Looking for ACA/Obamacare Stories

Gwen M.
on 2/14/17 5:30 am, edited 2/15/17 4:49 am
VSG on 03/13/14

Hi all.  I was given the opportunity (and I'm still all o_O about it) to meet with one of my congresspeople on Saturday to talk with him about ACA.  I'm trying to gather stories and information so that I can be intelligent and engaging on the topic and, since weight loss surgery is something that's near and dear to my heart, I was hoping that some of you might have stories to share with me about your experience with ACA and WLS.  

Things I'm looking for include, but are not limited to -

Did ACA help/hinder your ability to get WLS?  

Did obesity pre-WLS hinder your ability to get insured?  

Are you concerned that your WLS/obesity might hinder your ability to be insured if ACA is removed and pre-existing conditions become an issue again?  

Do you have any other stories, good or bad, relating to ACA that you'd be willing to share?  

Feel free to message me if some of this is too personal for you to share here - I promise that I'll keep any information confidential (no names mentioned, etc.)  

Thank you so much!

VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
Reconstructive Surgeries with Dr. Michaels - 6/5/2017 (LBL & brachioplasty), 8/14/2017 (UBL & mastopexy), 11/6/2017 (medial leg lift)

Age 42 Height 5'4" HW 319 (1/3/2014) SW 293 (3/13/2014) CW 149 (7/16/2017)
Next Goal 145 - normal BMI | Total Weight Lost 170

TrendWeight | Food Blog (sort of functional) | Journal (down for maintenance)

H.A.L.A B.
on 2/14/17 8:28 am, edited 2/14/17 1:17 am

I run a small company. Before ACA we had group insurance. We had a few levels.  Everyone who worked for us had HI. We subsidized the HI. Enough to make it affordable

when ACA was introduced - the rates went up by 50%.  Some of the employees' portion on new plans were very high. And based on the small business model - as long as they use the  group insurance- they were not eligible for the subsidies.  50%of those covered by my group insurance decided to get ACA and we did not have enough participants to get the group for the rest of the people. we had to cancel the group insurance, gave people raises based on the how much the company subsidized their HI and telling them they need ACA HI. We even brought insurance agents (2 ) to help them with selection.  2 years later - 1/3 of my  employee chose not to get insurance.   They are the older group, whose HI runs for over 1  per month...In Sc- it is only 1 or 2 insurance that offer ACA..  

I am trying to get a group plan - but with my group - I only got one quote - based on individual. 

BTW: in my state WLS is not covered. And when one of my labs was marked as post op RNY malabsorption lab work - the coverage was denied and I was charged over 700 for the lab work.. great - no?   I am paying more than double that I used to pay before ACA, with much higher deductible, and out of pocket. 

plus - some meds - are either not on my plan or we have to deal with 2-3 months of approval process with every time I need new prescription. 

Yeay ACA...

Hala. RNY 5/14/2008; Happy At Goal =HAG

"I can eat or do anything I want to - as long as I am willing to deal with the consequences"

"Failure is not falling down, It is not getting up once you fell... So pick yourself up, dust yourself off, and start all over again...."

Fredbear
on 2/14/17 5:25 pm
VSG on 11/29/16

You can thank your state for planning to fail. Without getting political (this is not the place for it), those states that actually supported and invested in their own citizens are doing well. Those states whose legislators chose to ball their fists up and have tantrums are inflicting your situation on their own people.

Don't blame the ACA, blame your state.

"Friends are like flowers; no matter how well you pick them, they all eventually die."

Citizen Kim
on 2/14/17 5:30 pm - Castle Rock, CO

So much this.  Colorado embraced the ACA and if it wasn't for our feckless numbnuts of a Republican senator, we'd still have our state co-op.   Repealing the ACA was more important to him and his masters than cheaper healthcare for his constituents.

 

Proud Feminist, Atheist, LGBT friend, and Democratic Socialist

Patty R.
on 2/14/17 8:52 am - Harrisville, RI
RNY on 09/08/16

My family has health ins. thru my husband's job, so we are all set. For my parents, who are retired and using medicare, the ACA has helped them. Especially where medications are involved. My mother would enter the "Doughnut Hole" by early June every year. This means she would have to pay full price for all meds, some very pricey, until spending reached a certain spending level, then the meds would be free. Usually that point was reached in December. My parents had a "Part D" plan and still paid upwards of $10,000 above and beyond what was covered. This devastated their retirement monies. With ACA, their out of pocket expenses are drastically reduced. For me, that is a big positive!!  My parents prepared for their retirement and healthcare/meds  almost wiped them out. I worry about other elders who weren't prepared.

Thank you for asking for all views on this issue!!

CC C.
on 2/14/17 9:09 am, edited 2/14/17 2:11 am

While I was annoyed with the 23.5% price increase for my insurance this year (self-insured with Blue Cross of CA, no subsidies), I do have coverage for WLS, my frequent labs for my overactive thyroid and now WLS are cheap, and my prescriptions costs which were never high for the stuff I take went down a few dollars a piece. All in all, I'm not unhappy with what I have. I will receive way more in WLS surgery services than I will pay this year.

PS- At 45 and no subsidies, mine is $408 a month with a $2500 deductible and $6800 in copay maximums. It was about $300 pre-ACA, but I'm a few years older now too.

Deanna798
on 2/14/17 9:25 am
RNY on 08/04/15

I think it's a double edged sword, and while I'm a proponent of Universal Healthcare, I think that ACA needed lots of work.  I have health insurance through my husband's employer, but my mother had an experience with Obamacare.

She worked for a small company who provided healthcare for everyone, without a premium.  It was a good HMO and she'd had it for years.  With the price increase that came with Obamacare, the company couldn't afford to provide the health insurnance for their employees.  They discontinued the insurance and like Hala, gave everyone a pretty decent raise.  Most, if not all, of the employees qualified for a subsidy, which allowed them to be able to afford their health coverage with the additional monies.  

My mom has Polycystic Kidney Disease and COPD, as well as a history of cancer and other medical issues.  She was still able to purchase affordable health insurance, which was good because she honestly couldn't afford to go without.

Things have changed for her, since she's become too sick to hold a job, and is currently applying for permanent disability.  She's just a little too young to draw Social Security and Medicare right now, so is struggling to make ends meet.  She finally got approved for Medicaid, so she's getting her medication and healthcare again.  I do fear drastic changes to the healthcare system, because my mother is in such a precarious situation with her health.

Thanks for listening and good luck with your meeting!

Age: 44 | Height: 5' 3" | Starting January 2015: 291 | RNY 8/4/15 with Dr. Arthur Carlin| Goal: 150

Listen to advice and accept discipline, and at the end you will be counted among the wise. ~Proverbs 19:20

* Nicole *
on 2/14/17 10:03 am

Oh ACA....

Lets see even though providing every bit of info they wanted for me to prove I made less than $1200 per month, I was denied anything ACA or medicaid (Im not the only one, I knew in that place). I refused to go to the hospital even when I was in anaphyleptic shock (4 different times and not WLS related at all). As I would never beable to pay. And I wasnt going into anymore debt. (And for the record I have wonderful friends who made it possible for me to keep my horses) Yet I could buy a policy at $700 /month with outrageous deductibles.....again I was making MAYBE $1200 a month as a self employed contractor. Im lucky as my ins costs are nothing now since I work for a non profit hospital system. Whoes coverage exceeds anything the ACA can offer, and isnt bound by certain rules.

Then there is my parents who are without ins at all, mom works seasonal and dad is self employed, both to young for medicare. Know what a month of ins with an 8k deductable, and massive co pays is... $2600. That is freakin double the damn house payment. No one except thoes exempt from the ACA (our senators, congressmen, the president) can afford, since it looks at net pay only, not morgages, buisness expesnses etc etc.  And my dad so desparetly needs to go to a dr (ok many drs) and a dentist (which doesnt help his health either), but can not afford to. I gave my mom my FSA card to go to the dr cause she has a horrible "cold" that is constricting her breathing. I dumped money into that card for the simple fact of I wanted my parents to beable to go to urgent care if needed. If hospital is needed, they will come to where I work, as they can get a financial reprieve, non profit hospitals are nice like that. 

All ACA has done is give insurance to the uninsured lower income classes (with glaring exceptions) and make the middle class have to pay for it, which prices them right out and then the crazy $1200 a year penalty for not having insurance....cheaper than buying it. So truely its no where near affordable.

I would love insurance to be available and affordable to all. But it should NEVER EVER be forced on certain groups to carry an already terrible tax burden. 

DS Aug 15th,2005 @ goal, living life and loving it.

"An Arabian will take care of its owner as no other horse will, for it has not only been raised to physical perfection, but has been instilled with a spirit of loyalty unparalleled by that of any other breed."

Fredbear
on 2/14/17 5:28 pm
VSG on 11/29/16

You already were paying for it to begin with... those people without insurance would go to the hospital and don't pay, which means the hospital (who legally can't turn people away) passed the cost along to everyone else.

AggieMae
on 2/16/17 11:54 pm
VSG on 10/25/16
On February 15, 2017 at 1:28 AM Pacific Time, Fredbear wrote:

You already were paying for it to begin with... those people without insurance would go to the hospital and don't pay, which means the hospital (who legally can't turn people away) passed the cost along to everyone else.

No, hospitals do not hike up your cost to cover non paying patients.

The cost of caring for uninsured and non paying patient is reimbursed to hospitals by the federal government. The ACA has saved the government money. e

Before ACA the federal government (your taxes) pained almost 50 BILLION dollars a year just for emergency room care, often for routine (non emergency). The abuse of emergency services by uninsured people went down 65% since introduction of ACA, and Oregon is a state that already had a better than average state insurance plan. 

Funny how you never hear about this cost when the GOP makes its partisan claims about the cost of "Obama Care".

 

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