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One man's ObamaCare nightmare


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2013 Sep 24, 4:39am   22,254 views  105 comments

by zzyzzx   ➕follow (5)   💰tip   ignore  

http://www.foxnews.com/politics/2013/09/24/one-man-obamacare-nightmare/

Andy and Amy Mangione of Louisville, Ky. and their two boys are just the kind of people who should be helped by ObamaCare. But they recently got a nasty surprise in the mail.

"When I saw the letter when I came home from work," Andy said, describing the large red wording on the envelope from his insurance carrier, "(it said) 'your action required, benefit changes, act now.' Of course I opened it immediately."

It had stunning news. Insurance for the Mangiones and their two boys,which they bought on the individual market, was going to almost triple in 2014 --- from $333 a month to $965.

The insurance carrier made it clear the increase was in order to be compliant with the new health care law.

"This isn't a Cadillac plan, this isn't even a silver plan," Mangione said, referring to higher levels of coverage under ObamaCare.

"This is a high deductible plan where I'm assuming a lot of risk for my health insurance for my family. And nothing has changed, our boys are healthy-- they're young --my wife is healthy. I'm healthy, nothing in our medical history has changed to warrant a tripling of our premiums.

"Well I'm the one that does the budget,” said his wife. "Eventually I've got that coming down the pike that I gotta figure out what we're gonna cut what we're gonna do, to afford a $1,000 a month premium."

Their insurance company, Humana, declined to comment, but the notice to the Mangiones carried this paragraph:

" If your policy premium increased, you should know this isn't unique to Humana -- premium increases generally will occur industry-wide.

"Increases aren't based on your individual claims or changes in health status," it continued. "Many other factors go in to your premium including: ACA compliance, including the addition of new essential health benefits."

ACA, of course, is the abbreviation for the President's new law, the Affordable Care Act -- which for the Mangiones will be anything but affordable because the law adds a new tax on every insurance policy and requires a list of additional benefits the Mangiones didn’t want to pay for.

Robert Zirkelbach, spokesman for American Health Insurance Plans, which represents insurers,explained that "for people who currently choose to purchase a high deductible, low premium policy that's more affordable for them, they are now being required to add all these new benefits to their policy.

That," he says, "is also going to add to the cost of their health insurance premiums."

#politics

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1   Homeboy   2013 Sep 24, 5:07am  

Their insurance cost $333 a month for four people?

Um, I call bullshit.

2   EBGuy   2013 Sep 24, 5:11am  

Seriously?! So does Mr Mangione make more $94,200 and is therefore ineligible for subsidies? Because according to Kynect (Kentucky's Healthcare Connection): A family of four making $48,000... Your estimated cost is $252 per month or $3,024 per year if you pick the second-least-expensive Silver plan. Even if you make $80k per year Your estimated cost is $634 per month or $7,600 per year, if you pick the second-least expensive Silver plan.
From: http://kynect.ky.gov/wp-content/uploads/4640.07-KY_8.5x11_Ind-fam_factsheet_4C.pdf

3   Homeboy   2013 Sep 24, 5:13am  

I guess Fox Noise's new strategy is to pretend like everything was great before Obamacare, completely ignoring the fact that the system was broken and that we were having DOUBLE DIGIT annual increases in premiums under Bush.

4   EBGuy   2013 Sep 24, 5:21am  

Their insurance cost $333 a month for four people?
Um, I call bullshit.

Don't be so quick. It's pretty clear from the article that they had some type of catastrophic care plan. In fact, if you look at articles that are critical of ACA, most compare catastrophic plans for the young and healthy to what will be available under ACA. It's somewhat sneaky, as it's not an apples to apples comparison, but it is also legitimate as many of the catastrophic care plans will no longer be offered. The ACA limits premiums for older folks to 3x those of younger folks. The younger generation does take a bit of a hit.

5   Blurtman   2013 Sep 24, 5:21am  

Someone must pay for someone else. The extended inclusion of kids until age 26, the inclusion of folks with pre-existing conditions, and the inclusion of uninsured folks who have been without healthcare for a while means someone must pay.

6   Blurtman   2013 Sep 24, 5:24am  

Here is a nice presentation showing the increase in employer provided healthcare insurance over time. Slide 2 provides a nice visual.

https://kaiserfamilyfoundation.wordpress.com/?post_type=presentation&p=82773&preview=true

So employer provided healthcare insurance costs continue to increase under Obamacare. But the rate of increase is not increasing, leading to the hypothesis that Obamacare is not increasing employer provided healthcare insurance costs beyond the norm. But Obamacare does not seem to be lowering employer provided healthcare insurance costs. And the gap between employer provided healthcare insurance costs and income continues to increase.

If you read the entire Kaiser study, the jury is still out on what will happen going forward, and the cause of the recent data.

With regards to folks who self insure, with Obamacare, if you qualify as low income, your costs go down. But somebody else will still pay.

7   EBGuy   2013 Sep 24, 5:35am  

Blurtman says:
Someone must pay for someone else.
Please stop with the zero sum bs. We ARE already paying for someone else at the emergency room and through inefficient delivery of care. The exchanges are a first attempt at pricing transparency. We've got a long way to go but we will get there.
Fee for service is dead, dead dead thanks to Kaiser. It will die a slow painful death under the ACA as we transition to a more effective means of keeping folks healthy and tending to those who are sick. More reforms may be needed, but going backwards is not the solution.

8   drew_eckhardt   2013 Sep 24, 5:43am  

Their actual increases should be lower provided that they have the sense to purchase through their state exchange which makes most people eligible for federal subsidies.

A family of four earning less than $94,200 a year (in the top 25%) that buys its insurance through a state exchange has its expenses capped at $745 a month.

At the 2011 median household income for people holding at least a bachelor's degree of $73,466 it'd be $581 a month.

At the 2011 median household income of $50,502 it'd be under $338 a month.

9   Blurtman   2013 Sep 24, 5:50am  

EBGuy says

Blurtman says:

Someone must pay for someone else.

Please stop with the zero sum bs. We ARE already paying for someone else at the emergency room and through inefficient delivery of care. The exchanges are a first attempt at pricing transparency. We've got a long way to go but we will get there.

Fee for service is dead, dead dead thanks to Kaiser. It will die a slow painful death under the ACA as we transition to a more effective means of keeping folks healthy and tending to those who are sick. More reforms may be needed, but going backwards is not the solution.

Going forwards may not be the solution, either. Non-profit insurance or single payer is the solution.

According to the head of Aetna, if you believe him, the uninsured jack up the cost of employer provided healthcare insurance by 12%. That is how we are paying for the uninsured now.

So as these folks become insured, employer provided healthcare insurance should decrease, presumably by 12% maximum.

Want to bet that does not happen?

10   EBGuy   2013 Sep 24, 6:36am  

BM said:
Non-profit insurance or single payer is the solution.
I don't disagree, although I'm taking a wait and see approach with multi-payer under ACA. In CA, Kaiser is the one to beat, but they currently are not going after new customers as they need to build out infrastructure. They essentially control the pricing 'floor' (as they have the best handle on costs) and if they don't provide competition on price, I suppose it could get ugly. I talked to a Kaiser doctor recently, and their current strategy is to provide the highest quality of care (not necessarily at the lowest price) -- which makes sense if you can't take on all the new patients coming into the system. As I said, I'll take a wait and see position. I think Sutter will eventually buy out an insurer or start offering their own insurance plans.
BTW, I didn't see they exact numbers, but our admin said Healthnet premiums are up ~5% this year.

11   anonymous   2013 Sep 24, 6:37am  

EBGuy says

Blurtman says:

Someone must pay for someone else.

Please stop with the zero sum bs. We ARE already paying for someone else at the emergency room and through inefficient delivery of care. The exchanges are a first attempt at pricing transparency. We've got a long way to go but we will get there.

Fee for service is dead, dead dead thanks to Kaiser. It will die a slow painful death under the ACA as we transition to a more effective means of keeping folks healthy and tending to those who are sick. More reforms may be needed, but going backwards is not the solution.

"Under the ACA as we transition to a more effective means of keeping folks healthy, and tending to those who are sick"

That's rich. You just lumped ACA and "we" keeping folks healthy, into the same sentence/thought! LOL

How do unisured folks drive up the costs of your healthcare?

Seriously, this is bizarro world. You're promulgating a lie in order to justify stealing from the healthy. Those of us that make sure to keep ourselves healthy, and avoid the hospital and doctor, altogether. Stop

12   Homeboy   2013 Sep 24, 5:48pm  

EBGuy says

Don't be so quick. It's pretty clear from the article that they had some type of catastrophic care plan. In fact, if you look at articles that are critical of ACA, most compare catastrophic plans for the young and healthy to what will be available under ACA. It's somewhat sneaky, as it's not an apples to apples comparison, but it is also legitimate as many of the catastrophic care plans will no longer be offered. The ACA limits premiums for older folks to 3x those of younger folks. The younger generation does take a bit of a hit.

If it was only $333 a month, it was some severe catastrophic policy with a HUGE deductible - in other words, they were basically paying out-of-pocket for EVERYTHING. So I still call bullshit, because Faux News fails to mention:

1. Their policy has a HUGE, HUGE, HUGE deductible, so is basically worthless if they actually need medical care.

2. Unless they make more than $94K, they are eligible for a subsidy under Obamacare. Faux News mentions neither their salary nor whether they are eligible for a subsidy. In fact, they don't even acknowledge that the subsidies exist.

3. As you pointed out, Faux News is making an apples to oranges comparison. Catastrophic policies will be phased out. Everyone should know this already; it is not news.

I think the "younger generation taking a hit" meme isn't really true. Young people tend to make less money, so most will get tax credits. And if you actually look up the rates for young people on the California exchange, you'll see that the rates are actually quite reasonable, even before the subsidies.

13   Homeboy   2013 Sep 24, 5:51pm  

Blurtman says

Someone must pay for someone else. The extended inclusion of kids until age 26, the inclusion of folks with pre-existing conditions, and the inclusion of uninsured folks who have been without healthcare for a while means someone must pay.

This is just unfounded speculation. Do you have any actual data showing that premiums are rising faster than they did before ACA? Of course you don't, because they AREN'T.

14   Homeboy   2013 Sep 24, 5:52pm  

Blurtman says

According to the head of Aetna, if you believe him, the uninsured jack up the cost of employer provided healthcare insurance by 12%. That is how we are paying for the uninsured now.

Why do you believe the CEO of Aetna? Hardly an unbiased source.

15   Homeboy   2013 Sep 24, 5:59pm  

errc says

Seriously, this is bizarro world. You're promulgating a lie in order to justify stealing from the healthy. Those of us that make sure to keep ourselves healthy, and avoid the hospital and doctor, altogether. Stop

Yeah, funny thing about that. You're healthy until you get sick. We could have a system where people who are healthy AT THE MOMENT don't have to pay anything, but then when they get an illness - be realistic - they aren't going to just let themselves die. Then they will immediately begin screaming for the healthcare that they feel they are all of a sudden entitled to. Nope, it's not gonna work that way. Everybody needs to be in the system. Yeah, if you don't have to go to the doctor right now, you're subsidizing someone else. But when you DO have to go to the doctor, someone else is subsidizing YOU.

All you clowns who think you are immortal can kiss my ass. You're not.

16   curious2   2013 Sep 24, 6:00pm  

Homeboy says

Why do you believe the CEO of Aetna?

That's a good question - like questioning why people quote the Kaiser family empire.

EBGuy says

Kaiser is the one to beat, but they currently are not going after new customers as they need to build out infrastructure.

You have got to be kidding. They are advertising constantly on TV to lure customers to replace the people who leave in frustration or die. Turn on your TV sometime, and see for yourself. And, notice all those Kaiser "studies" that get promoted by publicists and picked up by commercial "news" all the time.

17   Homeboy   2013 Sep 24, 7:39pm  

curious2 says

You have got to be kidding. They are advertising constantly on TV to lure customers to replace the people who leave in frustration or die. Turn on your TV sometime, and see for yourself. And, notice all those Kaiser "studies" that get promoted by publicists and picked up by commercial "news" all the time.

Once again, I saw your post on preview. This time I wanted to answer, so I took you off ignore for one post. The Kaiser Family Foundation (the group that does the studies) is no longer affiliated with Kaiser Permanente (the healthcare provider). The KFF is a non-partisan research firm. People quote them because they have the most accurate statistics on health insurance. That has nothing to do with any ads run by Kaiser Permanente.

Personally, I'm not a fan of Kaiser Permanente. Although the coverage and the facilities were fine, in my experience they had a high doctor attrition rate. Every time I found a doctor I liked, he or she would quit and I'd have to find a new one. Also, their appointment system was insane. If you wanted to see a doctor within 6 months, you had to call at 7:00 am and wait on hold for a long time to get a so-called "urgent care" appointment. If they didn't have any left, you had to keep trying each day at 7:00 am. Good luck ever getting the same doctor twice. Pretty stupid in my opinion. Some people like them just fine, though.

18   lakermania   2013 Sep 24, 7:47pm  

Homeboy says

Their insurance cost $333 a month for four people?

Um, I call bullshit.

Do you really think the rest of the nation pays the same price for health care and insurance that we morons here in California do? Because the rest of the nation does not pay what we pay here in California, might explain why such a large percentage of them are against the ACA. Their insurance, while still high, is nowhere near as insane as it is here.

It's not hard to figure out why, for instance in Modesto, where they collect on less than 10% of the bills they issue(in large part due to illegal aliens), a heart attack without complications costs $92,000, while the same procedure in Danville, Arkansas(who doesn't have the same demographic problem) costs $3300

http://money.cnn.com/2013/05/08/news/economy/hospital-bills/index.html

19   freak80   2013 Sep 25, 12:11am  

Homeboy says

Yeah, funny thing about that. You're healthy until you get sick. We could have a system where people who are healthy AT THE MOMENT don't have to pay anything, but then when they get an illness - be realistic - they aren't going to just let themselves die. Then they will immediately begin screaming for the healthcare that they feel they are all of a sudden entitled to. Nope, it's not gonna work that way. Everybody needs to be in the system. Yeah, if you don't have to go to the doctor right now, you're subsidizing someone else. But when you DO have to go to the doctor, someone else is subsidizing YOU.


All you clowns who think you are immortal can kiss my ass. You're not.

Great post. It's amazing how some people think they are invincible and don't need to rely on anyone else.

Even the Amish must sell quilts so they can buy the stuff they can't produce on their own. We are all dependent on each other...whether we like to admit it or not.

The whole "rugged individualism" meme is bullshit.

20   Blurtman   2013 Sep 25, 1:46am  

This is 4 years old, and so the dollar amounts likely have only increased. But as the uninsured enroll on Obamacare, then the average insured family’s premiums should ultimately decrease by at least $1,017. Want to bet if that happens?

MAY 28, 2009

The average insured family pays an extra $1,017 in premiums each year to cover the cost of health care for the uninsured, according to a new study from Families USA,Reuters reports. Individuals paid an extra $368. These “hidden health costs” costs accrue when “doctors, hospitals and other health providers try to recover the cost of uncompensated care by increasing charges for those with private insurance.” Medicare and Medicaid rules “make it difficult for providers to pass on uncompensated care costs” to the government insurance programs, so “the cost shift was borne almost entirely by private insurers.”

In 2008, the uninsured “received about $116 billion in care.” Of that amount, they paid 37% out-of-pocket, and “government programs and charities paid for another 26 percent.” The remaining $42.7 billion was “passed on to the insured in the form of higher prices for their care,” the study found. The “so-called ‘hidden health tax’” has increased from 2005, when Families USA conducted its last study. At that time, families paid an extra $922 in premiums and individuals an extra $341 (5/28).

http://www.kaiserhealthnews.org/daily-reports/2009/may/28/hidden-tax.aspx

21   Blurtman   2013 Sep 25, 1:48am  

lakermania says

It's not hard to figure out why, for instance in Modesto, where they collect on less than 10% of the bills they issue(in large part due to illegal aliens),

The undocumented are not covered under Obamacare and so all will continue to pay for their care, which is why a country should be able to control the demand on its resources by effectively controlling immigration.

22   freak80   2013 Sep 25, 1:50am  

He're an article from those dangerous socialists/communists at MarketWatch, a Wall Street Journal website. Everybody knows the Wall Street Journal is run by communists.

http://www.marketwatch.com/story/5-things-you-dont-know-about-obamacare-2013-09-25

23   Blurtman   2013 Sep 25, 2:04am  

freak80 says

He're an article from those dangerous socialists/communists at MarketWatch, a Wall Street Journal website. Everybody knows the Wall Street Journal is run by communists.

http://www.marketwatch.com/story/5-things-you-dont-know-about-obamacare-2013-09-25

No mention of why insurance costs continue to increase for the insured. Terrible fluff piece at that.

25   FortWayne   2013 Sep 25, 2:43am  

Usually this is done by insurance companies who are not part of the state exchanges.

It's a dirty trick, but it's on the news already. They try to scare existing clients into renewing faster (by threatening higher fees next year if they don't renew this year asap). So that they would not go to state exchanges. Sneaky.

26   Blurtman   2013 Sep 25, 2:50am  

APOCALYPSEFUCK is Comptroller says

Homeboy says

I guess Fox Noise's new strategy is to pretend like everything was great before Obamacare, completely ignoring the fact that the system was broken and that we were having DOUBLE DIGIT annual increases in premiums under Bush.

You should know that before the ACA, doctors paid me to show up and receive a savage blow job from nurses who looked exactly like Christina Hendricks. Now, I wake up and Michelle Obama is trying to climb in through the window with a pitch fork waving a clip board with a Death Panel list that bears my name.

Yes, yes....ohhhhh...what is Michelle wearing??? Please, every detail...

27   Homeboy   2013 Sep 25, 5:38am  

lakermania says

Do you really think the rest of the nation pays the same price for health care and insurance that we morons here in California do? Because the rest of the nation does not pay what we pay here in California, might explain why such a large percentage of them are against the ACA. Their insurance, while still high, is nowhere near as insane as it is here.

It's not hard to figure out why, for instance in Modesto, where they collect on less than 10% of the bills they issue(in large part due to illegal aliens), a heart attack without complications costs $92,000, while the same procedure in Danville, Arkansas(who doesn't have the same demographic problem) costs $3300

Actually, individual insurance in California is cheaper than it is in Arkansas.

http://kff.org/other/state-indicator/individual-premiums/

Ouch! Sucks to be you, huh?

28   Homeboy   2013 Sep 25, 5:47am  

The amazing thing is, for people who are committed to hating Obamacare, facts don't matter at all.

29   freak80   2013 Sep 25, 5:49am  

Homeboy says

The amazing thing is, for people who are committed to hating Obamacare, facts don't matter at all.

Whoa whoa wait...

There was a time when facts mattered?

30   HydroCabron   2013 Sep 25, 6:07am  

sbh says

freak80 says

There was a time when facts mattered?

Facts ceased to matter after the fact that Obama won.

Obama won in 50,000 B.C.?

31   EBGuy   2013 Sep 25, 7:32am  

curious2 said: You have got to be kidding. They [Kaiser] are advertising constantly on TV to lure customers to replace the people who leave in frustration or die.
Right. Everyone hates Kaiser. Around the U.S., the commercial health plans of all eight Kaiser Permanente regions finished in the top 25 out of 484 plans ranked. Among the 405 Medicare plans rated, the five highest-scoring in the country were Kaiser Permanente programs.

32   everything   2013 Sep 25, 7:44am  

Your dealing with a monopoly of collusion plagued by group think, health care rankings in America are, according to WHO, quite bad, we spend oodles of money with less results than any other country, some rank the U.S. health care last in performance.

33   curious2   2013 Sep 25, 6:53pm  

Homeboy says

That has nothing to do with any ads run by Kaiser Permanente.

It's both funny and sad how addicts can believe anything that enables their addiction to continue. It's especially sad when they're addicted to toxic placebos that don't even bring them any benefit. Maybe take up smoking: at least nicotine has cognitive benefits, although you can't get them free off your subsidized insurance. (At least not yet - I remember the RJ Reynolds' "physicians who recommend Camels" and advertising for "your T-zone," T as in throat cancer.) The Kaiser empire foundation push-polling and repeatedly oversampling Democrats all have everything to do with shilling for mandatory insurance/HMO conscription for their "nonprofit" HMO (net revenue > $1bn, tax free) and their expressly for-profit practice groups.

34   freak80   2013 Sep 25, 10:26pm  

Call it Crazy says

It just FEELS that long......

Do you think having Romney as corporate-raider-in-cheif would be any better?

Would RomneyCare be better than ObamaCare?

35   freak80   2013 Sep 25, 10:30pm  

From what I'm reading, Kaiser sounds a lot like Guthrie here in the Southern Tier of NY. A monopolized, corporatized medical-industrial complex staffed with incompetent doctors and nurses. It's like going to Wal-Mart for one's health care.

36   zzyzzx   2013 Sep 25, 11:10pm  

freak80 says

From what I'm reading, Kaiser sounds a lot like Guthrie here in the Southern Tier of NY. A monopolized, corporatized medical-industrial complex staffed with incompetent doctors and nurses. It's like going to Wal-Mart for one's health care.

Actually, everyone I know who has Kaiser likes it. I liked it when I had it.

37   freak80   2013 Sep 25, 11:14pm  

zzyzzx says

Actually, everyone I know who has Kaiser likes it. I liked it when I had it.

I guess it's all anecdotal.

I had a very bad experience at Guthrie, our local Wal-Mart for health care. I ended up in the hospital thanks to some (legal) mind-altering drugs they prescribed for me.

38   Homeboy   2013 Sep 26, 4:30am  

freak80 says

Whoa whoa wait...

There was a time when facts mattered?

Yeah, back in the time before Fox News.

39   freak80   2013 Sep 26, 4:32am  

curious2 says

It's especially sad when they're addicted to toxic placebos that don't even bring them any benefit.

You mean SSRI's?

40   zzyzzx   2013 Sep 26, 4:39am  

Homeboy says

Yeah, back in the time before Fox News.

Obligatory:

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