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EugeneJ posted:Insurance companies in NY want to raise their premiums for exchange plans by an average of 15%: They need to do what Connecticut did Article posted:Anthem Blue Cross and Blue Shield’s individual-market customers will, on average, see a slight decrease in their premiums next year under new rates approved by the Connecticut Insurance Department.
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Aug 22, 2014 22:30
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hobbesmaster posted:Its pretty telling that the first 10 pages of the state's brief is constantly saying "ORACLE FRAUD!!!!" and hearsay while the Oracle complaint had a ton dates and directly quoted emails. That's normal. You spend the first part of the brief summarizing what you're going to tell them, and then you go through each part in detail. The initial description is basically a roadmap of what the (200 page) brief is going to say so the reader can fit each part into the story the state wants to tell from the beginning.
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Aug 22, 2014 22:59
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Pohl posted:They need to do what Connecticut did I believe New York has the same process, where they ask to hike rates and then get told to go to hell.
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Aug 22, 2014 23:00
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hobbesmaster posted:Its pretty telling that the first 10 pages of the state's brief is constantly saying "ORACLE FRAUD!!!!" and hearsay while the Oracle complaint had a ton dates and directly quoted emails. Both of them are poo poo. I know this because of the way the state reacted and the fact that Oracle is Oracle. But, if they want to get into a claim-of-responsibility knife fight with Oracle, they're going to lose. Nobody spergs over data like an Oracle guy.
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Aug 23, 2014 05:10
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evilweasel posted:I believe New York has the same process, where they ask to hike rates and then get told to go to hell. CA has another similar thing in the works requiring approval before doing a rate hike.
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Aug 24, 2014 02:17
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Don't all states require rate filings?
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Aug 24, 2014 02:27
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What is going to happen with the court decision regarding the federal exchange?
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Aug 24, 2014 03:50
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DC court will hear the case in full(instead of the random 3 judge panel) and the full court will vote to uphold. At that point you'll have 2 appeals courts in agreement and John Roberts can avoid having to uphold Obamacare again and go back to reminding us racism is dead.
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Aug 24, 2014 03:57
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Amused to Death posted:DC court will hear the case in full(instead of the random 3 judge panel) and the full court will vote to uphold. At that point you'll have 2 appeals courts in agreement and John Roberts can avoid having to uphold Obamacare again and go back to reminding us racism is dead. So what are Justice Roberts's motives? Why uphold Obamacare and then go the other way with other issues?
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Aug 24, 2014 04:10
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Vahakyla posted:So what are Justice Roberts's motives? Why uphold Obamacare and then go the other way with other issues? Roberts likes federal power and is a privileged white catholic.
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Aug 24, 2014 04:12
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PerniciousKnid posted:Don't all states require rate filings? Not every state. And those that do often apply a "file and use" rule, which offers no practical control over the rates (no formal approval of the rates is necessary). As etalian said, California's ballot this year will include Proposition 45 for that very reason (to try to shift California from a "file and use" regimen to a "prior approval" regimen). Naturally, pretty much every healthcare association and every chamber of commerce is against it, to the tune of $37 million in ad spending against the proposition, to less than $1 million in favor. (For some reason, the NAACP is also against it, and some (but not all) unions also oppose it as it only has a carveout for employer health plans, not union health plans  ) Still, the (currently only) Field Poll on the proposition showed 69% in favor as of last month.EDIT: As the first link mentions, it seems Obamacare basically established minimal standards for rate approval (i.e. at least "file and use") mandatory throughout the US, primarily for tracking rate increases on a national scale as part of the paper-thin attempt to "bend the cost curve" ostensibly included in the law, but also presumably to help administer Obamacare subsidies and exchanges, which sorta need rates to be filed in order to actually be workable. Some states (primarily the biggest holdouts against Obamacare) have evidently refused to implement rate filing on the state level, making it the federal government's responsibility to handle rate filing in those states. ComradeCosmobot fucked around with this message at 04:31 on Aug 24, 2014 |
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Aug 24, 2014 04:18
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After waiting a month or so to see if WA State would work itself out on its own, and to work on more pressing things (like finding another place to live), my application is still messed up, and Premera doesn't know that I exist. I really hope they make good on that retroactive preauth that they said was possible, because $360 later, I may FINALLY have the inhaler that may quell this asthma flareup once and for all. This is going on Month 4 now. WA State has no reliable information, and Premera is powerless to do anything, as the state hasn't sent over my info yet. Who can I call to get this escalated - the State Insurance Commissioner? The Governor's Office? The Seattle Times Newspaper? Consult with a lawyer? Consult with a Broker? I have no confidence anymore in anything that WA State Health Plan Customer Service can say to me. My application is stuck at the 'verifying life change and supporting documentation' stage, and no one there seems to be able to - or feels motivated enough - to get it fixed. And they've verified many many times that I've submitted all the documentation that they need. This issue is way different from the 'payments' one that some users have, and has theoretically been rectified. Ideas? Qu Appelle fucked around with this message at 06:10 on Sep 3, 2014 |
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Sep 3, 2014 06:08
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Much like a VA issue you have to make as much noise as possible. Write your State Representative, House Representative, Senator, and everybody you've already listed. Explain how you have been verified multiple times (with proof) and have not gotten any where.
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Sep 3, 2014 18:51
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Well, I checked, and I saw this: Approved to buy a Qualified Health Plan!  I don't even know what this means anymore. I checked with Premera, and I still don't exist. Oh, and paying $550 in one trip for prescriptions is a hell of a lot of fun, I tell you. WA State, this time it's personal. ew note: I removed the screenshot since you didn't censor everything you probably meant to. Somebody fucked around with this message at 20:52 on Sep 3, 2014 |
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Sep 3, 2014 19:32
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Talk to an ACA-ceritified insurance agent, who can check with the insurance carrier.
Willa Rogers fucked around with this message at 21:21 on Sep 3, 2014 |
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Sep 3, 2014 20:45
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Qu Appelle posted:Well, I checked, and I saw this: Approved to buy a Qualified Health Plan! No worries on the removal, thank you. Broker called; she agrees that this is exceedingly messed up. She shall call tomorrow and find out what the shenanigans are, then call me back. I'll let these people work their magic before escalating this; I mean, this is what they're paid to do. It's good to know that I'm not trying to fight this alone anymore. Thanks for the help, all  Qu Appelle fucked around with this message at 22:13 on Sep 3, 2014 |
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Sep 3, 2014 21:35
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The DC Circuit has agreed to rehear Halbig en banc. It is widely believed that due to the recent Obama appointments that gave Democratic-appointed judges a significant majority (remember to thank Harry Reid for using the nuclear option to get these judges appointed), they will overturn the original decision and hold that the bill allows subsidies on healthcare.gov. http://talkingpointsmemo.com/dc/dc-circuit-grants-en-banc-halbig
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Sep 4, 2014 15:34
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Oh hey - look at this: http://www.kirotv.com/news/news/woman-pays-insurance-premiums-doesnt-have-insuranc/nhFhM/ This is the EXACT same situation that I'm in. Same month the coverage was to start, and the same plan. I contacted the reporter by email with my story, and gave her permission to interview me. I may even call the reporter this afternoon. 
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Sep 4, 2014 19:34
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New Kaiser Foundation report says that Obamacare is working much better than most expected:quote:A new report from the Kaiser Family Foundation finds that in seven major cities that have released data on 2015 premiums, the price of the benchmark Obamacare plan — the second-cheapest silver plan, which the federal government uses to calculate subsidies — is falling. http://www.vox.com/2014/9/5/6108493/obamacare-premiums-lower-2015
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Sep 5, 2014 22:50
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FCKGW posted:New Kaiser Foundation report says that Obamacare is working much better than most expected:  This won't be good for GDP growth.
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Sep 5, 2014 22:58
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If you are having a problem with your state run plan or stuck in the system, call your state rep or state senator or governor, they might be able to get you out.
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Sep 5, 2014 23:54
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Part of fall in CT(Hartford) can be attributed to the fact Anthem went and asked the state for an average of a 12% hike which the state responded with "lmao, no, rework your formula and try again", and lo and behold the new numbers showed some plans(in and out of the exchange) with falling premiums with the higher tier plans with much smaller increases. http://ctmirror.org/after-rate-hike-rejected-anthem-to-decrease-premiums-next-year/
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Sep 6, 2014 00:01
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Mooseontheloose posted:If you are having a problem with your state run plan or stuck in the system, call your state rep or state senator or governor, they might be able to get you out. This is exactly what I did today. Governor Jay Inslee's office was quite interested with what I am going through.  . Because right now? WA State Worst State.
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Sep 6, 2014 04:24
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Apparently Obamacare has been so successful that the unthinkable might happen: the House might pass up a chance to hold a repeal vote on it:quote:A more telling development may be a behind-the-scenes fight within the Republican Party over a simple message vote. This National Review editorial, which is an attempt to persuade Congressional Republicans to stiffen their anti-Obamacare spines, contains the only reporting I’ve seen about this episode. The subject of the fight is a prospective Republican bill to repeal something called “risk corridors,” which are a temporary program to balance out the actuarial risk insurance companies face. If an insurer turns out to enroll disproportionately healthy customers, the risk corridors force them to pay back some of their profit to the government; if their consumers turn out to be disproportionately sick, they get money back from the government. Risk corridors are based on a similar program created by George W. Bush’s Medicare expansion, which was uncontroversial then and now. Since it’s part of Obamacare, conservatives have attacked it as a sinister corporate plot. Last year, Republicans learned of its existence and started calling the program an “Obamacare bailout” and demanding its repeal. http://nymag.com/daily/intelligencer/2014/09/ted-cruzs-obamacare-nightmare-comes-to-life.html
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Sep 9, 2014 15:24
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In my latest news, I've contacted a reporter with the Seattle Times regarding my health insurance, as WA State says that it still may take several weeks to process my application. I am also highly considering getting a lawyer; if I would have had insurance, my stress levels would have been lessened, and I wouldn't have had that panicked suicidal ideation that sent me to the Psych ER. Via ambulance. Because I don't know when I'm going to get covered, and it's now $650 or so out of my pocket for my medications - and one of those is a name brand inhaler that Premera may not even cover, as they need a preauthorization for it. gently caress this noise. I want blood, health insurance, and restitution.
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Sep 10, 2014 00:42
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See if WA has a facebook page for its obamacare program and if so, repost that post there. There are ton of folks having similar problems in California, and it seems that posting publicly on the CoveredCa facebook page elicits an official response (even if it's "please message us with your deets so we can pretend to be responsive on our facebook page"). There've also been some class-action lawsuits in CA and it might be worth seeing if WA has any going on. And if it makes you feel any better, it's likely you'd have still had to pay that $650 as a deductible under most Obamacare plans.  eta: Californians have also had some success when they announce they're filing complaints with the state's insurance-oversight agencies, for what it's worth. Willa Rogers fucked around with this message at 01:09 on Sep 10, 2014 |
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Sep 10, 2014 01:06
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Willa Rogers posted:See if WA has a facebook page for its obamacare program and if so, repost that post there. I pinged WA State, and they said to hook up with a broker. Which I did - I'm trying to get back in touch with them. My deductible is $3000 for the year. If I was insured, and it was going towards the deductible, I'd be OK with it. It's actually mostly generic meds, and I checked the formulary before I joined - they're covered, with a $10 copay each. The Advair is the tricky one; Premera won't cover it without a prior authorization - which I obviously can't get as I'm not on their insurance rolls yet. But, breathing is kind of fun, so I've started buying it out of pocket. Even if Premera decides that they can't cover it, but applies it towards the deductible, I'm also OK with that. I just want something to bill it against. The ER visit and ambulance ride alone will probably make me hit my deductible. (And while this seems unlikely, Premera also said that they have retroactive preauthorizatons, especially since I've been paying my premiums on time, this is a necessary medication, and it's not my fault that they don't have my application to process in the first place.) Qu Appelle fucked around with this message at 04:46 on Sep 10, 2014 |
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Sep 10, 2014 04:43
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Ugh, I hate the new formularies for prescription drugs; they're proving to be a real jerkmove on the part of most insurers. Some insurers have effectively skirted the pre-existing ban by making it impossible for people with HIV or cancer to obtain the drugs they need to stay alive. I wish you the best of luck; do keep us posted.
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Sep 10, 2014 04:48
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It took tens of thousands of preventable deaths per year to get this far, it'll take tens of thousands more to get any farther.
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Sep 10, 2014 06:16
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Willa Rogers posted:Ugh, I hate the new formularies for prescription drugs; they're proving to be a real jerkmove on the part of most insurers. Some insurers have effectively skirted the pre-existing ban by making it impossible for people with HIV or cancer to obtain the drugs they need to stay alive. Thank you. I'm really fortunate to have a decent job and decent savings, so I can afford all of this crap. Plus, I lose my job in either late October, or late December. This may seem like a massive loss, but I'm going back to school in January for 6 months, and I can get on WA Medicaid AppleHealth for that period. Food stamps as well. So all I'd have to worry about is rent, and school supplies, and that's socked away in a separate savings account. I planned this months ago. If I didn't have this? I'd be screwed. Ironically, I could probably get the Advair for free from their prescription service. No idea about the other meds. Maybe get on the name brand equivalents through their prescription services.
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Sep 10, 2014 06:22
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I'm getting hired by the local school district and if I go with the offered PPO plan for my wife and kid, the premiums will take literally my entire paycheck after taxes and retirement. The HSA plan isn't much better. Meanwhile, I'm not sure yet, but from what I've been told, my GI bill money doesn't count as income for federal subsidies. However, the state medicaid program DOES count it for determining eligibility for medicaid. I'm not entirely sure what that means for me, but it doesn't matter, because I can get myself on my employers HSA plan for free, and it's better than any Silver plan on the exchange. I think it COULD mean that I wouldn't qualify for medicaid or subsidized insurance at all; but that's only if ineligibility for subsidies is based on the STATE accepting me for medicaid and not the federal government saying I should be eligible. Now my wife makes things even more interesting, as she is not a US citizen, and will soon be coming over on a spouse visa, for which I had to sign an affidavit of support saying she will take no means-tested benefits. They aren't counting marketplace subsidies for that purpose, but Medicaid DOES count, so she can't have Medicaid regardless. No one I've talked to is sure whether she would qualify for marketplace subsidies or not. Oh yeah, and she's pregnant. Assuming she has an uncomplicated pregnancy, it will cost us exactly the same amount of money with my employer's insurance as without. I don't even know if this is allowed, but I think our best option may be to have me on my employer's insurance, my wife on marketplace insurance, and our child on medicaid. But we're considering just not having her come here. This is not the first time America's nightmare health care system has hosed with my personal life. Long before I met my wife, I chose not to pursue a relationship with another foreign lady, mostly because she wanted to go to America, and I could not be sure I would always be able to pay for her dirt-cheap-at-home but $1000+ dollars-per-month-in-the-US medications.
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Sep 12, 2014 03:33
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What state are you in, VideoTapir?
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Sep 12, 2014 03:37
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Discendo Vox posted:What state are you in, VideoTapir? Arizona. I'm really starting to wish I hadn't come back here for school, but gone to one of the states which don't count medicaid as a means-tested-benefit for immigration purposes. (IIRC NY and maybe VT) Words can't express how much I hate Republicans right now. edit: Just found this gem in the Healthcare.gov FAQs: quote:Can my employer punish me if I get tax credits when I buy a health plan through the Marketplace? Hahahah, this is a thing that really happens? VideoTapir fucked around with this message at 04:22 on Sep 12, 2014 |
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Sep 12, 2014 03:46
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Arizona has platinum plans on the exchange that would be around 600 a month for two 35 year olds and a 5 year old kid. That might be your best bet. Also, I don't know what congressional district you're in but the congresswoman for CD9 does a lot of work for veterans and it's election season. Maybe see if they're willing to help you out.
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Sep 12, 2014 04:31
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My quick update - an insurance broker is working with WA State to get my application unblocked, and one of the problems is that there's no way for a human to come in an do a 'manual override' easily. But, I have confidence, and at least I don't have to do this alone. Completely separate question - how is the exchange in Illinois? I'm getting burnt out on this Seattle 'pay through the nose for a walk in closet' living phenomenon, and I want to live in Chicago for a bit. Haven't lived elsewhere for over 15 years now, and I want to be closer to my dad, who's in Wisconsin. Do they have an exchange that's vaguely functional, or is this a situation where you all laugh hysterically until you're wiping away tears? Do they have Medicaid expansion? Is it something that can be carried over from WA State, unless/until I become a resident of IL? It wouldn't be until I finish up my schooling (I hope!) next Spring or Summer. And it just may be a few month stint. I need a break from WA State. Qu Appelle fucked around with this message at 21:32 on Sep 12, 2014 |
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Sep 12, 2014 21:28
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Illinois, for some reason, decided to go with healthcare.gov instead of running its own exchange. It does have Medicaid expansion, although as with many other states it's an amalgam of managed-care plans that are privately administered. (As opposed to the old days, when you just found docs who took it.) As such, you'd prolly have to re-up when you returned to WA, but your eligibility would already have been established. I have no clue how seamless or easy it is to go back and forth between states & their plans; I'm pretty sure you have to prove state residency each time you switch.
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Sep 12, 2014 22:45
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Qu Appelle posted:My quick update - an insurance broker is working with WA State to get my application unblocked, and one of the problems is that there's no way for a human to come in an do a 'manual override' easily. But, I have confidence, and at least I don't have to do this alone. What makes you think Chicago is going to be less expensive than Seattle?
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Sep 12, 2014 22:53
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mastershakeman posted:What makes you think Chicago is going to be less expensive than Seattle? Hard data, probably.
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Sep 13, 2014 00:06
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Well I'll be darned.
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Sep 13, 2014 02:21
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Willa Rogers posted:Illinois, for some reason, decided to go with healthcare.gov instead of running its own exchange. It does have Medicaid expansion, although as with many other states it's an amalgam of managed-care plans that are privately administered. (As opposed to the old days, when you just found docs who took it.) As such, you'd prolly have to re-up when you returned to WA, but your eligibility would already have been established. That makes a lot of sense. Especially since this may be a more of a two-three month 'sabbatical' rather than a 'relocate across the country and build my life from scratch' type of move. At least for now. I'm just initially planning it out. Probably the first step is to make sure I can get prescriptions filled in IL with my WA State Medicaid card. (I go to Target, so it's a nationwide chain.)
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Sep 13, 2014 06:54
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