What health care reform will mean to me...

[Cleobulus]

First off a couple of assumptions, one is that my employer provided plan will either lower in premiums to match what would be available on the exchange with subsidies(approximately 50 dollars a month), so I can afford it, or they will drop it and I end up on the exchange anyways. Second assumption would be that what is available will match what my employer offers, which is equivalent to the silver plan on the senate bill and basic plan on the house bill(70% actuary value). The subsidy calculator also uses this as a base.

Now, I have a preexisting condition, I can get health care coverage now, just not to cover this condition. Basically the medical treatment I require will involve getting an MRI, surgery, hospitalization and physical therapy after surgery.

So first the positives, my premiums become affordable and the insurance company would have to cover my condition.

OK, that is the end of the positives, now onto the negatives, minimum deduct of 1,500 dollars, more likely 2,000 dollars and 20% co-insurance to reach a maximum of anywhere for 5,000 to 6,000 dollars out of pocket expenses for me. This is what it will cost for me to get treatment because it will easily exceed this cost.

So the HCR bill passes, I get coverage, and then, given my income level, I will have to find a way to pay a quarter of my income on my medical treatment. Most likely up front before I can even get treatment, so what would you recommend? A bake sale or a raffle to raise that much money, because I still can't afford to have access to health care.

[Ozymanithrax]

1. Access to Affordable Coverage for the Uninsured with Pre-existing Conditions

Immediate Insurance Reform Benefits
Access to Affordable Coverage for the Uninsured with Pre-existing Conditions

•The President's proposal will provide $5 billion in immediate federal support for a new program to provide affordable coverage to uninsured Americans with pre-existing conditions. This provision is effective 90 days after enactment, and coverage under this program will continue until new Exchanges are operational in 2014.

They don't like your pre-existing conditon. Fuck 'um. You will be able to get coverage through this.

[Cleobulus]

2. Federal support in what, paying deducts and copays? Or just premiums?

Specifics would be nice.

[Ozymanithrax]

14. If you are within 133% of the poverty line...you get medicaid.

and will pay deductibles inaccordance with the medicaid structure. check with your state.

Check your eligiblity for poverry rate here.
http://aspe.hhs.gov/poverty/09poverty.shtml

Beyond that, I don't know what it will cost for the insurance they offer, though it should be affordable since the cost is partially covered by the bill.

[Cleobulus]

15. I'm at 157% of FPL, I guess I could take a paycut but why should I? n/t

[Ozymanithrax]

19. The health care bill will provide considerable subsidies to make it affordable.

at your income level.

[Cleobulus]

21. Subsidies for what, just the premiums, or does it include everything?

Will the Government subsidize my copays and deductible?

[mdmc]

5. Wouldn't you need to be pretty affluent to afford health insurance

out of pocket when you have a pre-existing condition?

I have a pre-existing condition but have health insurance through my employer. If I lose my employer provided insurance I would need to go on disability - I could not afford to pay out of pocket for pre-existing condition medical insurance.

[Ozymanithrax]

16. Afluent, no. I am assuming that by affluent you mean the upper 10% of Americans.

In my family, we have health insurance through my wife's employer.

The PO did not state his income, only said that the insurance with his current employer did not cover a pre-existing condition. He has insurance. The bill is designed to help those with this problem and provide them with health care that will treat their pre-existing condition.

[Cleobulus]

18. I did not state that I had insurance, I said my employer offers it, there's a difference...

I cannot afford the premiums right now, so I don't have the insurance, but I have, of course, read the plan. This bill will allow me to afford the premiums but I see nothing to help me be able to afford to actually use the insurance.

[mdmc]

25. at least middle class then

ya can't be livin paycheck to paycheck and afford insurance out of pocket, imho..

[mdmc]

3. I too will continue to lack access to affordable medical treatment

but perhaps they can "make it better" down the line..

[Cleobulus]

4. We could combine forces and start a bake sale!

That will always help. It'd just be like old times before HCR, won't that be impressive!

[mdmc]

9. I am technically eligible to SSDI, and then medicaid

I have a documented medical condition that essentially disables me (read = it keeps me from performing 'gainful activity') unless I receive medical treatment.
I am currently holding on to my job and struggling to receive treatment.
Once I pass a certain point the treatment wont work and I will be on the dole.
If I end up on medicaid I will help hold bake sales for your for-profit insurance.

[Cleobulus]

12. My condition can theoratically disable one of my arms...

Though the doctor said its only a possibility, he still wanted me to have surgery that I can't afford, if the nerve dies, well, I'll be a unoplegic.

[kenny blankenship]

6. You could do what these guys did for quick scores

Go out and rob some banks.

[Cleobulus]

8. Well, I don't see any negatives, even if caught I'd still be able to get access to health care. n/t

[FrenchieCat]

7. First off a couple of assumptions??????

That where I stopped reading.
Anything after that is predicated on the speculative,
and not even speculations based on a series of established facts.
Sorry, won't do.

[Cleobulus]

10. The assumptions are based on what YOU have posted so far.

About costs of premiums and what plan those costs are calculated for. Don't complain.

[FrenchieCat]

11. Not really,

but nice try! :)

[Cleobulus]

13. The subsidy calculator that you link to uses the .70 actuary plan as a base...

that is all I'm basing this on, that and what is stated in the bills in question as to what the deducts and copays are in the .70 actuary plans.

[FrenchieCat]

17. Yes, but it will no doubt change.....

and it still doesn't provide some of the details.....
I provided it to assist folks with questions
because it was available.....
however, I'm not sure it is wise to base
your theories of health care and how it will work
100% based on a Kaiser calculator.

Kind of like folks who "thought" they would have to pay more at the end of the year
due to the Obama middle class tax cuts, and now they find out that wasn't true....

But I understand what you are trying to do,
but maybe it is because for me, this HCR bill ain't just about what I will get out of it,
primarily.....
Otherwise, I'd move back to France.

[Cleobulus]

20. My post isn't based 100 percent on the calculator, but also on what is actually in the bills...

I read them, yes they could change, but who knows by how much or whether the changes would be any better. I also base this on my own employer's insurance, and if nothing changes in it after the passage of HCR outside of reduced premiums.

[FrenchieCat]

22. Can you cite those portions of the bill you are talking about

with a link?

Thanks.

[Cleobulus]

23. Senate bill, as an example...

http://thomas.loc.gov/cgi-bin/query/F?c111:4:./temp/~c111gMtbCZ:e143748:


Section 1302, Scroll down to (c) and look at the maximum allowable deductibles, then scroll down to (d) where levels of coverage are defined.

As far as hard numbers are concerned for 70% actuary plans, my work has a plan rated that, hence I use it as a base, but most plans of this actuary value vary slightly. 2,000 dollar deduct, 20% copay, and 5,000 dollar annual maximum out of pocket.

[Q3JR4]

24. What it means to me.

I am 28 years old, single, and haven't ever been down with a condition. Under this bill I will be forced to get some kind of insurance, that I won't ever use (same as you, not easy to come up with the minimum deductible) and that won't do me a bit of good (since I'll probably have to get the cheapest insurance with the highest deductible that meets the requirements to avoid paying the fee they're planning to attach). I put off going to the hospital now because I can't afford it and when this bill passes I'll STILL put off going to the hospital because I won't be able to afford it and at the same time I'll get to pay for a piece of crap insurance policy.

It does good things by banning pre-existing condition limitations and reigns in some of the excess, but that comes at the cost of higher co-pays, premiums, and 58% rate hikes.

God help me, I hope someone files a lawsuit and this whole thing makes its way to federal court. The Supreme Court might eventually rule in favor of the bill, but it will probably be stayed until then. By the time they get their grimy mitts on it, I will have had time to flee to warmer and saner waters overseas.

Q3JR4.

[Cleobulus]

26. Kicking this back to the top, because none of the HCR cheerleaders...

except one have even bother responding to this post, and that one just decided to insinuate that I'm a selfish person because I would like to live ONE day without being in constant pain.