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The PPACA Implementation Phase II - Love it or Lose it!

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Re: The PPACA Implementation Phase II - Love it or Lose it!

DrDemento said:
FF makes an important point however. You can sign up the entire world for medicaid-but then try to find a physician who will accept it as payment-harder still, try and find a certifed, competent, specialist who will accept the patient and the payment from medicaid. I just do not see this being very different with the ACA. it is correct that the insurers already steer people to in network providers but if the ACA is going to succeed in any fashion at all it will have to show that patients will have far greater access than what has happened with medicaid over the years.

Just one personal anecdote here-back in 1975 my office accepted anyone, anytime, with any coverage. Medicaid paid us the great sum of $6.62 for an office visit to see a patient. We figured that it cost us in overhead about $10.00 to see each patient. How much sense did it make for us to see those with medicaid? For me it was a no brainer, I wanted to continue to participate as it was still helping to build our practice with patients who might refer others who were not covered by medicaid. But eventually it was just not something we could continue and had to limit medicaid acceptance to those we had already seen and did not accept any more new medicaid patients. Just as the ACA needs a percentage of young healthy individuals to sign up to keep costs in the ballpark-we too had to make sure we had enough insured or self paid patients to be able to see those with medicaid. Just thinking locally now-i am not sure i can find a single physician who is accepting any new medicaid patients in most of the specialties.
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Except that wasn't his point. And to be honest, if the whole world were on Medicaid physicians would only have 2 options, accept patients or go home :) Fishy is making up some garbage about private insurers offering plans through the exchanges intentionally restricting their networks. As best as I can tell through the power of google the reimbursement rates through the exchanges are set by the private insurers offering those plans, and in most cases are actually not yet determined, but expected to be comparable to the rates already paid by those insurers on their existing plans. So maybe in states offering expanded Medicaid those people on Medicaid will struggle to find providers, but that was not the crap he was selling.
 
Re: The PPACA Implementation Phase II - Love it or Lose it!

jerphisch said:
Except that wasn't his point. And to be honest, if the whole world were on Medicaid physicians would only have 2 options, accept patients or go home :) Fishy is making up some garbage about private insurers offering plans through the exchanges intentionally restricting their networks. As best as I can tell through the power of google the reimbursement rates through the exchanges are set by the private insurers offering those plans, and in most cases are actually not yet determined, but expected to be comparable to the rates already paid by those insurers on their existing plans. So maybe in states offering expanded Medicaid those people on Medicaid will struggle to find providers, but that was not the crap he was selling.
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If the whole system was medicaid based-physicians have another choice that you do not list. Simply do not accept anything and go cash only-or perhaps concierge type of practice. I know of several physicians who accept no insurance at all-they will be happy to fill out forms for you or provide detailed receipts but you pay them and seek whatever reimbursement you might receive on your own from whoever. I had mentioned my own anecdotal experience with medicaid just to answer a previous query that someone had made-that the administration could have just expanded medicaid instead of offering the ACA. The practice of medicine is indeed getting complicated-but for the most part physicians will not work for a pittance and will find a way to maximize their income regardless. My personal experience with the insurers is that they are being incredibly tight lipped about any future reimbursements and for that matter any future premiums. My wife will have her policy cancelled soon-and despite several discussions with her current insurer, we can get no information whatsoever about the coverage she could be offered and even less about what it might cost. I will believe the reimbursement rates through the exchanges only when i see them first hand. I have learned over many years that what the insurers 'expect' and what the government 'expects' are terms to be taken very loosely.
 
Re: The PPACA Implementation Phase II - Love it or Lose it!

unofan said:
Relinquishing grandfather status != cancelled plans. That's like saying if craig mctavish started wearing a helmet he would have no longer been an nhl player.
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But as tightly written as the grandfather regs are, it is in effect a cancellation notice.
 
joecct said:
But as tightly written as the grandfather regs are, it is in effect a cancellation notice.
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No it isn't. My employers plan meets all the requirements. If they do something as simple as raise the premium or change a service, it would lose grandfather status. That doesnt mean it'll be cancelled outright.
 
Re: The PPACA Implementation Phase II - Love it or Lose it!

unofan said:
No it isn't. My employers plan meets all the requirements. If they do something as simple as raise the premium or change a service, it would lose grandfather status. That doesnt mean it'll be cancelled outright.
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If they lose grandfather, that means the plan is "substandard" and is no longer allowed to be offered??
 
Re: The PPACA Implementation Phase II - Love it or Lose it!

All of those people who couldn't afford health insurance before are now covered. Without exception. Until they're not. It's a good thing they piled up all of those "freebies" that got loaded into your health insurance. It makes things so much more Affordable now.

http://politicalticker.blogs.cnn.com/2013/11/19/woman-cited-by-president-as-obamacare-success-story-frustrated-by-sign-up-process/?hpt=hp_t2

(CNN)– Washington state resident Jessica Sanford was bursting with pride when President Obama mentioned her story during a Rose Garden event on health care reform last month at the White House.

"Who wouldn't?" Sanford asks. "I'm a nobody really to have him mention my story."

Back in October, Sanford had written a letter to the White House to share her good news. The 48-year-old single mother of a teenage son diagnosed with ADHD had just purchased what she considered to be affordable insurance on the Washington state exchange.

"I was ecstatic. I couldn't wait to call the doctor for an appointment on January 2nd," Sanford told CNN about the feeling she had when she first enrolled.

...

The president said Sanford's story was proof, despite the technical problems with the healthcare.gov website, that the Affordable Care Act was working.

...

Then another letter from the state exchange with even worse news.

"Your household has been determined eligible for a Federal Tax Credit of $0.00 to help cover the cost of your monthly health insurance premium payments," the latest letter said.

"I had a good cry," Sanford said about her reaction to the latest news from the state.

As a self-employed court reporter, the new quote was simply out of her range.

...

Sanford reiterated her frustration in a post to the Washington HealthPlanFinder's Facebook page last Friday.

"Wow. You guys really screwed me over," Sanford wrote. "Now I have been priced out and will not be able to afford the plans you offer. But, I get to pay $95 and up for not having health insurance. I am so incredibly disappointed and saddened. You majorly screwed up."
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Re: The PPACA Implementation Phase II - Love it or Lose it!

St. Clown said:
All of those people who couldn't afford health insurance before are now covered. Without exception. Until they're not. It's a good thing they piled up all of those "freebies" that got loaded into your health insurance. It makes things so much more Affordable now.
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Like the woman from California whose quote is now famous: "I was all for Obamacare until I found out that I'd be paying for it."
 
Re: The PPACA Implementation Phase II - Love it or Lose it!

What a spoiled brat. So rich she doesn't qualify for a subsidy and STILL wants a government handout... :)

"I've got good news and I've got bad news. The good news is that the government will make the rich people pay for Obamacare. The bad news is that the government thinks you're rich!"
 
Re: The PPACA Implementation Phase II - Love it or Lose it!

LynahFan said:
What a spoiled brat. So rich she doesn't qualify for a subsidy and STILL wants a government handout... :)

"I've got good news and I've got bad news. The good news is that the government will make the rich people pay for Obamacare. The bad news is that the government thinks you're rich!"
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That's the thing, I know there are parts of Washington state where it's cheap to live, and there are parts where it's very expensive to live. So if you're in one of those expensive places, like the Seattle are, you could be out of the range for qualifying for any sort of PPACA subsidy and still be barely able to make ends meet. It sounds like she was doing just well enough to kick in a couple hundred per month for insurance, but the cheapest "bronze" package offerred was still too expensive for her to purchase. Again, I would look at all of those nifty added coverage requirements for making these plans so much more expensive. Because the government told people they would get something for nothing.
 
Re: The PPACA Implementation Phase II - Love it or Lose it!

St. Clown said:
That's the thing, I know there are parts of Washington state where it's cheap to live, and there are parts where it's very expensive to live. So if you're in one of those expensive places, like the Seattle are, you could be out of the range for qualifying for any sort of PPACA subsidy and still be barely able to make ends meet. It sounds like she was doing just well enough to kick in a couple hundred per month for insurance, but the cheapest "bronze" package offerred was still too expensive for her to purchase. Again, I would look at all of those nifty added coverage requirements for making these plans so much more expensive. Because the government told people they would get something for nothing.
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Yep - and if you have medical needs, you can't ignore the impact of an increased deductible. A $300 per month plan with a $2400 deductible really costs you, on average, $500 per month. Worse than that, it's obviously going to be "front loaded" with your deductible coming due in the first few months of the year, so your average cost for those months could be upwards of $700-$800 or so. Problem is, those pesky landlords and gas companies want to be paid during those months, too, so by the time your insurance kicks in later in the year you've probably already been sent to collections.

No great surprise that people in that situation might choose to pay the penalty instead of signing up. Here's where Rover runs in to tell us what a fool she is for preferring to eat Alpo when she should be eating cake.
 
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Re: The PPACA Implementation Phase II - Love it or Lose it!

Might want to give it a week before anybody runs with this story. We've seen countless "this person's getting screwed" stories until it turns out they are eligible for a subsidy or a better plan after all.

Unless....you righties have complete trust in the honesty of a CNN story...:eek: ;)

PS - Lynah I believe Priceless was using the Alpo analogy. What are you, a 60 Minutes reporter or something?
 
Re: The PPACA Implementation Phase II - Love it or Lose it!

When I get time I will try to find a link to the New York times story I read this morning. It was talking about an uptick in the number of people signing up over the last month, nearly hitting 50,000. The author noted this was still far short of the hoped for numbers. The story went on to say that the administration was changing it's goal of having 4 out of 5 eligible parties signed up, to 4 our of 5 having a "good experience" when they went to the website. I really thought that was funny.
 
Re: The PPACA Implementation Phase II - Love it or Lose it!

SJHovey said:
When I get time I will try to find a link to the New York times story I read this morning. It was talking about an uptick in the number of people signing up over the last month, nearly hitting 50,000. The author noted this was still far short of the hoped for numbers. The story went on to say that the administration was changing it's goal of having 4 out of 5 eligible parties signed up, to 4 our of 5 having a "good experience" when they went to the website. I really thought that was funny.
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Maybe they have some links to porn on there. ;) It makes sense that #'s would go up if there's a million people who've completed everything but choosing a plan. That's why all this hyperventilating is amusing but pure nonsense. It reminds me of the aftermath of the 1st Presidential debate, where a subpar showing by Obama was spun as an unstoppable boost in momentum to Mittens that nothing would be able to alter.
 
Re: The PPACA Implementation Phase II - Love it or Lose it!

Wait!!!

So my bank and rover's bank are going to do away with offering us health insurance next fall?!?!?!?

Honest and for true?!?!?!?
 
Re: The PPACA Implementation Phase II - Love it or Lose it!

I thought PPACA was well-intentioned but naive, and more than a bit of overreach by people who didn't really know what they were doing, and yet did not even know what it was that they did not know.

This guy, though, really hates it with a vengeance, yet always has good material to work from:

The most interesting opinion survey we've seen about the ObamaCare cataclysm is one that's only indirectly about ObamaCare. Gallup asked Americans: "Do you think it is the responsibility of the federal government to make sure all Americans have healthcare coverage, or is that not the responsibility of the federal government?" Only 42% of those surveyed said it is the federal government's responsibility, vs. 56% who said it isn't.

More telling is the trend. Gallup has been asking the question since 2000. "Prior to 2009, a clear majority of Americans consistently had said the government should take responsibility for ensuring that all Americans have healthcare," the firm reports. The proportion answering "yes" peaked in 2006 at 69%--27 points higher than today's number. Then it began declining, to 64% in 2007 and 54% in 2008.

The current 42% is the lowest figure ever recorded, but the percentage answering in the affirmative hasn't risen above 50% since 2009
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Re: The PPACA Implementation Phase II - Love it or Lose it!

mookie1995 said:
Wait!!!

So my bank and rover's bank are going to do away with offering us health insurance next fall?!?!?!?

Honest and for true?!?!?!?
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They'd better not keep the money they deduct from my paycheck then the bahstids! ;)
 
Re: The PPACA Implementation Phase II - Love it or Lose it!

FreshFish said:
I thought PPACA was well-intentioned but naive, and more than a bit of overreach by people who didn't really know what they were doing, and yet did not even know what it was that they did not know.

This guy, though, really hates it with a vengeance, yet always has good material to work from:
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You aren't the least bit concerned trusting a polling organization (Gallup) that had Romney 51 - Obama 46 the weekend before the election? :D
 
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