Has anyone (in U.S.) had any bad experiences with Obama Care?

I've never had to deal with it myself but I knew someone who had complaints about it. I've heard talk about Obama care being repealed and maybe even replace with something better. I can't see how anyone can be penalized for having too good of insurance, that just don't jive, and if it don't jive it's probably not true

And over and over.... where I live the ambulances haul drunks and druggies to the hospital, where they get "hydrated" to dilute the alcohol and stuff, instead of to the jail, where they - especially the chronic ones - should go. Guess who pays for most of it? Not them....

I can't see how any amount of competition could induce insurance companies to insure high risk clients, at least at an affordable price. They're not in business to lose money. I just can't imagine companies competing to insure people my age with pre-existing conditions. Extending Medicare to cover younger retired people on a voluntary basis would have been the best option for folks in my position, but that idea did not get off the ground.

And for people who could not get coverage before because of pre-existing conditions; that's where a truly free market would have solved the problem. If insurance companies can compete across state lines or even across oceans their pool of insured would be larger and would off set the cost of higher risk insured.
For example, my dad couldn't find house insurance in his state for property in a flood zone that was affordable, so he bought it through a very reputable company in London at a much lower rate. True free market competition saved the day.
Of course insurance companies don't want true competition and enjoy the benefits of this quasi monopoly so they will keep buying off politicians to keep things going like this. Health insurance companies need to be called on their greed. And politicians need to be held accountable.

FYI, for the person who mentioned the insurance rates going up because of the employer not wanting to pay for the coverage after ACA .....Mom was self-employed with that great BC/BS coverage that didn't drop her after Cancer either. BC/BS said they had to raise the rates because of ACA.

And that is the point. When politicians raise taxes on industries or businesses to supposedly support some government program (and of course not line their pockets at all) who ends up paying for the tax hike? The consumer. It has always been that way and will always be that way. Big businesses have to keep their profits up to keep shareholders happy to sell and trade shares etc. And small businesses can't afford to take financial hits caused by tax hikes. So all businesses pass the tax hike expense off to the consumer. And in the case of Insurance companies they have the added benefit of having quasi monopolies. So those things added together equalled government sanctioned price gouging. Again I say hats off to the insurance companies and politicians for really screwing the American people over.

I will agree that the one good thing about the ACA is that it prevents insurance companies from denying coverage to people with pre-existing conditions. That is something that already was in existence in insurance plans through an employer.

It would have been smarter if the law had started out simply "insurance companies may not deny insurance due to a pre-existing condition" and then let the insurance companies figure it out, form risk pools, etc. That would have covered most of those people without insurance (who wanted it) Instead the government created a Frankenstein monster which is totally out of control, failing and costing a fortune, driving our doctors away and draining seniors' savings.

I think Obamacare has some serious issues, but I also think it's a godsend for people who couldn't get insurance any other way. You saw what happened when Congress tried to repeal and replace it - they couldn't devise anything better that could get the votes needed to pass it. It's a very complex problem, how to offer people at least some minimally decent health care protection without bankrupting the country. I can't claim to have an answer or even any good suggestions.

I had better coverage under COBRA until it ran out. I was shocked to find myself paying more, even with the subsidy, with higher copayments and deductibles under Obamacare. Still, I intend to keep paying for it until I qualify for Medicare, in less than a year now. I too have pre-existing conditions, and my insurance in the private market would have been even less affordable, if I could have qualified at all.

Katiekate, I had something similar regarding trying to get health insurance with a pre-existing condition which was something minor, allergic to gluten.

Not to make light on this, but I was wondering if the insurance companies were thinking I would OD on a loaf of bread.

I was self-employed at the time, so once a job opened up in the same career path which included benefits, I jumped onto it, and got excellent insurance. Then I was home free once I could get Medicare. And didn't have to worry about looking for a secondary insurance since the ACA allowed for pre-existing conditions.

Agree with Mally & akdaughter. Obamacare is terrible. I have seen so many great physicians retire in the past 3- 4 yrs and more are leaving practices every day. What a loss for us! And why, because reimbursement rates are awful for Medicare & Medicaid. So many providers don't even take Medicare & Medicaid anymore. The entire premise of the individual mandate backfired. People opt not to pay and accept the IRS tax as they are not sick & don't use the system. The mandate was supposed to help pay for those with preexisting conditions but it doesn't.  
There are only 2 or 3 major insurance companies left, and they are licking their chops making profit hand over foot. Those three are powerful lobbyists that don't want Obamacare to go away. It's almost a monopoly.
Agree we need to be able to purchase insurance over state lines and increase competition as yes that's the way to keep cost of premiums down.
Sure it's good for those that had preexisting conditions and I don't think that was going to change in the last Republican plan. Even the Dems stated there is plenty wrong with the ACA this past July. But many of those people are train wrecks that never took the least bit care of themselves and it's not fair the middle class has to foot the bill. Sorry but as an RN I have tried to educate many people that know better but they choose to ignore their MD's advice & continue to make the wrong choices over & over again.  
It will only get worse for all of us if Obamacare isn't repealed or replaced. No blame, just facts. A poorly written law "you had to pass it to know what's in it". Passed without one Republican vote. Ditto this last attempt- no Democrats voted for it this time.
Politicians need term limits - they have no clue what we middle class workers go through. We get to pay for everyone.
Yes also to cleaning out the ranks of those that are taking entitlement programs like Medicaid and SSDI that can clearly work.
It's frustrating for me. But the younger generations will bear the worst of it. I am pretty set with Medicare $ SS when I retire, what about them? There won't be those safety nets. 
 

Before Obamacare i could not get insurance...pre-existing conditions. The only (garbage) policy I could get basically excluded everything and would have cost me $850 per month....just for me. Needless to say I could not afford to pay that much for no next to no coverage.

Now, my premiums are $400 per month....but it covers everything after $3000 annual deductible.

So, you were lucky to have such great coverage. His company could still provide it..they just want an excuse to cut their costs...and gee, its easy to blame Obamacare....

For every story of coverage cost increase...there are just as many like me that final HAVE coverage at all

meghart13 I agree; my husband (who is an advanced EMT) sees so many people over 80 with lots of things wrong with them, and I see them at the AL facility I visit and the SR building my mom is in, and think people are just being supported to live too long.... If I get cancer; I will not do surgery and chemo or radiation - have seen too many suffer from those - nor go through extensive/expensive surgeries, or take 6 different meds each day - some of which are life threatening, cognitive damaging, and interactive..... and I am only 66.

Amygrace, I can answer your last question. There are two parts to medical billing - the amount of the charge and the amount insurance allows. Did you get an EOB that showed what your insurance actually paid for that CT scan? Insurance companies negotiate payments with the providers and then pay according to their contracts. I would be surprised if the urgent care got more than half of that charge. Providers cannot charge patients different amounts based on insurance coverage, so everyone is "charged" the same, even though reimbursement depends on insurance allowances. Medicaid is the worst for reimbursements. My husband is sometimes reimbursed less than 20% of charges for Medicaid services. He could "charge" Medicaid 20% for the service, knowing that it is all he would get anyway, but then he would have to charge all patients that figure for that service. He would have gone bankrupt years ago. It is a messed up system. The government does not want to "investigate and calculate the reasonable cost of medical care and drugs" because then they would have to pay those amounts rather than continue to require health care providers to essentially be subsidized by patients who have commercial insurance or are private pay.

Chiye5 - I so agree. ACA has impacted Medicare Advantage big time also. You are right - the insurance companies are making out just fine, so are the politicians and certain people who are on a free ride - and many of those are not the people who really need the help (like seniors and veterans). I know several doctors who have retired early because insurance pays them less each year, they are working more and more and still have to struggle with the ACA rules. A few have had to close private practice because complying with all the red tape ACA laws have literally cost them more than they earn. They end up going to large groups and have to practice "herd medicine" according to the "rules". My wonderful family doctor was one of them - she finally gave up and retired 10 years before she planned to.
For myself, all I know is that as the ACA kicked in, my Medicare Advantagecare plan premium doubled. My co-pays are double what they were 3 years ago. Coverage no longer includes vision care or dental checkups or cleaning. I now have to pay a huge co-pay for x-rays, MRI and CT and ultrasound are even higher. Urgent care (which was supposed to fill in with the same co-pay when GP practice was not open now is three times as expensive as seeing your doctor in the office. I need physical therapy and had to drop it - who can afford $40 twice a week for a few exercise tips and a hot pack and stim?
I wish the congress would get off their self serving high horse and simply let the free market take over - allow insurance to be purchased across state borders. Nothing keeps prices down better than competition. For those who need help, we already have Medicaid - that wouldn't change. And how about investigating those getting things for free when they can really afford it, or do not qualify. That is driving prices up! The only thing the government should be doing is create an unbiased commission to investigate and calculate the REAL (and reasonable cost of medical care and drugs) and punish price gougers. (I had a CT scan in urgent care and the original bill the hospital sent to my insurance company was $5800! Something has to be done about that kind of highway robbery.) Why are they allowed to set prices 10x the actual cost?

I realize this is a 3 yr. old thread, but I'd like to comment on it since we have the benefit of time now.
I have no idea how anyone can afford the insurances offered through ACA. My mother's insurance went from $380 a month for BC/BS, $20 copays, $0 deductible for preventative and routine visits, and $1000 deductible for catistrophic prior to Obama and ACA. Also, she had cancer in early 2000s and it remained the same coverage, same price, and she was not dropped. Then Obama was elected and her insurance premiums for the exact same coverage went up several hundred dollars a year. This went on for several years and she had to keep getting different insurance for worse coverage and was paying a lot more than the $380 she had been paying. By the time she was able to get Medicare, her insurance was $1240 a month for $10,000 deductible for catastrophic, $5,000 deductible for routine doctor visits before her insurance would kick in and then she would pay $35 copays.
ACA has greatly benefited the insurance companies. Their revenue jumped dramatically and their coverage is now minimal. Hats off to the insurance lobbyists who were able to push this through D.C.

The only way to have truly competitive and the best insurance is to make insurance companies have to compete for people to buy their insurance. Currently they have quassi monopolies divided by states. Policies should be truly free market. The free market works for the benefit of the buyer and government works for itself (politicians) and lobbyists these days anyways.

Jessie, I don't want to argue about why healthcare costs are higher. There are many reasons, and I said that advances were responsible for a significant percentage, not the entire amount. As far as regional differences, insurance companies enter into contracts with providers that dictate what the provider will be paid. These rates vary greatly by location, supposedly because of factors like cost of facilities (it is more expensive to build a hospital in New York City than it is in a rural area of South Dakota), wages in the area, etc. My husband, a pediatrician, (which is one of the lowest reimbursed specialties), can charge whatever he likes, but he will only get paid what the insurance contract (or Medicaid) allows. He cannot bill the patient for the difference. I don't know of another profession where a third party determines what you can be paid for your work or products. If his cost for a vaccine is more than the reimbursement, he takes the loss. I have often wished that I had "gas station insurance" so that I could fill up my car, and then pay only the amount that my insurance contract allowed.

Comparing foreign costs is even more complicated. Health care delivery systems vary greatly. There are as many opinions about the Canadian system or the British system as there are patients. One thing that has always seemed unfair to me is that foreign health care systems are reaping the rewards of research, development and stringent testing that occurs in the US without paying for any of it. The companies that develop new equipment or drugs are trying to recoup their costs. They only have a limited time to do this before the drugs go generic or patents expire. If they can't make a profit, they go out of business, and we don't get the benefit of new treatments. About ten years ago, I needed a relatively new drug which was quite expensive. I paid for it for 18 months. If I needed it today, I could use the far cheaper generic that is now available. Am I angry that patients today get this drug for so much less? Of course not, I am just glad that it was available when I needed it. You never know when you might benefit from research. Even that easier appendectomy is the result of research into less invasive surgical procedures and the development of the equipment to do it. My grandmother's seven year old brother had his appendectomy done on the kitchen table and did not survive.

Is there waste in the health care delivery system? Absolutely, but again, there are a multitude of reasons for this. Malpractice insurance, government requirements (always changing), licensing fees, permit fees, inspection fees, time spent getting pre-approvals from insurance companies, all add to the cost of health care without providing any services to the patient, but at the same time, all these regulations help to maintain the quality health care that we expect.

And I agree with meghart13 about keeping people alive without meaning. I guess that is why we should all have medical directives and the courage to make the tough decisions about how much care our loved ones should have. Those of us who have faced this know how hard it is, and I would never presume to tell someone else what they should do.

I wish that we could find a way to make high quality health care available and affordable for everyone. At the same time, I want research and development to continue toward new treatments and cures, and I want health care providers to be fairly compensated for their investment in training and equipment, and the time spent providing care. If they are not, provider shortages will become the norm. I just wish I knew how to make it all happen.

It is interesting. Your results were similar to the ones I found. I found others that had smaller sample sizes with different amounts reported. I couldn't find any report on what insurance actually paid and what the actual copay would be. That would be useful information. It is clear to see that without insurance in the US, a simple operation like an appendectomy could be financially devastating. It is sad that we can be so worried about our own healthcare system. I am so glad that our elders have Medicare.

Here is an article on the difference of cost that is interesting.
http://247wallst.com/healthcare-economy/2012/03/05/the-28000-appendectomy/

Compare the cost of US healthcare costs to those in other countries and you'll be really shocked. Our healthcare costs are so over-inflated it is disgusting. The same procedure in another country cost probably 1/3 of what it does here.

As for medical advancements, they have been tremendous for sure. However, they are keeping people alive longer yet not offering people better options to continue the care it takes to live medically or financially. We can keep people alive but can they afford to live a meaningful life while doing it?

Rising healthcare costs aren't just about the advances in medicine. Costs vary from city to city and state to state. I just looked up the average cost of an appendectomy and it varied tremendously, with the average in the US of $33K. A typical copay would be about $6.6K -- a large amount of money from most of us, and to me seems like what such a standard procedure should cost. I was not really surprised to read that the operation cost less in more rural hospitals.

Appendectomies can be done more easily than they once could and the person may have to stay over night to stabilize. $33K is a big bill for a quick procedure and an overnight stay.

I just have to respond to a couple of these statements. Kacunnin, it IS the government that is causing policies to be cancelled, and it is the government that is requiring you to pay for maternity coverage. Policies were cancelled if they did not meet the new government mandated coverage requirements under the ACA. One of those requirements is maternity coverage for everyone, regardless of age. My insurance was cancelled because it was through a professional group, and my husband's office was a sub-group of one, which was not allowed under the ACA. BC/BS would have been happy to renew our old policy, and, in fact, offered to do just that after the government extended the mandate for another year, but I had already contracted for replacement coverage. I didn't think the savings was worth going through the hassle of cancelling the new coverage and going through the whole process again next year.

My other response is about the rising cost of health care. I agree that health care costs have risen sharply for many years. A significant percentage of this increase is due to the vast improvement in care, and the availability of procedures to improve health. If you went to a doctor forty years ago with a bad knee, you would have been given a cane. Today you get a knee replacement. Organ transplants have saved countless lives. My cousin's wife has had two liver transplants and a kidney transplant. She was diagnosed with a rare liver abnormality as a young mother in her twenties. These procedures were covered by insurance and are very expensive, requiring extended hospital stays and lots of equipment. They have allowed her to live to see her children grow up, and graduate from high school, and she has been able to welcome a grandchild into her life. None of this would have been possible if she had been born a generation earlier. Since insurance pays for things like this, in effect we all pay. Health insurance spreads the cost around, just like the insurance on your car or your house. It's the same situation with the earlier poster who has a son who will be able to get expensive scans while paying a very low premium and deductible. We all contribute to his care through our premiums.

I agree that there should be some control over the profits that insurance companies are allowed to keep, They negotiate reimbursement rates with healthcare providers, thus limiting the profits of the providers, so their profits should be limited, too. Hopefully, competition in the marketplace and the profit limitations will solve this.

Meghart, believe it or not, the letter said exactly what I quoted. It was so outrageous that I wondered if I should respond, or report it to the state agency regulating ALFs, or write a letter to the editor of the local paper. But I suppose there was nothing illegal about it (it's clearly unethical). Then I worried about repercussions for my mother. The letter came out just as the ALF was undergoing an inspection by the state, following an anonymous complaint about serious management problems. Maybe they wanted to distract us from their other problems?

I was part of that 5% that were a big issue for the ACA, but I was able to get it worked out. My problem was that my income now is low, but I have good retirement savings. I am self employed. This year my insurance premiums almost doubled. I couldn't afford them, but I also didn't qualify for any relief when I was considering only my income. I didn't qualify for Medicaid, either. I imagine all of this is a common caregiver problem, since our incomes are low and our savings might be high.

The solution was pretty simple. I started pulling down a bit of money from my Roth IRA each year to put me in the qualifying zone.

It's rather funny. The thing that pulled my income down so low last year besides having a bad year was my healthcare insurance. It was very expensive, of course, and totally deductible. It made me realize that I was working for the insurance companies. Not a good thought!

Anyway, after a bad start with being in the 5% that fell through the cracks, my retirement money pulled me out of it. I don't like to have to depend on taking any out, so I hope customers will be buying more this year. So far so good this year. I was able to qualify for help with the insurance, so now am paying less than I was last year. Yea! Insurance was driving this modest person to the poor house.

I personally think the problem with healthcare is the cost of the care itself. It is ridiculous. I know what the president wanted to do is to have one payer in order to help contain the cost of healthcare. Somehow the AMA and insurance companies convinced people that they actually did want to continue to pay more. They are tricky and most people don't even realize how foxed they were.

realtime, did they use the term Obamacare? Because anyone who uses it, especially in a professional setting such as an Assisted Living facility regarding my mothers finances would get a huge side eye and lack of respect to their business practices from me. It's not Obamacare. It's the Affordable Care Act. ACA for short. Unless of course you are paraphrasing. Also the COL has gone up and that isn't because of Obama or the ACA.

To those that blame ins companies...the ACA limits the amount insurance companies can make over cost of claims to 20 percent. BEFORE EXPENSES. So out of that 20 put come all their costs and profit which is below 5 pct. So the reason insurance prem are raised is because cost of claims paid out for meds and Rx are rising. Like I said..Lots of mis - information out there..There is no one villain in this mess. Plus insurance companies have the network leverage to negotiate huge discounts w hosp and doctors..which are passes on to policyholders.

pamstegman I just had that same discussion yesterday. The healthcare industry has stopped it's original intent to keep people healthy and heal. It is now a huge business that is only concerned with the bottom line. Regulating our insurance companies private and gov't was needed in the worst way.

Health care and health insurance are two different things. From my perspective, the problems the ACA has experienced are largely due to the insurance companies -- these companies are being forced to insure people they'd rather not insure (i.e. older, sicker people who will cost them more). Thus, they've raised rates across the board. Lower income people will get subsidies from the government to help, but a lot of people (especially a huge chunk of middle-income families) won't.

It's not the government that is raising rates -- it's the insurance companies. And it's not the government that's cancelling policies -- again, it's the insurance companies. My individual policy through BC/BS was cancelled because it "didn't meet the requirements of the ACA." Why didn't it meet those requirements? Because it didn't include maternity care! Well, I'm 62, so I have no need for maternity benefits! But my new policy, which will cost me about $100 more per month with a 50% larger deductible, includes maternity care! This isn't the government's fault; it's the insurance companies that are doing whatever they need to do to keep their profits up (and that means getting their money in any way they can). There are only two questions they are now permitted to ask when they are insuring people under the ACA -- how old are you, and do you smoke? Older people like me are getting hit with higher premiums and increased deductibles so the insurance companies can keep their profits up.

We need good, affordable health care in this country -- not health insurance! Insurance companies make money by denying care, as we've all found out over the years. I applaud President Obama for attempting to do something about the ridiculously expensive health industry in this country, but it's hard to put something together that works if you have to cater to insurance companies. I'm hoping that a single-payer option is eventually available, which would provide actual HEALTH CARE (rather than health insurance) for the huge percentage of Americans who are struggling each month to pay their insurance premiums -- not their health care bills, their insurance premiums!

My only bad experience was getting on the web-site when it was initially available. After that, found it pretty nice to be able to decide what level of health care I wanted and to be able to compare plans in my price range in order to find the one that fits my family the best.

With myself self-employed and my husband unemployed, am just pleased as anything about being able to get affordable health care as, in the past, we'd just go without.

When you're laid-off, you have the option of COBRA, but it's quite expensive, actually AND your eligibility period runs out after some period of time, so it's not a long-term option.

My husband and I are in CA. On our corporate plan, we were paying appx $500/month for an HMO with only local access. Our ACA plan is a multi state Anthem Blue Shield Silver PPO plan. There is no deductible, and a $4500 out of pocket maximum for the family/yr. Prescriptions are $3/$5/ or $10 + 20% for non formulary drugs. Our monthly premium, based on our new reduced income, is only $139.70. If we make more money (based on odd jobs or if I get disability, which I hope to if my appeal goes through), then we will pay extra at tax time (remember, these are tax credits that are given early in the form of premium assistance) and the premiums will go up.

Russkm I don't know that my sharing will help...but I signed up (I'm in Illinois) for a Blue Cross/Blue Shield plan that is a Gold PPO Plan. I was previously with BC/BS and was paying close to $500 a month (which was going to increase in 2014 to about $550 and has increased every year I had it). My plan (with the discount based on my income) is $280 a month with a $1,500 deductible. My previous deductible was $2,400. I believe I can now get a colonoscopy (which I've put off) covered as a preventative service at no cost to me. Before I would have paid the full shot.

When I left my corporate employer and had to get self insured, only BC/BS would even quote me (I went through a broker). I am healthy (no meds, no history of medical issues). My dad died at 92 and my mom is 94. So my genes are pretty dam*ed good. But because I'm overweight, no one else would even give me a quote. So the idea that I can always have coverage is VERY big to me. And that I don't have to fear being denied coverage is also VERY big to me.

I truly believe that a lot of the horror stories are put out by people who either don't understand insurance (I'm a former HR person, so spent 20 years working with benefits) or haven't really looked to see what is available. The individuals that have been highlighted in the media and identified have (when tracked down by the media) had programs available to them that they didn't know about or wouldn't investigate because of their hatred for Obama. Which is just plain silly.

Or they are high income people who have to pay a bit more now and aren't happy about that. I'm sorry for they have to pay more, but for the millions who need coverage, it's a blessing. A blessing that I am VERY happy about. I've worked since I was 19 and have never taken a penny of government assistance. No unemployment insurance (which I've paid for in all of my jobs), no welfare, no food stamps, etc.

If you're unsure or confused about what coverage is available to you, contact a navigator to get some help. If you need info about where to go, post it and I'll research it and send you a note.

To Blannie - I've not had luck with the ACA..could you please share which plan you signed up for and how much you pay? If people who found great plans at a great price would share this info, it would help more of us who have having problems. Thanks so much...I'm hoping I hear from you or anyone.