You raise an interesting point, but the old people on Facebook who already have government funded health care me that Obama is trying to destroy America.
Oh man, this is music to my ears. I was at an event at Wharton a couple of weeks ago that was four extremely thoughtful and well-prepared panelists who just kept saying "It remains to be seen" and "A lot depends on how the exchanges work out" ad infinitum.
So I just checked to see what my current health insurance would cost on the exchange and it will save me... $80/month. If I moved into SF, it wouldn't save me a cent. OTOH that's for a platinum plan and not having to worry about having my coverage canceled if I ever send in a COBRA payment late is worth a hell of a lot.
A thousand dollars a year in savings for a dude who already has good health care is actually impressive, given that "reduce the upfront costs for people who have good health care already" wasn't a design goal.
"What If I Can't Pay My Medical Bill?"
Republicare allows you to volunteer as a lobbyist for the health-insurance industry to work off your debt.
3: You're currently between jobs, right? I infer from your mention of COBRA. I assume you prefer private coverage to Medicaid, which you'd be eligible for with zero income regardless of assets, but that also unfortunately means you wouldn't benefit from subsidies if you voluntarily went to the Exchange. (Subsidies aren't available for the Medicaid-eligible.)
(Although on the off-chance your plan is Anthem, they also act as a Medicaid plan in your county, so that would be some continuity at least.)
Oh, and also COBRA coverage is time-limited.
Although on the off-chance your plan is Anthem
If your plan is Atlas Shrugged, you're pretty much screwed.
4: I suspect, based on the premiums, that the exchange plan I'm looking at is the exact one I'm currently on, and that the difference is based on the difference between where I live and where my former employer was based. But really, even just being able to buy my current plan on the exchange is in fact a giant win for me. (And really, other than getting rid of the preexisting condition exclusion, no one should be basing health insurance policy on me; I'm way off at one end of the spectrum in a whole bunch of ways.)
6: Yeah, currently unemployed. (And while COBRA's time-limited, thankfully Cal-COBRA gives you an extra 18 months on top of the federally-mandated 18.) Actually, this is something I've been trying to figure out: if you're on COBRA when the exchanges kick in, are you eligible to switch?
Hooray! I was recently talking to a friend of mine about healthcare, since she lost her job-related insurance. Pre-ACA (and until January), she would have been (will be, until January) completely fucked. But even the estimates I was seeing a month or two ago on Kaiser's site looked great (with subsidy, at least) for someone making $18k.
9.last is certainly a question my friend will want to know the answer to, so please let me know when you find out.
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Man, reading the blog is really different when you can put faces and voices to a whole bunch of previously imaginary disembodied text generator functions.
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5 keeps bringing up a mental loop of Beyonce singing, "Can you pay my medical bills?" which is the worst thing in the world except Beyonce singing the real song.
The Cobra Kai plan sends the weak to Mercy Hospital.
The Cobra Kai plan sends the weak to Mercy Hospital.
I wish I could blame a phone for that.
It's worth noting that the rate decreases California is expected to see may well not be duplicated in most other states, alas:
When California created the country's first-ever health insurance exchange, way back in November 2010, it made a very significant policy decision. The state decided that it would act as an "active purchaser" that would select a small number of health plans allowed to sell on the California exchange. Health plans would have to do more than meet a set of requirements in the Affordable Care Act. They would need to be selected by the California exchange's board to compete in the marketplace.
This is different from the vast majority of states, which operate under a "clearinghouse model."
Boo. But really great news for California and the 5 other states that do have the active purchaser type of exchange.
I've begun to wonder whether there's any value in lobbying Maryland to switch to an active purchaser model in future; Carefirst rates in the state going up a projected 25% is insane. That's not set in stone as yet, but it would amount to my current individual plan increasing to $8000/year (with a $2000 deductible), clearly madness.
19: Yes, and HHS has said it won't be an active purchaser in the states it will be running the exchange for (27, I think).
Actually, this is something I've been trying to figure out: if you're on COBRA when the exchanges kick in, are you eligible to switch?
I found some Labor Department documents telling employers to notify upcoming COBRA recipients that the Exchange is a possibility for them.
20: 33 states with federally run exchanges, according to the linked article. (Doing the math on how the remaining states fall out, I come up with a total of 51 -- I take it Puerto Rico falls under the ACA?)
I'm a bit sympathetic to HHS declining to run active purchaser exchanges in those 33 states; it'd be a hell of a lot of work to suss out the needs of each state.
22.1: Right - 27 defaulting, 7 partnering with the federal government at last count.
5 out of the 13 selected plans are publicly operated or affiliated, and so in their counties (which include some very populous ones) could conceivably act a bit like a public option over time.
LA County has about 10 million people and a publicly operated plan, so (if that's true, I don't really know one way or the other) you'd have a rough equivalent of a public option for a country the size of Belgium or Sweden.
23: Oh, I see. I hadn't heard about the Partnership Exchange option.
22: You get to 51 by counting Puerto Rico but not DC?
27: Good point. I assumed PR -- no idea what the situation would be in DC with respect to the ACA.
We're relocating the nation's capital to San Juan.
I see from Minivet's link that the 51st is DC. Sorry, DC people! I think of you as Virginians, though that is obviously not the case, legally.
PR should be covered; I was engaging in aspirational thinking.
Brad Delong just misspelled H-G's name, but he linked this post.
(I'm almost home, just over an hour away.)
30:
I think of you as Virginians
Ouch.
32: NoVA, northern Virginia. I know, it is wrong of me.
No. Virginia is for Loudoners.
31: Neat! We don't get linked very often anymore.
Thanks for ruining my night, Halford.
Hey, a topic I actually know something about!
Actually, this is something I've been trying to figure out: if you're on COBRA when the exchanges kick in, are you eligible to switch?
Yes. To be more specific, the only people who can't purchase at all through the exchanges (apparently we're supposed to call them "marketplaces" now, but everyone agrees that's stupid) are undocumented immigrants. And more to the point, being on COBRA shouldn't disqualify you for eligibility for subsidies, since having access to COBRA doesn't count as having access to "affordable minimal essential coverage."
47: what about legally authorized immigrants in their first five years in the US? I thought they were excluded too, but this is decidedly not my field, so I'd be delighted to be wrong....
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If you don't know anyone from Minnesota, let me be the first to inform you that Michele Bachmann will not seek reelection in 2014. Not that this means we're rid of her by a long chalk, but her ridiculous assertion that this has nothing to do with anything (like the ethics scandal, or the exceedingly tight race, or her absurd advertisement getting mocked) was somewhat pleasurable to see.
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I do know someone from Minnesota, but you're still the first to inform me that Michele Bachmann will not seek reelection in 2014.
I gather, based on the last 5 minutes, that my FB feed will consist of little else today.
Bachmann is a special kind of crazy. I look forward to her getting a spot on Fox News as an analyst.
A friend just suggested that the 2nd craziest woman in MN politics, Mary Kiffmeyer,* would be a natural choice to replace Bachmann. I think this is all too likely to be the case, sadly.
*When she was Secretary of State, she insisted that her underlings address her as "Madame Secretary."
48: Unless I'm remembering incorrectly, LPRs under 5 years are eligible for tax credits (subsidies) for a commercial plan through the exchange, but are ineligible for Medicaid if they're under 138% of FPL.
54 is right. For this group, subsidies are at their highest so that premiums can be at their lowest as a percentage of income.
Hey Minivet, someone on FB was groping for an explanation of why Jan Brewer would endorse expanding Medicaid, and I couldn't quite retrieve your explanation. What was it again?
I doubt this is all of it it, but one aspect is that because per 54 and 55, low-income LPRs under 5 years would get access to insurance regardless of what the state did, whereas equally low-income citizens would be completely left out by failing to expand Medicaid, and she couldn't abide immigrants getting more than natives.
Oh, interestingly, the question of Puerto Rico's status comes up here: Is Puerto Rico in America?
I do think of it as our 51st state. Not everyone does.