ACA Probably Not Affordable – But Who Knows?

October 24, 2013

By Karen

I’ve been writing about the ongoing agony of being individually insured by Anthem for years now, so I should follow up with my 2 cents on the debacle called the Affordable Care Act.

I’m not surprised that we couldn’t get a working website after 4 years. Government bureaucrats are good at discussing problems, never solving them.

Virginia’s Republican governor, Bob McDonnell, is among those who turned his back on any responsibility to help citizens get health insurance in favor of the federal exchange.

I first tried to log on to healthcare.gov Oct. 4 and couldn’t get in. I tried again Oct. 23 and it seemed to work better. I didn’t have to create an account to browse the plans — for all the good that did.

Apparently, the quoted premiums are garbage unless you’re exactly 20 or 50, so I accomplished nothing but to upset myself.

Currently, my Anthem policy has an 80/20 split, a $2,500 annual deductible, and includes dental. I pay $392 a month.

Anthem has been cheerily reminding me that I’m “grandfathered” in and can keep this plan. Since it’s outside the exchange, I suspect that means Anthem can continue to stick it to me good with rate hikes, so they don’t want me defecting to the exchange.

I learned that my 80/20 plan is considered “gold” on the exchange. A silver 70/30 plan without dental runs a 50-year-old roughly what I pay now. So, at 59, I assume my coverage will be considerably higher.

I suspect I’m royally screwed no matter what, but I’ll get my insurance agent to confirm that later in November. Hopefully, by then there will be accurate pricing available SOMEWHERE.

It’s exactly as I’ve predicted. With insurance company profits still a factor, and Republicans offering NO alternative but to go backward, it’s going to take more employers dropping health insurance as a benefit, and more Americans going broke trying to pay for insurance before we get serious about single-payer.

Amazing, I find myself agreeing with Ken “Cuckoo” Cuccinelli, our Republican attorney general who wants McDonnell’s job as governor this year. We both think Kathleen Sebelius needs to go.

Her utter inability on The Daily Show with Jon Stewart Oct. 7 to make a clear, compelling case for the ACA, or to give the slightest reassurance it’s going to get better, was shocking.

Lady, you’ve had FOUR YEARS!!

Where was she while the cost of that catastrophic mess of a website TRIPLED and went into the pockets of Canadian software developers? How many hundreds of millions must be squandered to get it right now?

Obama should kick asses and hand out pink slips. Everyone responsible for this disaster deserves to lose their cushy government healthcare and end up on the exchange they couldn’t set up.

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Anthem Cut the Crap (Finally)

March 28, 2008

By Karen

After nearly 3 months, Anthem has approved my cheaper policy. It essentially rolls back my premium two years in exchange for me shouldering more out-of-pocket expenses. I don’t know if I’ll really come out ahead in the end, but right now I’m betting on continued good health.

Anthem put me at premium Level 2. Level 1 would have been cheaper, but here’s how that works:

In 2003 when I first applied, I took no medications and my health was nearly perfect for someone my age. Anthem made me Level 2 by dredging up an old stress fracture in my toe from too much ballroom dancing and a few other one-time things.

In other words, unless you’re 18 and have never seen a doctor in your life, you’ll never qualify for Level 1.

This time my Level 2 rating was for my “unoperated hiatal hernia.” That means it gives me no trouble and requires no treatment – but unoperated sounds scarier.

Anthem explains (bold emphasis is theirs), “Even if you are currently healthy and have no immediate health problems, your chances of needing medical care are greater than someone who does not have similar health conditions or lifestyle characteristics.”

They’re referring, of course, to someone who is already dead.

Apparently, that was the best they could do, since my harmless freckle and a blood pressure reading in the 120s over 80s didn’t pan out as crises.

They were so relentless about digging into my records, I really expected a bump into Level 3 to end up paying even more for less coverage. That’s how individual health insurance works.

So I’ll be saving $110 a month at least until December when they hit me with another huge rate hike and I’m back where I started.

I’m 12 years from qualifying for Medicare. If insurance companies are allowed to continue reaching for the moon for profits, at some point I could join the 47 million Americans who can’t get or afford coverage unless I find some employer to cover me.

Politicians of both parties, please, please, please end this nightmare. Passing HR 676, the universal healthcare bill that’s been sitting under your noses since 2005, would be a good place to start.


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