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If you are not subsidized, there's very little benefit for signing up with a Marketplace plan. You can still sign up for any plan you want if you are paying cash.
What the ACA did, was provide a means for people who couldn't afford to pay full price for health insurance, to buy in at a discounted rate, funded in part by a tax rebate (which is part of the subsidy). Some states expanded that and allowed a better rate, or have fewer minimum requirements to qualify. Other states opted out of the expansion.
The House and Senate during the Obama administration, which were both majority GOP, chose not to require certain things that were needed in order for the ACA to work with few glitches. And so, there are now a lot of glitches. If they had approved more of the steps within the ACA's plan of action, you'd see more people insured, more people getting health care they need, fewer people unable to afford it at all, physicians with more time to spend on patients and less on paperwork, and insurance companies still doing just fine.
This is true, but ACA eliminated choices that were available for the unsubsidized folks. Prior to ACA I was with a self employed group that had a great broker that could find good plans from known insurers with higher deductibles and HSA compatibility that made things work well.
After ACA the unsubsidized just had the same plans as those on the marketplace because these people were used to help pay the cost of the subsidized. You could no longer piece meal different plans together.
This past year I went the route of getting a subsidy by reducing my income via large SEP IRA contributions and other business deductions. When I reconcile my taxes I will see if it was worth it or not in terms of getting a ACA tax credit aka subsidy or should I just have deducted the full premium of an unsubsidized plan.
I still submit that ACA was too large and unwieldy and could have been easily replaced by a sliding scale Medicaid based on your income which in turn would have supplied Medicaid with a healthier pool of insured people and a cash inflow from the unsubsidized while providing services for those who needed help.
Location: Stuck on the East Coast, hoping to head West
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I wrote about this in another thread, but here goes: We had Christian healthcare ministries. We also had a short term policy. My son ended up with pneumonia in the hospital. The healthcare ministry paid what was explained in our membership packet. It took about 3 months. We got the check we were supposed to receive.
The short term policy took 9 months and the involvement of our state insurance commissioner to pay the hospital bill. They denied everything, denied appeals, claimed they didn't receive bills (hospital assured us they sent the bills in) and was a huge PITA.
We reimbursed CHM the appropriate amount that insurance ended up covering.
Now, my state (MD) has told CHM that the only way they can operate is to have MD members send checks to each other. So I'd submit my bills to CHM. They'd share my address with other Maryland CHM members and they'd send me a check directly. I have very little faith that this set up will work. I just don't think there will be enough MD members. The state regs have effectively taken CHM out of the picture here.
Additionally, MD limits short term policies to 3 months and then you have to reapply (they won't cover pre-existing condition).
We have some of the most expensive healthcare in the country, our insurance is ridiculously expensive, the state actively limits our choices. I cannot wait to move.
We are continuing with the short term policies and, recently, signed up for Direct Primary Care. Basically, we pay a small monthly fee to a doctor's practice and have 24 hour access to the practice. Office visits, labs, etc cost an additional fee, but are greatly reduced. We have a fee schedule that was handed out when we signed up. We can call, skype, email, or come in. Same day guaranteed. AND the physicians have arrangements with other providers for reduced fees. For example, colonoscopies and mammograms. I imagine it's only a matter of time before MD stops this, too.
We also increased our auto insurance in case we're injured in an auto accident.
I think healthcare should go back to covering catastrophic illnesses. Prices should be transparent. We should all pay for routine doctor's visits or labwork out of pocket.
I think healthcare should go back to covering catastrophic illnesses. Prices should be transparent. We should all pay for routine doctor's visits or labwork out of pocket.
I really agree with this. In fact, I thought the federal govt would've been more helpful if they would've simply covered extreme medical costs over a certain amount, so you could purchase affordable insurance up to maybe $300,000 and then anything over that the feds would cover. The ACA pretty much did the opposite.
Also, I looked for these supposedly available catastrophic plans and like the other poster, only found them for people under 30.
Also, I looked for these supposedly available catastrophic plans and like the other poster, only found them for people under 30.
Well, it's not CALLED "catastrophic only" but when you have a $6750 deductible EACH, it's pretty much catastrophic. That's what my husband and I both have, at ages 58 and 62. We each pay for just about everything till we meet our deductibles. After that, everything is covered.
I can't argue that it's a gamble either way - either an expensive one or a cheaper one. At some point it's just going to outstrip people's ability to pay and we'll be back where we always are: with a whole lot of people uninsured, and a whole lot of fingers pointed at each other and not the real problem.
My friend is a health care insurance broker. We just went through this with my son who lost his job. He opted for the bronze plan through blue cross but it has high deductible and isn't the best but still protected against catastrophic bills. He is very young and healthy but you never know. There was another health care plan we could have gone for that was a one year plan and then something called Health Guard Protector. Its not great but at least its something and affordable. You can't have any preexisting conditions with this. If anyone needs insurance, pm me and I can see if my friend can help. She is licensed in a few states and is very honest. What's out there is not great and she will be honest with you. At least though you will be protected from financial ruin.
"Illegals" - if by that you mean people from Mexico and South America, already get "free" health care. The USA is the only country in the Americas that does NOT have universal health care.
No one is coming to the USA illegally for the purpose of getting free health care. They are coming for several reasons - but health care is not one of them.
The richest country and the only one without universal healthcare.
It's rooted in individualism and that the other guy's healthcare need is "not my business." The other countries have a sense of community so people don't have to worry when medical needs arise.
Last edited by Rastafellow; 01-04-2020 at 04:45 PM..
Reason: correction
Because the rich can afford to pay and they don't care about anyone else?
Also, even if catastrophic illness is covered, what are people supposed to do about chronic illness? It's pre-existing and the person needs ongoing care.
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