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Amid the Uproar Over the Health Law, Voices of Quiet Optimism and Relief

Discussion in 'BBS Hangout: Debate & Discussion' started by da1, Dec 9, 2013.

  1. da1

    da1 Member

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    Since his chronic leukemia was diagnosed in 2010, Ray Acosta has paid dearly for health insurance: more than $800 a month in premiums, plus steep co-payments for the drug that helps keep him alive.

    Mr. Acosta, 57, owns a small moving company in Sierra Vista, Ariz., which he said had barely made it through the recession. He was thinking about dropping his coverage, but the insurance company beat him to it, informing him recently that it would cancel his policy at year’s end.

    He sought advice from an insurance agent who had used his moving company. She connected him with an application counselor at a community health center, who found — to Mr. Acosta’s astonishment — that he qualified for Medicaid under the new health care law, the Affordable Care Act, which gives states the option of expanding the program to include more low-income adults.

    “I’m kind of in a disbelieving fog,” Mr. Acosta said last week, two days after completing an application. “I’m just hoping, keeping my fingers crossed, that this might really help me out.”

    The rollout of the health care law has been plagued with problems so deep that even some of its strongest supporters have soured on its potential. The bottlenecks in the federal online insurance exchange, which serves 36 states; the cancellation of hundreds of thousands of policies that did not comply with the minimum requirements of the new law; and the high price of some plans sold through both federal and state-run exchanges have all cast a pall over President Obama’s efforts to win support for the law.

    But for all those problems, people are enrolling. More than 243,000 have signed up for private coverage through the exchanges, according to the Kaiser Family Foundation, and more than 567,000 have been determined eligible for Medicaid since the exchanges opened on Oct. 1. For many, particularly people with existing medical conditions like Mr. Acosta, the coverage is proving less expensive than what they had. Many others are getting health insurance for the first time in years, giving them alternatives to seeking care through free clinics or emergency rooms — or putting it off indefinitely.

    Not all who need health insurance are happy with their new options. Many have complained that the prices are too high, especially if they earn too much to qualify for federal subsidies. And many will have a limited choice of doctors and hospitals under the new exchange plans, which have “narrow networks” to hold down premiums.

    But Mr. Acosta, like the people in the following profiles, says the health care law has given him a cautious sense of hope.

    He lives alone and has turned to his siblings at times for help with his insurance and medical costs. And those costs have at times been high: He sees an oncologist in Tucson twice a year and sometimes needs expensive tests that his current insurance does not always cover. He has also recently been stretching his medication, a drug called Gleevec, which helps make his type of leukemia manageable, to ensure he would have some on hand if he became uninsured.

    “After being gouged all these years, trying to make ends meet, to all of the sudden get this?” he said. “I’m really blown away.”

    Claire He grew up worrying about her parents’ health. Her mother, who is a waitress, and her father, who is a cook, work long days at a Chinese restaurant in Battle Creek, Mich., where they settled after immigrating from China 14 years ago. Health insurance has always been a luxury they could not afford.

    Whenever her parents got sick, it fell to Ms. He, who is now 23, to help them navigate the patchwork of low-cost health services available in their city. Members of the community came together in 2012 to pay her mother’s medical bills after tests uncovered precancerous cells that, left untreated, could have led to cervical cancer. Her mother receives care from a clinic that treats women and children, but Ms. He has had less luck finding a doctor to care for her father, who suffers from smoker’s cough and other ailments. Both of her parents are in their 50s.

    “My dad, he’s getting older, and frankly he’s having a lot of health issues,” said Ms. He, who is studying public health as a graduate student at the University of Michigan. “It breaks your heart.”

    Ms. He and her brother, who is a year older, did not have health insurance growing up, aside from a few years when they were teenagers and enrolled in Michigan’s health insurance program for children. “If we had the flu,” she said, “we just stayed home and waited it out.”

    Twice, the family has combined visits to China with comprehensive medical checkups, paying out of pocket to visit doctors and stock up on prescription medicine, which Ms. He said are less expensive there.

    This Thanksgiving, she and her family sat down to explore their options in the new insurance marketplace. After about 45 minutes online, they selected a midlevel, or silver, plan that would cost the family about $30 a month, after tax-credit subsidies based on income.

    “We were shocked,” Ms. He said. “I actually called a few places to verify that.”

    Ms. He is on her parents’ plan because the health insurance her university offers is not comprehensive enough. Her brother, an engineer, receives insurance through his employer.

    “I see so much negativity behind this,” she said of the criticism of the new law. “But in reality there’s a lot of families who are like mine.”

    At 61 years old, Bruce Kleinschmidt, a lawyer who is mostly retired, has no illusions about whether he needs health insurance. He has a chronic sinus condition that has required three operations, including one last year, and has had a few serious accidents over the years, including a fall that required back surgery. Doctors also recently diagnosed a heart condition.

    “I just don’t believe in not being insured,” he said.

    Last spring, Mr. Kleinschmidt moved to Louisville, Ky., to care for his parents and be near his family. Kentucky is successfully running its own state exchange, and he is among the 5,600 who have signed up for private insurance since Oct. 1. He said he had chosen the most generous plan available from Humana, a large national insurer based in Louisville. He did not apply for federal subsidies, he said, and the policy will cost him about $550 a month, roughly $300 less than the Blue Cross plan he has now.

    Although Mr. Kleinschmidt was usually able to find coverage through his employer, there were times between jobs when he had to enroll in state programs aimed at people who have potentially expensive medical conditions. Before the Affordable Care Act, which requires insurers to offer policies to everyone seeking them, carriers were reluctant to cover him.

    “I have been declined before,” he said.

    The coverage available through the state high-risk pools for people like him, Mr. Kleinschmidt said, typically have “extraordinarily high premiums with really high deductibles.” On the state’s new online exchange, he was able to select a plan from a well-known insurer that came with a deductible of only $1,000.

    “It’s a godsend,” he said.

    Although he had trouble signing up through the website because it froze when he first tried, he said, it took only about 90 minutes to enroll after he called someone at the exchange, which is called Kynect. His only concern now is that he has yet to hear directly from Humana so he can set up a payment plan for his premiums.

    “I’m going to call them next week,” he said.

    Tasha Huebner, 45, had long wanted to leave Chicago, but one of the biggest roadblocks was the fear of losing her health insurance. Ms. Huebner learned that she had breast cancer five years ago and, given her costly medical history, knew the chances of a new insurer accepting her were slim.

    So when she finally sold her house and moved to Silverton, Ore., this year, she did so knowing that the new health care law would soon make it much easier for people like her to get coverage. Under the law, insurers cannot turn away people with existing medical conditions, nor charge them more for coverage.

    Ms. Huebner, who works as a marketing consultant, pays $780 a month for coverage through Blue Cross Blue Shield of Illinois, even though she has left the state, and was recently told that her plan’s premium would increase to $820 in 2014. The increase made her worry that she might have to go without insurance.

    This summer, Ms. Huebner applied for new coverage in Oregon, but two insurers refused to cover her, even just a few months before the law would require them to do so.

    “It made no sense to me — I was like, you’ve got to be kidding,” she said. “The train has left the station.”

    So she turned to the new exchange after it opened on Oct. 1. Oregon’s online marketplace has not worked properly, but Ms. Huebner figured out that a midlevel plan would cost her about $300 a month — within her budget. If she qualifies for subsidies — which is uncertain, given her unpredictable income —her bill may drop to about $150, she said. She applied through the mail and is awaiting approval.

    Ms. Huebner said she is in good health and is training for two half-marathons. But she needs annual mammograms and checkups with an oncologist, and she lives with the knowledge that her cancer could return.

    “I’m young,” she said. “The chances are that it will come back.”

    For that reason, she said, being able to afford health insurance is “just a huge, huge relief.”

    http://www.nytimes.com/2013/12/09/u...et-optimism-and-relief.html?pagewanted=2&_r=0
     
  2. Ender00

    Ender00 Member

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    can someone please explain how ACA suppose to work? it seem to me that people that has high medical expense seem to be getting help but it screw over healthy people. It seem to me like another social security, they promise me that if i pay now to help old and sick people. When its my turn i will get help for my medical bills, what happen when its become too expensive. I believe i will get screw like they are screwing me over on my social security, which i believe firmly to be a a government run pyramid scheme
     
  3. Air Langhi

    Air Langhi Contributing Member

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    That is how all insurance works. Healthy people subsidize the sick people. If everyone got sick at the same time the whole system would collapse.
     
  4. FranchiseBlade

    FranchiseBlade Contributing Member
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    I'm not sure I totally understand your apprehension based on what you've said. Prior to ACA healthy people paid less, and some people couldn't really get insurance at all.

    Also Social Security has been an extremely successful program.
     
  5. Ender00

    Ender00 Member

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    in the past, if you are a high risk your premium reflect that fact but its seem to me that government will subsidize the cost of the insurance for some people. What guarantee is there that I will get the help i need when i am older, and social security is great now but how about 40 years from now when i need it, will it be there since there will be more money going out than coming in, the very definition of pyramid scheme. I am worry that when i am older, the medical will be so expensive that they government can no longer afford to subsidize the premium or people just can't afford it
     
  6. Space Ghost

    Space Ghost Contributing Member

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    This is not how insurance works. With any other insurance, whether its automobile, life, flood, ect..., there comes a point where a person can become uninsurable. With health insurance, an example of this kind of person is one with pre-existing conditions. Once insurance companies were required to take on these people, it was no longer insurance. Its a communal health care plan.

    We should take care of those with pre-existing conditions. But to wreck the traditional insurance system is a mistake. We should have expanded on medicare to cover these people.
     
  7. Ender00

    Ender00 Member

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    thank you space ghost for articulate on what i am trying to say. I am worry that since insurance has to cover all these sick people, which will result in increase on my premium. which I don't mind paying for it now but i want to be assure that I will be taken care of when I am older. I kind of expect not to get anything for my contribution to social security but i feel like the government seem to fix problem by piling on more responsibility onto future generation for this generation mistake.
     
  8. Major

    Major Member

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    So now you're for expanding government run health care? I'm pretty sure if it could have passed, Democrats would have been fine with dumping people with pre-existing conditions into Medicare. Pretty sure insurers would have widely expanded who they declare to be uninsurable too and become far more profitable while skyrocketing the budget deficit.
     
  9. CometsWin

    CometsWin Breaker Breaker One Nine

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    Hey Space Ghost, who pays for Medicare? Doh.
     
  10. Space Ghost

    Space Ghost Contributing Member

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    It wouldn't have passed. This topic is much like gay marriage; It has less to do with fixing the problem and more about the politics.

    I am not a cold-heart person who thinks we should fend for ourselves, discarding the poor and disabled. However I am against subsiding those who disregard their health and waste and inefficiency.

    I do believe we can lower health care cost w/out burdening everyone else. The ACA has done the opposite. Yes, there are many people who will benefit from it, and unfortunately, its the insurance companies who will benefit from it the most. That is what disgusts me about the ACA.

    Instead of channeling the help into the health care industry, we have channeled it all directly through insurance companies. In the end, its the patients who will suffer the most.
     
  11. Space Ghost

    Space Ghost Contributing Member

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    The rich do, of course!

    Or is it the middle class. Yes, I think its the middle class.
     
  12. otis thorpe

    otis thorpe Member

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    No the govt will abandon you personally if you get sick. Obama has probably already secretly decreed it about you.:rolleyes:
     
  13. dumbartonbass

    dumbartonbass Contributing Member
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    The problem is that personal health isn't a car or water damage. It doesn't affect me one way or another if your home is in a floodplain or you have a car accident. However, we all get sick. The social compact says that we don't turn people away from treatment who would otherwise die.

    However, once the bill comes, we have to settle things somehow. Therein lies the rub: the previous system wouldn't allow people to die from preventable medical problems, but also couldn't pay for their humane treatment without adversely affecting the rest of us who are biding our time before we inevitably become ill. Coupled with a massive, for-profit insurance industry, "pre-existing conditions" was used liberally to deny people coverage that they could eventually use when they did get sick and the costs would, of course, be passed onto the rest of us.


    Commoditizing people's health doesn't make a lot of sense, which is why no other first-world countries are rushing to emulate the American system. The degree to which we allow profit to be made off of unavoidable illness is part of the argument we're having now.
     
  14. bigtexxx

    bigtexxx Contributing Member

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    all the left can cling to are anecdotal stories -- which of course is the worst kind of evidence
     
  15. otis thorpe

    otis thorpe Member

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    Apparently this poster did not sse the Republican hearings on the web site"scandal"

    I"I have this letter from Joe the plumber" lol
     
  16. Air Langhi

    Air Langhi Contributing Member

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    Well Medicare is subsidized so you would have to increase taxes to pay for that.
     
  17. CometsWin

    CometsWin Breaker Breaker One Nine

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    So no difference. You are really on the ball.
     
  18. GladiatoRowdy

    GladiatoRowdy Contributing Member

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    ROFL!!! The ONLY arguments I have seen from the GOP regarding shortcomings of the ACA are anecdotal!
     
  19. mc mark

    mc mark Contributing Member

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    Shhh let him have his fun.
     
  20. Rocketman95

    Rocketman95 Hangout Boy

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    Too bad anecdotal evidence won't mean my 5 year-old cousin with Cystic Fibrosis will actually have insurance for the first time in his life.

    OH WAIT, IT MEANS EXACTLY THAT.
     
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