Information on Affordable Health Care Act

Neveranurseagain, RN · Jul 30, 2010

I looked into this for a friend of mine. It would would cost almost $1200 month for her and her 2 kids (all three have prexisting conditions) for the health insurance. That's 40% of her take home pay, yet she makes $50 a month too much to qualify for the state medicaid program. So she still will not have health insurance. So how can it be called affordable?

Obama, you dropped the ball by not offering a viable public option that people can afford. But at least it's a start!

mandyc · Jul 30, 2010

I hope that soon things will change with this. According to the plan changes..It seems as though the Insurance companies will no longer be able to charges HIGH premiums for pre-existing conditions. There is also a "pool" for those that are considered to have pre-existing conditions. I know that currently I am paying close to 700.00 a month for medical/dental insurance, and I WORK for the hospital...It is crazy! The costs have got to go down. At one company I worked for (prior to being a nurse) I was paying close to 1200.00 a month. My paycheck to say the least was less than null. I have to care insurance for my family, 1.) my husband is self-employed and has pre-existing condition and 2.) he has been denied private insurance...I hope that by the year 2014 everything will change, but until then....what is person to do.

This is directly from the site: "May I apply for the Pre-Existing Condition Insurance Plan if I have existing health coverage?

You are not eligible unless you have been without health coverage for at least the last six months. For example, if you have Medicare or TRICARE, you shouldn’t apply. If you are uninsured and have been told that you may be eligible for other coverage programs like Medicaid and the Children’s Health Insurance Program, you should check out those programs first, as they may better meet your needs. If you have job-based coverage, or individual insurance coverage, you aren’t eligible to apply."

Who would even CHANCE being without insurance for 6 months to qualify....kinda a hard choice to make. There are some other options, depending on which state your friend is located in. The pre-existing clause to the changes is to be in effect by July of this year...Maybe it will be different than Colorado?

**NickiLaughs, ADN, BSN, RN** · Jul 30, 2010

Like actually having health insurance now is even much better. I will say that my job covers most of my health care insurance. However, because it is an HMO (my hospital doesn't offer a PPO or better option) I usually wait forever for appointments with specialists. I have a ventricular septal defect, I let them know at 9 weeks pregnant. at 21 weeks pregnant I finally had the clearance to see the cardiologist, wait 3 weeks for the appointment. He sees me and says that I need to see a specialist who can better care for my needs. Finally get the approval at 30 weeks pregnant, takes 4 weeks to get into see the specialist for an appointment. He orders some tests, but cannot see me again for a follow up without my primary physician making another referral to him (explain that??????????). So I am now 36 weeks pregnant, still waiting on the OK. I figure by the time I've had my follow up to address any special concerns that would have applied during labor...I'll have a month old baby.

Now oddly enough my friend on medicaid, similar circumstances, has been followed since week 10 of her pregnancy by all sorts of specialists, no problem.....hasn't worked in years, has 3 kids already.

I'm actually going to hunt for a job with better insurance after I have this baby, because it seems to me that as a working person who contributes should have better health care options. I am frustrated with health care, much like many of us. I don't know what the solution is, but I don't think this health care plan is going to help anything. I will give Obama credit for trying though.

eriksoln, BSN, RN · Jul 31, 2010

Like actually having health insurance now is even much better. I will say that my job covers most of my health care insurance. However, because it is an HMO (my hospital doesn't offer a PPO or better option) I usually wait forever for appointments with specialists. I have a ventricular septal defect, I let them know at 9 weeks pregnant. at 21 weeks pregnant I finally had the clearance to see the cardiologist, wait 3 weeks for the appointment. He sees me and says that I need to see a specialist who can better care for my needs. Finally get the approval at 30 weeks pregnant, takes 4 weeks to get into see the specialist for an appointment. He orders some tests, but cannot see me again for a follow up without my primary physician making another referral to him (explain that??????????). So I am now 36 weeks pregnant, still waiting on the OK. I figure by the time I've had my follow up to address any special concerns that would have applied during labor...I'll have a month old baby.
Now oddly enough my friend on medicaid, similar circumstances, has been followed since week 10 of her pregnancy by all sorts of specialists, no problem.....hasn't worked in years, has 3 kids already.
I'm actually going to hunt for a job with better insurance after I have this baby, because it seems to me that as a working person who contributes should have better health care options. I am frustrated with health care, much like many of us. I don't know what the solution is, but I don't think this health care plan is going to help anything. I will give Obama credit for trying though.

I'm hearing you loud and clear.

I used to be a travel nurse. Everyone knows, the health insurance for travel nursing is not good at all. At least is wasn't for the company I worked with. I became a full time staff nurse, and better health coverage was a small part of the motivation for this.

I honestly don't see the difference. In fact, my company made changes to their plan and I'd say its probably worse now. When I have a chance, I'll be leaving.................and the poor coverage is a big part of the reason.

mandyc · Jul 31, 2010

I am told to be HAPPY that I have health insurance! That WE have great coverage. Well, I am paying a premium of close to 700.00 a month and 300.00 a month towards medical bills that my INSURANCE did not cover. Not to mention and increase of premium every year for the last 4 years, and I AM in the health care field. No wonder people get so frustrated....I actually had a patient ask me if they had to pay EXTRA for the toothpaste that I gave him to brush his teeth...R u kidding? These poor people on a fixed income...how do they survive...We talk about "NON-COMPLIANCE" with medications , Well there is a reason for that....feed the family or take medications! We need an Affordable insurance that covers PREVENTATIVE education and medicine and gives us the right to see a doctor/specialist ouside of network. Maybe this "Affordable" Health Care Act will be a step in the right direction.... But until then is it fair to make any person suffer through all of this? The economy has been in a downward slope for a long time now....Its time to start climbing up again..Everyone deserves a chance at good, afforadable, non-complicated, medical health care and insurance. But, that is just my opinion...!

RetRN77 · Jul 31, 2010

I looked into this for a friend of mine. It would would cost almost $1200 month for her and her 2 kids (all three have prexisting conditions) for the health insurance. That's 40% of her take home pay, yet she makes $50 a month too much to qualify for the state medicaid program. So she still will not have health insurance. So how can it be called affordable?
Obama, you dropped the ball by not offering a viable public option that people can afford. But at least it's a start!

Yes, but she WILL buy health insurance or she will be penalized monetarily. Nice. AHCA. What a misnomer.

RetRN77 · Jul 31, 2010

Like actually having health insurance now is even much better. I will say that my job covers most of my health care insurance. However, because it is an HMO (my hospital doesn't offer a PPO or better option) I usually wait forever for appointments with specialists. I have a ventricular septal defect, I let them know at 9 weeks pregnant. at 21 weeks pregnant I finally had the clearance to see the cardiologist, wait 3 weeks for the appointment. He sees me and says that I need to see a specialist who can better care for my needs. Finally get the approval at 30 weeks pregnant, takes 4 weeks to get into see the specialist for an appointment. He orders some tests, but cannot see me again for a follow up without my primary physician making another referral to him (explain that??????????). So I am now 36 weeks pregnant, still waiting on the OK. I figure by the time I've had my follow up to address any special concerns that would have applied during labor...I'll have a month old baby.
Now oddly enough my friend on medicaid, similar circumstances, has been followed since week 10 of her pregnancy by all sorts of specialists, no problem.....hasn't worked in years, has 3 kids already.
I'm actually going to hunt for a job with better insurance after I have this baby, because it seems to me that as a working person who contributes should have better health care options. I am frustrated with health care, much like many of us. I don't know what the solution is, but I don't think this health care plan is going to help anything. I will give Obama credit for trying though.

I agree, something needed to be done about the high costs of insurance. But no one seemed to be able to overcome insurance lobbying and regulate the insurance companies when things began getting out of hand. Too many political paybacks for keeping the status quo. Nor would the insurance companies make any meaningful changes. I think they are probably one of the most profitable businesses going today. Not for long, and it's their own fault.

However, my prediction is that government run insurance is just going to look like the worst run HMO we could ever imagine.

Jolie, BSN · Jul 31, 2010

This is what happens when our elected "representatives" ignore the will of the American people and pass a piece of legislation with unknown (or deliberately undisclosed) costs, provisions and consequences.

Only after it was passed, did we begin to learn its contents. There was clearly a reason for that.

lab1 · Aug 1, 2010

Well there is a cure for that. Come Nov 2, if they have the word incumbent beside their name vote for the other candidate. I suspect that if enough lose their cushy government jobs with government insurance some changes will be made:yeah:.

mandyc · Aug 4, 2010

What suggestions would anyone have to change the AHCA? What would you include and what would you not? would insurance cost be based on income/need/health Hx. ?

Jolie, BSN · Aug 4, 2010

What suggestions would anyone have to change the AHCA? What would you include and what would you not? would insurance cost be based on income/need/health Hx. ?

mandy,

I've debated this ad nauseum on AN-Central and don't have the time or will to repeat myself. (I can get very long-winded :)

In a nutshell, personal responsibility must come into play. If people perceive that thealth care is "free" or that their premium "entitles" them to utilize healthcare endlessly, we will be far worse off.

I firmly believe that catastrophic coverage with preventive benefits and a health savings account is the way to go. It is what my family has had for years and it causes us to think about our expenditures, plan and budget for predictible expenses, shop around for the best values, and even negotiate costs after-the-fact when emergencies arise. I've never had a provider yet refuse to lower a bill when asked.

Health insurance was originally designed to protect families from catastrophic and unpredictible expenses. It was never intended to be pre-paid health care. Unless we return to those roots, we will bankrupt ourselves.

For low income families, I could envision a tax-funded health savings account, to be used for approved health expenses only.