Silver Linings

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Health Care

Among other things I’m still messing around trying to get a cheaper health insurance policy through the New York exchange. In December I gave up and paid my old premium for January. (I did finally get a notice from New York about my eligibility, dated December 26, advising me to be sure and sign up by December 23.)

Since I do qualify for a subsidy, there are four or five plans that would save me considerable money on premiums, and I’ve calculated I would still come out ahead even if I end up paying all of the deductible. And if I don’t need much medical care this year I could come out way ahead. Only one of them lists my doctor as a provider, though, and I just need to get hold of someone at my doctor’s office to confirm they are in that network. And no one’s ever there when I call. It’s always something. I’ve got to sign up by tomorrow, I understand, to be covered in February.

There’s still a lot of bitching and moaning about Obamacare in the headlines. Jonathan Cohn writes that the actual enrollment data isn’t that bad.

Ed Kilgore summarizes,

The long-awaited breakdown on the age of young enrollees (defined as under 34) came in at 24%, not catastrophic but well below the target of 40%. But as Cohn points out, the Massachusetts precedent showed that young-uns tend to enroll in this kind of scheme quite late, so let’s wait a while before panicking over the age mix.

Cohn also notes that about 79% of enrollees are qualifying for premium tax credits, a.k.a. purchasing subsidies, which is very much in line with CBO predictions.

The real news to me in his post is which of the coverage levels is proving to be most popular. For 60% of enrollees, it’s the “silver plans,” which are distinguished by protection from really large out-of-pocket costs. Health reforms of all varieties should take notice of that (particularly conservatives who think shifting more health purchasing from insurance to self-payment is the key to controlling costs).

The silver plans are the ones you can get with a subsidy, so that’s probably accounts for a lot of their popularity.

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16 Comments

16 Comments

  1. c u n d gulag  •  Jan 14, 2014 @6:07 pm

    I forgot last week when I went to my local pharmacy, that my Medicaid coverage had changed from MVP, to Healthy NY.

    So, when I called in some prescriptions, I hadn’t yet updated that change at the pharmacy at my local Hannaford,

    I figured the three drugs would cost me about $18, and when I went to get them, I thought the young clerk said $18.90.

    When I pulled out my debit card to pay for it, I looked at the screen, and it said $189.90!!!!!
    Holy shite, I almost pooped-the-big-Frito, and had a aneurism!

    When the young guy asked me if anything had changed, I remembered my new card.

    Well, in between inputting the info and helping other pharmacy customers, in about 45 minutes, he gave me the verdict – $3 for three medications!

    That saved me at least $15, from what I’d been paying for the same med’s before.

    There’s not much good about being piss-poor, but in a Blue State, not everything’s horrible! :-)

  2. semi-adult  •  Jan 14, 2014 @9:18 pm

    Allow a small urging that you deal on the telephone, with a person, or even (if possible) visit a real bricks-and-mortar office. You should get the service you need, and a more immediate outcome (papers, certificates, whatever) that nails down dates and choices and moves you into the current century of health care. Because sometimes you just have to.

  3. Doug  •  Jan 14, 2014 @11:31 pm

    A friend of mine in NC has been writing medical billing software for doctors for, about 30 years. He knows medical insurance. He’s the owner of his own small company and he wrote me the following….

    “There is good news though…..MY health insurance….right now I pay $1100/mth just for me. Next year to about the same insurance(it may actually be better) it will only cost me $3200/yr….because of the “exchanges” that let us small bus guys buy insurance from these huge pools of people…and apparently the government made the insurance companies price the insurance the same for all people no matter what age!…..Thats half my mortgage every month.”

    I don’t know how ‘typical’ this kind of change is. I know some people are seeing a bump in cost for health insurance but the impartial assessment by groups like Kaiser is that there will be more winners than looser among the currently insured who must change – or have the option to change. If that’s true AND you provide health care for tens of millions who did not have access before, then Obamacare will be scored as a huge success.

    The war is over perception, and I’m unwilling to be deceitful. But a lot of independent voters will not allow Fox or anyone else to decide for them. The deceivers might not win. I’m hopeful that we will win the day on ‘perception’ because more people will benefit than will pay more.

  4. maha  •  Jan 15, 2014 @10:40 am

    semi-adult — the catch is that (I’m reasonably certain) if you want the subsidy to be applied you have to either go through the website or make an appointment with one of the authorized official state “navigators,” which would require more time that I don’t have. And for all I know the navigator still has to go through the website.

  5. waspuppet  •  Jan 15, 2014 @12:11 pm

    “For 60% of enrollees, it’s the “silver plans,” which are distinguished by protection from really large out-of-pocket costs.”

    Wanting to be protected in case of catastrophe is so un-American. Don’t they BELEEEEEEVE in themselves enough to think nothing bad will ever happen to them? Obviously Obamacare has made them slaves.

    - Conservatives

  6. moonbat  •  Jan 15, 2014 @1:26 pm

    My research (for myself and a poverty stricken friend) show that all the plans, not just silver, qualify you for a subsidy. Also discovered that (at least in my case) the premium for silver in some cases isn’t that much more than bronze. In for a little, in for a lot. It may have the right set of features at a good price point for many.

    California has been pretty aggressive about putting people out in the field to enroll those who 1) are clueless about Obamacare or 2) don’t want to go through the website. They hold meetings at libraries and other public spaces to sign people up. You can see a long list of these signup events at the state’s website.

    Personally, I let my old catastrophic plan end on Dec 31, and am holding out for the enrollment deadline of March 31 – taking a cue from my poverty stricken friend who has gotten away with having no health insurance – before I get another plan. Rolling the dice with my health at this point, but so far, I’m doing OK.

  7. Sondra  •  Jan 15, 2014 @3:34 pm

    Dear Maha,
    If no one answers at your doctor’s office try their menu of options and request to speak to someone in their billing department. They will most likely either pick up the phone or call you back.

    If you still can’t reach them, I’d consider changing docs. What good is your regular doc if you can’t reach him/her?

  8. maha  •  Jan 15, 2014 @4:53 pm

    I did reach the doctor this morning, and we’re good with the insurance. He doesn’t have a billing department; he’s in a solo practice. I can reach him in case of medical emergency, and he’s really a sweetheart. And I don’t want to have to break in another one. :-)

  9. Swami  •  Jan 15, 2014 @10:54 pm

    Drats, the conservative anti-Obama crowd have been foiled again.
    http://news.yahoo.com/u-judge-rejects-challenge-obamacare-insurance-subsidies-175728247.html

  10. moonbat  •  Jan 16, 2014 @12:13 am

    Chris Hedges, on Chris Christie:

    …Christie is the caricature of a Third World despot. He has a vicious temper, a propensity to bully and belittle those weaker than himself, an insatiable thirst for revenge against real or perceived enemies, and little respect for the law and, as recent events have made clear, for the truth. He is gripped by a bottomless hedonism that includes a demand for private jets, huge entourages, exclusive hotels and lavish meals. Wall Street and the security and surveillance apparatus want a real son of a bitch in power, someone with the moral compass of Al Capone, in order to ruthlessly silence and crush those of us who are working to overthrow the corporate state. They have had enough of what they perceive to be Barack Obama’s softness. Christie fits the profile and he is drooling for the opportunity…

  11. Doug  •  Jan 16, 2014 @12:59 pm

    OT – There’s the story about Governor Christie when he was a youngster that explains his personality. It’s reported that as a young teen he went to a local brothel and asked the madame if he could .. visit.. one of the ladies, any one of the ladies, who was infected. She was shocked and explained he didn’t want to contract an STD. To which he said he did, so he could give it to the maid.

    The madame, still in a state of shock, asked why he hated the maid. Young Christie said he didn’t hate her – but he had to transmit the disease to his father. Getting a grip, the madame asked if he had issues with his father. No, but it’s the easiest way to pass it on to his mother. Back to shocked, the madame asked why Christie hated his mother. Christie answered with some resentment that he loved his mother, but she could give it to the mailman.

    Realizing she was out of her depth completely, the madame admitted she didn’t understand, and the future Guv explained, “I gotta get back at the mailman – he ran over my freekin’ bicycle!”.

    While the story may not be true, it explains the main drawback of revenge politics. A lot of folks get infected on the way to getting revenge.

  12. c u n d gulag  •  Jan 16, 2014 @1:06 pm

    Doug,
    LOL!!!

  13. Swami  •  Jan 16, 2014 @1:35 pm

    Doug, LOL.. and in some respects Christie would get away clean, as least as far as delivering his retribution….Ah, just like he did in Ft. Lee.

  14. semi-adult  •  Jan 16, 2014 @2:03 pm

    @maha: As I understand it, once you begin the process you get to be an entity with an identity (number), so even if you deal with a navigator you should be able to “resume” your process on your own. The advantage of the navigator is, once you have a firm grip on at least the outlines of your need, they can point you in the best direction, if not finish the job. Anything, from whatever source, that speeds up the game — and more importantly guarantees you the confirmations that make you legal to the carriers — must be good.

    In any case, best thoughts on getting it done.

  15. c u n d gulag  •  Jan 18, 2014 @8:37 am

    Forget “Silver Linings!”

    Here’s an example of ‘GOLD Linings!’

    http://money.cnn.com/2014/01/17/technology/yahoo-golden-parachute/index.html?hpt=hp_t2

    A $60 million golden parachute – for a FIRED Yahoo executive!!!!!!
    Not bad, eh?
    Fired, no less.

    Of course we can’t pay poor full-time work poor, or the un/under-employed moochers, takers, and parasites!

    How the hell can we, when the money goes to Executives who were F*CKING FIRED?!?!?!?!?!?!?!?!?!?!?!

    If I was on The Board of Directors, I’d say he can have it – IF he decided to go in a plane up to 30,000 feet, we open the door, hand him $60 million in gold in a parachute pack, and he jumps!
    Or else, we take the money back, and push him out.

    I got fired only once.
    And all I got the next day when I went to the entrance, was a box of the sh*t that was in my office.

  16. Doug  •  Jan 18, 2014 @11:00 am

    CUND GULAG – 60 Million.. And where did that money come from? They just wrote a check.. but what’s the source of revenue for Yahoo. Advertisers. Those little window pop-up ads generated just for you based on information collected by Yahoo or Google or collected by tracking programs. Which is why if you go to a web site on Tahiti, you will be drowned by travel ads on Tahiti for the next 3 months.

    So who pays the advertisers? People who go to Tahiti or buy a laptop or get back surgery. Who pays? Consumers! You and me. This is an angle the conservatives don’t get. They see that government services are paid for by the taxpayer (and they don’t think we have figured that out) which means we all pay for services, directly or indirectly and conservatives resent that benefits frequently go to the ‘unworthy’ poor. This Yahoo is an example of how the free market extracts a tax of its own for the unworthy rich.

    Is there an answer? Maybe. There has been a trend building for decades which insulates management at the highest corporate levels from accountability to the ‘owners’ – the shareholders. Legislation could ban the rules that shift power to the shareholder and allows communication and coordination by shareholders to revolt against ‘insider’ payoffs of millions from the company to the connected. Maybe President Warren would like to design the reform.



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