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I didn't see any indication in your reply that you have factored in or considered the human costs of the current system paid by those who cannot afford healthcare under the prior system. If one chooses to ignore the more critical aspect of the issue, the human side of it, the human costs, then there is little confusion about why one supports the wrong side of the conflict.
Quote:
Originally Posted by jimazee
so in simple terms what is it?
The assumption that there is a simple answer to one of the most complex issues in our society is a naive fiction.
Wait until it kicks in and then the premiums will be lower and the coverage better. It may take a little while, but it is supposed to even out after a few years. And remember, the only ones getting on the insurance will be healthy people as it progresses. Meaning lower premiums.
I finally got to check the FLA policies. The only ones that make sense are about $300. Is that a lot? I have always gotten insurance through work, but my GF currently is uninsured so I'm looking for her, we are the same age. She doesn't make much, so she's been getting healthcare through the county on a sliding scale. Really doesn't make sense to shell out $3600 when she doesn't even come close to that in yearly spending. I guess we are insuring for the unpredictable?
For perspective, when I was young and healthy and living in Colorado, I paid $150-$200 a month for insurance. Under this insurance, I visited a dermatologist once for a minor skin issue. I had to switch providers several months later and in doing so the cost went up to $300/month because I went to see a dermatologist for skin issues under my last insurance. I also tweaked my knee pretty bad once but didn't see anyone about it because I didn't want my insurance to go up. My wife and I were thinking of having kids at the time but could not buy a plan that covered maternity for less than $800/month. Eventually I got a job and got her on my work plan. That was something like $450/month for her and included maternity care.
Okay, so for your situation. $300 a month is a lot of money for anyone. But in my experience, it represents a relatively fair price for what you get. You will be able to take a tax credit for your premiums to offset the cost. You can use this calculator to figure that out - Subsidy Calculator | The Henry J. Kaiser Family Foundation
Good luck. Dealing with health insurance is a giant pain in the neck. As someone who for many years maintained non-employer insurance, the new system is actually substantially more user-friendly and sensible, which is hard to believe i know.
I think the best part is that you won't be penalized for actually using your insurance. It is a predictable cost that won't change based on if you go see a doctor or not. It used to be like car insurance -- get in wrecks and you pay more. It isn't like that anymore and that is a relief in my opinion.
Now for people who rolled the dice and never maintained coverage at all, i'm sure this will be a tough pill to swallow.
I didn't see any indication in your reply that you have factored in or considered the human costs of the current system paid by those who cannot afford healthcare under the prior system. If one chooses to ignore the more critical aspect of the issue, the human side of it, the human costs, then there is little confusion about why one supports the wrong side of the conflict.
One is entitled to their opinion as to which is the 'wrong side' of 'the conflict'. You have shared yours. Thanks. Despite your implication, I am pretty neutral on the topic and seek to understand more about it.
This is a personal finance forum...
I proposed a model based on my simple understanding of what I can best derive from the vast amount of misunderstanding, emotion, politics, obfuscation, disinformation and shifting facts and policies into a straw man 'simple model' for a financial thread.
The 'human side' impacts are pervasive in 'to be' model that I defined, but it should be noted that it is everyone...all citizens (and non-citizens if eligible?) are affected 'humanly'. One can sympathize with the millions affected in both the 'as is' and 'to be' models...noting that often they are generally different people with often different impacts.
For me, the 'human side' is tough to define in financial terms, and in 'end state' expectations/results.
Quote:
Originally Posted by bUU
...
The assumption that there is a simple answer to one of the most complex issues in our society is a naive fiction.
No one suggested there is a simple answer to 'the problem'. The model is a high level financial simulation defining a few assumptions. It made no attempt to factor in the 'human' aspects...for example: pain/suffering, loss of life, delayed/denied treatment, dental/mental health, birth control/abortion, impacts on family, drugs affect on behaviors, suicides, addiction, plagues, anguish, 'death panels', trial treatments, mourning, loss of lifetime savings, immigration, faith, (loss of) employment, (reduced) income, chronically unemployed...ad infinitum
Others are invited to add their favorite 'human impacts' and share their version of a model that includes the human side. No problem. It will help all to understand how this is expected to work and the results. Maybe it should be on a different forum...
So get your healthcare through ehealthinsurance.com. Then you have health insurance. Problem solved. you do not HAVE to buy health insurance through your state program, you just have to have insurance.
ehealthinsurance.com only has ACA plans now. Same prices as the state exchanges. They are no longer able to sell those other plans since they don't meet the minimum standards. This is for 2014.
What you are missing is that you are reading the coverage wrong. It doesn't say that you pay the deductible first, what it says is that your copays do not go toward your deductible. If you go to your family doctor for say, a sinus infection. You are just going to pay your co-pay. What that plan is saying, though, is that with your $5000 deductible, that copay of $30 on the CT "Standard Silver 70" plan I just looked up your deductible is still $5000 and hasn't been reduced by $30 to $4970. This is NO different then a LOT of plans are now.
In the CT Platinum plan, there is NO deductible, $10 office copay and a max out of pocket for a family of $4000.
I just priced out a plan for a family of 4 in New Haven making $50,000/year, Mom/Dad were 45 and a 12 year old and a 5 year old child. Premiums were $270.91-$366.44/month with a max out of pocket of $10,400, $30 office copay, deductibles ranging from $4600 to $5000. That is a VERY reasonable plan cost and good coverage. Change that income level to $100,000 and the plans went to $850-1300/month depending on the deductibles/OOP you pick.
I read it right. For doctor's visits it said $30 copay AFTER deductible. Usually it says deductible waived, but on this bronze plan it said AFTER. That's what gets me. It wouldn't be a problem the other way around.
For perspective, when I was young and healthy and living in Colorado, I paid $150-$200 a month for insurance. Under this insurance, I visited a dermatologist once for a minor skin issue. I had to switch providers several months later and in doing so the cost went up to $300/month because I went to see a dermatologist for skin issues under my last insurance. I also tweaked my knee pretty bad once but didn't see anyone about it because I didn't want my insurance to go up. My wife and I were thinking of having kids at the time but could not buy a plan that covered maternity for less than $800/month. Eventually I got a job and got her on my work plan. That was something like $450/month for her and included maternity care.
Okay, so for your situation. $300 a month is a lot of money for anyone. But in my experience, it represents a relatively fair price for what you get. You will be able to take a tax credit for your premiums to offset the cost. You can use this calculator to figure that out - Subsidy Calculator | The Henry J. Kaiser Family Foundation
Good luck. Dealing with health insurance is a giant pain in the neck. As someone who for many years maintained non-employer insurance, the new system is actually substantially more user-friendly and sensible, which is hard to believe i know.
I think the best part is that you won't be penalized for actually using your insurance. It is a predictable cost that won't change based on if you go see a doctor or not. It used to be like car insurance -- get in wrecks and you pay more. It isn't like that anymore and that is a relief in my opinion.
Now for people who rolled the dice and never maintained coverage at all, i'm sure this will be a tough pill to swallow.
It's not a bad deal. For $300 it was a $0 deductible policy, with $30-60 copays for Dr. visits and a $500 copay for ER. Coinsurance on other services at 30%. It's not bad, but it's a lot of money since she doesn't make much. I have check on whether she would qualify for a subsidy or not, that would change things.
It seems that you would qualify for a subsidy if you make less than 400% of the poverty level. So a single person making roughly $28K is at 250% and the required premium is 8.05% of income or $192. So then it makes sense to select the most expensive plan and then get the tax credit for everything minus $192. Am I missing something? Is the subsidy a straight credit off of your taxes, or does it reduce your AGI?
I read it right. For doctor's visits it said $30 copay AFTER deductible. Usually it says deductible waived, but on this bronze plan it said AFTER. That's what gets me. It wouldn't be a problem the other way around.
post a link to what you are seeing please
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