Is ACA Coverage Affordable for Low-Income People? Perspectives from Individuals in Six Cities

[eridani]

http://kff.org/health-reform/issue-brief/is-aca-coverage-affordable-for-low-income-people-perspectives-from-individuals-in-six-cities/

Issue Brief:
http://kff.org/report-section/is-aca-coverage-affordable-for-low-income-people-perspectives-from-individuals-in-six-cities-issue-brief-8867/

While people were grateful for coverage, unexpected bills, dealing with insurance companies, and facing known deductibles were sources of stress which made those with Marketplace coverage fearful to use the coverage they had. They were particularly frustrated by the out-of-pocket costs, which were unaffordable to many and wanted insurance that didn’t come with so many hidden costs.

Comment by Don McCanne of PNHP: This report of nine focus groups confirms that real people have found that the Affordable Care Act (ACA) often fails to provide access to affordable care.

Although the leading candidate for president has said that she wants to build on ACA, reducing premiums and deductibles pours yet more tax money into what is the most expensive and least efficient model of health care financing. The model cannot really be fixed if we want true value in health care. It needs to be replaced with a model that does work - a single payer national health program - Improved Medicare for All.

[Cresent City Kid]

1. No

The deductible on the most affordable plan is so high that it's worthless. All the law really does is make be a bureaucrat in charge of transferring money from the treasury to an insurance company, and taking my tax refund away if I fail at this or can't afford to pay the uncovered portion of the premium.

[nationalize the fed]

2. k&r

Obama on the public insurance option

Harry Reid doubled down

NY Times Reporter Confirms Obama Made Deal to Kill Public Option

For months I’ve been reporting in The Huffington Post that President Obama made a backroom deal last summer with the for-profit hospital lobby that he would make sure there would be no national public option in the final health reform legislation. (See here, here and here). I’ve been increasingly frustrated that except for an initial story last August in the New York Times, no major media outlet has picked up this important story and investigated further...
http://www.huffingtonpost.com/miles-mogulescu/ny-times-reporter-confirm_b_500999.html

"The truth of the matter is that my policies are so mainstream that if I had set the same policies that I had back in the 1980s, I would be considered a moderate Republican."- President Barack Obama

[Hortensis]

3. No health bill is affordable for low-income people,

certainly not even the 10% coinsurance on really good policies. Before we can significantly advance our fixes for this problem, though, we're going to need a smaller hard-right SCOTUS block and a more cooperative Congress. And of course a Democratic president.

Lose this one, and we'll be back to worrying that simply going to the doctor might document a "preexisting" condition and result in no insurance coverage at all. Or being unable to move or change jobs for fear of ending up uninsured.

[Mnpaul]

8. MnSure has been affordable for low income since '92

I just looked, still quite affordable. It is paid for by a tax on policies collected from the insurer.

[Hortensis]

10. Sorry, I didn't examine all the state programs,

and that is nice to hear, MnPaul.

[sendero]

4. The ACA is disintegrating...

.... in a way that I did not see coming.

I live in a lesser populous county. There are zero,NO plans here that meet our needs in terms of who/what is in the network. If you live 50 miles away in a more populated county, there are plans that do.

But when you see large insurers abandoning the plan you know things are not good. I'm afraid that United Healthcare is just the beginning but time will tell.

In any event, I was moderately in favor of the ACA but it is not really working out as far as I can tell.

[KG]

5. no.

'affordable' - the first lie.

[strategery blunder]

6. I could afford it, with some sacrifice, the first year.

Of course I have a prescription that makes health insurance more important to me than it would be for most 30-year olds.

I managed to find a $200 deductible/600 OOPM plan for $72/month (after subisidy). The doctors' appointments that the DEA requires to maintain my prescription guarantee hitting the OOPM late in the year, so my premium was effectively $122/month.

But then at the start of the new year, the premium went up. The subsidy didn't, so I had to bear the entirety of the increase, which turned a nominal increase of ~10% into an effective increase of ~40% for the premium or ~30% after averaging in the (smaller) increase of the OOPM. I'm now at $102/month, with $700 OOPM. So, effectively ~$160/month.

The subsidy portion effectively pays for the actual "insurance" of my health insurance, in that if something unforeseen happens to me, I would simply hit my OOPM a little earlier in the year, and the net out of pocket cost of such unforeseen event would be near zero (excluding possible lost wages which has NEVER been the domain of health insurance).

At some point in the near future it will become less expensive for me to pay for the doctor visits and prescription (which alone is $70/month, for generic, with no insurance), than it will be for me to maintain a usable ACA policy. And given that I'm at ~150% FPL, it will become sadly necessary as well.

ACA is great for me while it lasts, but as currently legislated it contains insufficient cost controls to become anything more than temporary to me.

[Baobab]

7. Health insurance is a racket but we're trapped by trade deals in it.

Maybe a million people have died unnecessarily, but how could we hope to export our "successful" system to the rest of the world if we gave our own people a sweetheart deal?

So this is one area where both parties agree. Let the poor die rather than fix the system by moving the 2/3 of every health care dollar the government already spends to make it pay for free high quality healthcare for everybody, which likely WOULD be possible without spending any more money, because the current system is so inefficient.

[Skittles]

9. no

it's private health insurance; the only difference is now they can f*** taxpayers, too