Finally.

Thank you for posting this.

Here's an explanation of the family "glitch":

Some working families are being locked out of lower cost health insurance options due to a quirk in the Affordable Care Act (ACA) known as the “Family Glitch.” This Family Glitch hinges on the definition of “affordable” employer coverage. Employer coverage is considered affordable if the cost to cover the employee only is less than a specified percentage of the employee’s annual household income (9.66% in 2016) – even if the cost to cover the entire family is much higher, as is typical. Families with access to employer coverage that meets this definition of affordable are prohibited from receiving tax credits to lower the cost of coverage purchased through a health insurance marketplace under the Affordable Care Act. Impacted families are left either paying for relatively expensive health insurance to cover the entire family, or using a patchwork of available options that may still leave certain family members without coverage.

Source

Annie, thanks-but I wonder why they can't fix that now under Obama? (Unless he doesn't agree with it?)

Olliesmom, I suspect that this is a case of something Obama would like to fix but doesn't have the political capital (lame duck president, Republican House and Senate). Clinton saying she would fix it is a campaign promise, or maybe less cynically, a policy goal, but that doesn't mean that she will be able to push it through either if both houses of Congress stay under Republican control.

Olliesmom, given that the house has voted over 50 times to repeal obamacare, do you really think that's a can of worms Obama wants to open? Especially with only 6 month to go? I don't think so.

Annie, from my understanding, there have been changes done to ACA by the administration, as well as Congress, so I just wonder why Obama and his administration cannot make some of the changes Hillary proposes to do if she were elected. And, truth be told, it would probably be longer than 6 months before effective anyway.

Both houses of Congress are controlled by Republicans. The only ACA legislation considered are the 50 some votes to repeal. The only bills put forward are the ones allowed by Ryan and McConnell so that's why we haven't seen any fixes yet.

Obama can try to fix things, but then he gets sued when he does. So...

Trump doesn't really have a health care plan aside from signing one of those repeal laws and his "lines around the states" word salad.

My sister falls within that family glitch. Because her employer offers a family health care plan, she is not eligible for an exchange plan, even though the exchange plan is cheaper and more comprehensive.

Exactly loonlake, this is why I cannot understand how in the world this ACA carp ever got approved in the first place. How is that "affordable"? Not in my world! I don't have $9000 a year....can't pull it out of my assets.

They call it "affordable" because if you fall under a certain amount of income (somewhere around 400% of poverty level), the "government" (taxpayers) will give you a subsidy to help pay your premiums (but if you happen to earn $1 over that magic amount, you have to pay it back). So in reality, it's not at all affordable to a whole lot of people, not without the assistance of other taxpayers.

One good thing I can see about the ACA is that insurance companies can no longer deny someone coverage or charge them a higher premium because of a pre-existing condition. That needed to happen.

Too bad a public option could not be included in the ACA. Did you know that Medicare's administrative costs are about 2% vs about 25% for private insurers?

I don't get it. Why do you loathe Obamacare? Prior to Obamacare my insurance company collected all the premiums and provided absolutely nothing. Post Obamacare I get at least my annual physical for the premiums. It is a much better situation. I don't think you have ever applied for health insurance on your own and been turned down for a "pre-existing condition" that has never been a problem and will probably never be a problem. Do you understand how abusive the insurance companies were being?

What we really need to do is go after the billing collection agencies. They keep the percent of what they collect. They are rebilling the codes to increase the charges. The insurance companies turnaround and hand on all of those higher prices to us. And all that extra money is not making it to the doctors hands, it's going to the collection agencies. So you are a cash cow for these third-party people who are largely unregulated and for the most part appear to be really dishonest.

Meanwhile everyone hates Obamacare. And I don't think it's the problem. Why do you think it's the problem?

Obamacare is a step in the right direction, but just a small step. That's because so much of the legislation was written by the lobbyists for the drug and insurance companies who wanted to make sure it benefited them, not the insured. I'm not sure how any Congress is going to avoid those pitfalls in this day and age of politicians who view Job #1 as being reelected, not making policy that's good for the voters.

practigal, for one thing, I was actually a little excited about Obamacare in the very beginning, even though I am a Republican, I know something needed to be done about health insurance.

Before Obamacare, very small business owners (like me) could get a group policy, which, like any business group policy, took you with "pre-existing conditions". Our deductible was $1500 month. Our premium for the three in our family was $620.00 a month, and we could go to any doctor we wanted. Now, for the same premium, we have $6800.00 deductible-2 dr. visits a year-we pay for all prescriptions-have to go to in-network doctors and their was only one in my town and he moved to New York- and the insurance only pays for hospitals not even in our city-you would have to go to a less desirable hospital 30 mins away. Plus, now we are down to ONE insurance company-only ONE-in the Marketplace-all other insurance companies left because they were losing too much money.

So, on Obamacare, people pay their premium, plus if you go to doctor more than twice-you pay for the doctor visits-remember, while still paying your monthly premium, until you hit the $6800 deductible per person. Our previous insurance cancelled us-wasn't suppose to happen. Had them for years-premium would go up sometimes, but it was affordable.

To get our same coverage as before, now on Obamacare-I think our premium would be $1900 a month premium vs. $620 a month premium. It is not affordable to the middle class. I think I have said it a number of times on this forum-the rich can easily pay for it-the poor get tax credits or virtually free-and the middle class is forced to pay (many can't or don't) for a horrible policy. My family can afford the $6800 deductible if we had to, but many, many middle class cannot-and choose not to go to the doctor or get tests done because they have already gone to doctor twice and now they cannot afford the doctor visit or the tests-so how is this affordable??? Or, keeping you healthy-when you can't afford the tests?? You tell me!

You say at least you get your annual physical for your premiums-I should hope so! I would rather pay for my annual premiums out right! You must have a great premium where you live!

I have been turned down for pre-existing conditions before we went to a company policy-a doctor wrote something down he thought I had and it turned out not to be-and it is still on my record-so, believe me, I know how it feels and something should have been done about that. I am actually for universal healthcare, so see, I do think everyone should be able to have health care. It's just the middle class as usual taking the real hit for Obamacare!

eta: added the word can't

Our health care in this country
is a for-profit business, which is the problem, and except for the change that
we get our yearly physicals included, it is actually sick care, not health
care. I remember that before the ACA, my premiums and deductibles went up
considerably every year, so I don’t agree that it’s just the ACA causing that
to happen. Health insurance companies now have to spend 80% of their premiums
on actual health care, so I believe that they are charging us more so that the
CEOs can make the big bucks they are used to getting. As long as it is
for-profit, it will not work the way health care works in the rest of the
Western World. I don’t know how we get away from that.

My employer doesn’t offer health
insurance, so I am actually glad that the ACA exchange is there for me to
compare plans and prices easily. I think it’s a start in the right direction,
but there’s much improvement to be made.

Olliesmom, thank you for providing an explanation.

I had the same problem on my pre-existing condition. One of the doctors that I worked with said that she would back me up all the way and what I found is that when the matter went to a review board the insurer had to admit there was not really a problem and give me a policy. I wonder if you can employ the same strategy (review board) to reduce your costs.

Rather then hit Obamacare, maybe we should start a dialogue on the many sources of our current problems. Unfortunately the trend is to pick up a gun and shoot anybody we perceive as the source of our problems or who we think does not agree with our solution or who we think shouldn't exist anyway... Perhaps we can start one of those massive open online classes (MOOC) on the subject of how to have a dialogue without having a war, how to disagree politely, how to negotiate, how to have a difference of opinion and not use a gun…how, for instance, our politicians could actually work together to get something done in Washington.…

Once we can get to the dialogue stage, I would like to open a discussion on how to fix Obamacare. Maybe it needs to be fixed or maybe it is just one cog in a much larger wheel of things that needs to be fixed.

I can say with certainty that someone is making a profit on our health insurance misery. To me, that is just not right. My portion of my last employer "provided" PPO for profit premium was 700+ a month ( reportedly, this amount was one third of the actual cost) . My last policy directly with Kaiser reportedly a nonprofit HMO cost about $450 per month. So one possibility could be that we re-examine whether health insurance should be "for profit ." Not for profit, of course, shots the capitalist cow. We can't do that. No, no, no. Currently unfettered capitalism is non-negotiable, kind of like the NRA on guns.

Actuaries also play political games and can be instrumental in swaying votes by setting premiums. The insurance companies want to get rid of Obamacare, and, oh surprise, premiums are really high! Going to go higher! Yes, I believe there is a political relationship between the continued existence of Obamacare and the premium you are paying. The actual economics of the situation are much less important.

With the failure of the GOP, many "conservatives" are now proclaiming that they are libertarians. Libertarians pursue the "principle of nonaggression" which means that they don't tell people how to spend their money or live their lives. What they don't discuss openly is the fact that they seem intent on making sure no one else has money to spend and that really determines how you will live your life. Consider the subhuman Shrekli who is not just happy to raise the price of the drug, but raised it deliberately to the point where it is unaffordable (from $13+/month to $700+/month) and even though lack of the drug will literally kill people, he thinks it's funny. He appears to giggle about it. To me, this is the new face of the politics-laughing at others' misery (or outright ridiculing them). At this point, I do believe that the entire grand plan is to make sure that every penny the middle class has goes into the billionaires' pockets. In fact the billionaires were instrumental in getting the inheritance section of the tax code rewritten to ensure that the money stays in their pockets or in the pockets of the corporations they own and does not go anywhere other than to their children.

Then there are corporations, they have perpetual existence and therefore have an opportunity to amass much greater amounts of wealth then any natural person. The current trend in estate planning is to set up a family office-a family owned corporation (or LLC or other entity) holding company that can exist in perpetuity. Maybe we should re-level the playing field by forcing these entities to disband every 70 years?

The majority ownership of many significant corporations is defintely held by millionaires, wanna be billionaires. The billionaires want there to be nothing for you and certainly nothing for your children. They can most easily accomplish that with healthcare because you will be willing to pay/pay more in order to stay alive. They do not want benefits. They do not want pensions. They do not want minimum-wage. Eventually, in order to eat you will be happy to accept food for your labor. And if you have to sleep in a ditch, oh well. The fact that the Koch brothers' (they are libertarians) fortune was made in relation to Nazi Germany, a place where they worked slaves to death, doesn't exactly give me the warm fuzzies... Although it is amusing to watch the brothers realize that they may end up voting for Hillary, a woman they have spent millions of dollars trying to destroy, over Trump.

You can see from the above but there's a lot to be discussed. And I'm sure you have your own opinions on everything that I've mentioned. But can we have a dialogue?

I'm fortunate that my employer covers the majority of my premiums, a few years ago we had to start paying up to 2% but can get rebates through health incentives. For just my husband and I, the premiums are over $1300/mo, of which I pay $150 oop. We have a no deductible, HMO type plan.

I've looked into plans for when I retire (at age 58) and they're about the same, but I haven't looked into the ACA exchange yet. I imagine we'd be over income, but I don't know. My eldest, when she was in college, prior to the age of 26 that was allowed under the ACA to be covered under my insurance, could not afford premiums on private insurance. She had a medical emergency and racked up over $8K in medical bills from one ER visit. Had the ACA been available to her at the time, she'd have been able to get further treatment covered through our state's medicaid program. The hospital forgave $5k of the bill, but while she was a barely employed undergrad, she still had to pay for the remainder, and she suffered with her problems until she was able to be covered under insurance when she got a job. That would also not have been covered as it was pre-existing.

"I don't think you have ever applied for health insurance on your own and been turned down for a "pre-existing condition" that has never been a problem and will probably never be a problem."

Of course people were turned down for insurance prior to the ACA for pre-existing conditions, or had their rates jacked up because of them. What do you mean that has never been a problem?

I think she means getting turned down for a pre-existing condition that is unlikely to cause a future problem, jellytoast. I had a similar problem with changing insurance post-hysterectomy. They eventually caved and agreed to write the policy but made sure to make it very, very clear that I would not be covered for problems with my uterus. I just said, "fine." It was all so stupid.

I have a friend who's a hospice nurse who had to leave the US because she contacted latent TB in her work and couldn't get insurance for less than 5K a month. Since obamacare she's been able to return.

As long as healthcare and insurance companies are for profit, it won't be affordable for everyone. IMO as someone who has been in healthcare my whole working life, it will have to move to a single payer/administrator. I understand that we don't "want" "socialized" medicine. But.....

The biggest mistake in the present plan is that it didn't go far enough. Healthcare institutions and practitioners are, of course, to blame for the present state of healthcare. But insurance companies are as much at fault. Greed on the part of all involved is no different than any other industry. Please do not assume I am saying all nurses, doctors and health workers are greedy; I'm not.

I completely agree, cattyles. It works just fine for Medicare, after all.

Jellytoadt, Writersblock explanation is correct.

Cattyles you have called it correctly-greed...