Affordable Care Act made easy. .

[MizMeesha]

On my interwebble tour today I found this video explaining the new Affordable Care Act (in super easy terms), thought it might be informative for my American friends.

http://www.upworthy.com/the-simplest...ver?g=2&c=huf1

M

[TLC_31]

Upworthy was started by a former executive of MoveOn, a left-wing public policy group. From Wikipedia: “It (Upworthy) is dedicated to publicizing progressive narratives.”

I'm not in a position to watch the video where I'm at, but because it comes from Upworthy, I can't imagine it's of any value other than to spew its political point, which isn't needed here.

[onlyairfare]

The video is actually produced by the Kaiser Family Foundation, a reputable and impartial health policy organization. I did watch it and found it well-done and quite informative.

The video emphasizes the positive aspects of ACA, but also discusses the increased taxes involved, and the "individual mandate" that some object to. Kaiser Family Foundation is in favor of ACA, based on some very good data about health and health policy in the United States. I'd urge caution - don't throw the baby out with the bath water.

I don't know anything about Upworthy, but the video is quite good, so I would not discard it as "unworthy" just because of where it appears.

Thanks MizMeesha for posting the link.

[misslux]

Thank you for posting!

[JerryD]

Thanks for posting. I am glad to see someone here isn't blinded by political nonsense. Good post.

[rdmc]

I posted a rather "interesting" article link in Medications forum a few days ago that has to do with ACA.

The AP article said that the exchanges were looking at increased out of pocket for "newer pricey" drugs for chronic diseases like MS and Rheumatoid Arthritis...they mentioned a 40% copay.

They didn't mention any med by name, just used the words "newer" and "pricey" meds.

Here's the article: http://hosted.ap.org/dynamic/stories...09-25-14-24-32

[22cyclist]

I read that article. I buy my own insurance now and my deductible is 5,000. Then I have another 3,000 out of pocket before my insurance pays everything. So it is way worse than what this article says. Also my insurance doesn't cover drugs. I am on Tysabri. I have Charity Care at the hospital I go to. Plus I have help through Biogen. This is the only way I get my medication every month. There are ways to do it. You have to apply for help. Most individual plans suck. Thats just the way it is. Mine was like this before they knew I had MS. It is what they would consider a Bronze plan, not even a Silver plan. It happens, but at least I am insured. I hit my 8,000 deductible/out of pocket every year. Then it covers my MRIs, hospital stays, etc. Its not so bad in the end.

Lisa
Moderation Team

[its2much]

22 cyclist

do you mind sharing your monthly insurance premium cost? I can't wait to see what the exchanges are going to provide in terms of care and cost.

[22cyclist]

Mine is 286.35 per month. It goes up the more I use it. When I don't use it as much it goes down. However, it is the cheapest one I could find that covers major medical. It is BCBS of NC Blue Advantage.

Take care
Lisa
Moderation Team

[rdmc]

Mine is 286.35 per month. It goes up the more I use it. When I don't use it as much it goes down. However, it is the cheapest one I could find that covers major medical. It is BCBS of NC Blue Advantage.

Take care
Lisa
Moderation Team

Whoa!
So your out of pocket counting premiums is $11.5K?

If it's a private policy, how did you get it to cover you since you have MS? Of course that's the good thing about the ACA they can't deny you, but there's nothing in the law that says you don't have to pay more if you have a pre-existing.

We've been fortunate because of the group insurance from my husband's work is good, even though we pay about $300 per month (that's spouse and employee)...family plan which we used to have is now $450 a month. My son's company has quit covering spouses, if they have insurance available through their workplace. So they've created a new category, employee plus children. Ours still has only 3, employee, employee and spouse, and family plan.

The copays have crept up over the years as have the deductibles and max out of pocket. But drugs have been the one thing they've kept manageable...even though you have to use their mail order pharmacy for a DMD (which I don't take anymore, so no issues there.) As far as the quote about pricier meds having higher copay (in the article) can't one get Tec for $10 per month. But if more DMDs bring heftier patient payments, will the drug company assistance be overwhelmed with those needing assistance? I'm still figuring out why Tec is $10 unless you have Medicare...that makes no sense to me.

Every year when the open enrollment comes around, I get the packet and see what's changed. Now with exchanges coming into play, and some employers opting to give money to their employees to buy on the exchanges...we'll just have to see how it plays out.

Thinking about it all, sort of boggles the mind. No wonder I keep hearing Bob Dylan in my head singing "The times they are a changin'"

[22cyclist]

I bought this policy before I had MS when my husbands employers stopped covering spouses. It was expensive then, and it is expensive now. However, I was healthy then and thought I wouldn't need it that much.

Lisa
Moderation Team

[rdmc]

I bought this policy before I had MS when my husbands employers stopped covering spouses. It was expensive then, and it is expensive now. However, I was healthy then and thought I wouldn't need it that much.

Lisa
Moderation Team

I understand.

Truth is, insurance, at any price, is a bargain for a lot of us MSers when you think about the bills we rack up.

But at some point, "bargain" or not, it can become unaffordable...that's the sad part. And depending on our circumstances, for some that's a lot sooner than for others.

That's why I'm interested to see what the exchanges will charge and what they'll cover. Being able to acquire insurance even with a pre-existing condition is a good thing, being able to afford insurance, is a whole other story. Being required to purchase it or pay a fine adds a whole new dimension.

I'm not ragging on the ACA or getting political, just realistic... having the IRS involved in it...reminds me of that line from the Twilight Zone episode, "Want to see something really scary." (sorry if I've offended any IRS employees who might be reading this...but I've had my experiences of waiting hours on the phone just to clear up a simple tax question )

[JerryD]

All of this conjecture over the ACA is overblown. It is the 'LAW' and we have to live by it! Let's all calm down and see how it rolls out. I am waiting to hear some news from those that it effects ina positive way. Good luck

[MSW1963]

Sticker shock...

Some states are opening Medicaid enrollment for low income applicants who didn't qualify before ACA, but may now qualify under ADA.

There will porobably still be folks who earn too much to qualify for Medicaid, but not enough to afford subsidized premiums, in my case for full time student/part time working dependent.

[onlyairfare]

I am one that could be helped by ACA. Having MS I cannot buy health insurance today at any price, due to pre-existing condition.

I was self-employed for many years and loved it, but realized I could no longer do that once I developed MS and couldn't buy insurance for myself or my employees.

In discussing the "cost" of health insurance, remember that the premiums we pay as employees are just a fraction of the real cost of health insurance. The cost of an average plan family plan for an employer is well over $20,000 per year; the employee pays a premium of $200 or $400 or whatever, the employer pays the rest.

My past experience with health insurance was like 22cyclist only worse. My husband lost his job, and my job at that time did not offer insurance. The COBRA insurance was $1,600+ monthly (nearly $20,000 per year), and then I was charged a 25% co-pay for my copaxone, which was $800 per month or $9,600 annually. Not to mention our other medication co-pays, office visit co-pays, MRI co-pays, etc. That's nearly $30,000 annually out of pocket we were supposed to pay to remain insured.

I quit Copaxone, we emptied our savings, we moved across country, eventually got new jobs with insurance.

There are many things I don't like about ACA, but it can't be worse than what we went through, which happens over and over again to many people in the US.