You forgot this part.

it. Period." Not you can keep it if it meets the new standards.

Those policies that did not comply were to be changed or discontinued.
He said many more things in addition to that quote, and went into quite a bit of detail of how this was supposed to work.
Those old policies have lifetime limits and many health conditions that they didn't cover. Therefore you may have been covered for an accident, but not cancer or maternity care.
And yes, he did say policies must meet the new standards. He did. Many times. For months. Over and over again.How did you miss it?

both a plethora of new benefits mandated and at the same time promise that if you like your plan you can keep it. I think the President knew this (or at least SHOULD have know it) at the time he said it but said it anyway.

What's the problem?
I feel for those who live in red states like mine who aren't covered under the Medicaid expansion. We have some of the highest rates on the exchange. I'm mad about that. That's the indignity I'm suffering over this law.
States need to set up their own exchanges and expand Medicaid now! I'm pissed ya'll!

the ACA. I am benefiting from it BIG TIME! What I don't like is being misled.

He made a broad statement and then took his time to break it down. You understood, as you have already indicated, so why should you feel mislead?
Those that were not paying attention to his full comments may feel mislead but, if they go back and rewatch the months and months of Pres. Obama explaining the the law and how it would work, then they could see for themselves that he explained everything.
The television media replayed quotes of him saying this phrase over and over and now nobody seems to remember the rest of what he said.

THEY were told to make their insurance more effective and to quit wasting money on non-patient centered crap. Well, THAT wouldn't be profitable for THEM, so FU to the ACA rules. DUMP everyone possible.

THEY are dumping so many people out and onto the ACA that it should be a crushing weight and overwhelm the system into an EPIC fail so the insurance industry can go back to business as usual screwing people over.

Had Obama embraced a public option, then he would have had at least some basis for making promises of what options would be available. But instead, by leaving the private insurance companies completely in charge, Obama really had no control over the key decisions.

The insurance companies were mighty quiet during this whole period leading up to the launch of the exchanges. And now we see why. They had a whole load of surprises for us.

and this is a bad thing? Don't you think that most people would want better coverage if the price is basically the same? Or do you think that people will demand plans with worse coverage?

But that's just me.

It offers crappy bronze policies, after all, which will bankrupt you in the event of serious illness. The problem is that in every age bracket, 15% of the people account for 85% of health care costs, and 85% of the people account for 15% of the costs. For that reason, a shitty cheap plan is a very good statistical bet. If you heard of a casino with slot machines that paid off something 85% of the time, you'd be over there yanking those levers all weekend. Naturally, the unlucky 15% are totally fucked, bankrupt and possibly homeless. Which is why we must eventually put everyone in the same risk pool--single payer. Luckily ACA allows states to do this starting in 2017.

So not only does it allow states to do it, but they mandate at least one multi-state plan that is non-profit, which is a big incentive to do it.

You might not like this but this would actually be a very lucrative business to start. Have a very efficient, 1500 employee or so call center, and do everything digitally, and run it wisely without billionaire CEOs you will make the entire company very rich and you'd only have 1-2% overhead (around the same as Medicare) and still be super duper rich.

The cheapest pool is the one with everyone in it, period. Anyone leeching off of smaller pools is essentially harming people for money.

Especially because the damn plans segregate healthy people from sick people cost-wise. If you live in an unhealthy area, your costs are higher and people in healthy areas have lower costs.

I can't see getting anything better than ACA nationally because of all the reactionary red states. The best thing the rest of us can do for them is to set them a good example.

These are for-profit businesses. They will take every penny the market (or government) will allow. From what I can tell, in Marion County Indiana where we have basically one competitor, a policy that costs $1500 for two people would cost more like $500 if that same couple lived in California where they have a dozen or more competitors.

I don't doubt that the average Californian lives a healthier lifestyle than the average Hoosier. But not 300% worth.

And I don't believe an appendectomy costs three times as much in Indiana as it does in California.

These price differences aren't rational. It is all about the amount of real competition in the market.

It's statistics, if you live near a coal plant, you might have bad air, and are more likely to get sick. If you live in a town where there are a lot of alcoholics, you have to pay higher because eventually one of them is going to get sick.

Car insurance does it the same way, too. The insurers take into account the infrastructure in your area. Bad roads? Area with lots of accidents? You're a higher risk to the insurer.

considering how much better the new ones are?

How stupid libertarian do you have to be to think that women should be charged a higher price for medical insurance than men?

“I don’t feel like I need to change, but I have to,” said Jeff Learned, a television editor in Los Angeles, who must find a new plan for his teenage daughter, who has a health condition that has required multiple surgeries.

The union is working to unionize them.

the ACA debates in congress that the promise that "If you like your health plan you can keep it. Period." was at best an exaggeration. Didn't anyone tell him this would bite him in the butt?

they aren't being left in the cold...the companies have to cancel the policy and give them another that is ACA approved.

promised. The promise was "If you like your health plan you can keep it. Period." Nothing about if it complies with new requirements. Nothing about it meeting new standards. Straight up you could keep it. Now we know (and really, those following the ACA debate knew at the time) that that statement was an exaggeration.

It's less of an exaggeration than "Obamacare is hurting millions."

Your perspective is skewed.

Give it up.

First you are having a sad that you might have to take out a new insurance policy because the old contract expired and has to be renewed with the additional services required to meet ACA Standards...but still you are saying... "WAH...I wanted to keep my sub par insurance coverage with less services than I will now have under "Obamacares"

then you are complaining that "WAH I make too much money and wont qualify for a subsidy" when you are not subtracting standard deductions and you will either qualify for help towards you coverage...such that you won't pay more than 9.5% of household or you are finally going to be getting those health care diagnostics you have been putting off because now they basically come WITH that a little more expensive insurance you "might" have get. Some that even cover Eye Care, Dental Care and even the rarely ever seen before in the history of Insurance in the U.S......Hearing Coverage.

And you know what....this is only the beginning...more and more coverage for other things like maybe you local gym membership etc....when the companies really do have to compete with each other for customers...

It took Medicare 2 years to begin working as designed.

I NEVER SAID I did not qualify for subsidies. In fact, I NEVER mentioned anything about my specific situation except that I LOVE the ACA and I am getting MAJOR BENEFITS from it. Can you point out a SINGLE POST where I said this effected me personally?

My questions about the President's statements were questioning the political ramifications of that statement when faced with the OP's post.

My points in our infamous MAGI/AGI discussion below were to dispel erroneous information being put out. (BTW, did you read the link from post 59 yet?)

Keep a policy which would terminate if the insurance company decided a condition occurred and they declared it a pre-exist condition and canceled your coverage? If you found out next year you now have a condition in which the limits on your policy would be reached and then you would not have any more coverage, would this make you happy? The insurance policies sold in the future must be compliant with ACA. It is not the promise of keeping your old coverage, it affords you more protection.

your health plan you could keep it. Period.

Why did he say that when he knew (or at least should have known) that that was not true?

Present plan become ACA compliant?

by ending the pre-ACA policies and offering fresh new policies that are either:

a) GREATLY reduced benefits at the same price level (for example, moving people from 10% co-pay to 40% co-pay, or ending out-of-network reimbursements altogether

or

b) GREATLY increasing the price (like a 100-200% increase) for equivalent coverage under the ACA rules. And they can get away with that in markets that have little competition because the majority of applicants will be getting a government subsidy that obscures the cost of that increase.

And yes. I am aware that the ACA has rules that say they have to apply 80% of the premiums toward actual health care. But the companies have had 3 years to figure out clever gimmicks to stretch those rules.

The people who are arguing with you will never admit it. They just can't somehow.

And, some of the people who have to change their plans are going to have to pay more.

I mean, they are getting more, more, more! Why can't they shut up and be happy already?

Obviously the POTUS either didn't know the truth or else calculated that it was better to lie.

The insurance companies could have added the missing pieces to the policies (for instance, mine did). Instead, those insurers are canceling the non-conforming policies and suggesting more expensive ones without offering alternatives to the suggestion or clearly informing the policyholders that they might find better choices on the exchange.

would be made illegal to protect consumers.

You are benefitting from ACA, yet you feel compelled to bitch and complain about it? Very curious........

Obama said those who are happy with their plan could keep it and it clearly is not the case.

How can you turn that into the other person bitching about it when all they are doing is stating a fact?

The core issue is that the ACA requires more things to be covered. An insurer could simply incorporate the additional risks into the current policies. But I believe the ACA also puts caps on how much a premium can increase each year. So the insurers may simply decide that their best option is to stop offering that policy. That allows them to establish a new, higher price level on the exchanges.

That is what happened to me. Anthem is terminating all the existing policies, but not immediately. Under the ACA, they can keep those policies in force until their next anniversary. For me that anniversary would have been September 2014, but Anthem is offering to reset the anniversary date to December 2014. But after that, it is done. I have to move to an ACA policy after that.

My current policy is under $600/mo for two people. The cheapest policy on the exchange is over $1300, and it is a piece-of-crap policy that has a tiny provider network. None of the Docs I see are in network. The Anthem ACA policies don't pay anything for out-of-network except for emergencies. So if nothing changes by 2015, I will not be able to buy ANY insurance that covers me seeing my current doctors. I won't be able to buy any insurance that covers me being treated at the better hospitals in the city. Not at any price.

Griefers always leave that part out!

subsidies, right? Do you think that couple would be able to come up with the extra $700 or so per month for a new ACA approved policy?

Nothing?

is having a plan Bluestreak liked for under $600 per month that is being cancelled as it does not meet ACA standards and having a new plan that costs $1300 per month that meets ACA standards. Did you even read this sub-thread? Do you think that couple both making $15 per hour will easily be able to come up with the extra $700 per month?

Perhaps facts would be more appropriate to the situation, which are not in evidence in most of these threads that have brought out the naysayers en masse.

Word must have gone out, the gang's all here.

Up to $45,000 a year for a single person...qualifies for subsidies...

a couple?

I will give you the benefit of the doubt in that I did not specifically state married couple. FYI the cutoff is $62,040. At 40 hours a week that is $14.92 per hour for each person in a two person household.

is the point of your graphic?

at 40 hours per week with no 401k/HSA/IRA contributions would be $62,400. 400% of FPL for a 2 person household is $62,040. They are $360 over the limit for subsidies.

that is what I keep trying to tell you.....Govt is never about Gross income....it's about your Adjusted Gross. And that is what they want in this case.

Here is a link

:http://laborcenter.berkeley.edu/healthcare/MAGI_summary13.pdf

Let me ask you a question, please. What do you think is deducted from the gross income as described above to come up with ACA AGI?


There are some slight modifications (I listed the main ones above) but there is NO STANDARD DEDUCTION or PERSONAL EXEMPTION. For the VAST majority of people close to the 400% FPL cuttoff for ACA subsidies and WITHOUT 401k/IRA/HSA deductions there GROSS INCOME will be their ACA MAGI.

The standard deduction, as defined under United States tax law, is a dollar amount that non-itemizers may subtract from their income and is based upon filing status. It is available to US citizens and resident aliens (for tax purposes) who are individuals, married persons, and heads of household and increases every year. It is not available to nonresident aliens residing in the United States. Additional amounts are available for persons who are blind and/or are at least 65 years of age.[1] The standard deduction is distinct from personal exemptions, which also are available to all taxpayers and dependents.[2] As one may not take both itemized deductions and a standard deduction, taxpayers generally choose the deduction that results in the lesser amount of tax owed.[3]

http://en.wikipedia.org/wiki/Standard_deduction

I don't know how many times it has to be explained to you. The 400% of poverty is basically gross income (with a few exclusions), not after tax income. This is because the poverty level is also stated on a gross income basis.

Standard deduction will reduce your federal income tax (and possibly your state income tax) but it will not have any effect on your eligibility for ACA subsidies.

Its after tax....

Two singles would each be able to earn $43,000 and still receive help to purchase health insurance, but if they got married and combined their earnings to $86,000, they would be far above the limit. As a married couple, the most they could earn and still get government help with health insurance premiums is $58,000, a difference of almost $30,000, or 32 percent. This is a substantial disincentive to getting married, or to working while married.

http://waysandmeans.house.gov/news/documentsingle.aspx?DocumentID=181665

Your "After Tax" income

at post 59.

Filing status
Year Single Married Filing Jointly Married Filing Separately Head of household
2013[4] $6,100 $12,200 $6,100 $8,950
2012[5] $5,950 $11,900


http://en.wikipedia.org/wiki/Standard_deduction

use one of the major tax software programs this coming year (which, BTW, will have a whole new section for ACA subsidy calculations) you will probably be using a section that I was on the compliance team for. You are confusing INCOME TAX AGI with ACA MAGI. They are related, but not exactly the same. The link provided in post 59 will explain it in detail.

is 'deductibe' from your w-2 gross. Also, it INCLUDES non-taxed SS payments (ie for 62-64 year olds), muni bond interest, non taxed long term capital gains.

Things you CAN deduct from from your gross is 401k/IRA/HSA contributions. That is really about it.

this ain't my first rodeo!

calculation, right? So, although you continue to conlfate ACA MAGI with Income Tax AGI, you are wrong for saying that the standard deduction has anything to do with calculating AGI, even in the Income Tax arena.

And, not everyone gets the standard deduction. If you itemize, you do not get the standard deduction.

I hope you did not pay for that rodeo school!

Did you bother to read the link in post 59 yet?

is over $12,000 for married filing jointly!

ALWAYS take the standard deduction over itemized, even if the standard is higher. The reason is that many states 'piggyback' on federal itemized deductions so you could have a higher combined return by itemizing on both state and federal taxes rather than getting a slightly higher federal return and a significantly lower state return.

But that is getting way off track.

particularly when the best deal is a policy for two people costing $1300/month.

Why do you feel compelled to insult those of us who are facing real problems here?

and then there are subsidies...

A single person making less than $45,000 a year qualifies...AND you cannot pay more than 9.5% of your Adjusted Gross income...


Don't blow smoke...blue or otherwise...

Three are lots of people who need insurance and don't qualify for the government subsidies -- especially when we are talking about policies that run $1300-1800 a month.

sheeesh...

If you fall within 400% of poverty....you cannot pay more than 9.5% of your after tax income. Including after standard deductions...

and very few of them can afford to pay $1300/mo for health insurance.

400% of the poverty level is something like $65,000 of income in my area. That's maybe $50,000 after paying all the federal and state taxes. $10,000/yr for a very modest dwelling leaves $40K to cover transportation, food, education, clothing and all the other costs of participating in society. And you think these people will find it easy to come up with $18,000 for health insurance?

Do any of them have better networks?

(other than corporate group policies of course) after the current policies reach their anniversary (i.e. by December 2014).

There may be other companies offering off-exchange policies, and intending to do that after 2014. I have not checked because that isn't particularly relevant until by current Anthem plan hits its anniversary. But if others are doing that, I'd expect Anthem to compete in that space as well, and they say they are not going to do that.

I am in CT and Anthem is offering both on and off-exchange. The on-exchange networks are absolutely pitiful; I'm not sure that the off-exchange networks will be as bad. Aetna, however, is offering only off-exchange policies which have much better networks (no subsidies, however, obviously).

I anticipate some major shitstorms next year when someone in an exchange plan gets treated out of network for some emergency and gets balance-billed for tens of thousands of dollars and needs to file for bankruptcy.

but they will not continue these after those policies reach their next anniversary. I highly recommend you ask questions because both agents I spoke with today indicated this was how they were handling all the states where they operate, and the call center I contacted dealt with all the states that Anthem covers.

They said emphatically and unambiguously that after December 2014, Anthem will not be offering ANY private insurance except what is on the ACA exchanges. The letter I received was stated a little more vaguely, but was 100% consistent with what the agents both told me.

They appear to offer off-exchange plans in Indiana for next year (I'm not sure if it's all of the state, though, I just tried a random zip code). Perhaps their network is better.

https://consumer.eassuranthealth.com/IM/Consumer/EASE/Demographics/StartQuote

BTW Anthem does appear to offer off-exchange plans in IN for next year. If you go to their site (Anthem.com) and search for plans, it breaks them down into "Subsidy Eligible Plans" (on the exchange) and "Quick Apply Plans" (off-exchange, called "DirectAccess" plans). However, the provider network appears to be the same in IN for both sets of plans.

I will keep that in mind when my Anthem policy expires. As of this moment they do appear to offer a policies in my area.

Re: the in-exchange and off-exchange, I believe the ACA requires all exchange participants to offer the same policies at the same prices outside the exchange. If they have the same tiny provider network, that doesn't solve my problem.

At this point, my only real hope is for providers to decide they really do need to get into the ACA networks for 2015. Without an adjustment to ACA reimbursement rates, I think that isn't too likely.

for a single person who makes up to $45,000 adj. gross...Qualifies for subsidies!

Anthem is not offering ANY policy on the exchange that allows me to see my doctors unless I want to pay 100% of that out of pocket with NO DEDUCTIBLE CAP FOR OUT OF NETWORK.

I may or may not be able to arrange a subsidy. That is mostly an accounting question, as I don't expect to have any employment income, being retired. But it is irrelevant because I am not going to buy a policy that only allows me to go to the worst hospital system in town and only pays for services from the 10% of the professionals who have decided to honor ACA insurance.

Last edited Fri Oct 25, 2013, 11:27 AM - Edit history (1)

there's your preconceived notions oooozing out....

You are flat out Anti "Obamacares" and you don't give a damn that even if you are falling through a crack for the moment (no system is perfect...there are gaps that have to be tightened)...It might mean you have to make a tough choice personally. HOWEVER, certainly you are NOT so selfish that you don't have children or sisters...or cousins...or brothers...or nephews....or friends...or neighbors....certainly (and hopefully) you have a number people in your life that you love that will be THRILLED to finally be able to take a looooong deserved deep breath! This LAW is providing relief for and will continue to provide relief for many many many Americans....who have long struggled under the burden that is maintaining health insurance. Please tell me you are not so without loved ones in your life for that not to be the case!

apparently you are just Anti-ACA from the get go...and apparently you don't have children or other family members or loved ones that have long suffered under the system as it is...for you to see why ACA is so important...

That being the case...I have pity for you...


“The modern conservative is engaged in one of man's oldest exercises in moral philosophy; that is, the search for a superior moral justification for selfishness.” ~~ John Kenneth Galbraith

I, too, had my current Blue Cross policy "cancelled." What it really means is that I am being automatically moved from my current plan, which doesn't meet ACA standards, to a similar one that does meet the standards. I'm not losing coverage, but the headline implies that people will be without insurance coverage which isn't true at all.

You would think that Kaiser would avoid using an intentionally misleading headline.

The only downside to this is that, in many cases, the replacement policy that offers similar coverage levels (deductibles, copays, etc.,) costs substantially more.

Its not so because I can't believe anything bad can happen from this political win.

Instead of a stupid, temporary, high deductible catastrophic plan for my perfectly healthy son, I'm getting an actual plan that actually covers stuff.

If you like your doctor, you can keep your doctor...

some here are not as gullible as you seem to think!

do you have any purpose here?

I have given a clear explanation of how the ACA affects me. Others have posted links that show I am not alone -- not by a long shot. There is no question whatsoever that the Obama claims that you could keep your own policy and keep your own doctors are simply not true.

If you believe otherwise, let's see your evidence. And, random insults are not the same thing as evidence.

Your AFTER tax income is what is being judged.....

read Standard Deduction...

http://en.wikipedia.org/wiki/Standard_deduction

The President said I can keep my policy. I cannot. Anthem is terminating that policy at the next anniversary

The President said I can keep my Doctor. I cannot. Anthem is the only real supplier in the exchange, and none of my doctors are in the super-reduced network that they have set up for their ACA policies.

What the president said was completely untrue in my case. That is beyond any debate.

I am not accusing him of lying intentionally. I am accusing him of being way too trusting that the insurance companies and providers would behave in the way his brilliant 9-dimensional mind had predicted they would behave. He was wrong, plain and simple.

But there is more to the story than that. A major reason why the ACA networks are so inadequate is that the ACA puts a big squeeze on providers. Do you recall all the debate during the election when the "$630 Billion in health care savings" was being thrown around? The President argued that this wouldn't affect any voters because it was coming out of the providers' pockets. Well that chicken has come home to roost. I suspect that is a major reason why my doctors are not in the ACA network.

So what is the upshot? It is a mixed bag. On balance it is probably better than having done nothing. In some states it will be very beneficial to most people, In every state there are some people who will get hammered. In some states that have minimal competition and/or Governors that opted out of Medicaid expansion, a lot of people are getting hammered hard.

the contract HAS to end...and a new contract has to be created BECAUSE there are regulations they are now required to give you...and they are not going to do so without constructing a whole new policy.


Do you think this is the first and only year that insurance policies have been terminated or canceled? That's not unusual at all...policies change and Insurance companies make you take out a new policy with them normally because they found new ways of giving you less coverage for even more money!

The intent of the President's claim was clear enough. He said "If you like your policy, you can keep it." Nobody is going to object to a transaction that closes one account and opens another equivalent or superior one. What I am describing is a vastly INFERIOR policy. It has a provider network that consists mostly of the 10% bottom feeders who currently accept Medicaid patients. Call me an elitist if you must, but if I get a life threatening disease, I want to be seen by doctors in the IU, Methodist, or St. Vincent's system. In my area, those are the systems that have the best reputations and include the kind of people you are willing to trust your life to. Those people are in my current Anthem network. For the most part, these people are NOT in the network Anthem has assembled for ACA.

According to Anthem, after 2014 they will not be offering any private policies with their traditional full network. So the only way I can keep anything resembling the coverage I have today is to ride my non-ACA policy WITHOUT ANY SUBSIDIES to its anniversary date. And after that time, unless something changes, there will be no option that let's me keep my doctors, other than paying everything out of pocket, which kind of defeats the point of insurance coverage.

Maybe you don't understand how health insurance provider networks work. Providers join the networks based on their acceptance of the reimbursements. In the traditional world, the reimbursements were set by the insurance companies. In the ACA world, the reimbursements are set by the government. This is why the provider networks are so thin. Don't feel bad. Obviously Obama didn't understand that either.

Are you serious?

This is such a lame argument and it's all over this thread. What the fuck!

I posted a video of promises from Obama. Perhaps you meant to reply to someone else.

It appeared that you wanted to keep your older less good and more expensive plan.

Fairytales is right!

If it's 300,000 in one state, I mean, come on.

bitching and complaining about every single aspect of ACA. And most of them are people I never saw around here until Oct. 1.

Fascinating. The same dozen or so on thread after thread after thread........

and simply refuse to concede one millimeter even when given irrefutable facts.

Pathetic. The same dozen or so on thread after thread after thread........

as anyone with open eyes has seen. I heard him say a lot of things that haven't gone as he said it would. Oh but its the fault of congress. Well he knew that could stop him so why the promises? To get votes! Can't believe I actually went to one of his rallies. Where's is my single payer? Why are we fighting the Taliban? They are "NOT" Al Queida. How does he dare to turn against seniors and offer CPI?

It started out okay, and then BCBS just decided to keep creeping up the premium and co-pays on me.

In the end, it made more sense to go onto my wife's policy, so I chucked it to the curb last year.

I wonder if I would have made the cut.

I cannot stand for-profit insurers. There's something so immoral about it all.

If the insurance companies drop it, where do they go? Is this how the single payer system is created?