Streams

The ACA Enrollment Deadline is Today

Monday, March 31, 2014

Initial reports indicate that Obamacare is on track to meet the enrollment goal of 6 million people, but the state-by-state landscape is much different. Sarah Kliff, senior editor at the soon-to-be-launched news site Vox.com, explains why some states, like Connecticut and New York, have done well and why others, like New Jersey, have done so poorly.

 

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Sarah Kliff

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Comments [32]

Affordable Care Act a Problem for Many Seniors

The Affordable Care Act defines "affordable" as health insurance that costs you less than 9.5 percent of your income.

At 100%-133% of Federal Poverty Level [FPL] 2% of your income should be the ACA monthly premium.
At 133-150% FPL: 3-4%.

In NYS, at or under 138% of FPL, you will be referred to Medicaid to sign up.

Medicaid income limits are increased in 2014. Those newly eligible will have the full Medicaid benefit package except institutional long term care. New Medicaid income limits are 138% of federal poverty guidelines: Individual $15,856/year
Family of 2 $21,404/year
Family of 3 $26,951/year

Now here is the shocking part:
The old Medicaid budgeting limits will continue to apply to most people who qualify for Medicaid based on disability, blindness, or being age 65 or over.... Note that you don’t have to be enrolled in these programs to be disqualified for subsidies; just being eligible for one of these programs is sufficient to disqualify you.

So if you qualify for Medicaid and are over 65 years of age the new
"Medicaid income limits are increased in 2014" does not apply to you.

The "old Medicaid budgeting limits" for two is $1192 monthly or 1192 X 12 = $14,304 yearly.
The difference HAS TO BE PAID TO NYS MEDICAID AS A PREMIUM.
So the family of 2 at $21,404 would be surpassing the "old Medicaid budgeting limits"
which is $14,304.
The difference of 7,100 would have to be paid to Medicaid as a spend down [premium].
That is 33% of income!!

A couple with total monthly Social Security of $1527 after the - $1192 ["old Medicaid budgeting limits" for two is 1192] would have a $335 monthly spend down/premium or 21.65% of income! Why would NYS Medicaid want $335 month, when, if those Seniors have Medicare Part A, all in-hospital care would be directly paid by Federal Medicare Funds?

What a con, when the Affordable Care Act defines "affordable" as health insurance that costs you less than 9.5 percent of your income.

So the poor over 65 years of age get to pay as much as 33% of their Social Security for health care while a the same time they got a decrease in Food Stamp allowance!

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Apr. 09 2014 11:48 AM
Denise from Long Island

I caught the tail end of this segment, and found myself yelling at the radio while driving, when I heard the 34-year-old guy calling in toward the end, saying he was weighing a plan that would be about $3,000 annually, versus the $1500 he'd be fined if he didn't sign up, and in the end decided to take the penalty because he wanted to save for a house. I was wishing Brian or his guest would have asked the guy, has he thought of what it would cost if he got injured or sick? Statistically, a man that age is likely to get hurt, and he's definitely aging out of the youth-takes-care-of-everything era. So, dude: You go snowboarding and break an ankle and need complicated surgery to put pins in your bones and get physical therapy? If you've already bought that house you're saving for, say goodbye because hospitals charge full whack if you're uninsured. And under the law, any plan has to provide essential benefits like check ups and immunizations. Get a plan, get a check up, be sure you're healthy. Cancer? Early heart disease? Injury? It's not just a simple, $3,000-versus-$1500 calculation. [Rant over!]

Mar. 31 2014 07:09 PM
jm

Dboy: "Sara Horowitz lobbied AGAINST healthcare reform to protect her newly formed health insurance corporation."

Do you have any links? I don't doubt this is true, and I was already suspicious about their supposed mission when they refused to work with the ACA.

I get the impression those raving about FU have only used them for the last year or so.

Mar. 31 2014 11:19 AM
Freddy from bushwick

Many of the people who are saying that they are not making much money and still can't afford ACA, may want to visit a navigator to walk them through. My friends and I had an Obamacare Signup Party last night and were knocked out how much we CAN afford considering our status as freelancers. I'm paying $77 a month--which includes dental! I encourage everyone who says they can't afford ACA to reach out to a navigator because there is a way for everyone to afford this.

Mar. 31 2014 11:05 AM

ALSO:

Sara Horowitz lobbied AGAINST healthcare reform to protect her newly formed health insurance corporation.

Freelancers "Union" is TOTAL BS!

fyi: Horowitz also sits as deputy chair of the New York Fed...

Mar. 31 2014 11:03 AM
jm

Dboy, correct!

My sister was on a mid-level Freelancers Union PPO plan, and was fortunately able to switch to Healthy NY during her pregnancy. She saved $6000 in labor and delivery costs.

And there is really no "Freelancers Union" other than the for-profit insurance. They bill themselves as an advocacy group, but other than useless "motivational" Facebook articles they serve no other purpose.

Mar. 31 2014 11:01 AM
jm

I just realized why my international friends are so energetic and entrepreneurial - they don't have to spend 50% of their energy stressing out about health coverage.

Imagine what US could accomplish if we removed this obstacle through some form of universal coverage. In addition to the other economic benefits (mainly, increased competition for workers without health insurance as compensation), we'd be better equipped for innovation and risk.

There's your "jobs bill!"

Mar. 31 2014 10:57 AM

AMEN, MikeInBk from Clinton Hill!!

Mar. 31 2014 10:57 AM

fyi:

Freelancers "Union" is not a union, but a FOR PROFIT insurance company!!

Their plans SUCK!

One example:

A friend was in the hospital with a serious, but not life-threatning condition - 3/4 days. He had the absolute BEST Freelancers "Union" plan. Two years later, he's still negotiating the $20,000 portion that the so-called union doesn't cover.

Buyer beware!!

Mar. 31 2014 10:55 AM

All of these "pesky" financial details (future policy costs, future penalties, future taxes, tax-penalties, and how they will be collected are all subject to the same moral hazard as "If you like your health insurance policy, you can keep your health insurance policy."

Mar. 31 2014 10:51 AM

Brian, along with the caller Lisa who is complaining about the price of her plan, my dh and I are in the same position. We pay $20,000 a year for our current policy DESPITE my husband being eligible for Medicare. Even if he signs up for Medicare, our family plan is still the same price. It is NOT a great plan and more expensive.

The other side of the equation is that both my husband and I are health care practitioners and we have to deal with the random acts of rejection that is the maze of the chaos of the insurance industry. My husband is established enough that he is offloading all sorts of plans and moving towards clients who pay out of pocket.

Unfortunately, the response of the insurance companies to the Affordable Care Act provision to the mandate to provide free breast pumps and free lactation services is actually destroying one profession that it should have helped. The Surgeon General stated Board Certified lactation consultants should be reimbursed. This is because pediatricians and obstetricians get minimal training in breastfeeding management and the American Academy of Pediatrics recognizes this fact. Nevertheless, many of the insurance companies are insisting that only MDs get reimbursed. Previously many women were willing to pay for lactation services. Now they wait or go to MDs who don't know anything at all about breastfeeding management and they end up with far worse iatrogenically induced problems than I have seen in my 12 years in this profession. Excellent practitioners who have been seeing women for many years with very thorough care are now going out of business because of the insurance company response to the ACA.

And the breast pumps? Literally I have seen such crappy junk pumps that I unapologetically label some of them torture devices.

Mar. 31 2014 10:51 AM
MikeInBk from Clinton Hill

Again, how stupid this all is. Because of gutless politician and the short sightedness and gullibility of the American population, we end up with this kind of nonsensicle type of system(s).

Somehow it is easier to sell to Americans the idea of paying high monthly premiums vs. paying small tax increments to ensure health coverage for all -- Premiums that probably are more costly than what would be paid in taxes.

How moranic!

Mar. 31 2014 10:50 AM
jm

Tina: I've been using Freelancers Union since 2007, and only when the threat of competition in the form of the ACA was solidified did they begin improving their customer service. Although I do like their Brooklyn facility, it's too little too late for me.

I'm still relatively healthy and am willing to risk the uncertainty of an ACA plan as a placeholder to ensure we can all continue to have real choices in the future.

Mar. 31 2014 10:50 AM
CC Washington Heights from NYC

There are a batch of retiring parents with college bound kids. Colleges are cutting back on student insurance plans. What's the best option for these kids?

Mar. 31 2014 10:49 AM
Truth & Beauty from Brooklyn

I'm sorry but these people calling in saying that they can't afford the premiums are either lying or just don't want to pay for this. If they can't afford premiums, they are eligible for Medicaid. If they go on line and sign up for regular insurance, they will find that the Feds will subsidize them to a great extent. My husband and I got a more than sufficient subsidy and the care that we are getting is pretty comprehensive.

The other thing these people don't understand is that if they think they can't afford insurance now, they should contemplate possible bankruptcy if they wind up needing coverage and haven't got it. I was assaulted a few years ago, which was not a health issue, but an injury issue, and if I hadn't had insurance at the time, I'd still be digging myself out from under the financial burden. This is literally the ounce of prevention that will cost less than the pound of cure.

Mar. 31 2014 10:49 AM
Jeff from New York

Also, my girlfriend signed up through ACA in NY with no problems last week and got better coverage than I have for $90/mo!

Mar. 31 2014 10:49 AM
Robert from NYC

ACA sucks! It is, and Obama and Baucus make sure it is, to the advantage of the insurance companies. It doesn't cover most stuff costs too much on the individual.

Mar. 31 2014 10:49 AM

LOL, your callers are NOT supporting your Obama talking points, Brian.

Yikes! Maybe this really IS a knucklehead law.

Mar. 31 2014 10:48 AM
Jeff from New York

Tell your previous caller who runs her own business to join Freelancer's Union. They have excellent coverage starting at $225/mo.

Mar. 31 2014 10:47 AM

Save the horsesh*t: SINGLE PAYER!

Mar. 31 2014 10:46 AM
J M from UWS

Where does this British woman live? On the NYS exchange $800 is a platinum plan. There are plenty of gradations below that, and the subsidies make them even lower.

Also, please note that in the NYS exchange there is no gradation according to age. It's the same rates for everyone.

Mar. 31 2014 10:46 AM
inwoodite from NYC

I'm gonna have to go with a medical discount plan, because I have credit card debt that I'll never be able to pay down if I pay $419 a month for health insurance. I'd love to pay in and help Obamacare work, but I can't. They don't give subsidies to people with "bad" debt.

Mar. 31 2014 10:45 AM
Peg

Seems like there will be many people who will not be able to keep up monthly payments. Sounds like an ACA accounting nightmare.

Mar. 31 2014 10:44 AM
Dee from NJ

I tried to sign up and it is incredibly expensive. I am in your callers age group and I have given up. I have just sold my house and am returning to Canada. This system, even with the ACA is a mess.

Mar. 31 2014 10:42 AM
Tina Suszynski from East Harlem

Caller "Jersey Girl", go to Freelancers Union for your health insurance. They're great. You won't qualify for Medicaid without a proof of income. If you are starting your biz and you can't show income, they won't help you. Contrary to that, they will start to ask you for your lease and proof of how you're paying your bills--very invasive information.

Freelancers has a range of packages and they are totally better than what's available on the exchange when I compare what I have had to what my friends have via the health exchange.

Mar. 31 2014 10:41 AM
carolita from nyc

Doesn't anyone know that age-discrimination is allowed under Obamacare as part of a compromise that was made to actually have it at all?

Mar. 31 2014 10:40 AM

Hey, Brian, maybe the low Jersy enrollment has some thing to do with Bridgegate.
Yummy ... let's roll out a segment on that !

Mar. 31 2014 10:40 AM
Mike from Brooklyn, NY

Hello. I'm currently insured, but my coverage will unexpectedly end in a week. What are my options?

Mar. 31 2014 10:39 AM
Ed from Larchmont

Of course the numbers are up ... people lost their insurance, had no place else to go.

Mar. 31 2014 10:37 AM

PLEASE DISCUSS - premiums on these plans will CONTINUE to increase, starting even in April, because the risk pool is turning out to be way below expected and because the administration is handing out so many exemptions (e.g. if your “income has changed in the past year” ... duh!).

Barry O’Bummer will then go on TV and blame these rising costs on … the insurance companies!!
(... And then Brian will parrot that talking point here in between Bridgegate segments)

Mar. 31 2014 10:04 AM

Hoo-ray! I hope this is done as an issue but I *know* that the GOP will not let it be so...It's the only arrow in their election hopes quiver.

Against Obamacare, the GOP needs to explain -
-near constant filibuster of Presidential appointments
-delaying the budget to the point where the nation lost its AAA credit rating
-shut down of the Federal government
-termination of long term unemployment bennies while do little or nothing to raise employment
-stalling of the immigration bill.

If voters don't go to the polls to express their anger over the obstruction, over putting donors and party above the peoples' will, we are giving consent to it.

The election is in 218 days, make up your mind not to let TP and GOP obstruction become the way our country is run. Make up your mind to vote on November 4...and convince two friends who are a little 'meh' on why they need to vote, too.

Mar. 31 2014 09:57 AM

Brian – Please tell both sides of the story here (for once) beyond these meaningless website “sign-ups”/visit numbers.

“The administration has 'cooked the books' on ObamaCare numbers,” John Barasso ® Wyoming said on Sunday morning news shows.

The administration admits that it won’t reveal(!) the actual numbers of:
-How many young people have signed up? (!)
-How many people have actually bought and begun paying for a plan? (!)
-How many are signing up only because they lost their other insurance due to …Obamacare? (!)
-How many are actually the “uninsured”. (!)
-How many will be paying more for these plans than they paid their old plans. (!)
-How many will be able to “keep their doctor if they like their doctor”. (!)

The Obama administration is “cooking the books” (i.e. “LYING” for NYC public school grads) once again. Barry has gotten so comfortable with the Obama media/NPR letting him say (or not say) anything he wants to say (or not say), that he lies adroitly and serenely now as a matter of course.

PLEASE DISCUSS IN (BRIDGEGATE-LIKE DETAIL) WHY THE ADMINISTRATION MIGHT BE WITHOLDING THIS BASIC DATA.

(P.S. – any detailed numbers that you “read” have not come from the regime, but independent estimates)

Mar. 31 2014 09:47 AM

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