Obamacare and you

[derspiess]

There was a gun show a couple weeks ago at the civic center here.  As usual it was packed and as usual there were political fanatics in the parking lot.  This time they had "Impeach Obama! Stop World War III!" placards.  I'm still puzzled as to how making Biden president would make World War III less likely.  He seems like he'd be willing to use nukes to keep kids off his lawn, given the opportunity.

Oh, it gets worse when you go inside.

[MadImmortalMan]

Oh, it gets worse when you go inside.

I once met Randy Weaver at one.

[derspiess]

Oh, it gets worse when you go inside.

I once met Randy Weaver at one.

I walked by his table, briefly made eye contact and kept on walking.  Very creepy encounter.

[Razgovory]

Aryan nations types are creepy.

[derspiess]

Aryan nations types are creepy.

Yeah.  Not sure he was totally one of them, though.  But we've had that discussion before 

[merithyn]

I saw this today, and I thought it might be of interest to Languish. It is just one person's experience with ACA, but it does show kind of the breakdown in costs for a relatively healthy person and how that will (and will not) affect their yearly costs.

My Obamacare nightmare, concluded

I posted a while back about my experience with Obamacare. To recap:

I was informed that my existing insurance plan (for which I was paying $7100 per year) would no longer operate;
I was offered other plans that looked to be better value for money.
I ended that post with:

So yes, Obamacare is a freaking Rube Goldberg machine, and single-payer would be simpler, more just, and cheaper. But at least in New York, at least for people like me, *it has nearly halved premiums.*

That ain't nothing.
But at that point I hadn't actually enrolled in a plan. Now I have. Here's what happened.

The plan I finally enrolled in, which was offered on the New York health exchange website, costs less than $3700 per year. That's almost exactly half of the premium I was paying. For me, Obamacare hasn't nearly halved premiums; it has halved them.

For that, I get a plan with a high deductible and, once that high deductible is met, a high copay. The plan just plain doesn't pay as much as my last plan did. So if I have, say, $8,000 in expenses in a year, I might wind up paying $5,500 of that, instead of maybe $1,600 with my old plan.

That sounds pretty bad. But there are two things mitigating that.

First off, preventive care–which is all I generally need anyway–is free (or maybe three visits are free. I'm not 100% clear here).

Much more important: Like all plans offered in all states through these exchanges, there's an out-of-pocket limit; this year it's $6350 for an individual.

That's right–I can't pay more than $6350, plus premiums, in a year (for covered charges; if a charge isn't covered at all, I'm on the hook for it, but all plans need to have broad coverage, by law).

So yes, if I have $8,000 in expenses, I'll have to pay more with my current plan. But if I have $80,000 in expenses, I'll pay $6350, rather than maybe $16,000. If I have $800,000 in expenses, I'll pay $6350 instead of $160,000.

For me, that's much better than my old plan. I wasn't paying $7100 per year in order to keep my medical costs down in ordinary years–I was paying it in case something really really bad happened that would otherwise ruin me. This plan actually protects me better (oh, and like all Obamacare plans, there's no annual or lifetime limit on benefits either).

And the extra I'll have to pay in years when my medical expenses are substantial but not ruinous? That can come out of the $3500 per year I'm saving in premiums.

Now: There are some caveats here.

One is that I live in New York, and New York is a special case. Essentially, New York made it illegal for insurers to exclude sick people (or to charge them so much that they were just pre-paying their medical expenses). BUT, this meant that they had to raise premiums on everyone else in order to cover those sick people, which meant that some young healthy people decided to drop their expensive insurance, which worsened the risk pool, leading to higher premiums, so more healthy people dropped insurance, and so on. This is called the "adverse selection death spiral," and New York was in the middle of one when Obamacare came along. By getting more people back into the risk pool, Obamacare seems to have broken that spiral, at least for now.

In other words, in New York Obamacare replaced poorly-thought-out regulation with better regulation. States that didn't have poorly-thought-out regulation to begin with will have different experiences. Although those states had other problems that Obamacare solves, like plans that excluded sick people or arbitrarily dropped them.

The other caveat is that my new plan has a narrow network, and my doctor isn't on it. But that's fine–I was never all that fond of my doctor. Still, that's exactly what Obama categorically said wouldn't happen, so score one for the critics there.

Of course, that sort of thing happened before Obamacare as well; I really liked my *previous* doctor, but I had to drop him when I originally enrolled in the plan I just switched from, and that was in the 1990s.

[Baron von Schtinkenbutt]

So yes, if I have $8,000 in expenses, I'll have to pay more with my current plan. But if I have $80,000 in expenses, I'll pay $6350, rather than maybe $16,000. If I have $800,000 in expenses, I'll pay $6350 instead of $160,000.

This here is the problem when populism crosses Obamacare.  The vast majority of people have less than $8,000 in medical expenses, so a significant number of them are seeing their overall care bills increase, and in many cases their premiums as well.  The people who are truly crushed by medical expenses appear as just a handful of anecdotes in comparison.  If the Democrats, Obama in particular, had not been so forceful with the bullshit that nothing would change for the vast majority and with trumpeting the "affordable" part of the bill, that populist argument would probably not work as well.

[crazy canuck]

I would be very frustrated if I had to live with this

[CountDeMoney]

So yes, if I have $8,000 in expenses, I'll have to pay more with my current plan. But if I have $80,000 in expenses, I'll pay $6350, rather than maybe $16,000. If I have $800,000 in expenses, I'll pay $6350 instead of $160,000.

This here is the problem when populism crosses Obamacare.  The vast majority of people have less than $8,000 in medical expenses, so a significant number of them are seeing their overall care bills increase, and in many cases their premiums as well.  The people who are truly crushed by medical expenses appear as just a handful of anecdotes in comparison.

You think these people that have less than $8,000 in medical expenses would rather be in the kind of situation where they have more than $8.000?  You want to deal with increased premiums as a healthy person, or would you rather be dealing with a colostomy and shitting in a sandwich baggie every day?

Healthy people bitching about their premiums really have nothing to bitch about.  People with leukemia, now they have a gripe.

[Admiral Yi]

That's not the decision tree most people were confronting prior to Obamacare.

[CountDeMoney]

Tough shit. Time for everybody to jump on the team and come on in for the big win.

[derspiess]

Seedy = Maduro

[Jacob]

That's not the decision tree most people were confronting prior to Obamacare.

I'm not sure I follow... seems to me that the logic in Meri's post is pretty sound.

[Admiral Yi]

I'm not sure I follow... seems to me that the logic in Meri's post is pretty sound.

My post was a reponse to Seedy's about preferring to pay $8,000 a year over shitting in a colostomy bag.

[The Minsky Moment]

Seedy = Maduro

Because Venezuela is the only country into the world with universal health care.