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Merc14

Is Obamacare on death's door?

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danielost

I always thought that six and half million was more than two million.

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Agent0range

I hope it does fail and it makes - Obama, the dictator look bad once agian

So, basically, you hope a major program fails, which could essentially cripple the country and really only hurt the middle and lower classes just to make someone look bad? You have the mentality of a child..."No one will play! I'm taking my ball and going home!".

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F3SS

http://www.theblaze.com/stories/2014/02/24/shock-claim-obamacare-cancelled-my-mothers-cancer-treatment-and-forced-her-to-buy-a-new-plan-that-would-accelerate-her-death/

Shock Claim: Obamacare Cancelled My Mother’s Cancer Treatment and Forced Her to ‘Buy a New Plan That Would Accelerate Her… Death’

“Her old plan, now considered illegal under the new health law, had been canceled,” Blackwood said.

And that was only the beginning.

“Because the exchange website in her state (Virginia) was not working, she went directly to insurers’ websites and telephoned them, one by one, over dozens of hours,” he said. “As a medical-office manager, she had decades of experience navigating the enormous problems of even our pre-ObamaCare system. But nothing could have prepared her for the bureaucratic morass she now had to traverse.”

His mother eventually tracked down and signed up for a plan that she hoped would fit her needs.

“The enrollment agent said that after she met her deductible, all treatments and medications—including those for her cancer—would be covered at 100%. Because, however, the enrollment agents did not—unbelievable though this may seem—have access to the ‘coverage formularies’ for the plans they were selling, they said the only way to find out in detail what was in the plan was to buy the plan,” he said.

Having exhausted all other options, she reportedly went ahead and signed up for the plan and was approved on Nov. 22.

But in January, she saw her that plan still had not updated on her online Humana account.

So she called to see if her plan was active and was told over and over again that she didn’t have anything to worry about.

Then it happened.

“(O)n Feb. 12, just before going into (yet another) surgery, she was informed by Humana that it would not, in fact, cover her Sandostatin, or other cancer-related medications. The cost of the Sandostatin alone, since Jan. 1, was $14,000, and the company was refusing to pay,” Blackwood said.

“The news was dumbfounding. This is a woman who had an affordable health plan that covered her condition. Our lawmakers weren’t happy with that because . . . they wanted plans that were affordable and covered her condition. So they gave her a new one. It doesn’t cover her condition and it’s completely unaffordable,” he added. “ObamaCare made my mother’s old plan illegal, and it forced her to buy a new plan that would accelerate her disease and death.”

Is faith the crux of this law? Buy it then see what's in it.

Edited by F3SS
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Merc14

So, basically, you hope a major program fails, which could essentially cripple the country and really only hurt the middle and lower classes just to make someone look bad? You have the mentality of a child..."No one will play! I'm taking my ball and going home!".

The middle class are getting hurt by this law now and the country most certainly wouldn't fail if this law was repealed and something realistic put in its place. BTW, it is already failing and they have pushed the worst aspects until after the election, which should tell you something.

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Startraveler

Is faith the crux of this law? Buy it then see what's in it.

It's unfortunate that this woman bought a plan outside the exchange (Humana doesn't sell inside Virginia's exchange).

A quick browse on health.gov shows that all exchange plans in the Virginia Beach market are through Anthem or OptimaHealth, both of which include Sandostatin in their exchange plan formularies.

If she'd bought coverage through the new marketplace established under Obamacare, her drug would be covered.

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F3SS

It's unfortunate that this woman bought a plan outside the exchange (Humana doesn't sell inside Virginia's exchange).

A quick browse on health.gov shows that all exchange plans in the Virginia Beach market are through Anthem or OptimaHealth, both of which include Sandostatin in their exchange plan formularies.

If she'd bought coverage through the new marketplace established under Obamacare, her drug would be covered.

Moreover, why was her expensive extensive blue cross/blue shield plan she satisfactorily used for two decades cancelled in the first place? I'm sure you might say that it was the choice of the insurance company. Possible as that might be, it would not have happened without the influence of the ACA in some way.

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ninjadude

Is faith the crux of this law? Buy it then see what's in it.

The crux of it is that she's lying for the Koch brothers and their money. Below is one of thousands of articles.

A hard-hitting anti-Obamacare ad makes a claim that doesn’t add up

http://www.washingtonpost.com/blogs/fact-checker/wp/2014/02/20/a-hard-hitting-anti-obamacare-ad-makes-a-claim-that-doesnt-add-up/

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Startraveler

Moreover, why was her expensive extensive blue cross/blue shield plan she satisfactorily used for two decades cancelled in the first place? I'm sure you might say that it was the choice of the insurance company. Possible as that might be, it would not have happened without the influence of the ACA in some way.

I don't know what was wrong with her old plan. I'm just pointing out that central conceit of the op-ed--that this drug isn't available in the ACA's exchange plans--is false. The plans available to this man's mother through the exchange in her area all include it in their drug formularies.

She bought a plan outside the exchange without seeing its drug formulary.

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F3SS

I didn't realize this was part of an ad campaign. Well, only two Pinocchio's for now. Not too bad considering she's still likely the victim of the four Pinocchio whopper that if you like your plan you can keep it.

Edited by F3SS
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F3SS

She bought a plan outside the exchange without seeing its drug formulary.

Well maybe it was out of sheer confusion. That's one unintended consequence you can't deny. Misinformation and disinformation is rampant from all sides.

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Merc14

I don't know what was wrong with her old plan. I'm just pointing out that central conceit of the op-ed--that this drug isn't available in the ACA's exchange plans--is false. The plans available to this man's mother through the exchange in her area all include it in their drug formularies.

She bought a plan outside the exchange without seeing its drug formulary.

Her deductible is outrageously high and unpredictable, something she didn't have to deal with before. The Post is saying in the long run she will be ahead but that is BS in this situation as she is in trouble now. You never sem to mention the 6 and 7 thousand dollar deductibles in many of these plans. Why? You never mention the incredibly insecure website. Why? You never mention that they don't even know who paid. Why?

Are you doing a service to people by lying? IS there nothing wrong with the ACA that you will mention? Nothing? It is a perfect program according to you I am guessing?

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Startraveler

Her deductible is outrageously high and unpredictable, something she didn't have to deal with before. The Post is saying in the long run she will be ahead but that is BS in this situation as she is in trouble now. You never sem to mention the 6 and 7 thousand dollar deductibles in many of these plans. Why? You never mention the incredibly insecure website. Why? You never mention that they don't even know who paid. Why?

You're mixing up stories. We're talking about Stephen Blackwood WSJ's op-ed that (falsely) implies his mother's medication isn't available in plans available to his mother in the exchange. It is, she just bought a Humana plan outside the exchange that doesn't cover her medication.

What you're (presumably) talking about is Julie Boonstra, the Michigan woman who ended up in the AFP ad. She doesn't have a $6-7 thousand deductible. Based on 1) her age and where she lives, 2) the fact that it's known she stuck with a Blue Cross Blue Shield plan because her doctor was in network, and 3) that we know her new plan costs about $570/month (down from the $1,100 her old plan cost her), it seems pretty clear she enrolled in BCBSM's Premier Silver plan in her county. That's a plan with a $2,800/year family deductible. This guy right here: Blue Cross Premier Silver. It's pretty easy to look this stuff up using the browse feature on healthcare.gov.

If she was really concerned about that deductible, she could've gone further and bought the gold version of that plan. Then she'd be paying $688/month with a family deductible of only $300/year.

Compared to her old plan, that's still a savings of $412/month, meaning the premium savings she racked up by January 23 would completely pay for the plan's family deductible for the entire year.

Are you doing a service to people by lying?

What are you talking about?

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Gromdor

This is the reason I wanted to hear about how Obamacare affected UM members insurance instead of the usual, "My friend's grandma was kicked off insurance and now Obamacare is killing her." stuff from the media. Those stories always make a claim but never give any details about the actual insurance plan.

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Agent0range

The middle class are getting hurt by this law now and the country most certainly wouldn't fail if this law was repealed and something realistic put in its place. BTW, it is already failing and they have pushed the worst aspects until after the election, which should tell you something.

I truly don't see it Merc. And to be honest with you, I don't have a dog in this fight, I have insurance and always will. But I personally have not been hurt by Obamacare, and I don't know anyone who has been hurt by Obamacare. I do, however, know people who now have insurance that haven't been able to afford it in years, including my brother and his family and my in-laws. There are always going to be extreme cases broadcast on the internet. Left leaning sites display the extremely good cases, and right leaning sites display the extremely bad cases. The truth is, the law IS here to stay, and even the Republicans are starting to admit that. No one is going to be "that guy" that takes away exchange plans from millions of people. It's time for people and politicians to band together and figure out ways to make it better instead of crying about it...and that includes you.

Edited by Agent0range

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danielost

You're mixing up stories. We're talking about Stephen Blackwood WSJ's op-ed that (falsely) implies his mother's medication isn't available in plans available to his mother in the exchange. It is, she just bought a Humana plan outside the exchange that doesn't cover her medication.

What you're (presumably) talking about is Julie Boonstra, the Michigan woman who ended up in the AFP ad. She doesn't have a $6-7 thousand deductible. Based on 1) her age and where she lives, 2) the fact that it's known she stuck with a Blue Cross Blue Shield plan because her doctor was in network, and 3) that we know her new plan costs about $570/month (down from the $1,100 her old plan cost her), it seems pretty clear she enrolled in BCBSM's Premier Silver plan in her county. That's a plan with a $2,800/year family deductible. This guy right here: Blue Cross Premier Silver. It's pretty easy to look this stuff up using the browse feature on healthcare.gov.

If she was really concerned about that deductible, she could've gone further and bought the gold version of that plan. Then she'd be paying $688/month with a family deductible of only $300/year.

Compared to her old plan, that's still a savings of $412/month, meaning the premium savings she racked up by January 23 would completely pay for the plan's family deductible for the entire year.

What are you talking about?

You need to redo your math. A four hundred a year savings will not cover a three hundred a month deductible unless she only goes to the doctor once a year.

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Agent0range

You need to redo your math. A four hundred a year savings will not cover a three hundred a month deductible unless she only goes to the doctor once a year.

You need to learn the difference between deductible and copay...

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Startraveler

You need to redo your math. A four hundred a year savings will not cover a three hundred a month deductible unless she only goes to the doctor once a year.

That deductible is $300 per family per calendar year. (For the plan she easily could've chosen if she wanted a low deductible option--inexplicably, she didn't choose that.)

Edited by Startraveler

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F3SS

This is the reason I wanted to hear about how Obamacare affected UM members insurance instead of the usual, "My friend's grandma was kicked off insurance and now Obamacare is killing her." stuff from the media. Those stories always make a claim but never give any details about the actual insurance plan.

Aren't you the one who was detailing your journey through the sign up process? With frustration too iirc. How'd that end up for you? I don't recall an end to that story. If it wasn't you, disregard.

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Gromdor

Nah, I have insurance through a Davis/Bacon plan. We can't quit it without forfeiting the $3 million we have in it to go to any other plan including Obamacare. I was complaining about it though because of how it basically tripled in cost over the last two decades.

On the positive side, It hasn't increased in cost in the last two years. It's the only thing that is making me favorable to the ACA. And to be honest, after hearing how much the people who did respond to thread were paying, I didn't feel as bad.

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danielost

Your going to lose your three million before this is over. Your plan doesn't have the right coverage.

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Gromdor

Your going to lose your three million before this is over. Your plan doesn't have the right coverage.

I was wrong it is a Taft/Hartley not Davis/Bacon. And no it is compliant, it added psych and what not a few years back.

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F3SS
http://www.theblaze.com/stories/2014/03/03/obamacare-architect-be-prepared-to-kiss-your-insurance-company-good-bye-forever

Obamacare Architect: ‘Be Prepared to Kiss Your Insurance Company Good-Bye Forever’

Once the health systems “make the jump to offering coverage in the exchanges, the health insurance companies will only have a few options if they want to survive, according to Emanuel.

“First, they can refuse to change, in which case they will eventually go out of business,” he writes. “Second, they can shift their business to focus on offering services they have expertise in, particularly analytics, actuarial modeling, risk management, and other management services.”

Finally, the “third evolutionary path is that health insurance companies may transform themselves into integrated delivery systems.”

“So be prepared to kiss your insurance company good-bye forever,” Emanuel concludes.

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Merc14

More news about the how successful Obamacare is. Another delay to help keep democrats in office in November.

As early as this week, according to two sources, the White House will announce a new directive allowing insurers to continue offering health plans that do not meet ObamaCare’s minimum coverage requirements.

Prolonging the “keep your plan” fix will avoid another wave of health policy cancellations otherwise expected this fall.

The cancellations would have created a firestorm for Democratic candidates in the last, crucial weeks before Election Day.

The White House is intent on protecting its allies in the Senate, where Democrats face a battle to keep control of the chamber.

I am sure startraveler will explain to us how this is another sign of the absolute success of this law. It has to be good law if you must keep delaying its implementation to keep your ****g job. So what happens when all these delays expire? What happens if they never expire, which is what I expect to occur. Maybe our resident cheerleader can explain the implications of that.

Edited by Merc14
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Yamato

Hey Merc, check this out:

Steve Buscemi, who while attending a campaign event for a liberal Democrat candidate in Ohio, actually uttered these words: “To have somebody be that Progressive and Liberal and be proud of it, and really work toward certain values, is to be admired".

So don't take that hat off, brah. ;)

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Yamato

Well I'd say our constant participation in these politics threads means that we certainly have an interest whether we like politics or not. Sure we hate the game but something keeps us coming back. The challenge question you just posted above is pretty much the driving force for all of us.

Saying I like politics is like saying a lifeguard likes drowning but o/w, fair enough. ;)

Politics. I'm here to throw a rope to people who are drowning in them. Not so much out of hatred for politics, more out of the conviction that seeing everything through a political lens first clouds our vision no matter what our politics are. I think we would all get the clearest big picture possible if we eliminated politics from the equation completely. That'll never happen of course, but mitigating it is possible, and it's a noble line of work methinks.

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