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Dutchess_III's avatar

Which people lost their previous insurance because of the ACA, and why did they lose it?

Asked by Dutchess_III (36148points) April 3rd, 2014

I don’t understand. I mean, we didn’t lose our employer-provided insurance. Nothing changed. Why did some people lose their insurance?

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17 Answers

eno's avatar

The people who lost the plans were those who were stuck in the middle between too rich for medicaid and not being offered a plan by their employer.

It was cancelled for two reasons. Plans were non-compliant with ACA standards and there is no law that prevents insurers from cancelling plans for other reasons, like cancelling plans that are too expensive to maintain. So to save money, the insurer just dumps the customer on the exchange to purchase a shitier, cheaper plan.

jaytkay's avatar

“Catastrophic” plans which have extremely high deductibles and exclude almost all useful coverage are not ACA compliant.

Plans which return less than 80% of premiums as benefits are not compliant.

Basically health insurance plans are required to provide some actual health care.

filmfann's avatar

My sister lost hers because it didn’t meet the required criteria for health care coverage, so she went on the Obama are website and found better insurance. Now she pays $700 less every month.

Skaggfacemutt's avatar

Thanks for this question – I was also wondering. My mom keeps telling me that people in her doctor’s office are bellyaching about losing their insurance since Obamacare, and I couldn’t imagine why, since everyone I know, plus myself, just kept the insurance we had.

Then it dawned on me. About a year ago, I was trying to find a private plan for my 18 year old granddaughter that my daughter could afford. I found some plans for about $120 a month, but when I checked to see what they covered, I was surprised to find that they didn’t cover a thing. Maybe if she was in a terrible accident and ran up about a million dollars in hospital bills, then it would be worth it, but otherwise she might as well have had no insurance at all.

So, those who lost their insurance because it was a scam to begin with, thank you lucky stars instead of crying about it. If you want to give your money away for nothing, buy lottery tickets. Then at least you have a slim chance of getting your money’s worth.

Tropical_Willie's avatar

@Skaggfacemutt It wasn’t a scam, I know of one person that had a “catastrophic” only policy the first $15,000 a year was on him. If he ended up with Cancer or something else the policy would kick in after he spent $15,001 in a year.
He now has a high deductible Gold plan.

Skaggfacemutt's avatar

I guess it depends on your point of view. “Catastrophic” insurance can’t be considered a “health plan”, to me. Who can afford $15,000 a year in medical bills? If you have that kind of money, then I guess you don’t need to worry about the cost of everyday medical care.

Tropical_Willie's avatar

But by law you have medical insurance, Catastrophic was not medical insurance and that is the group of people I know that “lost their insurance” because of ACA.

Dutchess_III's avatar

So, like Aflack and the like?

Skaggfacemutt's avatar

@Tropical_Willie I agree, catastrophic insurance would not meet the requirements for basic medical care, so really those people did not have medical insurance and can hardly say they lost their medical insurance. Since everyone is now required to have medical insurance by law, the catastrophic insurance would be redundant, as medical insurances do have an out-of-pocket maximum that is far lower than $15,000.

JLeslie's avatar

I see no problem with catastrophic insurance. $15k is extremely high for a deductable, but anywhere up to $10k I would not have a problem with if the person buying the insurance is ok with it. That insurance is usually very cheap.

Skaggfacemutt's avatar

I don’t have a problem with catastrophic insurance either, as a supplement to actual medical coverage. But it is misleading for people to say that Obamacare made them loose their medical insurance because that is not true. They still have to get actual medical coverage, but I am sure they could also keep their catastrophic insurance if they wanted to.

Tropical_Willie's avatar

@JLeslie The idea behind the ACA is to insure everybody and to charge for insurance everybody.

JLeslie's avatar

@Skaggfacemutt I disagree. I see no problem with catastrophic on its own. If a 24 year old otherwise healthy young adult wants to only pay for catastrophic and understands for their yearly PAP smear and occasional sore throat they will have to pay a doctor, that is fine with me. Those little appointments don’t bankrupt people and the system, major accidents and health problems do. Paying to go to the doctor for strep throat once a year costs the same as a hair cut and highlights in some cities. The person has to evaluate taking the chance and what makes more sense financially.

@Tropical_Willie Just to be clear my preference is completely socialized medicine. It doesn’t matter what my preference is, because America won’t go for it. If there is going to be insurance, why not have catastrophic as a very inexpensive option? I hope ACA winds up insuring everyone and addresses the very serious problem we have in America with opaque billing and fraudulent charges. I don’t understand how ACA will do that, but I hope it does. There is so much unscrupulous behavior in the medical system it has literally made me weep. It has stressed my marriage. It has affected other parts of my life.

Skaggfacemutt's avatar

@JLeslie Well, that is because you are one of the few people that actually pay your medical bills. The problem is that people without regular medical insurance were using the emergency rooms as their doctor’s office, and then not paying the bill, costing everyone a bundle (because someone has to pay for it).

I also have hopes that ACA will have more regulations on the medical profession to stop overcharging and fraud. The other thing I hope they stop are the hypochondriacs that run to the doctor three times a week, and the big one – keeping a comatose person on life support for 30 years because the family can’t let go.

JLeslie's avatar

@Skaggfacemutt I doubt people who don’t pay their medical bills have catastrophic insurance, but maybe. People like that why would they pay for any insurance at all? I think everyone paying into one big pot is a great idea, like I said I want it to be socialized, to be a tax. For now I am mostly waiting by the sidelines to see what happens over the next five years, how it all really works out. I still have my same high deductable plan. I think it is $2500 each for my husband and me. I might be wrong. I still get disgustingly locked in to paying too much for some procedures because insurance agreed to a higher price than self pay with a particular doctor and the doctor takes advantage of it even though it comes out of my pocket. Even when I don’t pay more they often are double dipping by charging much more because I am insured. I don’t care if it is the insurance pocket or my pocket really, both cost me money in the end. I don’t see how ACA cures that.

Skaggfacemutt's avatar

@JLeslie I think we are arguing, when actually we are on the same side. Yes, people who were using the emergency room as a doctor’s office probably wouldn’t have insurance at all. With the new Obamacare, everyone has to have and has to pay. It remains to be seen what they are really going to do with those who don’t.

I also wish they would have gone straight to socialized medicine. It works in other countries. No one has ever tried this half/half system that we are trying. Typical USA, always on the fence so as not to offend anyone. As I have said in many posts, I have lived in Canada, England and South Africa – all have socialized medicine, and it was wonderful. You go get taken care of, and doesn’t cost a thing. The only way to go. I would gladly pay a tax for that service.

JLeslie's avatar

@Skaggfacemutt I do think we are on the same side. I know someone who worked running a doctors office in Canada and she talked about how many of them barely worked November and December because they had maxed out on what they could bill. From what I understand Canada still reimburses doctors on services, so there is still incentive to perform procedures that might not be necessary. I do think Canada’s system is probably better than America, especially from the perspective of the average person, but I think there is probably still some fraud in that system too. All systems have some fraud I am sure, and having single payer helps reduce the chance of gouging. Even very conservative Maragaret Thatcher left socialized medicine alone because she feared medical costs would go up for the country if she unleashed a private system again.

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