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  1. #1

    ACA and what I would supposedly not save.

    I went on, and someone asked about what I would pay, this is what it would come out to. I have pics but I haven't figured out how to rub my name out so it won't be used for unintentional purposes, because I do not care for the ACA and thinks it highly damages the working class and above.

    Some notes:

    These rates are for a family of four.

    Anthem BC/BS is the only insurance provider on the exchange in NH. They just announced they're dropping 10 of NH's 26 hospitals from coverage on the exchange, as well as their affiliated medical providers. That includes the hospital about a mile from my house. I'd lose all my doctors.

    Anthem also announced they wouldn't cover any out of state specialty hospitals for subscribers on the exchange (i.e. Children's Hospital in Boston, Dana-Farber Cancer Center, etc)

    I currently pay $512.32/month with a $3,000 deductible through my employer. No copays, no co-insurance, no limits. My kids see specialists at Children's in Boston. I see specialists in both NH and MA, I've had a rough couple of years. By choice I also see a specialist that I pay for with cash.

    Assuming I max out each of these plans:

    My current plan - $9,148/year
    Cheapest Bronze plan - $21,300/year (monthly premiums + max out of pocket)
    Cheapest Silver plan - $18,936/year
    Cheapest Gold plan - $19,983/year
    Most expensive plan - $22,971/year (one of the Silver plans).
    Highest monthly premium: $1178.30/month (one of the Gold plans)

    This is clearly the UNaffordable Care Act.

    Cheapest Bronze plan:
    $716.74/month Premiums
    $11,500 deductible
    $40 copays + 10% co-insurance
    $200 ER visits
    $500 per hospital stay + 10% co-insurance
    Rx - 10%
    $12,700 - Max out of pocket



    Cheapest Silver plan:
    $911.36/month Premiums
    $5,000 deductible
    $0 copays (after deductible)
    $200 - ER visits + 10%
    10% per hospital stay
    10% - Co-insurance
    10% - Rx
    $8,000 - Max out of pocket



    Cheapest Gold plan:
    $1,081.88/month Premiums
    $2,000 deductible
    $30 + 10% co-insurance - copays
    $200 + 10% co-insurance - ER visits
    $500 + 10% co-insurance per hospital stay
    $15 - Rx generics
    $40 - Rx brand names
    $7,000 - Max out of pocket




    Most expensive plan:
    $914.30/month Premiums
    $3,000 deductible
    $35 copays + 30% co-insurance
    $200 + 30% co-insurance - ER visits
    $500 + 30% co-insurance per hospital stay
    $15 - Rx generics
    $40 - Rx brand names
    $12,000 - Max out of pocket

    - - - Updated - - -

    Also here's a link if you want to see what you can get for the ACA that I found that was easier to use.

    https://data.healthcare.gov/dataset/QHP-Individual-Medical-Landscape/ba45-xusy

  2. #2
    So right wing americans don't like the idea of public healthcare because it will inevitably lead to higher taxes. And they are like "rawr, people should take it upon them to get their own health insurance."

    But according to my calculations I pay about 4-5 grand more in income taxes per year than I would in the states. But I would need to spend a bare minimum of 10 grand a year if my employer didn't offer health insurance?

  3. #3
    Void Lord Aeluron Lightsong's Avatar
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    Quote Originally Posted by Gheld View Post
    So right wing americans don't like the idea of public healthcare because it will inevitably lead to higher taxes. And they are like "rawr, people should take it upon them to get their own health insurance."

    But according to my calculations I pay about 4-5 grand more in income taxes per year than I would in the states. But I would need to spend a bare minimum of 10 grand a year if my employer didn't offer health insurance?

    It all leads to the cliche of *Responsibility* they like to throw around. I'm not a big economic nerd but I have to say Insurance is pretty damn expensive.
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  4. #4
    Over 9000! Milchshake's Avatar
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    Quote Originally Posted by Gheld View Post
    So right wing americans don't like the idea of public healthcare because it will inevitably lead to higher taxes. And they are like "rawr, people should take it upon them to get their own health insurance."

    But according to my calculations I pay about 4-5 grand more in income taxes per year than I would in the states. But I would need to spend a bare minimum of 10 grand a year if my employer didn't offer health insurance?
    Pretty much. The insurance industry has a divide and conquer policy in the US. Well bribe, divide, and conquer.

  5. #5
    I couldn't even imagine paying 11,000 a year for health insurance, and then still having to pay a 2 grand deductible if I needed major medical work. That's completely ridiculous.

    I don't know a single person who wouldn't be completely fucked if they ended up with a 2 grand expense out of nowhere. And I'm a middle class suburbanite.

  6. #6
    1. Assuming you max out.
    2. You don't mention if you will receive subsidies or not. Assuming you make under 4x the poverty level, and since you stated you don't have employee copay, you most likely do. If you make above that amount, you can probably afford it.
    3. You don't list what your current plan offers, only its basic costs.
    4. Often times existing insurance doesn't cover everything that it is now required to cover. This may or may not affect you personally but it could be a lifechanger for many others.

  7. #7
    Herald of the Titans theredviola's Avatar
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    The ACA is far from perfect, and in many aspects even a liberal such as myself can't completely like the ACA. But, it is a step in the right direction.

    I couldn't care for the individual mandate (which was put in the ACA for the Republicans; it was their idea after all), and I don't like that it forces you to have Insurance; BUT! It does make it much harder for insurance companies to turn down people for "pre-existing conditions" and it makes it to where children can't be turned down either.

    Yeah, it does hurt the middle class and 25-30something Americans that don't have their careers in full swing; BUT! It does force employers to do the right thing and give their full time employees health insurance. That is a double edged sword by itself, because it forces employers to do the right thing.. You can't legislate morality.

    There's some good in the ACA, but all the staunch opponents of the ACA only want to focus on the negative. A law this large, this verbose, and this broad is bound to have draw backs. The "Patriot Act" comes to mind when recalling large, verbose, broad legislation that is highly controversial.
    "Do not only practice your art, but force yourself into its secrets, for it and knowledge can raise men to the divine." -- Ludwig Van Beethoven

  8. #8
    Quote Originally Posted by Gheld View Post
    I couldn't even imagine paying 11,000 a year for health insurance, and then still having to pay a 2 grand deductible if I needed major medical work. That's completely ridiculous.

    I don't know a single person who wouldn't be completely fucked if they ended up with a 2 grand expense out of nowhere. And I'm a middle class suburbanite.
    This is for a family of 4. I pay about 3200 a year and I am single, so his expenses aren't out of the ordinary.

  9. #9
    Quote Originally Posted by Deathcries View Post
    I currently pay $512.32/month with a $3,000 deductible through my employer. No copays, no co-insurance, no limits. My kids see specialists at Children's in Boston. I see specialists in both NH and MA, I've had a rough couple of years. By choice I also see a specialist that I pay for with cash.
    Your employer pays part of your insurance plan as one of your benefits. If you were to be dropped from the company plan and have to get insurance somewhere else, they should increase your salary by the amount they put into your healthcare. Otherwise it is a paycut. Either way, the ACA plans may come out to less than your employer insurance is worth and when everyone finally gets insurance, prices should go down due to increased bargaining power for insurance companies and caps on how much they can charge you.

    The reasons why healthcare is so expensive in the US is because of uninsured people, unhealthy people(due to preventative care not being offered), and low bargaining power of insurance companies vs hospitals(countries with nationalized healthcare can dictate prices because providers have no choice).

  10. #10
    Quote Originally Posted by Prokne View Post
    Your employer pays part of your insurance plan as one of your benefits. If you were to be dropped from the company plan and have to get insurance somewhere else, they should increase your salary by the amount they put into your healthcare. Otherwise it is a paycut. Either way, the ACA plans may come out to less than your employer insurance is worth and when everyone finally gets insurance, prices should go down due to increased bargaining power for insurance companies and caps on how much they can charge you.

    The reasons why healthcare is so expensive in the US is because of uninsured people, unhealthy people(due to preventative care not being offered), and low bargaining power of insurance companies vs hospitals(countries with nationalized healthcare can dictate prices because providers have no choice).
    He said his employer doesn't offer a co-pay. If they did, he would only be paying about 5.5k, or exactly what he currently pays for far, far better coverage. Because they don't offer a co-pay, unless he is making a lot of money (>400% of 18k poverty for a family of 4) he likely get's a subsidy he doesn't yet know about.

  11. #11
    Quote Originally Posted by theredviola View Post
    The ACA is far from perfect, and in many aspects even a liberal such as myself can't completely like the ACA. But, it is a step in the right direction.

    I couldn't care for the individual mandate (which was put in the ACA for the Republicans; it was their idea after all), and I don't like that it forces you to have Insurance; BUT! It does make it much harder for insurance companies to turn down people for "pre-existing conditions" and it makes it to where children can't be turned down either.

    Yeah, it does hurt the middle class and 25-30something Americans that don't have their careers in full swing; BUT! It does force employers to do the right thing and give their full time employees health insurance. That is a double edged sword by itself, because it forces employers to do the right thing.. You can't legislate morality.

    There's some good in the ACA, but all the staunch opponents of the ACA only want to focus on the negative. A law this large, this verbose, and this broad is bound to have draw backs. The "Patriot Act" comes to mind when recalling large, verbose, broad legislation that is highly controversial.
    I'm 27. Will pay 28.11 a month under the ACA. Not really feeling the hurt there.
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  12. #12
    Quote Originally Posted by Hothgor View Post
    This is for a family of 4. I pay about 3200 a year and I am single, so his expenses aren't out of the ordinary.
    I pay 0 per year premium. Albeit my marginal tax rate is about 30-33% (it would be 25% in the US).

    Or roughly in the 3000-4000 range more in taxes to live in a country with healthcare (employers pay around 20% higher salaries for the same positions in Canada though, but that's mostly eaten up by the fact that most things are 20% cheaper in the states (but not all).

    $0 deductible
    $0 ER visits
    Some provinces there are small user fees for things such as official medical correspondence and stitches if they have to sew your ass shut in the middle of the waiting room. But it's nothing major.

    Ambulance rides are like 500 bucks though.

    Prescription drugs aren't covered except for seniors I think. But you can also get cheap generic drugs in Canada.

    And there's plenty of not for profits that can probably help out if you can't afford prescription coverage.

    So again, I think I get better value.

    EDIT:

    Oh, $0 unlimited family doctor service.
    $0 Access to all kinds of medical clinics.

    And then I have supplementary insurance from my employer, 3 grand a year in basic dental(3 grand lifetime ortho, 60% major). And $5 for any prescription.
    Last edited by Gheld; 2013-10-13 at 04:11 AM.

  13. #13
    Pit Lord lokithor's Avatar
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    What the hell? I currently don't have insurance, and i just went to BC/BS website and the cheapest insurance is only 100 bucks a month. I'm sure with a family of 4 it wouldn't go up that bad to 900 being the cheapest.

  14. #14
    First off, that $500 or so/mo your employer charges you is matched (or more) by the employer, making your actual costs for insurance way higher after all is said in done. the no co-pay diamond plan you get through them compares to the top tier, not the bottom for the comparison. Apple-to-apples, please.

    Second, if Anthem chooses to be assholes on gimp there coverage offering because they have a monopoly on coverage in NH, that is them being assholes, not the burden of the ACA. There was originally a provision allowing a gov't offering in places such as NH where competition lacked, which was axed by...yes..the (R).

  15. #15
    Quote Originally Posted by theredviola View Post
    The ACA is far from perfect, and in many aspects even a liberal such as myself can't completely like the ACA. But, it is a step in the right direction.

    I couldn't care for the individual mandate (which was put in the ACA for the Republicans; it was their idea after all), and I don't like that it forces you to have Insurance; BUT! It does make it much harder for insurance companies to turn down people for "pre-existing conditions" and it makes it to where children can't be turned down either.

    Yeah, it does hurt the middle class and 25-30something Americans that don't have their careers in full swing; BUT! It does force employers to do the right thing and give their full time employees health insurance. That is a double edged sword by itself, because it forces employers to do the right thing.. You can't legislate morality.

    There's some good in the ACA, but all the staunch opponents of the ACA only want to focus on the negative. A law this large, this verbose, and this broad is bound to have draw backs. The "Patriot Act" comes to mind when recalling large, verbose, broad legislation that is highly controversial.
    can't legislate morality? of course you can. there wouldnt be any laws at all if you couldn't.

  16. #16
    Quote Originally Posted by Tyraena View Post
    First off, that $500 or so/mo your employer charges you is matched (or more) by the employer, making your actual costs for insurance way higher after all is said in done. the no co-pay diamond plan you get through them compares to the top tier, not the bottom for the comparison. Apple-to-apples, please.

    Second, if Anthem chooses to be assholes on gimp there coverage offering because they have a monopoly on coverage in NH, that is them being assholes, not the burden of the ACA. There was originally a provision allowing a gov't offering in places such as NH where competition lacked, which was axed by...yes..the (R).
    I mean honestly, what would have been better than both the original plan and what would you ended up with, a straight up no bullshit single payer system would be much better.

    Especially in a country like the US where there is a very large population to split the cost amongst. But w/e.

  17. #17

  18. #18
    Quote Originally Posted by Puremallace View Post
    uhh so obvious question? No employer based coverage? You left that out.
    Scratch out what I said, since some of you guys are good at playing the system, what could a family of four with no job just getting money from the .gov get? You could make a pretty good living right with free insurance covered? I know of some families that actually do this. I should probably ask them. Thinking about it working really isn't the answer anymore, let someone else do the work for me, I'll sit at home and leech.

    - - - Updated - - -

    Quote Originally Posted by Gheld View Post
    So right wing americans don't like the idea of public healthcare because it will inevitably lead to higher taxes. And they are like "rawr, people should take it upon them to get their own health insurance."

    But according to my calculations I pay about 4-5 grand more in income taxes per year than I would in the states. But I would need to spend a bare minimum of 10 grand a year if my employer didn't offer health insurance?
    How much taxes when you buy a home cost? Sells tax and all that other jazz? Not including your income taxes, those I believe are much higher then the US, even though I know the bulk amount of your alls health insurance comes from income tax. Another different between US and Canada is the illegal immigration factor, you don't have millions upon millions of illegal immigrants flocking to Canada, like we do here.

    - - - Updated - - -

    Quote Originally Posted by Gheld View Post
    I mean honestly, what would have been better than both the original plan and what would you ended up with, a straight up no bullshit single payer system would be much better.

    Especially in a country like the US where there is a very large population to split the cost amongst. But w/e.
    Well when you have around 50% of American who pay no taxes at all, and million of illegal immigrants coming across the border, you're eventually going to run out of money.

    I remember a great quote by a European lady who said "The problem with socialism is eventually you run out of other people's money." so true, but people don't care until it hits their accounts and then they hit the streets. Kind of like what happened in Britain and Greece and the rioting. If you guys seriously think the gravy trains going to keep on going you're in for a rude awakening. One day you're going to run out of other people's money. Then what?
    Last edited by Deathcries; 2013-10-13 at 04:56 AM.

  19. #19
    I Don't Work Here Endus's Avatar
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    Quote Originally Posted by Deathcries View Post
    I currently pay $512.32/month with a $3,000 deductible through my employer. No copays, no co-insurance, no limits.
    I suspect your employer is shouldering some of the monthly charge, and you may never see that on any of your information. That doesn't mean they would be sharing any of the additional fees, just the initial cost.

    And even if that weren't true; you aren't making a fair comparison. Your employer has a group plan, and gets a preferred rate as a result. You're looking at single/family plans in the ACA. They aren't the same thing. It's kind of like how a big company can buy supplies in bulk and get a discounted rate, but you can't get that rate if you're buying only enough for personal use.


  20. #20
    Quote Originally Posted by Endus View Post
    I suspect your employer is shouldering some of the monthly charge, and you may never see that on any of your information. That doesn't mean they would be sharing any of the additional fees, just the initial cost.

    And even if that weren't true; you aren't making a fair comparison. Your employer has a group plan, and gets a preferred rate as a result. You're looking at single/family plans in the ACA. They aren't the same thing. It's kind of like how a big company can buy supplies in bulk and get a discounted rate, but you can't get that rate if you're buying only enough for personal use.
    Did you read this part in my post:

    Anthem BC/BS is the only insurance provider on the exchange in NH. They just announced they're dropping 10 of NH's 26 hospitals from coverage on the exchange, as well as their affiliated medical providers. That includes the hospital about a mile from my house. I'd lose all my doctors.

    Anthem also announced they wouldn't cover any out of state specialty hospitals for subscribers on the exchange (i.e. Children's Hospital in Boston, Dana-Farber Cancer Center, etc)

    I'm not a 1%, I'm in the middle/low end of the middle class. I'll go in Monday to talk to HR, but it looks like I'm going to end up paying double for the insurance I already had.

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