PPACA Discussion Thread: 2015 If You Like Your Subsidies You Can Keep Your Subsidies

The Something Awful Forums > Discussion > Debate & Discussion > PPACA Discussion Thread: 2015 If You Like Your Subsidies You Can Keep Your Subsidies

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Willa Rogers: Mar 11, 2005

If I were you, I'd enroll in Medicaid (as you're legally required to do under PPACA), but use those savings to pay providers cash to see them. Providers who accept Medicaid can be few and far between, and I expect it's gonna be tough to get appointments and/or care once tens of millions of people suddenly qualify for enrollment next year.

eta: The compulsory-Medicaid thing is gonna be an interesting sidebar to watch as PPACA rolls out, because a lot of folks don't undertstand it, and because of those who are self-employed and whose income varies by the month (as I mentioned upthread). I really don't know how the individual subsdies qualification can work when it comes to the self-employed unless eligibility is determined on the prior year's income.

***

The greatest risk in delaying the out-of-pocket limit for employer-provided (ie, the vast majority of) plans till 2015 is in the Senate's flipping GOP next year. It's kind of a chicken/egg thing: Employees maddened by huge out-of-pocket costs are gonna overshadow the low-income folks' getting Medicaid, and the GOP is surely gonna exploit that anger for votes.

Willa Rogers fucked around with this message at 21:34 on Aug 13, 2013

# ? Aug 13, 2013 21:30

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# ? Apr 29, 2024 18:45

Slow Graffiti: Feb 1, 2003; Born of Frustration

Thanks for the info folks. My biggest concern will be making sure my meds (which retail for $36,000 a year) and my yearly MRI will be covered no problem. If I learn any interesting info on the Medicaid front after we meet with the MA healthcare rep I will post it here.

# ? Aug 13, 2013 22:12

evilweasel: Aug 24, 2002

Willa Rogers posted:

The greatest risk in delaying the out-of-pocket limit for employer-provided (ie, the vast majority of) plans till 2015 is in the Senate's flipping GOP next year. It's kind of a chicken/egg thing: Employees maddened by huge out-of-pocket costs are gonna overshadow the low-income folks' getting Medicaid, and the GOP is surely gonna exploit that anger for votes.

It is rather unlikely that employees will be maddened by huge out-of-pocket costs for the simple reason this is delaying a new regulation so any costs they'd see would be normal to them.

# ? Aug 13, 2013 22:34

Willa Rogers: Mar 11, 2005

Increasing out-of-pocket costs are the fastest-growing consumer burden when it comes to healthcare costs, as we've discussed over the years since PPACA's made them the new normal. They're also the huge reason that labor is unhappy with the bill.

I guess we'll have to see whether employees who have $2500 in annual out-of-pocket costs this year are cavalier about having $5000 in annual out-of-pocket costs a year from now; I'd think it's a pretty big deal--particularly to lower-income employees. Keep in mind that something like half of all Americans say they wouldn't have access to $1000 in cash or credit to use in an emergency; also keep in mind that higher out-of-pocket costs have been shown to discourage people from seeking medical care (which is why the insurance industry has pushed to hard to make them the new normal).

eta: The comparison to an employee won't be "this vs. what I'd be paying with no reform" but rather "this is what I was told reform would fix, and yet I'm paying more now than I was before the reform." And the GOP will be poised to capitalize on this anger; they're already exploiting the various delays for maximum effect, as the polling shows.

Willa Rogers fucked around with this message at 22:57 on Aug 13, 2013

# ? Aug 13, 2013 22:52

evilweasel: Aug 24, 2002

Willa Rogers posted:

eta: The comparison to an employee won't be "this vs. what I'd be paying with no reform" but rather "this is what I was told reform would fix, and yet I'm paying more now than I was before the reform." And the GOP will be poised to capitalize on this anger; they're already exploiting the various delays for maximum effect, as the polling shows.

The number of people who have specific expectations about Obamacare are few and far between and the vast majority of those are "societal collapse, socialism". The message that has been conveyed to most people about employer plans is they're going to be left alone and that Obamacare is mostly about the individual insurance market. What is actually likely to happen is the GOP, far from running on a nuanced position of "Obamacare is not as successful as you were led to believe" will be running on an "Obamacare is destroying America" platform while most people see no actual negative effects and some people see significant positive effects.

I don't know what polling you're referring to but I strongly suspect it shows nothing of the sort.

# ? Aug 13, 2013 23:04

Willa Rogers: Mar 11, 2005

Huh, I had no idea about child-dental-care coverage having a cap on out-of-pocket costs. From Pear's NYT piece:

quote:

The law also requires coverage of dental care for children, but these benefits can be offered in a separate health plan with its own limit on out-of-pocket costs.

Federal rules say that a free-standing dental plan must have �a reasonable annual limitation on cost-sharing.� In states where the new health insurance marketplace will be run by the federal government, the limit on out-of-pocket costs for pediatric dental benefits can be no more than $700 for coverage of one child and $1,400 for a plan covering two or more children in the same family.

I knew that plans had to provide dental coverage for children, but I didn't realize there's an out-of-pocket cap on expenses. What are the premiums gonna run, Esquilax; do you know?

# ? Aug 13, 2013 23:34

The Maroon Hawk: May 10, 2008

As a follow-up to the Medicaid discussion, will there be any restrictions on college students enrolling in Medicaid? Right now I'm paying the school $990/semester for health insurance, and while that's apparently relatively cheap compared to the private market, I'm still well below the 133% FPL threshold and would jump at the chance to save that $990 every semester. We can't afford to put me on my parent's health insurance plan, so that's not an option, and my employer's health insurance plan for part-time employees is a joke (although it's kind of rare that they're offering it to PTers at all). I've heard that certain programs like food stamps exclude college students form eligibility, so I wasn't sure if the same applied to Medicaid under PPACA. I've tried Googling the issue using every search term I can think of and am coming up empty-handed.

# ? Aug 13, 2013 23:37

Willa Rogers: Mar 11, 2005

I can't seem to find any info on that, either, and I don't know whether your family is required to cover the cost of your insurance if claiming you as a dependent.

***

I came across this info, which was new to me, about subsidies toward out-of-pocket costs, on the Covered California website:

quote:

Am I eligible for cost-sharing subsidies?

In addition to the tax credits that reduce your monthly premium payments, you may be eligible for cost-sharing subsidies that reduce the amount you pay when you get care. Eligibility for subsidies is based on income level and family size. You may be eligible for subsidies if your income is less than about $27,936 for a single person and less than about $57,636 for a family of four in 2012, which represents about 2.5 times federal poverty level. Cost-sharing subsidies are offered by the federal government to reduce the amount of money you have to pay for health care expenses such as copayments or coinsurance.

For some reason, I thought the out-of-pocket subsidies were pegged to income levels that paralleled the premium subsidies. Expecting low-income workers making less than $30k/year to take on $6,000/year deductibles + copays is gonna lead to even greater voter blowback than I first figured it would.

# ? Aug 14, 2013 00:16

Great_Gerbil: Sep 1, 2006; Rhombomys opimus

Just as an aside, does anyone else think businesses were unprepared because they were dragging their feet waiting for a repeal or for the law to be overturned? I could see a lot of backroom promises that didn't pan out.

# ? Aug 14, 2013 14:22

Sancho: Jul 18, 2003

Great_Gerbil posted:

Just as an aside, does anyone else think businesses were unprepared because they were dragging their feet waiting for a repeal or for the law to be overturned? I could see a lot of backroom promises that didn't pan out.

Most businesses are ALWAYS unprepared. Hell, even huge ones like Microsoft are unprepared for a lot of stuff. I think it's easier to convince a business to do nothing than make changes so it's just a case of water flowing downhill.

# ? Aug 14, 2013 14:33

hobbesmaster: Jan 28, 2008

Sancho posted:

Most businesses are ALWAYS unprepared. Hell, even huge ones like Microsoft are unprepared for a lot of stuff. I think it's easier to convince a business to do nothing than make changes so it's just a case of water flowing downhill.

Microsoft is as of recent continually unprepared for actual business related stuff; their HR and other support being a huge clusterfuck should not be surprising. (Not going to get those 5s by being a downer and pointing out theres a bunch of stuff thats not done that will cost $$$!)

# ? Aug 14, 2013 18:43

Willa Rogers: Mar 11, 2005

These delays in PPACA aren't coming about because employers are unprepared, but because the government is unprepared. (Well, that--and the political unpopularity of the business-side rules. As Valerie Jarrett crowed, the admin is listening to employers' complaints about the new law. Listening to consumers, not so much.)

# ? Aug 14, 2013 18:52

Main Paineframe: Oct 27, 2010

Great_Gerbil posted:

Just as an aside, does anyone else think businesses were unprepared because they were dragging their feet waiting for a repeal or for the law to be overturned? I could see a lot of backroom promises that didn't pan out.

Businesses are always going to claim to be unprepared for new regulations, because they don't want to be held to them, and it's much easier for them to convince the government to gut the new rules if they act as though the rules impose a huge and unreasonable hardship on them. Corporate America will always continue to claim to be "unprepared" for any regulations that might cost them money...until about five minutes before they start getting hit with penalty fees, at which point they'll solve the problem awfully quickly. Even then, if the government seems to be weak, they might soldier on and start racking up penalties if they think they can bluff the feds into dropping the fines afterward. As long as the regulations cost them more than the status quo, business has every incentive to portray them badly because pushing to get them rolled back is cheaper than letting them come into effect.

It's like fridge doors that can be opened from the inside. When Congress first mandated that, business whined and complained about how it was an unreasonable demand that would be impossible to meet without placing a huge burden on businesses, but when the deadline approached with the government standing firm, fridgemakers suddenly had no problem easily and quickly replacing the old-style latches with modern magnetic doors.

# ? Aug 14, 2013 22:09

Russian Bear: Dec 26, 2007

I plan on moving to Sweden this year. I'll have a tax ID number here so I will be eligible for all the evil socialist perks, including healthcare. I will still be a US citizen and covered under my dad's insurance for two more years, but after that, will I be required to pay a fee/buy US insurance even though I don't reside there anymore per the mandate?

# ? Aug 17, 2013 14:52

parasyte: Aug 13, 2003; Nobody wants to die except the suicides. They're no fun.

Russian Bear posted:

I plan on moving to Sweden this year. I'll have a tax ID number here so I will be eligible for all the evil socialist perks, including healthcare. I will still be a US citizen and covered under my dad's insurance for two more years, but after that, will I be required to pay a fee/buy US insurance even though I don't reside there anymore per the mandate?

It looks like no. 26 USC 5000A(f)(4) points to 26 USC 911(d)(1) for its exemption of a person from the minimum essential coverage requirement. You have no penalty tax while you're a qualified individual residing abroad.

# ? Aug 17, 2013 23:50

Willa Rogers: Mar 11, 2005

Yo, Esquilax or other insurance know-everythings: I was reading this thread on DU and one of the posts says:

quote:

There is a provision in the ACA that allows insurers to charge up to 50% higher premiums for individuals who use drugs, including tobacco, and your insurance company can require annual testing for those substances. A number of insurance companies are reacting to this by simply requiring the screening during the blood test during your regular annual physical. It will be an invisible screening for you.

There is also a nullifying feature for the rate hike stating that you can't be charged extra if you are actively participating in any treatment programs. Because of that, there's some question as to how aggressively the insurance companies will be pursuing this, as a simple conversation with your doctor may qualify as a "treatment program", and they could end up spending more on testing and enforcement than they will actually collect in higher premiums. Whether the insurance companies will really implement this on a large scale remains to be seen.

On Edit:. The actual rule changes were a part of the CMS-9972-P rulemaking last year, which identified groups eligible for higher premiums. Smokers and drug abusers were at the top of the list.

Ok, I knew about the "higher rates for smokers" thing but the routine drug-testing during physicals (as well as the higher rates for "illicit drug users") was new to me. Is this info True or Untrue?

# ? Aug 20, 2013 01:58

Slobjob Zizek: Jun 20, 2004

Willa Rogers posted:

Yo, Esquilax or other insurance know-everythings: I was reading this thread on DU and one of the posts says:

Ok, I knew about the "higher rates for smokers" thing but the routine drug-testing during physicals (as well as the higher rates for "illicit drug users") was new to me. Is this info True or Untrue?

100% untrue -- CMS-9972-P doesn't mention drugs at all, and neither does the relevant amended section of the PHS Act:

code:


``SEC. 2701. FAIR <<NOTE: 42 USC 300gg.>> HEALTH INSURANCE PREMIUMS.

    ``(a) Prohibiting Discriminatory Premium Rates.--
            ``(1) In general.--With respect to the premium rate charged 
        by a health insurance issuer for health insurance coverage 
        offered in the individual or small group market--
                    ``(A) such rate shall vary with respect to the 
                particular plan or coverage involved only by--
                          ``(i) whether such plan or coverage covers an 
                      individual or family;
                          ``(ii) rating area, as established in 
                      accordance with paragraph (2);
                          ``(iii) age, except that such rate shall not 
                      vary by more than 3 to 1 for adults (consistent 
                      with section 2707(c)); and
                          ``(iv) tobacco use, except that such rate 
                      shall not vary by more than 1.5 to 1; and
                    ``(B) such rate shall not vary with respect to the 
                particular plan or coverage involved by any other factor 
                not described in subparagraph (A).

# ? Aug 20, 2013 03:59

redgubbinz: May 1, 2007

If my bare minimum plan is considered to be 'grandfathered,' next to none of the PPACA protections will apply to me? That's what I'm getting from this table, anyway.

http://www.dol.gov/ebsa/pdf/grandfatherregtable.pdf

I signed up for it this year since I turned 26 and would be without coverage otherwise. One thing seems odd, my plan 'doesn't meet the minimum standards of the ACA' as it gives me an annual limit ($2500) for coverage. It then goes on to say 'the DHHS has waived the requirement for your plan until the ending date of the plan or policy year beginning before 1/1/2014.'

Does this mean the limit will be removed on 1/1/2014 or a year after the plan's effective date (or never)?

# ? Aug 20, 2013 05:19

FAUXTON: Jun 2, 2005; spero che tu stia bene

Ineptus Mechanicus posted:

If my bare minimum plan is considered to be 'grandfathered,' next to none of the PPACA protections will apply to me? That's what I'm getting from this table, anyway.

http://www.dol.gov/ebsa/pdf/grandfatherregtable.pdf

I signed up for it this year since I turned 26 and would be without coverage otherwise. One thing seems odd, my plan 'doesn't meet the minimum standards of the ACA' as it gives me an annual limit ($2500) for coverage. It then goes on to say 'the DHHS has waived the requirement for your plan until the ending date of the plan or policy year beginning before 1/1/2014.'

Does this mean the limit will be removed on 1/1/2014 or a year after the plan's effective date (or never)?

Pretty sure it means they can gently caress you this year but not next.

# ? Aug 20, 2013 10:38

redgubbinz: May 1, 2007

That's probably what it means, I guess it'd be a fun surprise if I need to go to the hospital!

# ? Aug 20, 2013 21:41

SousaphoneColossus: Feb 16, 2004; There are a million reasons to ruin things.

Maybe I'm an idiot with Google, but I'm finding conflicting information: for states that are expanding Medicaid in 2014, is the 133% of poverty line figure supposed to be the applying individual's income or total household income? If the situation is that one spouse has insurance through employment, but the other spouse is unemployed and not eligible for insurance through the spouse for whatever reason, could the unemployed spouse be eligible for Medicaid?

# ? Aug 21, 2013 06:13

Willa Rogers: Mar 11, 2005

The FPL applies to single-person households for Medicaid eligibility, and PPACA does "penalize" married couples in that regard.

For example, if each of a couple earns $11,000/year, then the combined household income of $22k disqualifies them from the Medicaid expansion, while separately they would each qualify for Medicaid. (They still qualify for a highly subsidized private plan, though.) You have to go down to a combined income of $21k/year before the Kaiser calculator says they qualify (i.e., are compelled to enroll in) Medicaid.

eta: the link to the calculator I used.

etaa: In answer to your specific question, I'm not sure; I think it depends on what the employer offers as far as family coverage?

Willa Rogers fucked around with this message at 06:38 on Aug 21, 2013

# ? Aug 21, 2013 06:31

Great_Gerbil: Sep 1, 2006; Rhombomys opimus

This is an admittedly dumb question but I need to have it phrased in the most idiot-proof way possible:

As someone whose employer offers medical insurance, are there any subsidies or credits or what have you that are available? My fianc�e and I will brush $32k once we're married next month and I'm wondering. Would any of that be based on percentage of income?

# ? Aug 21, 2013 14:48

Willa Rogers: Mar 11, 2005

Your "subsidy" comes in your employer's contributions to your insurance premiums, and that money not being taxed as income.

If your employer decides to not offer insurance in 2014 or later, you'd qualify for a subsidy for an Exchange plan, and if the cost of family insurance exceeds 9.5 percent of family income (premiums alone; out-of-pocket costs for care are extra), you won't be fined for not having insurance, but I don't think you can say screw it, and go for an Exchange subsidy just because it's a better deal for you financially.

# ? Aug 21, 2013 23:03

EugeneJ: Feb 5, 2012; by FactsAreUseless

NY has their Premium Estimator up, albeit in some weird spreadheet format that barely works in Excel for me:

http://nystateofhealth.ny.gov/node/344

Estimator:
http://nystateofhealth.ny.gov/sites/default/files/Tax%20Credit%20and%20Premium%20Rate%20Estimator.xlsm

# ? Aug 22, 2013 20:20

Rubby: Aug 31, 2002; <3 Louby

EugeneJ posted:

NY has their Premium Estimator up, albeit in some weird spreadheet format that barely works in Excel for me:

http://nystateofhealth.ny.gov/node/344

Estimator:
http://nystateofhealth.ny.gov/sites/default/files/Tax%20Credit%20and%20Premium%20Rate%20Estimator.xlsm

Has there been any information as to what these plans are comprised of or has it just been the prices announced with the details being a "fun" October surprise?

# ? Aug 22, 2013 22:17

Willa Rogers: Mar 11, 2005

Trudy Lieberman over at CJR, who did a fab job of covering PPACA (and covering the media covering PPACA) as the Act was written, is also covering the rollout, and has 2 good pieces on where the PPACA stands to date:

An Obamacare scorecard, Part 1

An Obamacare scorecard, Part 2

eta: Kaiser reports on the trial run of Accountable Care Orgs. The news is mixed.

# ? Aug 27, 2013 20:52

FAUXTON: Jun 2, 2005; spero che tu stia bene

A coworker of mine claims her sister, a PT, lost her job due to "Obamacare."

Back in reality, her sister lost her job because one big Catholic hospital management company bought out the other big Catholic hospital management company in town and began referring their patients in-house (the one that did the buying has several hospitals and a bunch of clinics around town whereas the one that got bought had one hospital and a few clinics.) instead of to this otherwise independent clinic.

I would say I wanted to follow her home, stomp her Pomeranian to death, and use the dog's blood to explain in detail in writing on her walls that it was unconstrained capitalism that took her sister's job and not the goddamn PPACA but I've long since stopped being disappointed and sad over people who are that goddamn stupid and misinformed. I calmly explained to her that a hospital buyout is not Obamacare and I think she got it.

# ? Aug 28, 2013 23:46

Willa Rogers: Mar 11, 2005

I thought I'd read some things about PPACA's encouraging hospital mergers through various mechanisms, but it's unlikely those mergers wouldn't have happened anyway, for the most part, given the trends in for-profit hospitals buying up the non-for-profits. But yeah, it's an indictment of capitalism (although PPACA incentivizes extreme capitalism in various ways).

# ? Aug 28, 2013 23:50

FAUXTON: Jun 2, 2005; spero che tu stia bene

Willa Rogers posted:

I thought I'd read some things about PPACA's encouraging hospital mergers through various mechanisms, but it's unlikely those mergers wouldn't have happened anyway, for the most part, given the trends in for-profit hospitals buying up the non-for-profits. But yeah, it's an indictment of capitalism (although PPACA incentivizes extreme capitalism in various ways).

I'm fairly sure there's absolutely zero effect from PPACA on Physical Therapists at this time or at any point in the past, as they're generally covered as a number of visits per year and that kind of retail medicine (and chiropractors) try to keep costs down because they have more people paying out of pocket than your average surgeon doing appendectomies. The merger in my city (thankfully the non-Jesus'd up university med center is within a fart's sniff of my house, so if I broke my leg falling off my porch I'd probably be able to hobble there before adrenaline wore off but my insurance is more than happy to cover ambulance rides in full) has to do with what seems to be a nationwide takeover of Catholic hospitals by some outfit called Catholic Health Initiatives.

CHI may seem familiar because they're the ones who tried to weasel out of a wrongful death settlement by arguing that (contrary to Catholic dicta) fetuses aren't persons.

# ? Aug 29, 2013 01:45

Amused to Death: Aug 10, 2009; google "The Night Witches", and prepare for

Question! If your employer offers health care insurance, can you buy insurance on the exchanges paying for it fully out of pocket?

# ? Aug 31, 2013 06:32

Residency Evil: Jul 28, 2003; 4/5 godo... Schumi

The Entire Universe posted:

A coworker of mine claims her sister, a PT, lost her job due to "Obamacare."

Back in reality, her sister lost her job because one big Catholic hospital management company bought out the other big Catholic hospital management company in town and began referring their patients in-house (the one that did the buying has several hospitals and a bunch of clinics around town whereas the one that got bought had one hospital and a few clinics.) instead of to this otherwise independent clinic.

I would say I wanted to follow her home, stomp her Pomeranian to death, and use the dog's blood to explain in detail in writing on her walls that it was unconstrained capitalism that took her sister's job and not the goddamn PPACA but I've long since stopped being disappointed and sad over people who are that goddamn stupid and misinformed. I calmly explained to her that a hospital buyout is not Obamacare and I think she got it.

Willa Rogers posted:

I thought I'd read some things about PPACA's encouraging hospital mergers through various mechanisms, but it's unlikely those mergers wouldn't have happened anyway, for the most part, given the trends in for-profit hospitals buying up the non-for-profits. But yeah, it's an indictment of capitalism (although PPACA incentivizes extreme capitalism in various ways).

I'm not sure whether this affects freestanding PT centers specifically, but there has been a push over the past several years to cut reimbursement for services to free standing centers and raise reimbursement to hospitals for services. The idea is that by pushing people in to hospital systems you'll ultimately gain efficiency by seeing more people under single hospitals with EMRs and hopefully make gains. We'll see how it plays out over the long term, but the main thing you see right now is an increase in physicians selling out practices to hospitals and NYTimes articles about echos costs increasing by 50% as they move from being performed at freestanding practices to hospitals.

Something similar might be at work with your sister's PT practice, but who knows.

# ? Aug 31, 2013 16:48

Ceiling fan: Dec 26, 2003; I really like ceilings.; Dead Man’s Band

Amused to Death posted:

Question! If your employer offers health care insurance, can you buy insurance on the exchanges paying for it fully out of pocket?

Answer: Yes, as long as you are a citizen or legal resident, and not in jail at the time of enrollment, you can buy insurance on the exchanges regardless of whether you qualify for a subsidy. You also have the opportunity to try to prove your employer is a piece of poo poo who won't offer decent healthcare. It's covered in section 1312 of the ACA.

# ? Sep 4, 2013 06:09

Amused to Death: Aug 10, 2009; google "The Night Witches", and prepare for

Ceiling fan posted:

You also have the opportunity to try to prove your employer is a piece of poo poo who won't offer decent healthcare.

This is exactly why the person I know might do it. Although her employer insurance actually isn't bad and she's going to spend thousands of dollars to prove some kind of point, but whatever floats her boat.

# ? Sep 4, 2013 06:13

Sephiroth_IRA: Mar 31, 2010

So when the exchanges finally go up on October first will I have the option to purchase healthcare from either the federal or state exchange or just the state exchange?

I'm wondering this because I live in NC and I wouldn't put it past those fuckers to put nothing but horrible/expensive insurance plans on the marketplace just to gently caress things over.

# ? Sep 5, 2013 14:45

FAUXTON: Jun 2, 2005; spero che tu stia bene

Residency Evil posted:

I'm not sure whether this affects freestanding PT centers specifically, but there has been a push over the past several years to cut reimbursement for services to free standing centers and raise reimbursement to hospitals for services. The idea is that by pushing people in to hospital systems you'll ultimately gain efficiency by seeing more people under single hospitals with EMRs and hopefully make gains. We'll see how it plays out over the long term, but the main thing you see right now is an increase in physicians selling out practices to hospitals and NYTimes articles about echos costs increasing by 50% as they move from being performed at freestanding practices to hospitals.

Something similar might be at work with your sister's PT practice, but who knows.

That's also a pretty clear possibility, larger group malpractice insurance and having the overhead split among far more providers means lower prices and consequently lower reimbursement costs. I could see that happening with either in-house prices driving clinic prices down or simply moving patients from outside clinics to inside the hospital organization since it's money to the hospital org. I wonder if any doctors can chime in on whether they've had a management company start 'encouraging' in-house referrals over outside clinics.

# ? Sep 5, 2013 15:37

Leon Trotsky 2012: Aug 27, 2009; YOU CAN TRUST ME!*

_{*Israeli Government-affiliated poster}

Orange_Lazarus posted:

So when the exchanges finally go up on October first will I have the option to purchase healthcare from either the federal or state exchange or just the state exchange?

I'm wondering this because I live in NC and I wouldn't put it past those fuckers to put nothing but horrible/expensive insurance plans on the marketplace just to gently caress things over.

There is no Federal exchange, but all the state exchanges have to include non-profit plans set up by the Office of Personnel Management, which is the Federal organization that manages the health plans of Federal Employees.

# ? Sep 5, 2013 15:42

Sephiroth_IRA: Mar 31, 2010

Leon Trotsky 2012 posted:

There is no Federal exchange, but all the state exchanges have to include non-profit plans set up by the Office of Personnel Management, which is the Federal organization that manages the health plans of Federal Employees.

That's weird, I was just told by someone at healthcare.gov that since North Carolina didn't have a state exchange setup I would have to use the federal one.

edit: oh nm, I see what you're saying.

# ? Sep 5, 2013 16:06

evilweasel: Aug 24, 2002

Orange_Lazarus posted:

That's weird, I was just told by someone at healthcare.gov that since North Carolina didn't have a state exchange setup I would have to use the federal one.

edit: oh nm, I see what you're saying.

Because the state didn't set one up, the Federal government will set it up. But it's still a state exchange.

# ? Sep 5, 2013 16:11

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# ? Apr 29, 2024 18:45

Sephiroth_IRA: Mar 31, 2010

edit: nm. Thanks.

Sephiroth_IRA fucked around with this message at 16:31 on Sep 5, 2013

# ? Sep 5, 2013 16:25

The Something Awful Forums > Discussion > Debate & Discussion > PPACA Discussion Thread: 2015 If You Like Your Subsidies You Can Keep Your Subsidies

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