# News ACA is working

1. Jan 27, 2014

### turbo

I spoke to my younger sister yesterday, and she is really upset about the GOP nay-sayers that are trying to kill the ACA. She is a health educator, and she is working with several regional health providers to enlist poor and elderly people into one of Maine's two participating insurances.

She told me about an older man that qualified for a Silver plan for $2/month. He told her that he could afford more coverage and picked a more extensive plan for$26/mo. Another old guy had pretty good dental health and wanted dental insurance. With his income and discounts it would have cost him $30/mo. My sister talked him out of it, telling him that if he went in for routine examinations and cleanings, it would only cost him about$50/visit, so he is all set.

The people on the front lines know this stuff, and they are quite pissed at the GOP's efforts to kill the program. Anything we can do to get more people insured and reduce the costs of health care should be welcome. Every uninsured person who heads to the ER when they are sick costs us all money, and if they haven't been getting regular preventive care, the costs can be a lot higher.

2. Jan 27, 2014

### SteamKing

Staff Emeritus
As always, the disclaimer "Your results may vary." should be applied in these cases. Remember, the plural of anecdote is not data.

3. Jan 27, 2014

You call $30/mo for health insurance "working"? I call it "where's the scam?" And that's just for that example: of course one example where someone made out well tells us virtually nothing of value about whether in a general sense the program is "working". 4. Jan 27, 2014 ### turbo Where did you see that? 5. Jan 27, 2014 ### russ_watters ### Staff: Mentor Sorry,$26/mo. Doesn't change my point.

6. Jan 27, 2014

### turbo

Would you rather that these previously uninsured/uninsurable old guys pay whatever the whatever the insurance companies demand, IF they would even extend coverage at all? I don't get it.

7. Jan 27, 2014

### SteamKing

Staff Emeritus
You say that if an uninsured person shows up for treatment at an ER, it costs us all money. If an insured person with a $26/mo ACA policy shows up for treatment at a hospital, it still costs us all money. If this guy is getting a subsidized ACA premium, it's not Santa Claus or Uncle Sam making up the difference, it's you or your neighbor, one of those rapidly dwindling number of taxpayers in the US. If this guy with the ACA policy can't pay his deductible, then the hospital or doctor passes on that unreimbursed cost to the next patient or they go out of business eventually. It's like the old joke, "We lose money on every widget we make, but we make up for it in volume!" At some point, the books have to balance. There are a lot of problems already manifest with ACA, and more will undoubtedly appear in coming years when the employer mandate goes into effect. To deny this is unworkable as policy, especially for supporters of the ACA, since the program is already unpopular. 8. Jan 27, 2014 ### turbo It is unpopular with people who hate Obama. It is quite popular with people who have never had insurance coverage and can now get it. If insurance companies are required to cover people that they previously refused to cover, we can all hope to see medical costs go down at doctors' offices and hospitals. That is a plus for everyone. Let's get a grip. 9. Jan 27, 2014 ### Vanadium 50 Staff Emeritus Turbo, it's not about "hating Obama" - and your habit of putting words in the mouths of your opponents is not particularly attractive. Some people have gained insurance. Others have lost it. It's not surprising that people in the latter category don't like it. 10. Jan 27, 2014 ### turbo I beg to differ regarding the respect (or lack of) for Obama. Lots of people have been trying to kill the ACA for months. As for people losing insurance, it's not all that common among the poor and the elderly who rarely had coverage anyway. It is possible that some people have lost insurance because their plans don't meet the basic requirements of the ACA, but it is quite possible that such people can pick up coverage through the ACA, likely at much-reduced premiums. 11. Jan 27, 2014 ### Vanadium 50 Staff Emeritus Hey, turbo, I have an idea. Why don't you tell us what you think, and let other people tell us what they think, rather than you having to hold up both sides of the argument. 12. Jan 27, 2014 ### turbo Go for it. If you want, I will give you my little sister's phone number so she can talk to you. She's only 59, and she is fiercely protective about her clients - especially the retired military. Maine is a very poor and elderly state, and she advocates for them every day. 13. Jan 27, 2014 ### SteamKing Staff Emeritus No one is saying she doesn't advocate for her clients. Her client with the$26/mo. premium is proof. I applaud him for finding the pot 'o gold with the help of your sister.

However well one man has fared, there may be others who, through no fault of their own, have not been as fortunate. There have been reports of several people who formerly had insurance which has now been cancelled because the terms of the policy don't comply with the ACA. These people had complex medical problems which were being treated by a network of doctors and hospitals with whom the patient was satisfied. The plans offered under the ACA may not allow access to these same doctors and hospitals, the premiums may be more expensive, and the deductibles higher. What to do about their situation?

Last edited: Jan 27, 2014
14. Jan 27, 2014

I'm not sure exactly what they should pay (not the least because I don't know their exact situation), but $26 a month is absurdly unfair. Roughly, though, it is off by probably a factor of ten or more from what I'd consider fair. Clearly the first sentence is true. The second is a prediction that I think is likely to become true, but time will tell. 15. Jan 27, 2014 ### russ_watters ### Staff: Mentor Well sure, handing people money is always a popular way to get yourself votes. But if mandating coverage was all it did, that would be a good thing, but clearly it doesn't. The value of insurance coverage is never$26 a month for anyone.

I support many forms of health insurance reform, bu I don't support additional wealth redistributions.

16. Jan 27, 2014

### ModusPwnd

Im not partisan in this subject, but I am suspicious about ACA.

A report I heard on the radio talked about the ratio of old and sick people signing up compared to young healthy people. They are not getting enough young and healthy people signing up and paying to subsidize the old and sick people. If these old and sick people are paying ~\$30 a month, they are paying way less than they will consume. Somebody has to foot the bill, and young healthy people like me are not signing up. I'm just going to pay the tax rather than sign up.

Clearly if this is the situation it is unsustainable. Do the taxes we uninsured pay go to subsidizing the old and sick people with ridiculously low monthly costs? I dont know.

17. Jan 27, 2014

### lisab

Staff Emeritus
Yes, but that's the way *all* insurance works. The risk is shared among a large group of subscribers, and the larger the group, the lower each participant's cost. So having a cheap "opt out" door deflates the whole intention of this program.

Be aware, if you chose to pay the penalty rather than buy insurance: just because you pay the (very small) penalty doesn't mean you are off the hook for any medical bills you acquire. You still have to pay those, too.

18. Jan 27, 2014

### ModusPwnd

Yes, I know how insurance works... If only sick people are in the pool the costs per person are much higher. A large pool of sick people is not good. Thats the point I heard on the radio and was trying to convey. They need more young healthy people in the pool to subsidize the sick and the young healthy people are not joining. This gap needs to be made up and I am thinking it should be made up by the penalty, but I don't know.

Also, the penalty may be very small to you, but its not small to me! Its many days and eventually will be weeks of my wage. Ill have to reevaluate each year whether or not its worth it, but for now the tax is better option for me than the premium is.

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19. Jan 27, 2014

### lisab

Staff Emeritus
I think that's quite reasonable. When I heard what the penalty was, my first thought was, ugh sounds like a decision made by committee.

Yeah I realize that sounded insensitive of me. I know how it is to be a starving student and be faced with unexpected bills.

But I also had to have a surgery once when I wasn't insured. It was the late '80s so I made it through OK - medical bills were expensive, but not yet :surprised:surprised:surprised expensive. If that happened to someone today they'd be financially ruined.

20. Jan 27, 2014

### SteamKing

Staff Emeritus
The penalty is small in the first year or so, but it is scheduled to increase in later years. Whether this increase remains so has yet to be seen, given how several key provisions of the law have been waived by the President without consulting Congress.