Within the last 30 days I underwent surgery for cancer. At that time of my surgery I had health insurance and was covered.
After being terminated, the question is do I still have health care coverage? Unfortunately, today it is still not possible to obtain a definitive answer.
I do know I am eligible for COBrA benefits, however until my COBRA benefits begin, do I have coverage? During this time frame a complication developed requiring hospitalization. I do believe I have coverage until my COBRA application expires however, obtaining an answer from the insurance company, employer, or the govenment is a challenge in itself.
I am not eligible for FMLA as I do not have time in with the company. I do believe situations like mine listed above will develop and need to be address by the Affordable Care Act.
After being terminated, the question is do I still have health care coverage? Unfortunately, today it is still not possible to obtain a definitive answer.
I do know I am eligible for COBrA benefits, however until my COBRA benefits begin, do I have coverage? During this time frame a complication developed requiring hospitalization. I do believe I have coverage until my COBRA application expires however, obtaining an answer from the insurance company, employer, or the govenment is a challenge in itself.
I am not eligible for FMLA as I do not have time in with the company. I do believe situations like mine listed above will develop and need to be address by the Affordable Care Act.
How did our wonderful politicians ever design a system that fails working people more than any others??
Everything I read indicates that we would be much better off with a single payer universal access health care system. It would enable states to tell doctors that they have to accept payments from insurance. It would allow companies to drop a benefit that they don't really want to give to older employees. It would eliminate the problem of shopping around for a plan that meets your budget rather than your needs. It could be paid for as a percentage of our income taxes and taken out the way our income tax is taken out of our paychecks. Unlike social security, it should affect all income levels unless the family or individual makes less than 200-300% of the poverty level (and that needs adjusting upwards too.) It could also be a graduated tax like the income tax.
America is a very backward country when it comes to health care and a safety net for its citizens. We seem to believe that punishment for being ill or poor or unemployed is better than helping. We also overlook the fact that for many of us copays and deductibles are unaffordable if we have to deal with an ongoing medical problem. Couple that with being unable to find a job and you have the recipe for poverty in place. It's a shame that more politicians don't understand what life has become for many of us. We can't save for retirement. We can't plan for the future. And we know that decent medical care is unaffordable if we lose our jobs for any reason.
America is a very backward country when it comes to health care and a safety net for its citizens. We seem to believe that punishment for being ill or poor or unemployed is better than helping. We also overlook the fact that for many of us copays and deductibles are unaffordable if we have to deal with an ongoing medical problem. Couple that with being unable to find a job and you have the recipe for poverty in place. It's a shame that more politicians don't understand what life has become for many of us. We can't save for retirement. We can't plan for the future. And we know that decent medical care is unaffordable if we lose our jobs for any reason.
1
How about Medicare for everyone - you know - the program where everyone who is covered paid into the system and continue to do so when their coverage begins??
1
As a Midwesterner in a State held hostage by a Republican governor, I had to reply. In 38 years of employment (including 22 years as a RN - still am), I was laid off my job in 2014. Thank goodness for the ACA or I would be in big trouble. Of note, I am a Democrat and we were not able to stand up to the Koch Bros big money to boot our governor. The governor of Kentucky - Democrat - is exemplary for how the state program should be set up, including expanding the federal Medicaid. In the same State resides Mitch McConnell who will do everything he can to kick the ACA to the curb. Let us show the Republicans what it is like to be on unemployment and food stamps. No one on these is a bum; nor, are they bums who have coverage by the ACA. The old walk a mile in my shoes saying is perfect.
4
Elections have consequences.
At the risk of sounding cold hearted, I have decided that I don't much care if red state residents lose their healthcare. Why? Because they have spent the better part of the last 30 years voting for conservative (mostly) Republican'ts who oppose doing anything for the average citizen. They have been more interested in "God, guns & gays" than in ensuring more prosperous economic circumstances for themselves and their families. As I get ready to retire with my government pension and health care benefits (many of which they both envy and want to get rid of) all I can say is I've got mine Jack.
14
There is a lot of truth in what you have said Angela. You pretty much sum-up what I said above. I too am sick to death of the poorest of the poor voting into office Republican maniacs who really wish the poor dead rather than insured. I'm Native American - a member of the Choctaw Nation of OK Most of us avail ourselves of our Indian hospitals and clinics. Contrary to widely held beliefs held by my countrymen, WE - that is, our tribes - pay for a huge part of our own care. Congress is obligated by treaty - yes, treaties duly ratified and operational between sovereign states - to pony-up far more money than they ever do, so we use the proceeds from tribal enterprise like telecom, mfg. of missile components, operation of passport offices for the State Dept abroad, mfg of hard goods like heaters for the armed services, catttle ranching, construction and so on. (BTW gaming income constitutes a small part of the tribe's overall revenue). Tribes urge their members to sign-up for Obamacare because those policies then become primary payer and our cost is dramatically reduced. Most Native people I know qualify for at least a Bronze level plan for free. Yet, they do not enroll. They are brainwashed the likes of our psycho governor, state and national representatives and so forth. Obama is demonized right-wing clergy from the pulpits of Pentecostal churches where preachers scream for abolition of the evil, socialistic malignancy called Obamacare. Madness.
13
Angela, what about poor people in red states who vote Democrat or are prevented from voting by Republican shenanigans? Obamacare was a lifeline for them, too. Democrats should push for their inclusion.
In response to Look Ahead's reply to my comment, no, we can't truly project who will and will not buy insurance in 2016. So much of what we believed or projected about the ACA has not come to pass.
States didn't expand Medicaid (as a result, for e.g., 1 in 5 people in Georgia remain uninsured); states also did not set up their own exchanges which is why this lawsuit is before the Supreme Court. No one projected that.
The CBO projected 30% of those purchasing insurance in the marketplace in 2015 would be paying the full price. The number not receiving subsidies, according to Sylvia Burwell, was to 13%.
The NY Times recently ran a story asking why is Kentucky's exchange only serving the poorest and the sickest? Middle-income people are staying off Kynect apparently, keeping old grandfathered plans or finding options elsewhere.
Then of course there is the "if you like your doctor keep your doctor, if you like your health insurance you can keep it" promise, which was not true. As I supported President Obama and worked on both of his campaigns I prefer to give him the benefit of the doubt and assume he - if not his health advisors - did not project the plan cancellations.
Statistical projections are always suspect no matter how well intentioned.
States didn't expand Medicaid (as a result, for e.g., 1 in 5 people in Georgia remain uninsured); states also did not set up their own exchanges which is why this lawsuit is before the Supreme Court. No one projected that.
The CBO projected 30% of those purchasing insurance in the marketplace in 2015 would be paying the full price. The number not receiving subsidies, according to Sylvia Burwell, was to 13%.
The NY Times recently ran a story asking why is Kentucky's exchange only serving the poorest and the sickest? Middle-income people are staying off Kynect apparently, keeping old grandfathered plans or finding options elsewhere.
Then of course there is the "if you like your doctor keep your doctor, if you like your health insurance you can keep it" promise, which was not true. As I supported President Obama and worked on both of his campaigns I prefer to give him the benefit of the doubt and assume he - if not his health advisors - did not project the plan cancellations.
Statistical projections are always suspect no matter how well intentioned.
2
The ACA is a redistribution program. Yes, many people in states without their own exchange would lose access to the subsidy. But the vast majority of people, that is, those that are covered through other means, will benefit. Let's try to achieve the maximum return over all, and not just forced redistribution under the threat that the IRS will push people into personal bankruptcy.
3
Dear Doug:
If you don't like redistribution programs, you should consider giving up your much of your Social Security, Medicare (most Americans only contribute about 30% toward their own Medicare) and VA benefits.
You should refuse to take the income tax deduction for your mortgage, as much redistribution occurs through tax deductions. Speaking of mortgages, the Federal Government subsidizes your mortgage. No bank would offer you a 4% 20 year mortgage without government assistance. Would you please seek out a mortgage that my tax money has not subsidized? You have got to walk the walk if you want to talk the talk.
Speaking of bankruptcy, a recent news article asserted that about 35% of Americans are in collections, but half of them are in collection due to medical bills from our overly expensive and unfair medical system.
The fact is, that even conservatives benefit from government sponsored redistribution.
If you don't like redistribution programs, you should consider giving up your much of your Social Security, Medicare (most Americans only contribute about 30% toward their own Medicare) and VA benefits.
You should refuse to take the income tax deduction for your mortgage, as much redistribution occurs through tax deductions. Speaking of mortgages, the Federal Government subsidizes your mortgage. No bank would offer you a 4% 20 year mortgage without government assistance. Would you please seek out a mortgage that my tax money has not subsidized? You have got to walk the walk if you want to talk the talk.
Speaking of bankruptcy, a recent news article asserted that about 35% of Americans are in collections, but half of them are in collection due to medical bills from our overly expensive and unfair medical system.
The fact is, that even conservatives benefit from government sponsored redistribution.
16
As for me, I love the idea of a little redistribution in this country. A modified version of G.K. Chesterson's "Dstributivism" would be just dandy. Shoot, a little redistribution a'la France would be good too. BTW, had a little experience with medical care in France. My wife suffered a stroke in Bosnia. We took her to Paris where she was obliged, as a non-citizen, to pay the full bill at discharge from the hospital. The care surpassed any I've ever experienced in this country. Moreover, a 10 day hospital stay, 3 specialists, a CT scan, 2 MRI's, Doppler studies..... and more, cost just under $5,000 USD. That's what a little redistribution will do for health care costs. OH yeah, I fail to mention that they provided a bed for me in her room as well a fabulous meals with a split of wine. What a terrible state of affairs, huh? Wouldn't want that here! Go ahead, call me a socialist - I am a socialist.
18
Since 2000, the percentage of Americans covered by employer-provided
health insurance has steadily declined. Facing double-digit growth in health
insurance premiums, many businesses have either eliminated health benefits
or redesigned the plans to include higher deductibles, larger co-payments, and greater premium sharing by employees. This price pressure has created a paradigm shift in the way small businesses offer employee health benefits.
If subsidies go away, employers can still help pay for individual insurance plans, which cost less to the employer than group health insurance. The new book, "The End of Employer Provided Health Insurance" explains how employers and employees can benefits from the ACA. http://zane.tips/177NvdC
health insurance has steadily declined. Facing double-digit growth in health
insurance premiums, many businesses have either eliminated health benefits
or redesigned the plans to include higher deductibles, larger co-payments, and greater premium sharing by employees. This price pressure has created a paradigm shift in the way small businesses offer employee health benefits.
If subsidies go away, employers can still help pay for individual insurance plans, which cost less to the employer than group health insurance. The new book, "The End of Employer Provided Health Insurance" explains how employers and employees can benefits from the ACA. http://zane.tips/177NvdC
2
Recently a friend of mine has problems with balance. For over 6 months now she has attempted to obtain authorization for a MRI as she is currently enrolled in Medicaid without much success. When an individual attempts to contact Medicaid no one seems to answer the phone.
Finally to resolve the problem she wrote the doctor indicating she will pay for the MRI.
Is this future of health care? Instead of looking for justification of a program, how about looking at data five years from when the evidence is much more objective.
Edwin
Finally to resolve the problem she wrote the doctor indicating she will pay for the MRI.
Is this future of health care? Instead of looking for justification of a program, how about looking at data five years from when the evidence is much more objective.
Edwin
2
This whole analysis is based on a theoretical projection of who will purchase insurance in 2016. No one really knows who will be covered through the federal marketplace in 2016. Taking away the subsidies may be a terrible idea but it's impossible to project who will and will not lose coverage.
0f course, the South, which has the sickest population for any age group is going to be hardest hit. Insurance costs in Georgia have already escalated for healthy people of all ages who previously had coverage as the ACA's new benefits and community rating went into effect.
But, it's impossible to accurately project the events that will follow a Supreme Court ruling invalidating subsidies in the federal marketplace based on the information we have today.
Our divided government, hopefully, will be forced to take action, perhaps finally making needed improvements to the ACA so we enjoy affordable care for all Americans, not just some.
0f course, the South, which has the sickest population for any age group is going to be hardest hit. Insurance costs in Georgia have already escalated for healthy people of all ages who previously had coverage as the ACA's new benefits and community rating went into effect.
But, it's impossible to accurately project the events that will follow a Supreme Court ruling invalidating subsidies in the federal marketplace based on the information we have today.
Our divided government, hopefully, will be forced to take action, perhaps finally making needed improvements to the ACA so we enjoy affordable care for all Americans, not just some.
7
Dawn, its not "impossible to calculate who will and will not lose coverage". We already have two years of data and demographics on who has signed up.
There is zero chance that our divided government will be able to modify the ACA any time before 2017, when a new Congress and President take over. And that is what is impossible to predict.
But killing subsidies for the ACA by the SCOTUS, as well as continued virulent GOP anti-immigration legislation could be quite helpful for the Democrats in 2016 in rallying the base, which has been far too apathetic to date.
There is zero chance that our divided government will be able to modify the ACA any time before 2017, when a new Congress and President take over. And that is what is impossible to predict.
But killing subsidies for the ACA by the SCOTUS, as well as continued virulent GOP anti-immigration legislation could be quite helpful for the Democrats in 2016 in rallying the base, which has been far too apathetic to date.
5
"But killing subsidies for the ACA by the SCOTUS (...) could be quite helpful for the Democrats in 2016"
I am pessimistic about that: The Republicans succeeded in not expanding Medicaid in red states. It didn't hurt them to hurt their people.
I am pessimistic about that: The Republicans succeeded in not expanding Medicaid in red states. It didn't hurt them to hurt their people.
This challenge is only of concern because 5 Justices may not care about either the letter or the intent of PPACA.
Those bringing suit cite Sec. 1311, which only uses the term "State" when specifying the requirements of Health Benefit Exchanges to be established under PPACA. But Sec. 1311 (b) (1) says that "Each State, not later than January 1, 2014, shall establish a Health Benefit Exchange"
Then Sec. 3121 (b) State Action reaffirms that a State must establish and Exchange and in (c) Failure to Establish and Exchange or Implement Requirements says that the Secretary shall operate and Exchange on behalf of such State and implement all requirements (including calculating and administering subsidies). Sec. 3121 (c) 91) (B) says that if the Secretary determines by January 2013 that a State will not have an Exchange operational by January 2014 "the Secretary shall establish and operate such Exchange within the State and the Secretary shall take such actions as are necessary to implement such other requirements"
So, the letter of the primary law under challenge is crystal clear. It does not require interpretation as did "free speech" or the "right to bear arms". So, if 5 justices side with the challengers we will know they are no longer just activist judges, they have gone rogue.
Those bringing suit cite Sec. 1311, which only uses the term "State" when specifying the requirements of Health Benefit Exchanges to be established under PPACA. But Sec. 1311 (b) (1) says that "Each State, not later than January 1, 2014, shall establish a Health Benefit Exchange"
Then Sec. 3121 (b) State Action reaffirms that a State must establish and Exchange and in (c) Failure to Establish and Exchange or Implement Requirements says that the Secretary shall operate and Exchange on behalf of such State and implement all requirements (including calculating and administering subsidies). Sec. 3121 (c) 91) (B) says that if the Secretary determines by January 2013 that a State will not have an Exchange operational by January 2014 "the Secretary shall establish and operate such Exchange within the State and the Secretary shall take such actions as are necessary to implement such other requirements"
So, the letter of the primary law under challenge is crystal clear. It does not require interpretation as did "free speech" or the "right to bear arms". So, if 5 justices side with the challengers we will know they are no longer just activist judges, they have gone rogue.
10
oh please. Gruber made it perfectly clear what the intent of the law was. The states that do not set up their own exchanges would be punished by not getting access to subsidies. He could not have been more clear on this point, and he was the mastermind behind the bill writer's intent.
6
"oh please" is not a response to B's explanation of the statutory language.
4
Read the Bill Doug.
2
Everyone knows what will happen if the Supreme Court rules they are not eligible for subsidies. The Republicans will portray the ACA as a bill that planned to discriminate against these states in order to enforce the Federal mandate, as Jonathan Gruber has stated. They will use this as a club to force to Obama administration to accept various changes to the ACA. It will not be pretty, but that's democracy/fighting in action.
2
Red states can always establish their own exchanges and get back the subsidies. Accusations of planned discrimination wouldn't survive basic scrutiny.
Conservative voters are convinced that only Others will be harmed by Republican politicians' policies... "Others" meaning people with a different skin color, welfare frauds, and sinful women who have born children out of wedlock (oh, and also their kids, collateral damage).
They are also often willing to make personal sacrifices--their family's health, even their lives--in order to make a stand against things/people/beliefs they've been taught to hate and fear: Socialist Commies. Abortion. Uppity women. Uppity people of color. Uppity people who speak other languages. Unions.
One must admire their willingness to suffer and even die to honor their prejudices.
They are also often willing to make personal sacrifices--their family's health, even their lives--in order to make a stand against things/people/beliefs they've been taught to hate and fear: Socialist Commies. Abortion. Uppity women. Uppity people of color. Uppity people who speak other languages. Unions.
One must admire their willingness to suffer and even die to honor their prejudices.
32
Freedom is not a prejudice. It is a much greater right than free health insurance.
2
While the possibility that many people will drop coverage due to the end of the subsidy distresses me, I am also distressed by the writer's interchange of the phrase "drop coverage" and "lose coverage". There is a huge difference, as she knows, so I assume that represents a political slant.
5
If they drop coverage, they will be fined, so they still have a huge incentive to maintain coverage, even if they lose the subsidies. And this will not impact poor people, who are eligible for Medicaid.
If subsidies are taken away the individual mandate will also disappear. That's why the individual markets will collapse because the only people buying insurance will be those - young and older - who have chronic conditions. Or, presumably, the money to pay the higher premiums.
We are going to see higher premiums in any case after the built in protections for insurance company losses disappear in 2016.
We are going to see higher premiums in any case after the built in protections for insurance company losses disappear in 2016.
2
I never cease to be amazed by impoverished, downtrodden residents of my state who blast themselves continuously in the foot as surely as they were using shotguns, by ignorantly maintaining that the ACA is a communist plot candestinely designed and deployed that will destroy the country. The vast majority of the poor - and being poor myself I know a lot of poor people - have no idea that they are even eligible for a subsidy. They are dumbstruck when they learn that my wife has a Blue Cross plan with -0- deductible, $500 max out of pocket, -0- deductible on generics a superb PPO network for $37 per month. Its Oklahoma Blue Preferred Siver PPO 004. They are mystified and ask "how did you do it"? I simply tell them I called healthcare.gov. My subsidy is about $450/mo. Dems and other progressives must win the uphill battle to educate these incredibly dense, but tragic, people.
46
Thanks Fred - there was a lot of trouble with poor people even obtaining information because, I believe, the states with the Repub govs did everything possible to block it out. The original plan was given a nod by all governors - Dem or otherwise but then, Repubs objected. They have no clue about the way poor or middle class on the way to poor suffer. www.healthcare.gov or the 1.800 number will connect to extremely helpful people. This is my year #2 in ACA - hallelujah and thank you President Obama. But, shame on my governor who refuses to extend federal Medicaid. He thinks there is too much government - I say - find a different job then.
This sounds like a dream may be coming true for many of the people who object to Obamacare. The republicans, in dutifully convincing their constituents, (especially those in the South), that they don't want healthcare, may have found a way to accommodate them. If the repubs can get SCOTUS to disallow subsidies for healthcare, the white South in particular, can proudly give away another benefit for themselves . The republicans can then tout another "victory" for the plutocrats they so pathetically serve. Seems like a win-win for the repubs and their constituents.
Wouldn't be surprised if Scalia, Alito, Thomas, Roberts and Kennedy haven't already written the accommodating opinions so the folks won't have much longer to wait before their rid of their burdensome subsidy and perhaps health insurance altogether. Look forward to congratulating ya'll.
Wouldn't be surprised if Scalia, Alito, Thomas, Roberts and Kennedy haven't already written the accommodating opinions so the folks won't have much longer to wait before their rid of their burdensome subsidy and perhaps health insurance altogether. Look forward to congratulating ya'll.
28
Nothing is stopping the people of any state to adopt the Massachusetts model, once the ACA craters. If the people want it, they will demand it. If they don't want it, they will not. Not a difficult concept. It's the people trying to force centralized government on our federalist system that are to blame here.
1
The physical health of the citizens of the United States, which spends more per capita than any other country with results worse than half of the countries of the world is a national problem (not to mention a national disgrace), not one to be left to the discretion of the individual states.
3
Unfortunately, the irony in this statistic is that the citizens in the South are the ones that consistently send to Congress legislators that detest the ACA, want to destroy it, and have no alternative to offer in place of ACA.