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Lovin’ Me Some ObamaCare

26 Oct

In a previous post, Cluster wrote:

Now don’t get me wrong, if the ACA would have increased competition and allowed me to shop from a cafeteria menu of coverages and policies at lower premiums and reasonable deductibles – I would be for that. But that would have been a free market approach. As it is, the ACA is a Statist approach, so choices will fewer and costs will be higher. At least for most of us.

I wonder if Cluster has actually investigated coverage on ObamaCare.

I am currently semi-retired, meaning I work 20 hours a week. A nice thing about this is that I retain all of my employer-provided benefits, including health care. (And you thought all employers were cutting out health care for their part-timers, didn’t you. :-)) Of course, I’ve been thinking of retiring completely for a while.

One of the biggest concerns related to retiring early is health care. Typically, an early corporate retiree will go on COBRA in order to continue their company-provided health care coverage for as long as possible. The retiree enjoys the exact same health care he had as an employee, but must pay all of the costs, including the portion that was previously paid by the employer. In my case, the monthly cost to continue health care via COBRA would be $907 per month. (This is the cost to cover myself only.)

COBRA lasts a maximum of 18 months. Once COBRA eligibility is used up, a retiree younger than age 65 must seek out health care on the individual market. Prior to ObamaCare, this was a somewhat daunting task filled with unknowns. The problem was that in California, where I live, insurance companies were under no obligation to provide individual insurance, regardless of costs. People in their fifties and early sixties are exactly the kinds of people that insurers avoided on the individual market. For example, the Kaiser Permanente website explained,

“[T]hese plans [individual and family coverage] do go through medical review and those with serious pre-existing health conditions are often denied. The only automatic denial stated by Kaiser underwriters is current pregnancy, but those with serious health conditions such as cancer, HIV, heart problems, obesity, etc. are often denied. If denied, your only chance of getting healthcare coverage may be to find employment (for you or your spouse) that offers a group medical plan or to apply for Medicare or Medi-Cal.”

It’s hard to reach the age of 55 or 60 without some history that would be deemed a pre-existing condition. And most retirees need to consider both their own health as well as that of their spouse.

Acknowledging the uncertainty of the individual market for retirees, my company has for the past several years offered a retiree health care plan through Aetna for retiring employees 55 years of age or older. The main selling point of the plan is that there is no medical underwriting. All retiring employees are accepted regardless of their current health status or their history.

The cost of the Aetna plan is $1538 per month with an annual deductible of $3950 and maximum out of pocket of $6250 in-network, $10,000 out-of-network. After the deductible has been paid, I would then generally pay 20% of the services provided, though for some services I would pay 40%. This is just to cover myself. Sounds like a good deal, doesn’t it?

Now we have ObamaCare. I live in California, which set up its own exchange, Covered California. I went to coveredca.com and checked out the plans. Several insurance companies offer them; There are 26 plans available to someone my age living in my area. The most expensive coverage is a Platimum 90 plan. No deductible at all. Maximum out of pocket of $4000. $20-$40 copay, though no copay for preventative care. (Aetna would charge me 40% for preventative care.) I can get a Platinum 90 plan for $785 per month–about half the cost of the Aetna plan. This is sounding pretty good.

But let’s look for a plan with similar characteristics to the Aetna one. That would roughly be a Bronze 60 plan with a deductible of $5000 and maximum out-of-pocket of $6350. I can get one of those for as little as $464 per month. All of these plans have the same main selling point of that Aetna one–no one can be denied coverage. They just cost a lot less. I’m liking this. A lot.

Now let’s look at Cluster’s situation. I happen to know in which state and county Cluster lives. That state chose not to set up its own exchange, so I shopped for Cluster plans on healthcare.gov. Assuming Cluster is age 50 or over, there are 119 plans available available to him, ranging in price from $178 to $567 per month. What were you saying about competition, Cluster?

There are a lot of choices, but Cluster could get a Platinum plan with $20/$40 co-pays and a deductible of $2000 for $348 per month. A Bronze plan can be had for $237 a month. These prices assume that Cluster would not qualify for any subsidies. Only Cluster could tell us how that compares to his current plan, but as a Californian, I’m thinking I should move into Cluster’s old house when he leaves the country.

I notice they’ve been making improvements to healthcare.gov. A couple of weeks ago, it wasn’t possible to shop for plans without going through the application process. Now you can. It’s actually quite easy and I was able to find 119 plans for Cluster in about a minute.

Apparently, a minute is too long for many people to learn about their options. Instead, they’d rather go on television and demonstrate their ignorance to the rest of us. An example is a recent piece on Sean Hannity’s show about the ObamaCare “train wreck”–his favorite phrase these days. He interviewed six people who recounted their ObamaCare “horror stories,” including tales of “canceled policies, premium hikes, restrictions on the freedom to see a doctor of their choice, financial burdens upon their small businesses and so on.” As journalist Eric Stern put it upon viewing the segment, “none of it smelled right to me.” So he decided to investigate.

It turns out that none of the folks on Hannity’s show had bothered to look into their ObamaCare options. One couple, Paul and Michelle Cox, who own a small business, complained to Hannity that “they can’t grow their construction business and they have kept their employees below a certain number of hours, so that they are part-timers,” all because of ObamaCare. But as Stern points out in his article,

Obamacare has no effect on businesses with 49 employees or less. But in our brief conversation on the phone, Paul revealed that he has only four employees. Why the cutback on his workforce? “Well,” he said, “I haven’t been forced to do so, it’s just that I’ve chosen to do so. I have to deal with increased costs.” What costs? And how, I asked him, is any of it due to Obamacare? There was a long pause, after which he said he’d call me back. He never did.

None of this matters to Hannity, of course, as he depends upon the ignorance of others for a living. And it may not matter to Cluster, as he may well have perfectly fine health care coverage and no need to shop for something different. I wouldn’t look too hard myself, either, if I wasn’t contemplating leaving the corporate cocoon. But hopefully Cluster has, or will, do his own research so that he can come to an informed opinion. I hardly think he’s in the same category as the Hannity know-nothings. As for me? I’m liking what I see.

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15 Comments

Posted by on October 26, 2013 in Current Events, Health Care, Politics

 

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15 responses to “Lovin’ Me Some ObamaCare

  1. cluster

    October 26, 2013 at 12:15 pm

    Well I just tried 5 separate times to create an account again with no luck (I had tried a couple of weeks back to no avail as well) – but did access the “see plans and prices in my area” option and found that under the bronze plans, only 3 of the bronze plans offered cheaper premiums than what I currently pay (and that’s after a 20% increase last May), so I don’t know what the hell you were looking at Watson. In fact, the information you provided for me, I could not find at all. The cheapest catastrophic plan I could find was for $356/mo with a $6350 deductible and a 40% co pay after that. The bronze plans I looked at came with a $5,000 deductible and even after that, I am still on the hook for 40% co pay. My current plan has a $10,000 deductible with a $0 co pay after that. My current plan is far better than even the bronze plan available to me. I specifically chose the $0 co pay because if anything catastrophic would happen, I am only out $16,000 (including premium) for any given year. With my bronze plans options, I will be out $11,000 + 40% of all other costs. So my costs will go up if my current provider drops me, that’s not good at all.

    But I am glad that it works well for you Watson, that’s all that really matters right? And awfully classy of you to just dismiss other peoples stories. I guess they’re just not as smart as you.

     
    • watsonthethird

      October 26, 2013 at 8:30 pm

      Cluster, I provided the link in my article, but here it is: https://www.healthcare.gov/find-premium-estimates/

      I can also provide a direct link to the plans I found for your state, if you wish, thought the link does indicate your state and county. But I’m happy to do that if you wish. I mean, we can get to the point of screen shots, too, I suppose.

      As for other people’s stories, did you read the article about the folks who appeared on the Hannity show? Don’t criticize me for the fact that Hannity chose to put people on TV who didn’t know what they were talking about. The journalist who followed up discovered that by actually calling them up on the phone and interviewing them. You know: Journalism, something that’s foreign to the folks at Fox.

       
    • watsonthethird

      October 26, 2013 at 8:32 pm

      Actually, I can tell from the stats that you didn’t read the article about the Hannity show. You really should.

       
      • Cluster

        October 27, 2013 at 5:13 am

        I don’t even watch Hannity, Watson, why would I bother with the link? I don’t care what Hannity does, and don’t know why you do. You concern yourself with a lot of petty stuff.

         
      • kmgtwo

        October 27, 2013 at 8:26 am

        You don’t care if Hannity lied? Amazing.

         
      • Cluster

        October 27, 2013 at 8:36 am

        Yea, let’s examine that:

        1. A talk show host lying
        2. The President of the United States lying

        Hmmmmm, I am thinking those two are not exactly ethically similar.

         
      • kmgtwo

        October 27, 2013 at 9:08 am

        Practing situational ethics now?

         
      • Cluster

        October 27, 2013 at 10:24 am

        Well let’s see, Rachel Maddow lies almost on a nightly basis, but I never point that out do I? Mainly because she is completely irrelevant. Here’s just one example:

        http://www.politifact.com/ohio/statements/2013/jul/09/rachel-maddow/rachel-maddow-says-ohio-budget-includes-requiremen/

         
      • mitchethekid

        October 27, 2013 at 10:30 am

        I really like her. Just because you either disagree with what she says or don’t want to accept what she says, doesn’t make her a liar. If you want lies masquerading as facts, watch. fox.

         
      • watsonthethird

        October 27, 2013 at 2:24 pm

        I don’t even watch Hannity, Watson, why would I bother with the link?

        Because you essentially called me classless for dismissing the stories of the folks who appeared on Hannity’s show. (Or were you claiming I was dismissing your story?)

        It turns out those folks denigrating ObamaCare at Hannity’s request haven’t even bothered to check out their options. One of them said they hadn’t checked their ObamaCare options, nor would they. They’re on national TV explaining how bad ObamaCare is, yet they won’t even investigate it. That’s classless, if you ask me.

         
      • Cluster

        October 27, 2013 at 3:38 pm

        I called you classless for dismissing the thousands upon thousands of stories out there of people negatively impacted by Obamacare. I never referred to Hannity.

         
  2. Cluster

    October 27, 2013 at 10:20 am

    Watson,

    You may be one of the few Californians “loving you some Obamacare”. Glad it’s working out for you.

    http://www.latimes.com/business/la-fi-health-sticker-shock-20131027,0,2756077.story#axzz2iwN6OsdE

     
    • watsonthethird

      October 27, 2013 at 3:08 pm

      So Cluster, would you accept my response that I don’t even read the LA Times, so why would I bother with the link?

       
      • Cluster

        October 27, 2013 at 3:37 pm

        Well Hannity is right wing and lying according to you, which I had zero interest in disproving, although I suspect there is more to it than you let on. The LAT on the other hand is not exactly a conservative newspaper, won’t even allow anti global warming editorials, and often recites the liberal doctrine. So just thought you might be interested, because it is contrary to what you claim.

         
      • watsonthethird

        October 27, 2013 at 3:56 pm

        You “suspect” there is more to it, and yet you refuse to read the article written by the guy who actually interviewed the people Hannity put on television to advance his agenda. This seems to be a characteristic of conservatives. They “suspect” things are a certain way, and that’s good enough. No need to go further. Well alrighty…

        As far as classless, I wrote my article about my experience with my healthcare, as well as my experience looking up the rates in your state on healthcare.gov. And I threw in the deceit exhibited on the Hannity show because it should be exposed for what it is. I didn’t say or imply that my experience would be the same as everyone else’s. But for you to call me classless because I observe that my health care costs will be less than I expected is really pretty pathetic. I guess the classy people are those who “suspect” they will be negatively effected, true or not.

         
 
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