I went to a panel on health care reform at NN. A representative from HHS was there, and he spoke at length about the Pre-Existing Condition Insurance Plan, or PCIP.
PCIP was designed as a bridge to get to 2014, when health insurance for people with pre-existing conditions will be folded into the exchanges. Simply, the guarantee behind the PCIP is this: comprehensive health insurance coverage for people with pre-existing conditions at about the same price that people without a pre-existing condition pay.
The program is administered by state governments in 27 states and by the federal government in 23 states and D.C.
Here are the states (and D.C.) that are in the federally-administered plan:
Alabama, Arizona, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Kentucky, Louisiana, Massachusetts, Minnesota, Mississipi, North Dakota, Nebraska, Nevada, South Carolina, Tennessee, Texas, Virginia, Vermont, West Virginia and Wyoming.
The remaining states chose to administer their own plan.
I wanted to see what a monthly premium might cost, were I a person with a pre-existing condition. I went to the Ohio site, because that’s where I live. Ohio has a state-administered plan.
Filling out my actual information- but inventing an unspecified pre-existing condition- my health insurance monthly premium would be around 300 dollars. This is a subsidized rate. The funding for it came out of the PPACA. I then went to Texas, because I knew Texas opted out of creating a state plan so ended up with the default, which is the federal plan. In both instances, I chose the higher-value plan. The Texas rates are about like Ohio.
The rates for any state can be found here.
A problem with this interim measure is that one must be uninsured for 6 months to be eligible.
FoxinSocks
I have a friend who now gets her insurance through PCIP. It quite literally saved her life, saved her house, and saved her business. So it may not be perfect, but it’s making a difference.
Kay
That’s good. I was glad to see that all preventative care is “free”. You know, not free, but not co-pay :)
mclaren
This plan could be substantially improved by requiring that all sick people must first die in order to be become eligible.
NonyNony
Wow that’s got to be an expensive program to administer.
Did the HHS rep say how much it was costing to go this route? At least it’s only supposed to be for a few years, but it’s still got to be pricey to cover a generally high-risk group at the same price as low-risk and low-usage groups.
ETA: I think the overall idea of the program is great, but it strikes me that it’s a band-aid solution to limp along for a few years that could end up costing more than something more radical would have. That’s what I’d like to know – how much of a premium have we paid for not disrupting “business as usual” in the health insurance industry by going this route, and is it worth the cost.
Redshift
I have a friend who was diagnosed with a heart condition, and was lucky enough to have a doctor who was willing to let him pay out of pocket for a time, so he let his insurance lapse for six months in order to get into the PCIP pool. He said it was scary as hell because of the risk of something happening during those six months, but the alternative was to get bankrupted by the cost of care and any insurance he’d be able to get otherwise.
This is the country we live in. I’m so glad it’s changing, and I wish we didn’t have a party of sociopaths obstructing it and slowing it down.
Just Some Fuckhead
Step me through it. A person with a preexisting condition loses their job, then what..?
Arclite
Wow. So I have to run my whole family with no ins for 6 months before I can get into this program? WTF??!
Kay
He did, if practically screaming about what a great deal it is counts. I got the feeling it’s not cheap to subsidize.
They want higher risk in early, very much. This is how they get them in.
Kay
You do, or everyone would drop the expensive coverage they have, including COBRA, and just go with the subsidized plan.
They wanted to avoid an insane rush. The whole thing hinges on gradual.
jl
There are weirder eligibility criteria at the link than Kay indicates. If I read the the info on the eligibility tab correctly, you are NOT eligible if you are covered by an existing policy that does not cover the condition. That makes no sense to me. Anyone understand why that is a good idea?
From eligibility tab at post’s link:
“Please note that if you currently have insurance coverage that doesn’t cover your medical condition or are enrolled in a state high risk pool, you are not eligible for the Pre-Existing Condition Insurance Plan.”
For CA, another state administered plan, rates look to be a little under $500, and I didn’t see the ban for people with existing plans that don’t cover the condition.
kay
Then they choose to purchase insurance through their former employer or choose to go w/out 6 months and get this plan.
The point of the thing was not so people who had access to coverage would switch. The point was so people who are uninsured would have insurance.
I don’t know how you do it w/out the 6 months wait, because everyone is going to drop their insurance and buy this, if it’s cheaper, w/out that 6 month period in there.
MikeJ
The qualification that you must have been without insurance for six months isn’t really much of an issue since the whle point of the program is to help people who *haven’t been able to get insurance*. There are millions of people out there who can get covered right now, today, and couldn’t before PCIP passed.
I know it upsets some when a compromise bill actually makes people’s lives better.
kay
Absolutely. Read away.
mclaren will be here shortly to tell me I’m LYING because I didn’t read it to him.
Mike Kay (The Base)
$300 a month for a pre-existing condition.
What would the rate be with private insurance for the same person, but with no pre-existing condition.
I’m curious to see what’s the incremental difference.
jl
@13 Kay,
But what is the rationale for such a restriction? You want the high risk chronic disease pool to be as big as possible to spread risk, and in a pool where there will be reason to pay special attention to efficient provision of care for people with chronic disease, which will be more efficient in a big pool? And private insurers don’t want them anyway.
I don’t get it. Do you understand it? What am I missing?
Just Some Fuckhead
@kay:
So it’s not actually a refutation of the point I was making to ABL when you bigfooted me in the other thread?
HyperIon
Thanks, Kay, for another informative post.
I did not know about PCIP.
Mike Kay (The Base)
@MikeJ :
The ideologues who screamed kill the bill had the security of already having medical coverage. In a way, they’re as bad as the Neo-Cons. They willing to risk the lives of others as long as theirs remained secure.
kay
Yeah, actually it is. Because you were saying ABL couldn’t buy insurance under the PPACA w/her pre-existing condition. And she can. And you didn’t know that.
What’s your point? That the six month wait makes it less true? That I was supposed to read you the complete text of the link I gave you?
Ruckus
jl
The state site for CA lists a 50 yr old in SF would pay $499. What is it for a 60 yr old?
I know this is a great program and is much better than nothing but what does an unemployed 60 yr old do? With this cost and the co-pays an unemployed senior not old enough for medicare is still screwed. Actually any unemployed person is likely still screwed.
And the site healthcare.gov is overloaded with requests at this time. I wonder if all 40 million of us are looking at once?
kay
They allocated a sum-certain to this based on people who have no insurance. They know how many there are. Not under-insured people. Not people who don’t want to pay for COBRA. Not people who have insurance but need a better rate.
It’s an interim measure. The pool idea you’re talking about will only work with a large pool that has healthy people in it.
Just Some Fuckhead
@kay:
You’re right. I didn’t understand your original comment to mean she’d have to go without coverage for six months but in rereading it, that is exactly what you said.
ChrisNYC
@ Mike Kay at 14
In NY, if the reason you don’t have insurance is that you’re unemployed — $700 a month for not very good coverage — high deductibles/co-pays and some basic things not covered. The only cheaper option is catastrophic (hospital only) coverage for $150. For good coverage that you would get at any decent workplace, $1400 to buy private in NY.
entlord
3 years ago, I applied to the SC high risk pool and at that time was told the monthly premium was $2500/monthly. Of course the problem with such a pool is even if it is &300 monthly, it still requires income and/or savings to cover that much each month above food, shelter and other basics of life
Brandon
My biggest beef with the PPACA is the fact that so many aspects of the legislation are either phased in slowly or do not come into effect at all for nearly half a decade. Not only does it not help people who need to be helped now, it undermine public support for the programs because after all that hullabaloo, people still lack insurance and access to affordable healthcare. Even moreso though, what irks me is that I am finding out about interim programs on a snarky pet and political blog instead of from the government itself. Why isn’t the government out there making a bigger deal about the launch of these programs and ensuring that people know what is offered and how to get it? At the very least I’d expect the Sec’y of HHS to get out there and do the morning shiws and take a 50 state tour with well organized ‘kickoff’ publicity events and interviews with local media, coordinated with state agencies. It feels like there is a troubling lack of imagination, even thoughtlessness regarding government programs, just assuming that all one needs to do is design it well and launch a website and the work is done. When it comes to social welfare programs though, I believe that is only half the job. The other half of the job is getting the government out there to aggressively promote those programs to the public. Bush’s government was all publicity and no competence. Obama’s government seems to be making the opposite mistake of being all technocrat with no public face. I wonder if having both is too much to ask and I’m curios whether there is a Democratic version of Karen Hughes to help these folks out on these matters.
kay
I take people over there if they wander in here, lost, and don’t have internet.
I think I was the only one going, though :)
The Ohio rate is much better than it was. I’m not clear on what happened there.
Mike Kay (The Base)
@FoxinSocks:
That’s terrible! Obama is a monster! We should have listened to the well heeled nihilist and killed the bill.
jl
@21 kay – June 23, 2011
Thank you. I should have thought of that. It is to prevent a ‘woodwork’ problem, then.
That is the lingo used in these parts. A ‘woodwork’ problem in benefit design is that you will underestimate increased enrollment/costs/utilization by a totally unknown amount if you have a decent benefit design like they have in other countries. Because sick untreated people will ‘come out of the woodwork’.
Whenever I think about how messed up our health care system is, that phrase comes to mind, as in “Yeah, that (plug in decent standard of care here) is a great idea, and would save costs in the long run, but we’re a business you know, and we’d have a woodwork problem.”
kay
I’ll defend them on this, because Donald Berwick is going to drop dead from exhaustion w/ all his forums and such.
Our media isn’t interested in information. They don’t cover it. None of it. Look at the news, today, and tell me what you see.
Just Some Fuckhead
If a person can’t afford a subsidized premium because they don’t have any income, and they aren’t old enough for Medicare, this is where Medicaid comes in- if yer lucky enough to live in a state where you can qualify.
kay
You probably know vastly more about benefit design than I do.
Remember: I was sitting on the floor at something called “Netroots Nation” :)
Southern Beale
I’m trying to figure out how to solve the problems which we face and really don’t have any solutions except perhaps in this case entropy is our friend.
Frankensteinbeck
Brandon:
Hmmm. Well, what should be done to make this more public? That does not involve money congress won’t give or television/radio air time the media won’t give?
Southern Beale
Sounds suspiciously like “rationed care” and “death panels” to me but what do I know, I’m just a DFH housewife in Bumfug, Tennessee.
Jim Pharo
I suspect HCR will end some of the most egregious abuses (abuses that most state insurance commissioners have been free to end for decades), but it’s hard to see the roadmap that gets me to insurance that I can afford. I simply can’t imagine the insurance industry ever agreeing to actual cuts in their revenues.
And what’ with the “exchanges”? We’ve had websites in NYS and NYC for many years that list all the available options. It’s done nothing to reduce cost, it just incentivizes the insurers to hide the various outs and restrictions more cleverly.
I appreciate the President’s sentiment on HCR, and am DEEE-lighted that it is actually helping some folks who really really need it. But I’m afraid it’s just pushing peas around on our plate and than in 10 years time we will be no closer to taking care of each other at a reasonable cost.
jl
@31 kay,
Probably I only know about the statistics more. The political/business end is so horrifying to me that I avoid it whenever I can.
Once in awhile I have to sit in meetings with regulators, academics, and private and public health care business management types, and all I have to say is “I seen things”.
People like you are braver than me, and have a far higher tolerance for reading truly horrific and endless texts (worse than repair manuals, statistics, or even economics, IMHO).
Frankensteinbeck
Jim Pharo:
The insurance companies don’t have to ‘agree’ to anything. The ACA is a giant pile of new rules they have to follow and regulatory agencies capable of telling them that whatever they plan to do is unfair. It’s way, way more than just the system to cover the currently uncovered.
And the ‘exchanges’ are designed to combat exactly what you’re describing, because what they mean is that the government experts who ARE able to look through all those hidden details are negotiating what is fair and what is unfair, not the average person on the street who is both uninformed and has no negotiating clout.
kay
I go the other way. One person at a time. It’s easier. No one (regular) person is going to have to learn this whole thing. They’re going to slot themselves in to one or another part.
In 2005-6, they added something called “medical support orders” to child support. It’s a health insurance mandate, actually, although for some reason people didn’t go completely freaking berserk when Bush HHS + states imposed it.
Anyway, there was panic that people would never, ever figure it out, but they did, easily, because they were only looking at their own situation. They don’t have to understand the whole statute, or every eventuality. They just plug themselves in.
Mnemosyne
@ MikeJ
I think people are confused about what the purpose of a high-risk insurance pool is. A high-risk pool doesn’t exist to get coverage to everyone, or to people who think they’re paying too much for their insurance. It’s to get coverage to people who can’t get coverage at all, generally people with pre-existing conditions who make too much money to qualify for Medicaid and are too young for Medicare.
Yes, it’s an interim step to tide some people over while the rest of the system is put in place. Get over it, people.
Mike Kay (The Base)
@Jim Pharo : Paul Krugman disagrees.
O Possum
I’m getting on this next month. Being completely uninsurable for the past several years, I’ve blown at least 10-20k annually just keeping a couple of things from killing me or rendering me unable to work.
Even with the premiums and what I’ll pay out of pocket for an upcoming surgery, this is the first time in a decade we could do better than being one late paycheck away from total disaster despite working 60+ hour weeks each.
Mrs Possum and daughter Possum have gone from being fairly non-political to speaking of the President the way my miner grandparents spoke of FDR and John L Lewis.
Southern Beale
I simply don’t understand why we need “coverage.” WTF is this about? Why are we supporting a dying, dysfunctional, outmoded industry?
What, pray tell, do insurance companies DO? What function do they perform? Maybe once upon a time they existed to lower cost by pooling risk, but when they started cherry picking their customers by leaving out the poor, sick and old, they basically turned themselves into healthcare leeches. All they do is suck profit off the top.
I really fail to understand why our government is in the business of keeping a failed industry alive.
Oh, wait. Never mind. That’s what we always do. I get it.
Ochotona princeps
I just want to say how much I like these basic, informative posts explaining how some feature of a law or or program works. Both the media and the blogsphere focus waaaay to much on conflict and horse-race b******t, rather than actually explaining the mechanics of the underlying policies.
Ftw, coverage for a twenty-something healthy male in CA runs $150 to $300 a month, depending on the quality of the coverage.
Just Some Fuckhead
As long as we’ve got the existing system- enormously rising prices on the delivery side; hospitals, doctors, drug manufacturers, all bent on extracting the maximum profit possible, and health insurers extracting their protection money, it won’t really be about what you can afford. It’s more a question of how much is it worth to you. And the answer to that is practically everything.
Ruckus
jsf
If you qualify for medcaid. I have looked and there are a lot of pretty big holes that a lot of people fall into, at least in CA. Our patchwork of minimal programs that work for a specific limited group some of the time… I know this doesn’t help and has been heard over and over again but what is it about this country that we can bomb the shit out of countries half way around the globe, for decades, and we can’t manage to have much of anything that resembles health care?
Mike Kay (The Base)
@O Possum:
“[With ACA, Obama] will go down in history as someone who changed America permanently.” ~ Paul Krugman.
Monala
Another option, for those who fall within that 6 months waiting period, are the expanded community health clinics that were also a part of HCR. Most charge a sliding scale fee based on income.
West of the Cascades
So let’s review — a federal law sets a minimum nationwide standard for an essential service that the federal government has decided it is not willing to provide directly, but gives states flexibility to either let the government administer the program, or institute their own state program (that meets the minimum standard). People who previously could not get insurance now can, albeit at a price ($3,600 per year) that can eat into a modest income pretty quickly. But there are some subsidies available. And the price is pretty much the same in states that administer their own programs as states that use the federally-administered program. And it piggy-backs on an existing system (private insurance) – perhaps not the best existing system (which would be Medicare) to piggy-back onto, but it creates no new administrative costs (public or private). And it’s part of a larger scheme to control some of the costs within the private insurance and health care system.
Not single-payer, but better than the big fat nothing that existed before ACA (or the big fat less-than-nothing the GOP would put in place). But Obama is just like Bush, and he NEEDS TO BE PRIMARIED BECAUSE HE FAILED US ON HEALTH CARE REFORM.
John X.
“Another option, for those who fall within that 6 months waiting period, are the expanded community health clinics that were also a part of HCR.”
I thought those were slashed during the budget fight.
Straw Carpenter
I’m over fifty, live in dreaded Arizona and I had a heart attack some time ago. The representative from the hospital was able to get me on medicaid, which is quite good coverage. Of coarse, if you earn enough to live on, your not eligible. However the moron governor is about to throw most of us off medicaid. I checked on the coverage from the feds for preexisting conditions and it would cost me between $700 and $1000. Hardly affordable for an unemployed (previously self employed) carpenter. Seems like a bit of a cruel joke of a program from where I’m looking.
O Possum
@ Mike Kay (The Base)
Yep. I would trade ACA, two first round draft picks, and a player to be named later for Single Payer in a heartbeat, but still, this was monumental in a way I can’t adequately describe.
Monala
According to this article, the $11 billion in increased funding for community health centers began in 2010.
FlipYrWhig
I’m profoundly disappointed in Obama’s performance on [issue], and instead of what he did I would like something else! Something better! In fact, I demand it, and I won’t be quiet about [issue] until I get it!
How?
Um…
Does demanding count?
Frankensteinbeck
The big fat nothing that, let me remind you, every other president on either side has achieved arguably since Teddy Roosevelt.
Bob
I think the State of Michigan is seeing something similar to this.
Many State of Michigan Employees have spouses that work for the auto industry. As the auto industry laid off people and cut benefits, many of these spouses, or the entire family went over to the State coverage, increasing Michigan’s employee and retiree health care costs.
negative 1
Mnemosyne
Because, like it or not, it’s the system that we have. The majority of people in this country get their health insurance through their employers, and their employers buy it from private companies.
It’s not like the US is the only country that distributes healthcare through insurance companies. Switzerland and Japan (among others) have successful systems that are based on getting your coverage from private insurance companies. The problem in the US is that our insurance companies are for-profit, while the insurance companies in the other countries that use them are non-profit and tightly regulated.
So, no, health insurance companies in and of themselves are not the problem. For-profit, barely regulated insurance companies are the problem. Especially since they collude with our for-profit, barely regulated hospitals and other providers to get everyone the maximum amount of profit they can.
Martin
Of course, which is the problem between a free market – one you can as a consumer choose to not participate in, and a captive market – one you as a consumer cannot opt out of.
But the big health care cost villains here are the hospitals and doctors. That’s where roughly 60% of health care spending goes. Insurers, drug manufacturers, and so on are only about 15%. Medicare, Medicaid, etc. need to fight the 60% battle, because doing so will reduce those costs for everyone. Obama got the drug companies out of the way, mainly because their costs are relatively small and they’d be a huge distraction. Dems got incensed over the insurance company *costs* which actually are not that high and aren’t really worth blowing up a deal over, especially when the insurers are an ally in the fight against the 60%.
Remember, ACA was never about individual costs. It was always about government’s costs, with some individual benefits tacked on. It was designed that way because without solving the government cost problems, government would be forced out of programs like Medicare, and they’d never be able to help the individual cost problems. Reigning in government costs has always been the necessary step to single payer – without that, single payer is simply impossible to implement.
Just Some Fuckhead
Yes, but the wonks inform me that those arbitrary state-level restrictions on Medicaid will end in 2014.
This is the great thing about having so many wonks in the Democratic party- they can justify and implement Republican ideas that otherwise might never see the light of day.
(Medicaid expansion obviously not being one. My clumsy attempt to get a dig in at our own side for being effectively useless.)
Monala
The blog, “What IS Working” has an entire section of posts about successes resulting from HCR, including video testimonies of people who have been helped already.
Ruckus
The new laws are going to do quite a bit towards making health care available and even some what affordable. Or at least more affordable than it is now. The no pre existing conditions stuff is huge. And I fully understand why the delay in putting all this into motion, it is a lot and rolling it out just takes time. My problem is the hole I fall into (and of course I’m not alone). Self-employed, bad economy (minimal business so minimal money but not totally asset poor) not pregnant nor a child, not disabled, not old enough for medicare, etc. I’m stuck in that middle hell of not. I am still a productive adult (most days anyway). I’ll bet there are a lot of us out there.
ETA I see jsf has a reason for all the holes in the who, what, when, where, it’s just some days it seems like I will never be OK health wise ever again.
Monala
Ruckus, Google “community health clinics” and your location and see what pops up. Alternately, contact your state’s health department or visit its web site; they usually list resources for uninsured people.
ABL
he doesn’t have a point. he just doesn’t like to be proven wrong. he’d do better to rejoin all the schoolyard taunting on my other thread. :)
Just Some Fuckhead
@ABL:
Me @ Kay:
You should prolly stop digging at some point.
Ruckus
Monala
I’ve done this. Not as good an idea as it sounds here in CA. I know someone has posted here before that the NYC clinics were righteous, giving her better care than when she had insurance. So it varies a lot based on your state. In 2014 when the bulk of the law is finally implemented I will be 65 and on medicare. But that’s my lot in life, day late, dollar short. Murphy and I really are best buds.
ABL
which is precisely the situation i will be in once/if my temporary job ends.
i cannot for the life of me understand why people are balking at this.
ABL
i will, if you will… deal?
didn’t think so.
Just Some Fuckhead
With an economy in another slump and employers replacing expensive older workers with cheap younger workers, it should get a lot worse before it gets better.
Just Some Fuckhead
@ABL:
I’m not and you won’t anyway.
Jim Pharo
Let me just clarify that when I say the insurers will never agree to take less in revenues, I am aware that there is a law on the books that says they (ultimately) may have to. But our government is very responsive to its owners, and I simply don’t believe that the government will in fact make the insurers do anything they don’t want to do. Laws can be challenged, repealed, unfunded, interpreted, etc.
Second. I do loves me some K-thug, but his comment assumes that the ACA is going to be implemented more or less as written. As noted above, I don’t think this is the case.
Take a good, unjaundiced, critical-thinking look at the last 50 years. What has American industry been forced to do that it didn’t more or less agree to? The only time there’s any actual “forcing” is when competing moneyed interests are jostling for advantage, like when the banks squared off against the retailers over the pathetic debit card fees. As big American companies get out of the business of providing health insurance as part of their compensation, who is supposed to stand up for patients, the insureds, and the taxpayers? Max Baucus? Chuck Schumer? Diane Feinstein? Bob Menendez?
I’m just not seein’ it.
Ruckus
jsf
With an economy in another slump and employers replacing expensive older workers with cheap younger workers, it should get a lot worse before it gets better.
Like I said, Murphy and I are best buds.
MattR
@Mike Kay – Boy did you chop up Krugman’s article to create your quote from fragments across several paragraphs of the original. That is misleading to the point of dishonesty.
Mike Kay (The Base)
Here’s a great video from CBS News on how Massachusetts Commonwealth Care cut insurance from $900 to $176 per month. And Krugman says ACA is far superior to Commonwealth Care because it includes a variety of cost control measures.
http://www.cbsnews.com/video/watch/?id=5204308n
jl
@20 Ruckus – June 23, 2011
Very good point. The 50 year old rate will be relevant for me if I need it in a few years, so I guess I didn’t think about anyone else. I am a bad person.
Can’t find any info that gives an idea about how rates change with age, other things held constant.
That is not comforting.
Frankensteinbeck
Jim Pharo:
Your argument is endless and leads to it being absolutely useless to try anything ever. No, I’m not being hyperbolic and slippery slope about this. ‘Regulations are useless because they’ll never actually be implemented’ leaves you with nothing to do.
In addition, it’s utterly incorrect. We’re surrounded by so many examples of things that the government makes businesses do that they don’t want to do that you only notice the times they’ve resisted. Your milk is not paint. Black people don’t have to sit in the back of the bus. Regulations work so well that what we need are more and better ones, not giving up on them.
Ruckus
jl
Can’t find any info that gives an idea about how rates change with age, other things held constant.
That was sort of my point. It sounds pretty good till you dig deeper and find the answers aren’t really there and that every thing varies, depending on who know what. Is it that hard? I don’t think it should be but it is. If it wasn’t then the answers should be easy to find. And they are not. No one would confuse my google fu or my logic skills with a superpower but they are not that bad.
Comforting is the last thing it is.
Mnemosyne
@ Ruckus
Ugh. As someone who went without insurance for almost a decade (fortunately when I was young and mostly healthy), you may be able to negotiate directly with your providers for non-emergency care. Your doctor may be willing to give you a discount on office visits if you pay cash because it means they don’t have to dick around trying to get paid by the insurance company. Even hospitals are sometimes willing to negotiate if you’re able to do it for a planned visit and not during an emergency.
Pharmacies have a surprising amount of variation in what they charge even for brand-name drugs, so it’s worth shopping around. Here in California, Costco is required to let you use their pharmacy even if you’re not a member and you can check their prices on-line.
You’ve probably already looked into this since it sounds like you’re self-employed, but if there are any professional organizations that you can join, sometimes they offer health insurance to their members.
Mnemosyne
D’oh! Ruckus, I have a couple of suggestions for you to try and make your healthcare more affordable, but they got thrown into moderation. Hopefully they will be released from prison soon.
Josie
Kay – Thanks so much for an informative post and good answers to everyone’s questions and concerns.
Just Some Fuckhead
@Ruckus:
Try turning it on its head and view anything remotely helpful as a pleasant surprise. :)
Ruckus
Mnemosyne
If they are in mod hell then they must be good!
I’ll keep checking back, thanks.
Mnemosyne
Honestly, I think this is how a lot of younger people slip into libertarianism: since the government is going to be completely controlled by corporations anyway, we may as well give up on government entirely and try to do everything through the private sector.
But it’s like immunization. The government protections that we have are essentially invisible because they work very efficiently, so you don’t realize how much protection you’ve been getting until it’s gone.
Mnemosyne
I think it’s because I used a naughty word to describe how insurance companies treat doctors. Ahem.
But I thought of another suggestion after the edit window closed: a lot of university alumni associations now offer health insurance, so that’s another area to investigate while you wait for Medicare to kick in.
OzarkHillbilly (used to be tom p)
Well, here in Misery, my union carpenters plan costs app $400 per month. Fortunately, this unemployed carpenter can still afford it. If not, I would be on my wifes plan…..
and probably dying from my pre-existing condition.
Just Some Fuckhead
@OzarkHillbilly:
If it makes you feel better, prevailing wisdom says your death should lessen demand for healthcare and lower prices for the rest of us.
Pongo
In MN you need to have evidence that you have been rejected by a standard insurer. In order to do that, you have to formally apply. I have tried to apply to several major carriers, all of whom require a full month’s premium accompany the application. They take your money and if they agree to insure you, coverage starts from the day of your application. If they turn you down, however (they give themselves 4-6 weeks to make a determination), then they return your premium payment with 8 weeks. So they have your money for up to three months with no guarantee of any service. When I complained to my rep about this this and suggested the very least they should do is return the money, plus any interest they’ve earned on it, she said that ‘it’s standard practice and trying to change it would result in significant pushback from insurers.’ So even when they lose, they win and consumers are screwed yet again. For some people, the cost of a monthly premium is not extra spending cash. They don’t have spare money sitting around for an insurance company to futz with for three months.
Frankensteinbeck
Pongo:
One of many, MANY reasons why we need the ACA and its giant raft of regulations.
Brandon
@Frankensteinbeck:
Not at all. According to Kay, people are making the rounds, but the media has been ignoring them. My question is whether they have been thinking about this strategically enough. HHS surely has a travel budget that is adequate to send people out there. Expensive television commercials and not always necessary. The best publicity is always free publicity. Local newscasts love to have cheap content gifted to them. They don’t have to produce those Bushite ready-to-air propoganda infomercials or anything. But they need to give them something shiny to catch their attention. Sending an important, but unknown policy wonk out there to talk to people is probably not the best strategy. Hosting events in communities across the country featuring bigger names like Sebelius, state and local pols and perhaps even a well meaning celebrity and working hard to ensure that local media attend and provide them all the coverage and interviews they wish could do a lot more. Ostensibily these events could be hokey ribbon cutting type affairs to ‘launch’ these new servies (for some reason, local media love oversized cermonial scissors and shovels), or they could do something else. But what they don’t really need is more money to get the job done.
I just wonder why they have not spent more time promoting the PPACA because if they could just be on a non-stop publicity tour regarding this significant and important government program, a real positive externality is that it reminds people what Obama has done for them and that would help his re-election campaign. There are so many incentives to get out there and actively promote the PPACA that it pains me to wonder why this government seems to prefer to let the programs get implemented unnoticed. Remember all the local tv coverage that was generated by ‘Cash for Clunkers’, that is truly the model that I am hoping that they could emulate here. Perhaps they are truly concerned about the ‘woodwork’ problem. But I don’t see how having too many people try to sign up could be a problem. Obama’s response could just be to say, “I am sorry that you don’t have insurance now, the PPACA will be able to help you in a couple years but the reason you couldn’t have it now is because the Republicans and Joe Lieberman wanted to make you wait and suffer for no good reason.”
Mnemosyne
@ Pongo
I’m assuming that they insist on a paper check that actually clears the bank and won’t take a credit card payment. ‘Cause if they did, I would totally put it on the credit card and then ask the bank to reverse the charge if they took too long making their decision.
But that may be why they don’t let me have credit cards anymore.
BattleCat
The prices of PCIP (federally administered at least) have been going down ever since it started. I went from $326/mo to… what is it now, $260/mo?
I’d be facing bankruptcy without it… but now?
I’LL SEE YOU REPUBLICAN FUCKERS AT THE VOTING BOOTH.
That is all.
kay
I checked (using the links at the top of the page) and the rate for you is between 300 and 450 dollars, depending on plan. The federal program has an HSA option, and that’s the priciest plan.
I understand that no one is offering you the information. I understand that Arizona state government is too busy protecting a corrupt and rogue county government and law enforcement apparatus to actually serve the people that live there. I understand that this subject bores media personalities, so they have decided they will not cover it.
What that means, though, is that you (and me: Ohio is currently governed by conservatives who find it politically advantageous to run state government poorly) are going to have to do this by ourselves.
kay
I subscribe to two newspapers. I read both of them. One is local, one is located in the next large city. The median income where I live is 32k. It’s rural Ohio, so there’s a lot of people with pre-existing conditions here. The rural lifestyle may not be all that healthy, turns out :)
Neither newspaper has done any practical or informative coverage of the PPACA, other than speculation and fear-mongering offered by conservatives who are running for office, and broad defenses by (mostly, national) Democrats who are also running for office. My state government is rabidly partisan, and there ain’t no way any loyal Republican is going to offer anything like helpful or useful information on “Obamacare”.
So that’s what you’re up against. You’re going to have to get past them. They’re standing in the way.
kay
All really good points. I have to tell you, though, I’ve given up on that. I think conservatives have flat-out scared media to death.
My local paper treats the PPACA like all media treats abortion: as a purely abstract, purely ideological debate. They don’t get closer than 30,000 feet up in the air. I have heard 100 times more on the legal challenges than the the law, and to be honest, unless you understand commerce clause jurisprudence, you won’t understand the legal challenges. I have no idea why poor, sloppy coverage of a complicated legal issue is so appealing, when plain-vanilla facts on the actual law are verboten, but that’s what’s happened.
I think any practical coverage of anything in the law is treated as partisan and radioactive, because it’s Obamacare, and it’s controversial. Run! :)
sparky
i have long argued against the ACA for a number of reasons, most notably that it is really a subsidy to the insurance companies* disguised as positive legislation.** i am going to temper that a bit here, because the bridge programs WILL help some people though it appears that the number of people may be vanishingly small.
to recap: these programs are going to out of business in 2014. in the meantime, the federal government will spend a fortune taking the uninsurables out of the insurance pool. kinda the opposite of the mandate argument, no? this is why people like me opposed ACA–all it did was guarantee profits to the healthcare industry while subsidizing the losses. sound familiar?
in any case, while i think it is great that probably some peoples’ lives will be saved because of this, the real question is what happens when the true costs become readily apparent and the ACA limits kick in? what then?
additionally, the link is a handy one, so thank you for this post.
*not everyone who opposed the ACA is wealthy. some of us don’t even have health insurance.
**the medicaid expansion is a plus. i still don’t see any reason it had to be coupled to anything else.