of the working poor. And don’t give me that load about going to college crap, I did. Did anyone hire me when I got out?? Heck no because the work o studied for is all being sent overseas!! So I’m a freaking waitress making 3 measaly bucks an hour, getting tipped by old people who still think 2 dollars is a good tip! So don’t give me this horse shit about “saving”. I’ll be lucky if I have enough toilet paper to get through the month! It must be nice to be in La La Land, where money mysteriously falls out of my magical behind!!!
So no medical for me or my husband this year, and the government is gonna take my hard earned money one way or another, by golly, because they aren’t getting be paid enough. Hello fines!! Fock this greedy azz country!!!
The funny party (not funny “funny” of course) is that the GOP plan is like all HSA and deregulation. If you hate ObamaCare and HSAs, you’ll hate GOP replacement plan even more. But this is just logically speaking, I know that whatever they do Republicans will be supporting it like it is amazing. It is because… for some reason… politics. Speaking of La La land. La, la, ugh.
I am enraged right now.. My husband and makes too much for us to qualify for any assistance (we shouldn’t need any.. The cost of health insurance is criminal!). I am pregnant and going to deliver via c-section this year. The cost for United Healthcare gold plan is $960 a month for our family of 3. My husbands employer covers half his coverage so we pay $800. With dental, accidental, life, and vision on just him we pay $1050 a month. When the baby is born it will be over $1200. We were informed today that we will have e to pay $5500 out of pocket for my coverage when I have the baby as well as $5500 out of pocket for our new baby. Our deductible is $1500 but our max out of pocket per person is $5500 and they believed we would reach those limits. This is robbery!! We got the lowest deductible insurance option and we will end up paying nearly $26000 out of pocket for Healthcare by the end of the year.
What is even more sickening is all the lazy pieces of trash and illegals that don’t work but get free housing, free Healthcare, free food, and have the nerve to complain that they deserve even more handouts! Why are the working people being punished and the slackers being rewarded?
In the same boat as some other comments. Summing up the annual premium for family plan this year is staggering. Honestly, I understand why insurance companies are cranking up deductibles and max-out-of pockets in the marketplace. The pre-existing condition portion of ACA was such a bold, ethical, idealistic requirement. But it is very much doomed to fail. They should have delayed that part for 5 to 10 years. It crushed the insurance companies when you could select a gold plan, max-out-of pocket of $3,000 in 2014 knowing your family member had cancer and would be getting treatments costing over $250,000 or more! Completely unsustainable, and definitely occurred, and how could you really blame anyone for taking advantage of that deal. What a small price to save a life!!!! Well, we already knew life had a price, but ACA has surely provided a prime example to uphold the idiom.
The cost of healthcare is high, but so are the demands of the American people. Things are pretty nice in our hospitals, and the average Doctor knows a thing or two about keeping people alive by managing or stabilizing patients. And then you can always get a second opinion if you’re willing to call upon research institutions that are on the cutting edge. There really are incredible medical opportunities in the US, and really good practices, and they make a lot of money. It takes a lot of education (and therefore a lot of money these days) to become a Doctor, and there wouldn’t be much incentive to grind through that gauntlet if it wasn’t for high-pay and benefits. In many ways it is a thankless job and not much like the medical dramas on TV (The life of a policeman is rarely so glamorous either…) Medical devices are expensive because it takes a lot of money to build devices/monitors that are dependable and made to function with minuscule failure rates (Law Number XV: The last 10 percent of performance generates one-third of the cost and two-thirds of the problems.) Much, much cheaper to make consumer products in the post-modern age of planned obsolescence with the kicker of overseas anonymity/paper-trail invisibility, which people are accustomed to. High-end medical devices are really precise! People also really dump on Big Pharma without realizing how much money is spent on sunk cost endeavors before viable treatments are realized. Literally needles in haystacks, and all I see is complaints about how costly the needles are. Even when drugs are discovered, the maintenance costs of manufacturing labs required to churn out batches of high tolerance uniformity is greatly overlooked by these complainers.
The reality is American workers are not paid as many REAL American dollars as they were before. A very well-planned Inflation is how this is accomplished. Also income tax is taken from not only the wealthy, but even your middle of the road wage earners. Imagine if we had to pay our taxes to the US Gov’t every pay period like a bill, say a utility bill or rent. Think of it that way, and then read what the founders of the US thought about that… But with American workers purchasing power slowly and tediously eroding, fewer working class actually have enough to invest. So probably best to stay single so you can work, work, work to pay that little bit more interest to the banks, and also so you can just put that much more into the market for the big banks to play with.
Can we afford the high cost of life, if life is somewhat like it was for the serfs in the fields?
Nice little essay, it is always so much more tolerable when the punch line isn’t placing all the blame on Obama (or even the GOP for that matter). To the extent we make our frustration political and not just directed at both parties is to the extent we get lackluster policy and party politics.
This makes no since if a person cannot afford health insurance then have no extra money for a health savings account. The money in these cannot be used on any thing else and takes money away from food etc.
The only thing the health insurance concerning the high deductible is good for, is major medical. But, that is not what you need insurance for. Yes, obviously one day you will need insurance for hospital stays and such as we age, but the majority of us need preventive care and regular doctor visits to prevent major health problems and that is the flaw in this laughable cesspool of Obamacare. I checked on insurance and could only afford the high deductible plans with $7,000 deductibles leaving me to pay out-of-pocket for all routine doctor visits, etc.
Solution: don’t get health insurance and pay-out-of-pocket for routine doctor visits….using the money I’m not spending on $100+/month premiums.
In 2007 ten years ago I was was paying 38 dollars a week for blue cross blue shield insurance it was a great plan and now I can’t even afford health care insurance I make a little over 500 a week and it is crazy how it looks like the only people saving on healthcare costs in this country are the rich. This is a joke the united kingdom has universal healthcare and they take care of thier people this is the only country that does not take care of its citizens . With health issues the insurance companies are making billions of dollars and I myself probably go to the doctor once every 2 or 3 years and all that money that is paid into a plan that I never use . So from now IL just go to the emergency room
All government politicians should be required to go on Obamacare and pay into Social security. My taxes pay their salary. They voted this in. No exemption..
They have screwed up everything about health insurance. 60 year old woman having to pay for maternity insurance really… When we can’t spend money (due to premiums) the economy suffers. I won’t being buying better car. I won’t be buying new TV. My standard of living has dropped. In fact cutting cable. No eating out. No extras.. Thank you Obamacare My premiums are higher than my taxes. $10,000 a year of health insurance premiums just for having it. 20% copay after meeting $6,800 deductible. Cheapest ACA, no my doctor or hospital is not on this plan. 5 years ago premiums 4,000 a year and 1000 deductible same copay. I am single and cant imagine what’s is like for families.
I been trying to establish what the “free preventive services” are. No one at Blue Cross and Blue Shield can explain what they are! Between my monthly premium and what the government pays is about $1000 a month for a silver plan I do not see it as a cheap plan. I think the American public has been taken as fools. There is no preventative car because all doctors visits. lab work etc is never paid for by insurance until you hit the high deductables and coinsurance. Obama care stinks! But I am covered for ovary cancer but I am a male and do not need that.
This is a very valid complaint. This is an aspect of the ACA that should be being addressed by the Trump administration, but isn’t.
Wow amazing how much we pay in taxes and no decent health care exist in these good old United States of America. We have reached a time of more corruption and greed that a person can stomach. No longer a good place to live, American is falling fast. The rich will fall too and maybe they can burn all the money they hoard to stay warm.
This is not an answer. This is just more condescention: “You can’t afford both the premium AND high deductible? Too bad. Live with it.” And this is why more and more citizens want this fiasco repealed. I notice that Congress has its own health care plan. Why isn’t what’s thrust on citizens good enough for them? I also notice Obama signed special entitlements to alleviate the financial burdens White House and other staffers would have suffered had THEY had to abide by the ACA like other US citizens. Why wasn’t the advice to them the same as the advice here? That’s right, because the political powers and their direct servants are above the law. The rest of us have to suffer through what many of us cannot abide.
Honestly, we offered tips and tricks to help lower your cost… we didn’t say “too bad. live with it.” We are a private website, not the government (we don’t know or work with them actually), we can’t do more than offer helpful information.
Hope that helps clarify what we are doing here. Search our site for tons of useful information.
I was paying 300 per month for Cigna Silver. 40 dollars at the doctor and 20 dollars for each prescription. Then the doctor ordered an MRI. The insurance only payed 5% of the 7000 dollar procedure. Now I am being sued for 3000 dollars and I only make 22,000 dollars per year. Why doesn’t the co-pay I gave my doctor’s and the pharmacist count as part of my annual 3000 dollar co-pay?
You can generally appeal things like this, but the appeals process has to be done when you get the bill in general (and not after the fact).
It would potentially make sense for them to only pay part of something, but it depends on the claim and your plan. If something is out of network, or if it is subject to coinsurance and your deductible hasn’t been met yet, you can end up being responsible for a lot of the upfront costs. Thing is, it really depends on the specifics.
If you are at the point of being sued, you may want to find a lawyer who will work for part of the settlement (thus avoiding you having to pay too much up front). I would suggest calling around and finding someone who can help for direction (assuming your window to appeal is up).
Also please look into appeals: https://www.healthcare.gov/appeal-insurance-company-decision/appeals/