Health Insurance costs

whichone'spink, BSN, RN · Nov 17, 2015

I pay $91 for a HSA plan with a $2,000 deductible. $30 goes is my contribution to the HSA and my employer $30 more. I have about half of my deductible in the HSA account now, and I have not used it. There is a prescription tier, but if I were to need a prescription filled, I would be better off going to Walmart to check if it's on their $4 or $10 prescription list. I can only see doctors in my network unless I want to pay more to see doctors out of network. I tried looking for plans on MNSure, which is Minnesota's exchange site, but for a decent plan with a lower deductible, it would cost up to $250. I didn't know Texas had cheaper plans. Does Texas have a state exchange or is this from the federal exchange?

Not_A_Hat_Person, RN · Nov 17, 2015

Texas does not have its own exchange.

PinayUSA · Nov 28, 2015

I was paying zero for Health Insurance, I was self pay when I needed medical. I do carry Dental Plus for $130 a year, it pretty good.

I suspect with ACA I will be paying a fine for not having insurance, Thanks Obama for screwing the country.....

Editorial Team / Admin · Nov 28, 2015

Thanks Obama for screwing the country.....

A) This was not something Obama did on his own- it took Congress as well.

B) The healthcare system in the US was broken (still is) and something needed to be done. Maybe this isn't the right choice, but leaving things as they were wasn't the right choice either.

MunoRN, RN · Nov 29, 2015

I was paying zero for Health Insurance, I was self pay when I needed medical. I do carry Dental Plus for $130 a year, it pretty good.
I suspect with ACA I will be paying a fine for not having insurance, Thanks Obama for screwing the country.....

If you're truly able to self pay a potential bill then you won't be charged a fine since you would qualify as self-insured.

It's also possible that you aren't actually uber-rich, and what you're upset by is that there is now a punishment, albeit small, for being selfishly irresponsible and adding you're potential costs to my insurance premium, putting more money in your pocket by taking it out of mine even if you might have just as much ability to be responsible as I do.

PinayUSA · Nov 29, 2015

A) This was not something Obama did on his own- it took Congress as well.
B) The healthcare system in the US was broken (still is) and something needed to be done. Maybe this isn't the right choice, but leaving things as they were wasn't the right choice either.

This clown we have in office only has made insurance rates climb for most, and still we have a messed up healthcare system.

PinayUSA · Nov 29, 2015

If you're truly able to self pay a potential bill then you won't be charged a fine since you would qualify as self-insured.
It's also possible that you aren't actually uber-rich, and what you're upset by is that there is now a punishment, albeit small, for being selfishly irresponsible and adding you're potential costs to my insurance premium, putting more money in your pocket by taking it out of mine even if you might have just as much ability to be responsible as I do.

This is the only thing I have ever seen in my lifetime where a person is required to signed up or pay a fine, It is basically socialism.

What I am upset about is that if you are an illegal immigrant you get free insurance or if you decide you want to sit home and collect welfare and section 8 and pop out kids for a living then you don't pay for health insurance, If you work and make a good living in USA then you get penalized.

That is the part I don't like, I have to support the bottom feeders.........

MunoRN, RN · Nov 30, 2015

This clown we have in office only has made insurance rates climb for most, and still we have a messed up healthcare system.

One of the reasons health insurance reform was inevitable was that insurance rates were climbing long before the ACA, and at a rate much higher than overall inflation and that gap was growing year by year. Overall costs actually grew less in 2014 than they had at any other time in almost 50 years. There were some people in the individual market who had cheap, but very low value insurance; they were unlikely to actually cover severe costs which shifts their costs to others. In being required to purchase legitimate insurance, their costs did go up but only because their costs now reflect their fair share.

MunoRN, RN · Nov 30, 2015

This is the only thing I have ever seen in my lifetime where a person is required to signed up or pay a fine, It is basically socialism.

We're required to pay into police departments, fire departments, the military, etc. Why should you have a legal right to walk into a hospital with an acute condition and rack up a few-hundred-thousand dollars in cost and yet not do anything to have paid into that?

What I am upset about is that if you are an illegal immigrant you get free insurance or if you decide you want to sit home and collect welfare and section 8 and pop out kids for a living then you don't pay for health insurance, If you work and make a good living in USA then you get penalized.
That is the part I don't like, I have to support the bottom feeders.........

Illegal immigrants don't qualify for potentially subsidized insurance, much less "free insurance". Healthcare costs money, we put that money into the system mainly through insurance, if you're able to pay into that system but you're not, even though you might potentially benefit from that system, then you're the "bottom feeder".

What would your solution be?

Jolie, BSN · Nov 30, 2015

If you're truly able to self pay a potential bill then you won't be charged a fine since you would qualify as self-insured.
Please post a reference to this. I am of the understanding that taxpayers who do not present proof of health insurance on their federal tax returns will be assessed a penalty. I was not of the understanding that self-paid medical bills were an acceptable alternative to documentation from one's employer or health insurance company.
It's also possible that you aren't actually uber-rich, and what you're upset by is that there is now a punishment, albeit small, for being selfishly irresponsible and adding you're potential costs to my insurance premium, putting more money in your pocket by taking it out of mine even if you might have just as much ability to be responsible....

You are referring to the individual mandate as a means of enforcing responsibility for one's own healthcare expenses, which we know is ineffective. There is a simple solution to your above stated objection to others who are "selfishly irresponsible and adding... costs to my insurance premium, putting more money in your pocket by taking it out of mine even if you might have just as much ability to be responsible...." If they choose not to provide for their own healthcare, there is absolutely no reason for anyone else to provide for them. Simply quit providing treatment in any form for those who refuse to arrange to pay for it. If a competent adult chooses not to prepare for healthcare payment, take him at his word and don't provide it. Problem solved.

MunoRN, RN · Nov 30, 2015

Please post a reference to this. I am of the understanding that taxpayers who do not present proof of health insurance on their federal tax returns will be assessed a penalty. I was not of the understanding that self-paid medical bills were an acceptable alternative to documentation from one's employer or health insurance company.

If you are self-insured then you do have proof of qualifying insurance and wouldn't be subject to a penalty. But just being able to pay some of your potential bills doesn't qualify as self-insured, you have to prove you have adequate assets to pay most potential bills, which can easily run into the hundreds of thousands of dollars or more. https://www.healthcare.gov/glossary/self-insured-plan/

You are referring to the individual mandate as a means of enforcing responsibility for one's own healthcare expenses, which we know is ineffective. There is a simple solution to your above stated objection to others who are "selfishly irresponsible and adding... costs to my insurance premium, putting more money in your pocket by taking it out of mine even if you might have just as much ability to be responsible...." If they choose not to provide for their own healthcare, there is absolutely no reason for anyone else to provide for them. Simply quit providing treatment in any form for those who refuse to arrange to pay for it. If a competent adult chooses not to prepare for healthcare payment, take him at his word and don't provide it. Problem solved.

That wouldn't be legal since any CMS participating hospital is legally required to provide treatment of acute conditions due to EMTALA, that treatment is legally required up until the point the patient no longer requires acute care, which can be hundreds of thousands of dollars and weeks or more down the road.

I've pointed out many times that in order to let people opt out of paying insurance if able that we would have to get rid of EMTALA as well as the ethical expectations that doctors and nurse are bound by and I think you're the first person to actually agree and say that's what we should do.

While I agree that's really the only practical way of allowing people to opt out of insurance, it's not really clear if it's even workable if we were to decide to sink to that level. The first obstacle would be whether or not you could actually get doctors and nurses to take someone who might be relatively easy to fix, but instead just give them some morphine to make them comfortable as they die (assuming the would at least be allowed some morphine). Another problem would be differentiating who is actually declining future treatment vs who just can't afford insurance. Another would be the overall effect on healthcare. If only a relatively small portion of people are paying into the system, then various services currently available could not continue to be available since they would lose the volume that makes them viable.

Jolie, BSN · Nov 30, 2015

If you're truly able to self pay a potential bill then you won't be charged a fine since you would qualify as self-insured.

This response is a far cry from what you posted in # 22. Please be honest and forthright. Paying bills out of pocket is not the same as having a certificate of self-insurance. Your previous answer was misleading at best and dishonest in all likelihood. Please respond accurately and honestly and quit the double talk, Muno. It's tiresome.

https://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/Gathering-Your-Health-Coverage-Documentation-for-the-Tax-Filing-Season

As far as the individual mandate, it is a cornerstone of Obamacare. So either make it work, or get rid of it. The only to make it work is to deny care to competent adults who knowingly refuse to make plans to pay for healthcare. Yes, that would involve rescinding previous treatment mandates. No big deal. Of course, there is not a liberal on this planet who will enforce individual responsibility to any extent, let alone this extent, so it will never happen. Obamacare is ineffective by design and by intent. This is just one example.