Health Insurance Exchange 2015 (pre-Medicare Fulltimers)

[Greg Schoenberg]

Originally Posted by Smitty77

It seems to all depend upon whom is helped vs whom is paying. Especially the comment about being able to retire and affording healthcare...



For my wife and I, we are now spending a great deal more money, for less coverage. I also see people, one a family member, who are being helped by ACA - but are also on and or selling drugs, not working, and have their EBT (or 2, or 3...) - milking society from that spectrum too...



Feel free to quote me in the future, but I feel: "The squirrels that worked to save their nuts for winter, should choose who they help to share with. I don't like DC kicking my nuts where they feel they belong... ".



Greg - May have read more into that sentence then you intended. But my wife and I have worked hard over the decades, and are now impacted a great deal by Pre 65 ACA costs. And yes, others will, and have, said that we werer 'under paying' for heath care over those decades we worked our 50-65+ hour weeks. And I say our 'total compensation' for that effort (public, non government jobs) were adjusted salary wise downward based upon having health insurance. So, we did 'pay as we go' via lower compensation for our services.



Still hopeful that DC will start working to change the areas that need adjustment, via scrapping ACA - but for now, and probably until I hit 65 (the wife is young enough they may adjust things before she hits 65) - I suspect I'll still have my legal right to squawk how I feel it has impacted my wife and I... NOT a fan of ACA as it is...



Best to all,

Smitty

Just to clarify. A number of my clients of been able to retire, not just because it's affordable, due to subsidies, but because they now have access to health insurance without regard to pre-existing conditions. Too many people were stuck working a job they didn't particularly like, all because of limited or zero access to health insurance. That could've easily been you.

Greg

[Smitty77]

Originally Posted by Greg Schoenberg

Just to clarify. A number of my clients of been able to retire, not just because it's affordable, due to subsidies, but because they now have access to health insurance without regard to pre-existing conditions. Too many people were stuck working a job they didn't particularly like, all because of limited or zero access to health insurance. That could've easily been you.

Greg

I get that this helps, and Greg, I have no problem with that and certainly not your sharing your knowledge and experiences with us. Did not want it to come across that way.

In previous posts on ACA, I've voiced that I sure do not want ACA scrapped. Some of the examples you provided, are a few of the reasons why. I feel it's important to improve health care offerings to all. I also admit it's not an easy process, as it is very complex - always wonder why it is so... (What would happen if all of the billions that go into Health Insurance, were diverted to Health Care - perhaps via expansion of Medicare to all. Sure, insurance companies, and the people that work for them, would then be hurt. Probably a few less donations to DC too! But if we're going to have an attempt of National Health Care for all - what value added part are the Insurance Companies performing?) Complex yes, so easy to make suggestions, and easy to complain!

I do feel that the current ACA needs adjustments, and remain hopeful that changes will be made in the futures. Until then, we'll divert funds from other areas, to cover these higher costs. This then hurts other parts of the economy, as those funds are diverted. It also curtails some of our personal travel plans, ones that we had budgeted into our 5 year plan, and worked extra hours for before retiring to account for. But, that's the way it is - for now.

Best to you, and to all,
Smitty

[davidki]

Greg I think what Smitty77 are saying is that we both have worked and been responsible...My wife and I are in good health (with a few issues of shoulder surgery for her) and we pay for our premiums through her work. Other folks in the same situation now under the same circumstance are able to get large taxpayers subsidies to help pay their premiums... but because we have insurance and can not shop we loose those subsidies. If the goal is for the government to provided low cost insurance through the use of taxpayers subsidies than everyone should be able to receive the same subsidy... Am I whining.. Now I"m just stating a point where all the situation is the same other than point of purchase!

I think it was Pelosi that came up with the "Don't like your work" Now you can quite and get huge Taxpayers Subsidies to pay for your insurance.. that just isn't what I call fair and balanced politics.... At least with the Canadian system everyone pays the same...

I think you are providing a great service here Greg by communicating and helping folks, my beef is't with you or the folks here... I just think if there is a share cost plan that the government offers that all the taxpayers can sign on.. .(As for the non taxpayers... there is programs for them as well)!

[Greg Schoenberg]

Originally Posted by Smitty77

I get that this helps, and Greg, I have no problem with that and certainly not your sharing your knowledge and experiences with us. Did not want it to come across that way.

In previous posts on ACA, I've voiced that I sure do not want ACA scrapped. Some of the examples you provided, are a few of the reasons why. I feel it's important to improve health care offerings to all. I also admit it's not an easy process, as it is very complex - always wonder why it is so... (What would happen if all of the billions that go into Health Insurance, were diverted to Health Care - perhaps via expansion of Medicare to all. Sure, insurance companies, and the people that work for them, would then be hurt. Probably a few less donations to DC too! But if we're going to have an attempt of National Health Care for all - what value added part are the Insurance Companies performing?) Complex yes, so easy to make suggestions, and easy to complain!

I do feel that the current ACA needs adjustments, and remain hopeful that changes will be made in the futures. Until then, we'll divert funds from other areas, to cover these higher costs. This then hurts other parts of the economy, as those funds are diverted. It also curtails some of our personal travel plans, ones that we had budgeted into our 5 year plan, and worked extra hours for before retiring to account for. But, that's the way it is - for now.

Best to you, and to all,
Smitty

Smitty....completely agree that ACA needs some improvements but draw the line with expansion into public insurance. Right now, we have medicaid and medicare, and both are extremely inefficient. Most people are not aware of this but most of Medicare is administered by private insurance companies via Medicare Advantage plans. Reason...the insurance companies are far more efficient with claims, billing, etc. than original Medicare. So...Medicare pays the insurance company on their behalf. Win-win for all.

Medicaid is Cadillac coverage for little to no premium to the recipient. If it were expanded beyond ACA, it would bankrupt the country. As it stands now, Medicaid expansion has gone too far.

It's true that single payor works in Canada and Western Europe, but we are talking about small populations. Not a country of 300 million, who are not use to waiting in line for health services.

-Greg

[Greg Schoenberg]

Originally Posted by davidki

Greg I think what Smitty77 are saying is that we both have worked and been responsible...My wife and I are in good health (with a few issues of shoulder surgery for her) and we pay for our premiums through her work. Other folks in the same situation now under the same circumstance are able to get large taxpayers subsidies to help pay their premiums... but because we have insurance and can not shop we loose those subsidies. If the goal is for the government to provided low cost insurance through the use of taxpayers subsidies than everyone should be able to receive the same subsidy... Am I whining.. Now I"m just stating a point where all the situation is the same other than point of purchase!

I think it was Pelosi that came up with the "Don't like your work" Now you can quite and get huge Taxpayers Subsidies to pay for your insurance.. that just isn't what I call fair and balanced politics.... At least with the Canadian system everyone pays the same...

I think you are providing a great service here Greg by communicating and helping folks, my beef is't with you or the folks here... I just think if there is a share cost plan that the government offers that all the taxpayers can sign on.. .(As for the non taxpayers... there is programs for them as well)!

I share the same work ethic as you do. I've never collected a dime from any federal or state agency, including unemployment. I paid my way through college without any assistance.

At the same time, we are the richest country in the world. Why shouldn't our society ensure that the poor receive medical care and especially the working poor, being able to afford a decent health insurance plan. Personally I don't mind my tax dollars going for this. What I resent is the uninsured irresponsible walking into hospitals and having me pay for their choices.

-Greg

[saydiver]

Originally Posted by Greg Schoenberg

Smitty....completely agree that ACA needs some improvements but draw the line with expansion into public insurance. Right now, we have medicaid and medicare, and both are extremely inefficient. Most people are not aware of this but most of Medicare is administered by private insurance companies via Medicare Advantage plans. Reason...the insurance companies are far more efficient with claims, billing, etc. than original Medicare. So...Medicare pays the insurance company on their behalf. Win-win for all.

-Greg

I agree with you that both programs are inefficient.

Private insurance companies have always processed the claims for the Medicare program, even the part you're calling original Medicare. I started my career processing Medicare A and B claims for a private insurance company in 1971, 30+ years before the managed-care option, called Medicare Advantage Plans or Medicare C, was implemented.

Sue

[Greg Schoenberg]

Originally Posted by saydiver

I agree with you that both programs are inefficient.

Private insurance companies have always processed the claims for the Medicare program, even the part you're calling original Medicare. I started my career processing Medicare A and B claims for a private insurance company in 1971, 30+ years before the managed-care option, called Medicare Advantage Plans or Medicare C, was implemented.

Sue

Very interesting. I did not know this about Medicare claims. Thanks for the enlightenment.

[saydiver]

A little more info:

Since Medicare’s inception in 1966, private health care insurers known as Part A Fiscal Intermediaries (FI) and Part B carriers have processed medical claims for Medicare beneficiaries. The transition from the Part A FIs and Part B carriers to MACs, multi-state, regional contractors responsible for administering both Medicare Part A and Medicare Part B claims, began in 2006, and the last FI and carrier contracts will end by September 2013.

Medicare Administrative Contractors - Centers for Medicare & Medicaid Services

Sue

[Rusty years]

Originally Posted by Greg Schoenberg

Wealthy is a subjective term :-) I've heard financial planners state that one should maximize their IRA contributions first, before considering an HSA.

They aren't related so the advice is bad. HSA is a great idea for healthy people who want to control their health care costs. It is also a form of IRA.

[Rusty years]

Originally Posted by Greg Schoenberg

I ran the numbers with both being 64...smokers...and came up with a range between $1400 to $2400.

Time to move. :-)

Greg

Time to scrap ACA. Our system wasn't perfect but all it needed was tweaking. The cost to the middle class is going to continually increase.

[Greg Schoenberg]

Originally Posted by Rusty years

They aren't related so the advice is bad. HSA is a great idea for healthy people who want to control their health care costs. It is also a form of IRA.

HSA accounts is an expensive form of an IRA. From administration cost standpoint, one should maximize an contribution first before an HSA,

From a premium versus benefit standpoint, I have yet to see an HSA insurance plan that was a good value, in of itself. There are bronze plans that have co-pays for doctor visits and prescriptions, thus allowing the insured to have some upfront benefits. HSA plans do not have these features.

[Greg Schoenberg]

Originally Posted by Rusty years

Time to scrap ACA. Our system wasn't perfect but all it needed was tweaking. The cost to the middle class is going to continually increase.

The uninsured number nationwide is down to 11% from 35%. In Oregon, despite a broken website, the amount of uninsured is 6%. Given these numbers, what "tweaking" would you have recommended in order to accomplish the same thing? What parts of ACA would you keep?

[Steve Ownby]

Originally Posted by Greg Schoenberg

The uninsured number nationwide is down to 11% from 35%. In Oregon, despite a broken website, the amount of uninsured is 6%. Given these numbers, what "tweaking" would you have recommended in order to accomplish the same thing? What parts of ACA would you keep?

Given the government reluctance to share any "real" numbers, I would be interested in the source and veracity of these numbers.


Steve Ownby
Full time since '07

[Greg Schoenberg]

Originally Posted by Steve Ownby

Given the government reluctance to share any "real" numbers, I would be interested in the source and veracity of these numbers.


Steve Ownby
Full time since '07

Here is one of many links. I do not see the 35% number within the article and perhaps that figure was originally used to describe all insured, especially illegals.

http://www.whitehouse.gov/blog/2014/...te-or-near-his

Now....i'm not ready to land on the aircraft carrier yet. The critical portion of a ACA, insuring the young invincibles, has not been fully realized yet. I'm hoping that significant tax penalties they will face this year and next, along with hospital's aggressive tactics to collect payments for services, will force the remaining uninsured to become responsible. But there will always be a remnant who will not. Just yesterday I spoke to a 35 year old "man" who has a child already on Medicaid. He makes 30K a year as a fishing guide. Through ACA, he could buy a $500 deductible plan for $78 a month, subsidized with roughly $200 worth of tax credits. He rejected it. His comments… "Why doesn't it include dental?" "All my friends are getting free stuff. How come I'm not getting it?" The final one was a kicker for me. "I'll have to talk to my mom about this." It was all I could do to not scream at this loser.

Prior to ACA, this clown would show up in the ER and the insured would pay his medical bills. Now he will be held responsible and that's good for society.