IWETHEY v. 0.3.0 | TODO
1,095 registered users | 0 active users | 0 LpH | Statistics
Login | Create New User
IWETHEY Banner

Welcome to IWETHEY!

New The PPACA strikes my daughter.
Today my daughter turns 26 years of age. I was just informed by HR that she no longer has health insurance. This is the first notice I'd received. We switched carriers last year and our old carrier (like most) had a policy of continuing coverage until the end of the month the dependent turned 26. Foolishly, I believed such was the case up until this morning's visit by HR.

I think Obama will go down in history as the most ineffectual President in our history. The PPACA was a Pro-Corporate, Republican bill that with a super majority in the Senate and a majority in the House took all his effort to get passed. And he only got it passed by making the House strike down their included and passed Public Option (iow, by his donning of both the armband and the jackboots).

We are completely screwed by this nonsense.

Last week the trustees of the Medicare program, whose 50th anniversary is this Thursday (see accuracy.org/calendar), released their annual report. It showed that traditional Medicare overhead amounts are about 2 percent of the program’s expenditures. That figure sharply contrasts with the 12 percent to 14 percent overhead typical of private health insurance companies.

http://www.accuracy.org/release/medicares-50-years-of-low-overhead-vs-acas-increasing-bureaucratic-bloat-merger-mania/
Between 2014 and 2022, CMS projects $2.757 trillion in spending for private insurance overhead and administering government health programs (mostly Medicare and Medicaid), including $273.6 billion in new administrative costs attributable to the ACA. Nearly two-thirds of this new overhead—$172.2 billion—will go for increased private insurance overhead (data not shown in table).

Most of this soaring private insurance overhead is attributable to rising enrollment in private plans which carry high costs for administration and profits. The rest reflects the costs of running the exchanges, which serve as brokers for the new private coverage and will be funded (after initial startup costs) by surcharges on exchange plans’ premiums.

Government programs—primarily Medicaid—account for the remaining $101.4 billion increase in overhead. But even the added dollars to administer Medicaid will flow mostly to private Medicaid HMOs, which will account for 59 percent of total Medicaid administrative costs in 2022. (The subcontracting of Medicaid coverage to private HMOs has nearly doubled Medicaid’s administrative overhead, which has risen from 5.1 percent of total Medicaid expenditures in 1980 to 9.2 percent this year).

The $273.6 billion in added insurance overhead under the ACA averages out to $1,375 per newly insured person per year, or 22.5 percent of the total federal government expenditures for the program.

http://healthaffairs.org/blog/2015/05/27/the-post-launch-problem-the-affordable-care-acts-persistently-high-administrative-costs/

It's enough to make you want to vote for Trump.
New Look through a longer lens.
I think Obama will go down in history as the most ineffectual President in our history.

He'll go down in history as the first black man to be President.

That, first and foremost, is what he will be remembered for.

No-one will remember the fine detail of the ACA, just that happened, and that Obama made it happen. In the same way that few people nowadays can tell you the details of The New Deal, just that it happened and it was Roosevelt who made it happen.

Scholars of political history will note that he managed to get a certain amount of shit done, despite the full-blooded attempts of the most obstructive House and Senate ever.

And those scholars will observe that the ACA, despite its imperfections, extended health insurance to a metric shitload* of Americans who never had it before.

Things you have to remember about any large-scale changes to any large-scale system:

1. It will make someone worse off
2. Someone will game the changes
3. It'll cost a lot, and probably more than you'd expected or hoped

These are not reasons to not change.

*Well, maybe not a metric shitload.
New How do you understand US politics so well?
Is it from hanging out here, or does our shitshow even appear on your TV?
--

Drew
New You know how you don't know who David Davis is, or what he does?
Well, that's because he's not on your news or TV.

The reverse situation is not true. You could take any reasonably-aware Brit and the odds are good that they can correctly identify (by job/role, if not pick out of a photo lineup) Sanders, Warren, Trump, Pence, Clinton, McConnell, Christie, Romney, Santorum, Guliani, Biden, Powell - indeed, any number of prominent US politicians past and present.

Compare and contrast:

https://www.theguardian.com/us-news (OK, it's all Trump all the time right now, but that's to be expected)

http://www.nytimes.com/pages/world/europe/index.html

Seriously, no-one gives a crap about the Isle of Man. And that includes the people who live on the Isle of Man.
New I did not have medical insurance until I was 45 lost it when I was 55, shrug
always look out for number one and don't step in number two
New gotcher armband & jackboots right here
I'm not sure that I quite understand your account. First, would the mmoffitt moppet have enjoyed coverage to 26 under your health plan prior to the passage of the ACA? And second, is it the fact that this coverage has now ended on 21 September rather than 21 October that has you fulminating that Obama is an ineffectual fascist dictator*? And finally, could you please write your congressional delegation about the PPACA being a Pro-Corporate, Republican bill? 'Cause the GOP keeps voting to repeal the thing
It's enough to make you want to vote for Trump.
Who is this "you" to whom you refer? None of the rest of us here, I wot.

You know, I could actually see you going all True Believer on us and flipping polarities: you could be a full-throated Trumpista by November, convincing yourself that by your vote you'll be helping to make America great again. David Horowitz blazed that trail for you decades ago (although frankly I think you lack the innate thuggishness required to be a proper Horowitz).

cordially,

*See, you've got the doublethink bit down already: Obambi the tyrant. Really, I think that with a very little attitude tinkering you'll fit right in with the majority of your fellow Hoosier voters who will plight their troths to Trump (and was ever an archaic verb more aptly deployed!) several weeks from now.
Expand Edited by rcareaga Sept. 21, 2016, 10:37:48 AM EDT
New Re: second, ...
Did I pay the full premium to cover her until the end of September?
Yes.

Will she receive coverage until the end of September?
No.

Why?
Because the ACA allows it.

So, the private corporation to whom I must send money on pain of an IRS fine is allowed to sell me something they have no intention of delivering. Moreover, these private corporations are able to reduce the risk of claims payment, yet keep the money derived from the calculation of a monthly premium based upon the assumption of the full risk. You care to explain how this is not tilted toward corporate profit interests over consumers?

Once you've done that, perhaps you'd like to explain why the ACA allows for a 20% overhead when even most private corporate health insurers average between 12% and 14% overhead (contrast with Medicare at 2% overhead despite the fact that Medicare pays almost half of all medical claims filed in this country)? How is that not legislating an extra 6% to 8% profit for private health insurers?

If you can manage to do that, perhaps you can explain why, if the ACA is "good for people" and not a neo-fascist piece of pro-corporate legislation, there's going to be an additional "$273.6 billion in new administrative costs attributable to the ACA" over an eight year period. Guess where that money's going? Private Health Insurance companies, NOT for healthcare.

I await the crickets.

Oh, by the way, I never meant to imply Obama was a tyrant. I saw him for what he was in 2007 and am sad to say what he remains: YAN corporate tool.
New Point of order...
No offense, but your post really went off the rails after the first paragraph.

DOL:

Q1:How does the Affordable Care Act help young adults?

Before the Affordable Care Act, many health plans and issuers could remove adult children from their parents' coverage because of their age, whether or not they were a student or where they lived. The Affordable Care Act requires plans and issuers that offer dependent child coverage to make the coverage available until the adult child reaches the age of 26 [not until the end of the month]. Many parents and their children who worried about losing health coverage after they graduated from college no longer have to worry.

Q2:What plans are required to extend dependent child coverage up to age 26?

The Affordable Care Act requires plans and issuers that offer dependent child coverage to make the coverage available until a child reaches the age of 26. Both married and unmarried children qualify for this coverage. This rule applies to all plans in the individual market and to all employer plans.

[...]

Q13:It seems like plans and insurers can terminate dependent child coverage after a child turns 26, but employers are allowed to exclude from the employee's income the value of any employer-provided health coverage through the end of the calendar year in which the child turns age 26. This is confusing.

Under the law, the requirement to make adult coverage available applies only until the date that the child turns 26. However, if coverage extends beyond the 26th birthday, the value of the coverage can continue to be excluded from the employee's income for the full tax year (generally the calendar year) in which the child had turned 26. For example, if a child turns 26 in March but is covered under the employer plan of his parent through December 31st (the end of most people's taxable year), the value of the health care coverage through December 31st is excluded from the employee's income for tax purposes. If the child stops coverage before December 31st, then the premiums paid by the employee up to the time the plan was stopped will be excluded from the employee's income.

Q14: I'm a young adult currently covered on my parents' health plan. What are my options for health coverage once I reach age 26?

Once you reach 26 and "age out" of your parents' coverage, you may have several options. If you (or your spouse) are employed and that employer offers a health plan, ask whether you are eligible for coverage under that plan. Losing coverage under your parents' plan may qualify you for special enrollment in any other employer plan for which you are eligible. Special enrollment in another employer plan must be requested within 30 days of your loss of coverage.

If your parents' plan is sponsored by an employer with 20 or more employees, you also may be eligible to purchase temporary extended health coverage for up to 36 months under the Consolidated Omnibus Budget Reconciliation Act (COBRA). To elect COBRA coverage, notify your parents' employer in writing within 60 days of reaching age 26. In turn, your plan should notify you of the right to extend health care benefits under COBRA. You will have 60 days from the date the notice was sent to elect COBRA coverage. If your parents' plan is sponsored by an employer with 20 or fewer employees, you may have similar rights under State law, instead of under COBRA. You should ask your parents' employer, or your State Insurance Department if this applies, and if so, how you would request the extended coverage.

You may be eligible for special enrollment in individual coverage purchased through the Health Insurance Marketplace. To special enroll in Marketplace coverage, you must enroll within 60 days of aging out of your plan. For more information or to enroll, visit HealthCare.gov.


Check all the deadlines above. She's got ways of getting coverage - something that she wouldn't have under the pre-PPACA law if, say, she had an expensive pre-existing condition...

Hang in there.

Cheers,
Scott.
New You're missing the point.
Example: You have one child aged 25 with a birthday on February 2 (the child will turn 26 on 2/2/2017). You're employed and purchase a "Family" healthcare plan from your employer. You're contribution to the "family" plan is $500.00/month (there is also an "Employee + Spouse" plan that would include a monthly contribution from you of $300.00 per month). You have to select a plan in December, 2016 that will be in effect from 1/1/2017 through 12/31/2017 *and you cannot change your plan selection until contract renewal time*, in this case, December, 2017. In December 2016 you do not want your child's healthcare coverage to lapse, so you sign up for the family plan. In January, 2017 you have $500.00 deducted from your paycheck for the "family" plan for the month of February. However, one member of your family is covered for exactly one day. Because in March the ACA forbids you from continuing to cover your child under your health insurance policy and because the private health insurer will not allow you to change plans mid-cycle, each month you will continue to pay the $500.00 out of your check for the "family" plan despite the fact that a member of your family is not covered AT ALL for the period beginning February 2 and ending December 31. That will mean you will be getting $200.00 per month LESS coverage than you are paying for. Looked at another way, you'll be shoving yet another $200.00 per month out of your pocket into the already bulging pockets of a private health insurer.

This is *ALL* permitted by the ACA.

I so rarely get to tout anything about Indiana, I must take this opportunity. In 1999, I worked for a health insurance company in Indiana. Covering children up to age 24 and a prohibition against denying coverage for pre-existing conditions was already state law (the pre-existing exclusion was a meaningless intensive, but that's another story). Also, yesterday I was pleasantly surprised to discover that Indiana has a healthcare plan that my daughter can purchase for about a tenth of anything available on the ACA's exchanges. There are some caveats, of course. Because of the myopic vision of the authors of the ACA, it is *still legal* for healthcare providers to refuse to care for patients with the type of insurance of which I speak. Note: this insurance is only available to people who earn less than $16,000 and change per year. Still, it's better than nothing.

The ACA is an abomination. It should be repealed and replaced with a "Medicare for All" plan.
New it is *still legal* for healthcare providers to refuse to care
it is *still legal* for healthcare providers to refuse to care for patients with the type of insurance.

So one should be forced to work for substandard wages per government fiat?
always look out for number one and don't step in number two
New Providing healthcare? Yes.
And who said it was "substandard rates"? The bastards that put artificial hips in bedridden 90 year olds for $446,000 or more a year (that's the fricking median income)? You gonna listen to those assholes when it comes to "reasonable fees"?
New You're whining.
Were you born on Christmas? Some people are. That's not fair to them, either.

The ACA is an abomination. It should be repealed and replaced with a "Medicare for All" plan.


While you and President Trump are giving out ponies, I'll take a Shetland and Chincoteague. Thanks!!!

;-p

Cheers,
Scott.
New Serious question.
Whenever the topic of "Single Payer" comes up, you (or perhaps Rand or perhaps both or perhaps others) draw analogies to unicorns and rainbows and/or ponies.

Clearly, a Single Payer system *can* replace a for-profit health insurance system. All one need do is look a little north of here and/or observe health care delivery systems in most Western Democracies and/or around the world. So, what is it really that makes a "Single Payer" solution here a fantasy? Do you hold that we are just plain too stupid to do it or that our government is just plain too corrupt to do it? It's got to be one of those two as far as I can tell.
New Serious answer
Because every time someone gets close to taking a real step in that direction the purity ponies who want a giant leap give a big "fuck you" to the pragmatists and leave the vandals in charge for another round.
--

Drew
New By "Pragmatists" you mean capitulators, right?
Follow up question. Canada didn't need a baby step, why do we? Pick (1) or (2) from previous question.
New Canada's system started in a few provinces then went national.
It took decades.

http://www.hc-sc.gc.ca/hcs-sss/pubs/system-regime/2011-hcs-sss/index-eng.php

Before World War II, health care in Canada was, for the most part, privately delivered and funded. In 1947, the government of Saskatchewan introduced a province-wide, universal hospital care plan. By 1950, both British Columbia and Alberta had similar plans. The federal government passed the Hospital Insurance and Diagnostic Services Act in 1957, which offered to reimburse, or cost share, one-half of provincial and territorial costs for specified hospital and diagnostic services. This Act provided for publicly administered universal coverage for a specific set of services under uniform terms and conditions. Four years later, all the provinces and territories had agreed to provide publicly funded inpatient hospital and diagnostic services.

Saskatchewan introduced a universal, provincial medical insurance plan to provide doctors' services to all its residents in 1962. The federal government passed the Medical Care Act in 1966, which offered to reimburse, or cost share, one-half of provincial and territorial costs for medical services provided by a doctor outside hospitals. Within six years, all the provinces and territories had universal physician services insurance plans.

From 1957 to 1977, the federal government's financial contribution in support of health care was determined as a percentage (one-half) of provincial and territorial expenditure on insured hospital and physician services. In 1977, under the Federal-Provincial Fiscal Arrangements and Established Programs Financing Act, cost sharing was replaced with a block fund, in this case, a combination of cash payments and tax points. A block fund is a sum of money provided from one level of government to another for a specific purpose. With a transfer of tax points, the federal government reduces its tax rates and provincial and territorial governments simultaneously raise their tax rates by an equivalent amount. This new funding arrangement meant that the provincial and territorial governments had the flexibility to invest health care funding according to their needs and priorities. Federal transfers for post-secondary education were also added to the health transfer.

In 1984, federal legislation, the Canada Health Act, was passed. This legislation replaced the federal hospital and medical insurance acts, and consolidated their principles by establishing criteria on portability, accessibility, universality, comprehensiveness, and public administration. The Act also added provisions that prohibited extra billing and user fees for insured services (see this brochure's section on the federal government for further details).

Federal legislation passed in 1995 consolidated federal cash and tax transfers in support of health care and post-secondary education with federal transfers in support of social services and social assistance into a single block funding mechanism, the Canada Health and Social Transfer (CHST), beginning in fiscal year 1996-1997.


HTH.

Cheers,
Scott.
New You didn't say "Single Payer". You said "Medicare for All"
Medicare isn't "Single Payer" the way people think of what SP means. Medicare doesn't pay for everything. People on Medicare usually have supplemental insurance (A,B,D, private, etc.). People pay Medicare premiums, and have to pay more for more coverage. J's parents had Medicare and BCBS.

Canada isn't "Single-Payer". You can buy BC insurance up there.

I don't have much patience for "let's throw it all away and start over with something that will obviously be perfect because reasons" type of arguments.

What Medicare/Single-Payer system are you advocating that has been demonstrated to work in a large modern country, and cover everyone, and not have a significant private management/gatekeeper element (since that's what's so Evil about the PPACA, amirite)? Please be specific. And tell me how you're going to get the House, Senate, and President to go along and pass/sign it.

Thanks.

Cheers,
Scott.
(Who is all for expanding Medicare but who doesn't claim that that would address all the things that the PPACA does so we should throw it away.)
New Re: What Medicare system are you advocating ... Yes. That one.
Premium Billing: Handled.
Benefit Definition: Handled (Although not being completely familiar with Medicare benefits at this point, I believe they'll probably need to be extended to cover things like pregnancies, childhood immunizations, pre-natal care, and so on.) I'm advocating for a national plan that is essentially a hybrid of the existing Medicare and Medicaid programs.
Claims Payment: Handled and *vastly* more efficient than private health insurers.
Everyone covered: Yes. It's merely an extension of everyone being covered once they turn 65 or are living below the poverty line now.

This isn't hard. Every other country has done it. We pay more and get less because we're idiotically paying people in our system that have nothing to do with the delivery of healthcare. In fact, some of those people we're paying are people who have a monetary interest in denying healthcare.

The combined total of healthcare expenditures by the government (State programs and Federal) already amount to 2/3 of all healthcare expenditures (see here: http://www.pnhp.org/news/2016/january/government-funds-nearly-two-thirds-of-us-health-care-costs-american-journal-of-pub )

The balance is paid for by private health insurance. The private health insurance *only* pays medical claims for the most healthy of us. That leaves a "margin" absent in the public system. But that margin is money people pay for healthcare services that they are not going to receive. Instead that money is diverted to shareholder and corporate profit.

And tell me how you're going to get the House, Senate, and President to go along and pass/sign it.


Thanks. You answered my question. Our government is too corrupt to represent the people.
New Our government isn't going to change unless people vote sensibly. Which means voting D.
New The last D put private insurers in our system by law. How'd that help?
New "Put" isn't the word you're looking for there.
New Really? Private Insurers were in the system by federal law before?
New Define "the system" that you're talking about for me. "Medicare Advantage" ring a bell?
New Part C is redundant coverage that could have been placed in part B.
New Shoulda woulda coulda. The law and the system has to deal with reality. ;-)
New Action first, payment second
Most of us prefer that people get healthcare first and worry about how it's paid second. You've been very clear that payment is your first, last and only consideration.
--

Drew
New Not at all.
My first concern is that all people receive healthcare as a right. The second is that people get the healthcare they actually pay for.
New What does "as a right" mean?
If it includes "without having to pay for it individually" then yes, payment is your first priority.
--

Drew
New In America, you get the healthcare you can pay for and nothing else. That's wrong.
Physicans can refuse to take Medicaid patients. Even pediatricians. No system is worth anything that allows a situation where a child can be legally denied care based upon their parents ability to pay.
New In Canada...
http://www.canadian-healthcare.org/page4.html

Private Health Insurance

While the health care system in Canada covers basic services, including primary care physicians and hospitals, there are many services that are not covered. These include things like dental services, optometrists, and prescription medications.

Private health insurance plans are usually offered as part of employee benefit packages in many companies. Incentives usually include vision and dental care. Alternatively, Canadians can purchase insurance packages from private insurance providers.

The main reason many choose to purchase private insurance is to supplement primary health coverage. For those requiring services that may not be covered under provincial health insurance such as corrective lenses, medications, or home care, a private insurance plan offsets such medical expenses.


AFAIK, please correct me if you know otherwise, there is no national health care system that covers everything. There is always going to need to be other supplementary systems, which often involve separate private insurance.

Cheers,
Scott.
New Well, there was one once.
I know because I personally benefited from being mistaken for a Russian child in the Soviet Union. ;0)
New Re: Well, there was one once.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1025801/

Reliable information about the system of health care pertaining to the average Soviet citizen is difficult to come by. The health care offered important officials, artists and foreigners who become ill is at a much more sophisticated level than that available to the general Soviet community. Anectodal reports [1-5] depict the personal encounters of Western travelers with the health care system and reflect the preferential treatment given sick foreigners.


;-p

Cheers,
Scott.
New So, Mike was privileged even as a youth! :)
Alex

"There is a cult of ignorance in the United States, and there has always been. The strain of anti-intellectualism has been a constant thread winding its way through our political and cultural life, nurtured by the false notion that democracy means that "my ignorance is just as good as your knowledge."

-- Isaac Asimov
New So, you know my own experiences better than I?
The point is they *did not know I was a foreigner* until after they'd treated me because *that* was the point at which my father told them and asked how a fee for treatment could be made. My father and I spoke Russian *only* when we went into the office. It wasn't until *after* I was treated that they knew I was a foreigner. That's when they panicked. If they'd known before treatment, I'd have probably been sent to (at least) the embassy. Being a local clinic, I doubt seriously the practitioner would have wanted to chance an international incident by treating a US citizen and having something go wrong.

So you can fsck-off telling me what my own experiences were and the reasons for them. No one better than I knows how well (and differently) U.S. citizens were treated in the Soviet Union than Soviets. We were the "Golden Children" everywhere we went and we'd been raised to reject that "special treatment" for ourselves. Which is why, in public, neither my brother nor I *ever* spoke a word of English and it is also why we wore our school uniforms almost everywhere we went because we knew our Western clothes would make us stand out. We intentionally *always* tried to pass for Soviet children. We were often successful, as we were the first and only time I was treated by Soviet clinicians.

Quoting some US government propaganda site and suggesting that trumps my own, real-life experiences is beneath you.
New Point is, you were a sample of one. That is all. :-)
New Okay, Twas not the thrust anyway. :0)
New Thanks for confirming
No system is worth anything that allows a situation where a child can be legally denied care based upon their parents ability to pay.

So a system that demonstrably leads to more people being covered on a per-capita basis than any time in the history of the country is worth nothing because there are still cases where care depends on ability to pay. Like I said, finances are your first and only criteria. Doesn't matter who actually gets (or doesn't get) care.
--

Drew
New You've got a strange definition of equality embedded in that statement.
New More words, please?
--

Drew
New Re: More words, please?
I'm saying, "Everyone should get treatment who needs it without regard to whether they can pay for it."

My position is that a system that treats people unequally is not a system worth having. You are arguing my position is ill advised. This suggests you don't care if some people go without care because unequal treatment with regard to healthcare is insufficient grounds to toss a system. IOW, some people are more equal than others and you're good with that.
New You don't seem to understand *your own* words
No system is worth anything that allows a situation where a child can be legally denied care based upon their parents ability to pay.

I'm saying that the ACA is better than what it replaced because more people receive care than before. It could be still better if more were covered, and without regard to what they could pay, but it's BETTER. That's the word that doesn't exist in your world. It's not up to your standards, so it shouldn't exist.
--

Drew
New Simpler summary of my view: An unequal system is not a defensible system.
New Do you prefer no system?
There will be a system, even if that system is anarchy. If you don't choose something else you are choosing anarchy. Is that defensible?
--

Drew
New Two things
1) The ACA *requires* that children be covered *at least* until 26. I haven't seen language saying that it *prohibits* coverage *after* that.

2) A child no longer being a child is a "qualifying event" that allows changing your selection.

Do you not know this?
--

Drew
Expand Edited by drook Sept. 22, 2016, 06:39:36 PM EDT
New Re: (2)
It is a qualifying event *for my daughter*, not for me.

https://www.healthcare.gov/glossary/qualifying-life-event/
New Read much?
You may qualify for a Special Enrollment Period if you or anyone in your household lost qualifying health coverage in the past 60 days OR expects to lose coverage in the next 60 days.

https://www.healthcare.gov/coverage-outside-open-enrollment/special-enrollment-period/
--

Drew
New Might depend on what "household" means here.
But I think your interpretation is likely correct. It doesn't make much sense to be able to pick a different policy in one case and not the other.

A quick Google doesn't tell me explicitly what happens to the parents' policy choices when the 26 year old is no longer covered.

Cheers,
Scott.
New They're covered
https://www.healthcare.gov/income-and-household-information/household-size/
Non-dependent child under 26

Sometimes
Include them only if you want to cover them on your Marketplace plan.

If they're on your plan, they're considered a household member.
--

Drew
New That's because ...
like continuing coverage past the birthday, to the next billing cycle, to the end of the month, etc. it is up to (1) the insurance company (2) the State and/or (3) the employer. I won't disagree that most insurance companies will allow you to switch plans after your youngest has his or her 26th birthday, but our broker has told us that a plain text reading of the law does not compel the carrier to do that.
New Didn't you say ...
Because in March the ACA forbids you from continuing to cover your child under your health insurance policy and because the private health insurer will not allow you to change plans mid-cycle

http://forum.iwethey.org/forum/post/413805/

Now you're down to ...
I won't disagree that most insurance companies will allow you to switch plans after your youngest has his or her 26th birthday, but our broker has told us that a plain text reading of the law does not compel the carrier to do that.

So a plain reading does not compel them, according to your broker. This wouldn't by any chance be a broker you have selected because he agrees with your less-than-charitable views of the industry, would it?

You also aren't disputing my assertion that the clear intent of the law is that children must be covered at least until they are 26, and that their birthday is intended to be considered a qualifying event on the policy under which they're covered.
--

Drew
New So she would have been covered before the ACA?
Regards,
-scott
Welcome to Rivendell, Mr. Anderson.
New 24 by law, but some plans it would have been 26. Both with no restrictions on pre-existing.
This "you lose on your birthday" makes no damned sense at all. I *PAID* for her coverage through September ferchrissakes. Why TF was the law written to allow that? It should have been canceled on the next billing cycle *after* the 26th birthday. Being the corporate POS the ACA is however, the private insurer gets to *REDUCE* the risk associated with a plan and *KEEP* the money made from assuming that risk. It is *bullshit* plain and simple.
New OK, so you paid through the end of the month
Get back to us a week from Saturday with a detailed account of the practical hardships you and your daughter have endured by then as a consequence of her coverage lapsing today rather than ten days from now. How will your lives have been different during this period* than they would have been had the private insurer kept her enrolled until the thirtieth? Because it sounds to me that you're screaming about having been nicked for the cost of a third of a month's coverage: a petty piece of bean-counterly greed, but scarcely the cosmic injustice and indictment of the PPACA you make it out to be.

cordially,

*Obviously, if your adult child should happen to be mowed down by a practicing Rastafarian Uber driver on Friday—unlikely, of course, but caution her to look both ways before stepping into the crosswalk—then the insurer makes out like a bandit, and your cries to heaven carry with them some extra moral force. But absent something like this or the sudden onset of a serious illness, it's hard to see how you've been significantly harmed outside of elevated blood pressure, which your continuing coverage can presumably address.
New I'd expect that attitude from a Hillary supporter.
"Paying corporations for nothing isn't really all that terrible."

Have I got that right?
New FIFY
"Paying corporations for nothing isn't really all that terrible unusual."
It happens. So? Did I say that this was a good thing? I did not. I observed merely that your shrieks of righteous indignation were incommensurate with the novelty or, for that matter, the gravity of the offense.

I paid CaesarCare half a grand last month. The household did not avail itself of any of CaesarCare's panoply of services: not an office visit, nor a phone call, nor an email, not so much as a prescription renewal. In tangible terms, I paid something for nothing. Intangibly, I suppose you may regard yourself out of having been swindled out of peace of mind for the next ten days. If that's the worst thing that happens to you this year, count yourself lucky.

cordially,
New But you *DID* get something.
If you'd been severely injured on the 101 and had to be flown to hospital for treatment, it would have been vastly less expensive for you to get that care and at the same time the likelihood of you being refused admission for "lack of coverage" had been eliminated. While we may agree that half a grand is a pretty steep price to pay for that, it is at least something. The difference here is that I paid for that little something and I am not getting it. It would seem to me that the least I could expect would be to receive the "insurance" I paid for and I don't think it's unreasonable of me to expect it. (Aside: I at least got just shy of 3/4's of what I paid for with this daughter, but my other daughter was born on the third of the month. Is that equally "okay" as well? Paying for 30 days of coverage and getting two? And it gets worse. That year, I won't be able to switch from a "family" plan to an "Employee and Spouse" plan for six months because you can't switch plans until renewal time and so I'll be paying inflated profits to a private corporation above and beyond even what the ACA itself dictates!) But the ACA was written by and for profit driven corporations who have injected themselves (by federal law now) into our healthcare delivery system and this is the result.

Because we are ruled by our corporate masters, even the most myopic of minds could have come up with an "Obama compromise" that didn't leave people in the ditch. The law could have been written to include a "Public Option Rider for Catastrophic Coverage." His corporate masters would have *loved* that for the simple reason that private health insurers would be off-the-hook for catastrophic claims and the consumer *could* have at least had the comfort of knowing that he could receive care for trauma at a substantially lower cost (through the government plan) than he could through a for profit scheme. As it is, the waitresses, bartenders, common laborers, grad students working part-time, etc. that I know cannot afford even the most inexpensive plans because of the built-in profit the ACA demands for private health insurers. Even with the diminishing influx of money from the taxpayers going into "supplements." So they go without. But, better they should die for lack of coverage than to reach into the pockets of the monied class for a few pennies, right?
Expand Edited by mmoffitt Sept. 21, 2016, 04:28:21 PM EDT
New What part of "tangible terms" was unclear?
New What part of "no tangible thing != nothing" is unclear?
And it's only chance that you received to tangible thing. You had a path to receive a tangible thing that I also paid to receive on behalf of my daughter that I did not receive.
New you are betting hundreds of dollars every month that you will get a dread disease. You lose monthly
always look out for number one and don't step in number two
New I'm not so worried about myself.
The top five leading causes of death among White 25 to 29 year old females:

1. Accidents (nearly 4 times number 2 on this list)
2. Suicide
3. Malignant neoplasm
4. Heart disease
5. Assault

Edit:
Source: http://www.cdc.gov/nchs/data/dvs/lcwk1_2014.pdf
Expand Edited by mmoffitt Sept. 22, 2016, 01:12:56 PM EDT
New So....
You're bitching because she's now entitled to 2 more years coverage by law, but the law's authors messed up and allowed a loophole that screwed you out of 10 days of coverage.

Must have been definite intent to Do Evil on part of a corporate tool, you're absolutely correct. Couldn't possibly have been an oversight.
Regards,
-scott
Welcome to Rivendell, Mr. Anderson.
New This bad, it had to be intentional.
The ACA allows for 3 separate entities to decide what the last day of coverage is;

1) The healthcare plan provider.
2) The state.
3) The employer.

That has to be intentionally daft.
New Never ascribe to malice, etc.
Deaf ears, I know.
Regards,
-scott
Welcome to Rivendell, Mr. Anderson.
New Come on, nobody's that thick. ;0)
Expand Edited by mmoffitt Sept. 21, 2016, 04:30:37 PM EDT
New Could be worse
>>> "I think Obama will go down in history as the most ineffectual President in our history."

He's not doing too badly:

http://www.politifact.com/truth-o-meter/promises/obameter/

He will also be remembered for ending the embargo on Cuba among other things.

Edited to add:

Obama also signed an extraordinary agreement with Netanyahu.

http://www.newsweek.com/tel-aviv-diary-obama-exacts-cold-revenge-netanyahu-499392?rx=us
Expand Edited by dmcarls Sept. 23, 2016, 10:44:07 PM EDT
New Wow. Bibi got his, didn't he? Well done, Obama.
New Yeah, Obama's horrible all right.
New Touching. Nice to see he knows how to use a six year old.
     The PPACA strikes my daughter. - (mmoffitt) - (67)
         Look through a longer lens. - (pwhysall) - (2)
             How do you understand US politics so well? - (drook) - (1)
                 You know how you don't know who David Davis is, or what he does? - (pwhysall)
         I did not have medical insurance until I was 45 lost it when I was 55, shrug -NT - (boxley)
         gotcher armband & jackboots right here - (rcareaga) - (44)
             Re: second, ... - (mmoffitt) - (43)
                 Point of order... - (Another Scott) - (42)
                     You're missing the point. - (mmoffitt) - (41)
                         it is *still legal* for healthcare providers to refuse to care - (boxley) - (1)
                             Providing healthcare? Yes. - (mmoffitt)
                         You're whining. - (Another Scott) - (31)
                             Serious question. - (mmoffitt) - (30)
                                 Serious answer - (drook) - (2)
                                     By "Pragmatists" you mean capitulators, right? - (mmoffitt) - (1)
                                         Canada's system started in a few provinces then went national. - (Another Scott)
                                 You didn't say "Single Payer". You said "Medicare for All" - (Another Scott) - (26)
                                     Re: What Medicare system are you advocating ... Yes. That one. - (mmoffitt) - (25)
                                         Our government isn't going to change unless people vote sensibly. Which means voting D. -NT - (Another Scott) - (24)
                                             The last D put private insurers in our system by law. How'd that help? -NT - (mmoffitt) - (23)
                                                 "Put" isn't the word you're looking for there. -NT - (Another Scott) - (4)
                                                     Really? Private Insurers were in the system by federal law before? -NT - (mmoffitt) - (3)
                                                         Define "the system" that you're talking about for me. "Medicare Advantage" ring a bell? -NT - (Another Scott) - (2)
                                                             Part C is redundant coverage that could have been placed in part B. -NT - (mmoffitt) - (1)
                                                                 Shoulda woulda coulda. The law and the system has to deal with reality. ;-) -NT - (Another Scott)
                                                 Action first, payment second - (drook) - (17)
                                                     Not at all. - (mmoffitt) - (16)
                                                         What does "as a right" mean? - (drook) - (15)
                                                             In America, you get the healthcare you can pay for and nothing else. That's wrong. - (mmoffitt) - (14)
                                                                 In Canada... - (Another Scott) - (6)
                                                                     Well, there was one once. - (mmoffitt) - (5)
                                                                         Re: Well, there was one once. - (Another Scott) - (4)
                                                                             So, Mike was privileged even as a youth! :) -NT - (a6l6e6x)
                                                                             So, you know my own experiences better than I? - (mmoffitt) - (2)
                                                                                 Point is, you were a sample of one. That is all. :-) -NT - (Another Scott) - (1)
                                                                                     Okay, Twas not the thrust anyway. :0) -NT - (mmoffitt)
                                                                 Thanks for confirming - (drook) - (6)
                                                                     You've got a strange definition of equality embedded in that statement. -NT - (mmoffitt) - (5)
                                                                         More words, please? -NT - (drook) - (4)
                                                                             Re: More words, please? - (mmoffitt) - (3)
                                                                                 You don't seem to understand *your own* words - (drook) - (2)
                                                                                     Simpler summary of my view: An unequal system is not a defensible system. -NT - (mmoffitt) - (1)
                                                                                         Do you prefer no system? - (drook)
                         Two things - (drook) - (6)
                             Re: (2) - (mmoffitt) - (5)
                                 Read much? - (drook) - (4)
                                     Might depend on what "household" means here. - (Another Scott) - (3)
                                         They're covered - (drook)
                                         That's because ... - (mmoffitt) - (1)
                                             Didn't you say ... - (drook)
         So she would have been covered before the ACA? -NT - (malraux) - (13)
             24 by law, but some plans it would have been 26. Both with no restrictions on pre-existing. - (mmoffitt) - (12)
                 OK, so you paid through the end of the month - (rcareaga) - (7)
                     I'd expect that attitude from a Hillary supporter. - (mmoffitt) - (6)
                         FIFY - (rcareaga) - (5)
                             But you *DID* get something. - (mmoffitt) - (4)
                                 What part of "tangible terms" was unclear? -NT - (rcareaga) - (3)
                                     What part of "no tangible thing != nothing" is unclear? - (mmoffitt) - (2)
                                         you are betting hundreds of dollars every month that you will get a dread disease. You lose monthly -NT - (boxley) - (1)
                                             I'm not so worried about myself. - (mmoffitt)
                 So.... - (malraux) - (3)
                     This bad, it had to be intentional. - (mmoffitt) - (2)
                         Never ascribe to malice, etc. - (malraux) - (1)
                             Come on, nobody's that thick. ;0) -NT - (mmoffitt)
         Could be worse - (dmcarls) - (1)
             Wow. Bibi got his, didn't he? Well done, Obama. -NT - (Another Scott)
         Yeah, Obama's horrible all right. - (Another Scott) - (1)
             Touching. Nice to see he knows how to use a six year old. -NT - (mmoffitt)

Happiness is a lint filter full of thwarted pinworms.
200 ms