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Am I right or wrong?

Does Cousin Sue have Obamacare?

  • Total voters
    10
  • Poll closed .
RAMOSS said:
Uh. No they don't. For one thing, there is an added feature that the ACA put on insurgence.. and that is 'out of pocket maximum for the year' That means, once you hit that level, the insurence company pays 100%. Previous to the ACA, no one had that.
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I've always had 'out of pocket maximum for the year' under my HMO. It was through my employer, so I don't know if that made a difference.
 
MaggieD said:
Having a discussion with my cousin Sue today, we were talking about her concerns re premium renewal for her health insurance. She and her husband do very well. She gets no subsidy. When I began talking about Obamacare, she said, "Oh, we don't have that. We buy ours thru BCBS." They pay $$2200 a month for both of them, each one has a $6,000 deductible.

My position is that she does indeed have Obamacare. That every health insurance must comply with at least the minimum guidelines. Hers is, "No, that's only if you buy a policy on the exchange." She considers that she and her husband are self-insured and not a part of Obamacare.

So, who's right?
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Every health insurance plan is PP-ACA compliant.

The exchange is just a place you can go to shop.
 
holbritter said:
I've always had 'out of pocket maximum for the year' under my HMO. It was through my employer, so I don't know if that made a difference.
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I got it through my employer too.. and I didn't have that. Most plans did not, and now it's required.
 
holbritter said:
I've always had 'out of pocket maximum for the year' under my HMO.
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So did I. Long before ACA. HMO's were famous for 'out of pocket maximums'.

I don't know why people think ACA caused everything bad with HI and HC. It's amazing. Premiums go up? It's ACA fault, even though premiums went up long before ACA. Same with deductions. They've been around for 20 years. And there were out of pocket limits with HMO long before ACA.

I guess it's easier to pin all the blame on ACA, even though our HI and HC has been a mess for a long, long time.
 
MaggieD said:
While I've always favored rolling everyone into the already existing Medicare, Medicare insurance is, I'm sure subsidized by drs and hospitals charging more to other insurance to even it out. I'll see a charge for an X-ray come through as, for example, $245 and see Medicare adjust it to $35 and pay that amount with nothing else due. While I think $245 sounds high, $35 sounds ridiculous. They would have to change the payment model or hospitals would close and doctors would leave the business.
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No only subsidized by other payers, but also by the government itself. The premiums don't come within a country mile of paying for Medicare services.

Medicare is funded primarily from three sources: general revenues (45 percent), payroll taxes (36 percent), and beneficiary premiums (13 percent) (Figure 7). ... Part B is financed through general revenues (75 percent), beneficiary premiums (23 percent), and interest and other sources (2 percent).
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For a national medicare system, private and employer provided insurance would have to be shut down. Then a tax on income and businesses would need to be imposed to raise 1.5 to 3.2 TRILLION dollars per year.
 
SenorXm/Sirius said:
So did I. Long before ACA. HMO's were famous for 'out of pocket maximums'.

I don't know why people think ACA caused everything bad with HI and HC. It's amazing. Premiums go up? It's ACA fault, even though premiums went up long before ACA. Same with deductions. They've been around for 20 years. And there were out of pocket limits with HMO long before ACA.

I guess it's easier to pin all the blame on ACA, even though our HI and HC has been a mess for a long, long time.
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No, it didn't cause 'everything' bad. And it was very good for some people, but at the other end people have lost choices, paying more for less, and forced to do so or pay a penalty.
 
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