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I numbered my thoughts below so that I could put them in some kind of logical order:

1. Regarding cash payment rates, I've seen it go both ways. I've generally paid less because I was a cash customer (office visits, and a procedure here and there), but there have been a few times when I either paid more, or I got no discount at all (which was effectively the same thing). Generally speaking though, the cost of healthcare—even as a cash customer—has kept me from getting some care that I would have gladly purchased if I could have afforded it. More on that in
2. My wife and I finally got signed up for Obamacare, and we're covered as of 4/1/14. I hate it, I really do, and I have railed against this law from day one. I am philosophically opposed to the whole thing, and having insurance through it does not change my opinion of it one bit.
3. In the end, I signed up simply because I'll be hanged if I will pay a fine, still not have insurance, and my fine be used to buy insurance for someone else.
4. Here are the general details of the policy we are getting: It is a Blue Cross/Blue Shield Multi-State PPO, and it is a "silver level" plan. (The plans available through Healthcare.gov fall into Bronze, Silver, Gold, Platinum, and Catastrophic categories; so our "silver" plan is a mid-level plan.) This plan costs $1,278.00/month for the two of us, without taking the subsidy into consideration. The subsidy is where things get tricky. . . .
5. I have been self-employed since late 2007 in an industry where I might do handsomely one month, and then starve for the next three or four. . . .or more. It has been impossible to state with any certainty how much I earn per month, let alone per year, as it can change a lot from month-to-month and year-to-year. As of late, my business has been struggling, and my wife and I had been taking some disbursements from our retirement account to keep things afloat. We can no longer justify doing that, and so I am currently looking for a job. But until I can get a job with a steady paycheck, I cannot answer the question "how much do you make each month" that the healthcare.gov navigators ask you when you phone them.
6. I had to phone the navigators—it took several tries, including one in which I was on hold for 1:15 hrs waiting for a navigator, and they hung up on me before I could even talk to a human being—because the website is NOT set up to handle people who do not have a regular and quantifiable income. The horror stories I endured trying to do it online myself were enough to incite me to riot. In any case, I had to phone the navigators, and it took talking to a couple of different ones before I could talk to one who actually helped me to figure out enrolling. And by the way, once I did get someone to help their system crashed about halfway through the process, and I was instructed to wait two hours and then call back to complete it—which I did.
7. My 2013 taxes aren't filed yet, and all I have to go on is my 2012 Adjusted Gross Income. They are supposed to be able to work with that, but they can't. Get that? Their system cannot handle our 2012 Adjusted Gross Income, which was a modest "low-40K" figure.
8. Instead, she asked me how much I made this month—March 2014. In as much as the month isn't over yet, I couldn't accurately answer the question. So, she asked me how much I had made to date this month. Well, it's not a lot of money. I had the back half of a finished contract come in which paid me, and there was a few hundred other dollars in miscellaneous billing. Then she asked me how much I anticipated making before the end of the month. Well, unless another contract that I have out there waiting for signature comes in, I won't make more than another couple of hundred dollars this month. So.......get this.....she based the amount of my subsidy for the month on an estimated monthly income of about $1,700.00! This means that the amount of my subsidy is SO high that it brings our insurance plan down to $485.00/month from the original $1,278.00. That's a $793.00/month subsidy! Ridiculous.
9. The thing is, because my income fluctuates, I may not qualify for this same level subsidy next month, or the month after that. SO....... I am instructed by healthcare.gov to phone in each month at the end of the month, when I know what my income for that month was, and report the new monthly income amount and have my subsidy adjusted up or down accordingly. I have 30 days to report any changes to my monthly income. The thing is, nobody has told me how rapidly Blue Cross will be updated so that they invoice me for the correct amount each month.
10. God willing and the crick don't rise, I'll land a job here soon enough and I can begin reporting a regular monthly income to the gubmint so that I can count on a certain monthly premium payment. Hopefully, it will be a job that comes with an insurance benefit, and I can stop accepting a subsidy to be insured.
11. Now, before any of you start beating me up, believe me, I DO realize that some of you are paying higher rates than what is fair so that I can get the subsidy which makes this insurance affordable to me. I also realize that some of you will choose to pay the fine rather than enroll, and that your fine will contribute to paying for my insurance, and that isn't fair to you either. I really don't like the situation either, and I think it is unfair to you AND to me. Before Obamacare, I was content to continue being uninsured until such time as I could afford to buy a policy, which I anticipated being if my business could recover, or I came into my inheritance (sadly, probably not that far off from now). The only reason I signed up in the end was that I would be hanged if I would pay the fine AND still have no insurance. My wife had a very affordable plan ($245.00/month from Humana), that worked well for her, and was not encumbered by prenatal care, abortion provision, or any of that other crap that a middle-aged woman does not need. Obamacare eliminates that plan as of 12/31/14. So, unless she signed up for Obamacare, she would be uninsured too in a few months from now.
12. So, I feel very much like I was bullied into doing this, and I would happily take a bat to the head of any democrat politician who voted for this thing, and to the heads of most of the voters who elected those criminals.
13. I am going to state up front that I will keep this policy as long as I can sustain the payments, and then I will change to one of the lower level plans; but until I have to do that, I am going to take advantage of the insurance to take care of some things that I have been putting off because I won't be able to afford them when I have to downgrade my coverage. These are not frivolous items, they involve trying to fix the spine that has given me so much pain over the years, and getting some resolution on a long-term prostate issue which has bedeviled me with various difficulties.
14. I still think it is bad law, but as long as I have to deal with it one way or another, I figure to "get mine" while I can, and then deal with whatever happens when the current iteration of the system collapses because it was so badly conceived from the get go.
15. Personally, I think we are headed for a single-payer system. This is not what I want, but it's where I think we are headed. The current house of cards can't last, particularly when the president who demanded the thing in the first place keeps suspending parts of it, and giving out favors to his largest contributors in the form of exemptions for various of its provisions. The 1:3 ratio in youth:senior premiums mandated by the law impose unsustainability when young people are not signing up for it. There are little known provisions in the law which are going to prove extremely controversial in the next couple of years. One of them guarantees a taxpayer funded bailout of the insurance industry in order to keep the system going as currently configured, and that bailout is going to become a huge political football......one we can lay SQUARELY at the feet of the democrat party, since not one single republican (or libertarian) voted for this mongolian cluster.......you get the idea. After having bailed out the banks, General Motors, Fanny and Freddie, and others to the tune of trillions of $$ over the past 6 or 7 years, taxpayers are NOT going to be in the mood to bail out insurance companies to the tune of another trillion or two $$ (particularly when at least half of them believe the insurance companies to be part of the problem), and any politician who pushes it will lose his/her office. And then there is the provision which allows an individual to opt out of obamacare entirely if they can prove that the rates are unaffordable to them even with the subsidies included. So in the end, the system is primed to fail. When it fails, single payer is the only possible outcome which the majority of voters, after several years of obamacare fatigue, will finally submit to.
16. The only way to avoid single payer is for republicans to recapture the house, senate, AND the whitehouse, and pass some kind of laws which patch the system up and restore some kind of business sense to it. But by then, it is pretty much guaranteed that voters will have come to view taxpayer subsidized healthcare as an entitlement, the same way they view Social Security and Medicare now. So, democrap-care is with us to stay, one way or the other.
17. I believe that has been the democrat party's strategy all along: grind us down and wear us out until we just fold up and give in to their fascist dogma.
18. This is one of the reasons why I hate that party with such a passion. Republicans aren't a whole lot better, but at least they understand the meaning of a dollar; democrats on the other hand stand for the deliberate ruination of free enterprise and all the things which made America great.. . . . .including affordable healthcare—which is the exact opposite of healthcare as an entitlement.
19. Anyway, that is my personal Obamacare experience so far. If I were in a better boat financially, I would have resisted for a lot longer, but I am in a difficult situation because of what democrats did to the small business economy. . . .so I am getting hosed both ways thanks to that bloody abomination of a gang of political thugs. Forum rules prevent me from fully expressing the depth of the contempt I have for democrats.

mojo84 wrote:This issue started long before the current dictator in chief took office. He has just seized the opportunity to "change" the country.

Being in the insurance business for over 15 years and my wife close to 25, we were talking and laughing last night about how much we are hearing and seeing people say how much they "liked" their insurance plan and coverage. Not too long ago, you would be very hard pressed to find someone that didn't hate their coverage and insurance company to the point of cussing them.

I'll be the first to say, the system needed fixing but it didn't need this. Prime example of be careful what you ask for. Until we get a handle on the cost of care and treatment, the cost of insurance will just continue to skyrocket.

For my wife's Humana policy, we would be one of the ones that liked an old policy. It was only $245/month. It had a $5000 deductible, and 70/30 until another $5,000 out of pocket was reached. It had reasonable copayments for office visits and other services. Lest $10,000 sound like too much out of pocket, when my wife had her rotator cuff repaired in June, the bill for 4 hours at the Baylor outpatient surgery center in Trophy Club was over $23,000. Add to that the surgeon's fee, the anesthesiologist fee, all the physical therapy, etc., etc., and we got a comparative bargain. Yes, $10K is a lot of money, but almost anybody above the poverty level can beg or borrow that $10K if they have to. (We took it out of our retirement account.) No, it's not easy, but it is doable, and that much out of pocket was offset by the fact that for the past few years, the annual cost of her health insurance has been affordable. We didn't go so broke paying for a more expensive plan that we couldn't afford the $10K when it became necessary.

mojo84 wrote:The unique part is that the government has set up to sell you "private" insurance and they are pushing you to Medicaid, government program, even though people really are not qualified. That is definitely unique to Obamacare.

This is the statists dream: create as big a dependency as you can, because once you've got everybody on that dependence, you own them. There is something so massively evil behind this whole thing.

Anyway, I phoned my insurance agent and described what happened to him. He said that I should go ahead and try to call a navigator. He said that he has had other self-employed clients successfully navigate the process, but they had to bull their way through it by averaging income and so on. He also said that, of course, the danger is that if the system does not extrapolate your average numbers into something close to the actual annual number—like it did with me, see my previous post—then you risk understating your income and over-claiming your subsidy, and then you have to pay back the difference at the end of next tax year.......and that can add up to a LOT of money.

We are so screwed.

I tried to use Healthcare.gov today to purchase a new plan for my wife and me, and suffice it to say that it is just not usable for a self-employed person. Allow me to explain.......

I had two primary sources of income in 2013, as I did in 2012. Since 2013 is not over yet, I am supposed to use my 2012 figures, as they appear on my 1040. Those two sources of income are: A) the consulting/hosting income earned by my business; and B) disbursements taken from our retirement account. None of this income is regular. I never know from one month to the next exactly how much money I'm going to have/earn. I might get more than one contract in a month, and then have no contracts for 2 or 3 months.

So, I find the plan we're going to buy (if we can get past the website obstacles), I have my agent's FFM ID and NPN Number, and I set my account up at healthcare.gov. When I get to the part where you have to give them your income information, it can only accept self-employment income as a monthly figure. If I take the annual figure, divide it by 12 and use that as a monthly figure, it extrapolates that number into an annual amount that is less than it should be. For instance, if that annual amount off the 1040 were (hypothetically) $20K, I divided that by 12 and enter the amount of $1,666.67. Then the system says, "it looks like you make $18,446.60/year," which is actually short by a little over $1,500.........so that number makes no sense.

Then, it asks me what kind of other income I have, so I enter the amount of disbursements, and for each one I have to tell it the frequency...like just once, or monthly, or whatever. Well each disbursement is just once, but the system adds them in as just once in each month.

The net result is that the system tries to say that I've had hundreds of thousands of dollars in income, and of course nothing could be further from the truth. So now I'm dead in the water and exhausted. It was a 2 hour process to get to that point, and I'm stymied.

I have no choice now but to call a navigator, because I don't know what to do next, and I am royally ticked off. Whoever thought this was a good idea can stick it.

gringo pistolero wrote:It's interesting to observe many of these complaints are coming from people who already embraced socialist medicine in the form of medicare, etc. Don't take this the wrong way because I'm not in favor of obamacare. In fact, I think it's unconstitutional like 90% or more of the federal laws on the books, despite what old people in robes say, but I think it's an interesting comment on the differences between principles and practice.

That would exclude me. My "supplemental" insurance had nothing to do with medicare, as I am not yet on it. It was a privately sold product, like AFLAC, but not AFLAC. A major part of my complaint is that Obama/DemocratCare forces me into a dependency I don't want: subsidies for now, because Obama/DemocratCare puts insurance completely outside of the realm of affordability now, and medicare later because Obama/DemocratCare mandates it when I reach a certain age.

There is both an insult to the individual citizen (now subject), and an insult to the entire structure of government and its relationship to its subjects. Obama/DemocratCare has forced more people onto federal subsidy of some kind than any previous program in the nation's history. Here's why:

• Don't want to depend on Social Security? Then don't apply for it and collect it. You are not required by law to participate as a recipient. Yes, you are required to pay into it, but that is calculated as a tax upon your wages/income, and if you start collecting social security, you no longer pay FICA. You have (for now) the freedom to provide for your own retirement. . . . or to not provide for it, and starve. But at no point will you pay a fine for refusing to participate as a "beneficiary."
• Don't want to accept unemployment compensation? Then don't. There's no law that says you MUST receive it if you are unemployed.
• Don't want food stamps? Then don't get them. There is no fine for refusing to accept food stamps.
• Don't want to be on welfare? Then don't apply for it. There is no penalty for poor people who would prefer to dig their way out of poverty without any help from Comrade Sam.

I could go on, but you get the point, I'm sure. Obama/DemocratCare is the first program in the nation's history which A) artificially increases the price of the insurance product, B) limits the selection of available plans, C) forces those citizens who lack the wealth to buy the product at the inflated price onto a new federal dependency, D) forces those who can afford it to subsidize those who cannot, and E) in the final insult, forces those who cannot afford it but don't want to be part of the subsidy to pay a punitive fine for refusing to participate.

How exactly does this kind of abuse of the citizenry separate the U.S. from the U.S.S.R.?

And this is where it becomes relevant to the 2nd Amendment. How long will it continue to exist in a nation which now has the legal power to tell you that your gun ownership is a threat to the (politically driven) actuarial tables upon which this entire obamanation is based? The right may exist as a human right, but its observance as a constitutional guarantee may well not. We have witnessed general erosions of the rest of the Bill of Rights. The 2nd Amendment is the one most dangerous to a government seeking to impose an immutable will upon a resistant populace. Obama/DemocratCare is exactly such an imposition of will.

To add a little more fuel to the fire chasfm11 refers to which will affect seniors more than the young, by virtue of the general degradation of health that accompanies old age: The threshold for being able to write off medical expenses on your income tax return has gone up significantly from 7.5% to 10% of adjusted gross income. So in addition to having increased costs all around (premiums, deductibles, medical device taxes, etc., etc.), at a season of life when income begins to taper off, seniors have to pay out a much larger percentage of their shrinking income dollars in medical expenses before they can claim a tax write-off. People often like to say that the measure of a civilization is how well it takes care of its weaker members. Seniors are learning with a vengeance exactly how little their government values them.

I remember a great nation in which government cared about encouraging the creation and preservation of the wealth of its people. I defy anybody to tell me that nation still exists as anything except a leviathan which views its people as a cash cow it can squeeze while its elites in DC live a sybaritic lifestyle completely disconnected from realities outside the beltway, and completely absolved of the financial consequences of their own decision-making.

cb1000rider wrote:I'm sorry that happened to you.
I want to be concerned along side you.. But I believe that some companies are taking cover under Obamacare and taking advantage. I think other people (not necessarily you) are not fully making an apples to apples comparison. Help me understand:

1) What were your "before" premiums? You mentioned "pocket premiums are $13,200/yr". I assume that is for all 3 of you at $1100/mo.
2) New premiums are $842.33 for 2 people, but you switch to medicare and supplemental insurance (new policy) at $580/mo for a total of $1422.33/mo

So moving from 3 people from a Blue Cross Blue shield PPO to a Humania Platnium PPO (2 people) and adding medicare plus a supplemental policy results in a cost increase of 29%.

Are the coverages on the PPO plans the same, worse, or better?


That data helps me decide...

What were prior year to year increases on the Blue Cross PPO? I know that we dropped them due to increases over the last 3 years.

My wife's Humana policy, before the Obama/DemocratCare rollout was $245/month. First, she got a letter saying it was being canceled on 12/31/13. A couple of weeks later, she got a 2nd letter saying she could keep her policy through 12/31/14, but it would go up to $596.00/month. I had a supplemental insurance policy and a $50,000 life insurance policy which cost me $99/month. It is canceled as of 12/31/13, so I lose both my supplemental insurance AND my life insurance.

We talked to Blue Cross/Blue Shield about a multistate PPO plan for the both of us. (We didn't even consider the HMO because there are almost no providers in Tarrant County, where we live.) The cost is $1,278.00/month for a policy with similar coverage to my wife's previous Humana plan, but with a larger deductible. We're on a more or less fixed income. Because of our adjusted gross income for 2012 (2013 isn't calculated yet) we qualify for a subsidy which will reduce the payment from $1,278.00 to $536/month. So those are the numbers.

Here's the philosophical objection:

• Before Obama/DemocratCare, my wife and I were not a burden to the U.S. taxpayer. We paid our way, and we had contingency plans in place should the catastrophic happen. Obama/DemocratCare forces us onto a federal dependency. That robs me of my dignity if nothing else, or it forces me to pay a fine for refusing to kowtow to the commies, and that is just plain inarguably unjust and immoral. It forces us, who are both very pro-life, to support abortion, which is an abomination in God's eyes. It forces this aging empty-nester couple to pay for the pediatric care of other people.

The personal financial objections:

• Instead of an annual outlay of $4,128 plus office visits (I always got a good price because of being a "cash customer") plus deductibles, we are now going to pay $6,432 plus copays + a larger deductible. . . . .and this is AFTER the subsidy. In exactly what world is that a just thing to do to my wife and I, who are no longer spring chickens and whose purchasing power is rapidly succumbing to the ravages of a democrat economy? We're actually considering selling our 100% paid for home and moving to another county with lower property taxes, just so that Obama/DemocratCare doesn't wipe us out entirely.

The macro economic objections:

• The entire boondoggle depends absolutely critically on young people signing up. They're not doing that. The reason it depends on them signing up is that the system depends on their being part of the insurance pool to amortize the cost of insuring people like me and my wife. The reason they're not signing up is that the law mandates that the premiums for people like me cannot be more than 3 times the premiums of young people. But since they cannot possibly afford to insure people my age for three times what a young person used to pay, they had to raise the rates for young people to 1/3 of the rate of the (increased) senior rates under the new plan. So not only do seniors pay a significant amount more, but the young are paying a staggering amount more. So they are not signing up.
  
  The problem with that, of course, is that since they are not signing up, the whole house of cards is going to come tumbling down within 12 months. Come fiscal 2015, there won't be enough young participants to keep the thing going for seniors, and the insurance companies will no longer have the financial incentive to participate in the exchanges. The law doesn't require their participation, if they just want to sell "cadillac policies" (to use the democrat misnomer) to the rich, who don't need to worry about the cost of Obama/DemocratCare to their personal family insurance plans. When that system collapses, we'll have no insurance at all because the subsidy will end and Blue Cross/Blue Shield will terminate our policy which we'll no longer be able to afford at $1,278/month (for 2 people) on a reduced income.

In 24 months, either Obama/DemocratCare will be repealed, or republicans will cave in and allow passage of single payer. . . . which was the democrats' plan all along. Welcome to the "social democracy" of western europe. We're hosed. Honestly, if everyone of those peckerwoods who had anything to do with conceiving, writing, passing, signing into law, and implementing Obama/DemocratCare dropped dead tomorrow, I wouldn't give it a moment's thought. I would actually feel a burden lifted off my shoulders.