Healthcare deductables

MunoRN, RN · Jan 24, 2015

Poppycat, enjoy that union Cadillac plan while you can. If the unions had not obtained a delay then you'd be in similar shape to me.
My premium through work did not increase this year but deductibles and copays increased greatly. I am now buying my prescriptions out of pocket because it is cheaper than buying them with my insurance. My copay for a 3 month supply of a generic was $72. When I refilled I went to my grocery store where it falls on their $4/$10 formulary. There I pay $10 for a 3 month supply. My wife has separate insurance through her employer. Her copay for an office visit is $120.
This is an example of how our employers have had to increase our share so the plans will not be considered Cadillac plans and face a 40% tax. If the unions are not able to eliminate this tax, they will feel the change in 2018.
Labor Unions' Latest Problem: Obamacare's 'Cadillac Tax' Harms Their Gold-Plated Health Insurance Plans - Forbes

The cadillac tax is one area where I agree with republicans. The basic premise of the cadillac tax is that when able, people should be spending their own money up to a point, which encourages them to spend their money wisely and competitively purchase services. It's also intended to put a limit on the amount of tax breaks people get when purchasing insurance.

The "cadillac tax" puts a 40% on the value of a plan that exceeds $27,500 for a family plan, partly because these plans typically require no cost sharing on the part of the consumer and therefore should be discouraged. However there is nothing stopping employers from providing a cheaper plan, and giving the employee the cash they saved by getting a cheaper plan which the employee can use to pay their out-of-pocket costs. Also, someone getting $27,500 worth of health insurance is getting a $6,000 tax break, far more than those buying their insurance through the exchanges get in the form of tax subsidies. Someone getting a $30,000 insurance plan from their employer is still only paying $1,000 on that $30k in income, far less than what someone pays who is purchasing their own plan of equal value on their own.

A conservative physician/politician's view on the cadillac tax:

Obamacare's 'Cadillac Tax' Could Help Reduce The Cost Of Health Care - Forbes

Tenebrae, BSN, RN · Jan 24, 2015

Wrong. Zero republican votes for the ACA. Look it up.

Yet Mitt Romney the republican candidate in the last election signed very similar legislation into law in Massechutsis when he was the governor

azhiker96, BSN, RN · Jan 24, 2015

Thank you Muno for the excellent article. It seems to give good treatment to the potential benefits and problems of the Cadillac tax. I find it interesting that the Cadillac tax is meant in part to correct a problem of pre-tax dollars being used to pay for health insurance.

tokmom, BSN, RN · Jan 24, 2015

This whole thread makes me so grateful that my husband is a Teamster & our insurance is through his employer. We pay no premiums, no deductible, nothing for prescriptions, & only $10 copay for office visits.

Can you adopt me? :)

ComeTogether, LPN · Jan 24, 2015

I have a FSA I use for my deductible. Until we meet it, we pay 100% of everything, and it's been that way since way before the ACA.

We pay what the ins. would pay, once we meet our deductible we pay 20%. What a lot of people fail to realize is simply by having insurance, you pay much less than you would if you didn't, because you get the same rate the ins. company would get if you'd met your deductible.

Spangle Brown · Jan 24, 2015

Actually, I'm not wrong. I know MANY Republicans who voted based upon Healthcare. This is an issue that effects all sides equally and many believe it should be nonpartisan. The issue has been in play and being worked on LONG before Obama was elected President.

Yes, this is the compromise that was reached. The other choice was to have nothing at all, and some refused to believe that it was a VALID option, so refused to actually WORK to achieve a system they would like. Now they whine and claim they had no choice, it was forced, it is horrible, etc. Whine, whine, whine, blah, blah, blah. All that is an attempt to redirect the attention to what THEY should have done and what part they play in it. I was watching the whole thing, so I don't need talk shows to give me a different 'take' on the history of this. The REALITY IS, they had a responsible to get in there and WORK on the plan. They chose not to, and this is what we have. They are JUST AS RESPONSIBLE for the out come.

What is the solution?? If they are serious, where are their solutions?? I am not really hearing any plans. All I am hearing is that this one should be scrapped. You know, the same one they always had. THIS has always been their plan. Gut the first one, then complain about all that wasn't allowed in it, then get rid of it, and claim 'we tried." They have never tired, except to prevent having anything in the first place.

I don't care who gets credit for it. The only dog I have in this race is where we end up with affordable health care. I have been without insurance and ended up with major bills. I do not wish to be in that situation again. Yet, as I age I am developing issues that will cause me to be considered uninsurable. What is the solution that is being put out?? NOTHING.

WE have a mentality here, were we do not want 'others' to get something for free, or a step up. We want to claim that people will pay for things, that in reality they will not. Geesh, in some areas local governments are including yearly garbage fees, to ensure every home does have garbage pick up. This is to prevent people from taking their garbage and dumping it on private property. Call it FORCED, Call it a TAX, but tax payers are not having to pay people to clean up the garbage. It is unrealistic. In this age to think that people will really pay these medical bills, where a $200 cell phone bill is ok, but the same bill for medical expenses will be sent to collections for lack of payment. People use ER's as if it is nothing, since they don't worry about the bill. People will call for an ambulance to go to the ER, cause they have an ingrown toe. Why worry about the cost?? That means it is going to get worse ,the medical costs are going to get higher, nothing is for free.

You want to make this about party politics, executive actions, etc. Why? Surely you realize that no party is innocent in what you mentioned. If you believe it, then do some reading on the matter. You can even read those kinds of comments about the last President. Those issues are just smoke and mirrors to keep people from realizing that NO SOLUTIONS ARE BEING MENTIONED. Leave party politics at the door, it really has no place when trying to work out a solution.It gums up the wheels.

Red Kryptonite · Jan 24, 2015

Spangle, I meant congressional votes.

fawnmarie, ASN · Jan 24, 2015

Red Kryptonite is a CNA and nursing student. I think her attitude toward "the brave new world" so many of us voted for may change...when she actually becomes a licensed nurse and sees firsthand the abuses of the health insurance industry.

LadyFree28, BSN, LPN, RN · Jan 24, 2015

Red Kryptonite is a CNA and nursing student. I think her attitude toward "the brave new world" so many of us voted for may change...when she actually becomes a licensed nurse and sees firsthand the abuses of the health insurance industry.

True...especially when you have seen cuts in insurance to those who need it because they are deemed too expensive because of their pre-existing health conditions...no, wait, we don't have to worry about that anymore, at least.

"Free market" insurance can kick rocks!

SC_RNDude · Jan 27, 2015

Red Kryptonite is a CNA and nursing student. I think her attitude toward "the brave new world" so many of us voted for may change...when she actually becomes a licensed nurse and sees firsthand the abuses of the health insurance industry.

How condescending. What does being a CNA vs RN have to do with anything.

A vast majorty of RN's I know don't pay enough attention to have an educated opinion on the healthcare issue one way or the other.

I consider myself pretty knowledgable on the subject. It has very little to do with being a RN however. I work in a hospital, where most of us do, and have zero idea of what my patients insurance is, what it's paying for, what it won't pay for,etc.

I pretty much share RedKryponite's opinion on this, at least based on what she/he has posted in this thread. And I'm a RN.

Maybe instead of jumping in to make an insulting comment and offering nothing else, maybe you could tell us with how you disagree with what RedKrypto has said?

Loo17 · Jan 27, 2015

I am in my 30's with no ore existing medical conditions. I would not mind paying $100 a pay for health insurance if the deductibles were more reasonable. Currently the only way I can go to my doctor with a co-pay is if it is a well visit. If I am worried I might have strep or a sinus infection, I need to pay full price to see my PCP for the visit until I reach my $2500/yr deductible. Yet those with state sponsored insurance can come to the ED where I work to have their sty looked at, free of charge. There needs to be a happy medium. I shouldn't have to pay through my nose to maintain my health just because I work. Just because I make a decent wage doesn't mean I can afford the cost. I miss the days of $10 copays to see my pcp for cold symptoms. 10 years from now we are going to see the repercussions of high deductible plans being the norm for working class americans.

toomuchbaloney · Jan 27, 2015

How condescending. What does being a CNA vs RN have to do with anything.
A vast majorty of RN's I know don't pay enough attention to have an educated opinion on the healthcare issue one way or the other.
I consider myself pretty knowledgable on the subject. It has very little to do with being a RN however. I work in a hospital, where most of us do, and have zero idea of what my patients insurance is, what it's paying for, what it won't pay for,etc.
I pretty much share RedKryponite's opinion on this, at least based on what she/he has posted in this thread. And I'm a RN.
Maybe instead of jumping in to make an insulting comment and offering nothing else, maybe you could tell us with how you disagree with what RedKrypto has said?

To be honest, the bulk of RedKrypto's comments have centered around the partisan political debate of healthcare and the ACA rather than around the practical experiences or issues of health care delivery and health outcomes, IMHO.

Health insurance deductables are as high as health insurers can legally make them. That is and always has been true irrespective of the ACA. It is a feature secondary to having a financial "gambling" industry smack in the middle of our health care delivery model. They are there to make money, as much as possible, while acting as the financial middle man for millions of Americans who have no other choice in paying for their health care.

It is true that many RNs don't understand the features of the ACA. I might argue that even fewer CNA's understand that as a portion of their job. At least some RNs work in environments where we DO interact with and have need to know about the patient's insurance details, and have read the ACA.