dagblog - Comments for "Helping the Working Poor -- A Practical Defense of PPACA"

The good part for you (and

Commodore — Sat, 03 Dec 2011 08:30:24 +0000

In reply to I think the problem is more,

The good part for you (and most people, especially people who have yet to see their health care costs go down) is on the way shortly.

The truly best part of the bill went into effect, by my count yesterday now, as it is 12/3/2011.

Health insurers now must pay 80% of the premium dollars they collect on actual health care. And if they cannot meet that, then they must send out refund checks to all insurees to cover the difference.

Best of all, the Department of Health and Human Services (HHS) also released the rules of what does and what does not constitute medical expenses for the purposes of meeting that 80% requirement, and they are not screwing around.

One example: For months, insurance brokers and salespeople have been lobbying to include commissions they earn for selling an insurer's program to be counted as a 'medical expense.' Yesterday, HHS ruled that this is NOT a medical expense.

I would expect a refund check and probably reduced costs coming YOUR way in the coming months. THIS is the good part for YOU.

I like a number of the

MrSmith1 — Mon, 28 Nov 2011 18:04:03 +0000

In reply to You are right Mr. Smith, that

I like a number of the talking points about the bill; obviously, the not getting kicked out because of a pre-existing condition thing, the young people being able to stay on their parent's health insurance until the age of 26, the mandate, which, libertarians' complaints to the contrary, I think will eventually bring down medical costs that citizens pay, not on themselves directly, but in the required support of local emergency rooms having to give non-emergency medical treatment to people without health insurance. That loophole was one that should have been seen and it seems naive to have thought that given the loophole, the HMOs wouldn't take advantage of it. Oh well.

You are right Mr. Smith, that

tmccarthy0 — Mon, 28 Nov 2011 16:12:25 +0000

In reply to I think the problem is more,

You are right Mr. Smith, that is the problem, where are the good parts for you? I can't answer that question specifically, although I wish I could. Community Health Advocates help people keep their coverage in NY State and possibly have information on how to get subsidies for the rising cost of health insurance in your area. They would have better advice than I have on the particulars of your case.

Another excellent resource is Health Care for All New York. This year one of their proposed legislative goals is to challenge proposed health insurance rate increases under the newly reinstated prior approval process. This includes submitting letters in opposition to proposed rate increases, determining if rate increases can be justified (will require us to obtain insurer memos currently not public), and monitoring the prior approval process. This seems like your particular issue, because it seems some insurers in NY have dramatically upped premiums for certain subscribers, because of a loophole. I would like to think HCANY could offer some assistance.

I wish I could offer you more information.

I think the problem is more,

MrSmith1 — Mon, 28 Nov 2011 03:37:53 +0000

In reply to Helping the Working Poor -- A Practical Defense of PPACA

I think the problem is more, "if it's a problem for me, then I don't like the bill." People are judging the bill not on how noble it is or on all the good things it does, they are looking at whether or not their health insurance premiums are going up or not, and for a lot of people they are going up. Period. End of discussion. The arguments against the bill are just rationalizations that people use as cover, so they don't have to appear to be whining about their own health care problems. Insurance costs may be coming down, but those dang capitalist HMOs are still raising premium rates.

I'd like to be generous and feel good about all the wonderful things the bill accomplishes for other people, but my premiums in January of 2012 are scheduled to go up to a point where I will be paying nearly 33 % of my yearly salary for my health insurance. I am the working poor. In the last couple of years, I've seen my premiums go up in leaps and bounds, nearly tripling the amount I pay per quarter. So, if there's no public option, I'm going to be ticked off about any bill that allows my premiums to continue to go up, even if it helps a lot of other people who are worse off than me. Admittingly, I've probably been thrown into the 'high risk' group; because I'm one of the millions of people who take Anti-TNF meds like Enbrel and Remicade, which are expensive and HMOs hate to pay for, but even so... I thought the health care bill was supposed to lower my premium rates, but instead, my HMO has dramatically raised my rates twice since the bill passed. I can intellectually approve of all the good things the bill accomplishes, but how enthusiastic can anyone really get about a bill that does not affect their own situation in a positive way? I think a lot of Americans would support this bill, but, as in most things, they wonder, where's the good part for ME?