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Archive for Wednesday, September 25, 2013

Kansas premiums lower than expected under new health insurance marketplaces, report says

September 25, 2013

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— Most Kansans will pay less than the national average for health insurance coverage offered under the Affordable Care Act’s new online marketplaces set to open next week, according to a government report released Wednesday.

The Obama administration released the new data and sought to ramp up efforts to educate the public about the ACA as critics in Congress continued to hammer the law and try to defund it.

Lt. Gov. Jeff Colyer, a leading critic of the federal health care overhaul, said that the marketplace won’t be able to provide affordable coverage without far more competition.

Kansas is one of 36 states where the federal government is setting up or supporting the online marketplace, known as an exchange, which aims to help uninsured residents find health care at reasonable prices. Data released by the U.S. Department of Health and Human Services shows Kansans will have an average of 37 qualified health plans from which to choose, compared to an average of 53 for consumers in all 36 states.

In Kansas, more than 355,000 people are uninsured, including 15,200 in Douglas County.

The HHS report provided potential costs and federal subsidies in the states with federally run marketplaces. Kansans using the marketplace will have an average of 37 health plan choices, while the average for the 36 states is 53. The plans will be categorized as “gold,” “silver” or “bronze.”

The average premium for the lowest-cost silver plan in Kansas will be $260 per month, according to the report. The national average will be $328 before tax credits, or 16 percent below projections based on Congressional Budget Office estimates.

“We are excited to see that rates in the Kansas Marketplace are even lower than originally projected,” said HHS Secretary Kathleen Sebelius.

Nationally, those silver plans will range from $192 per month in Minnesota to $516 per month in Wyoming.

The overview of premiums and plan choices said that about 95 percent of uninsured people eligible for the marketplace live in a state where their average premium is lower than projections. But the report did not reveal copays and deductibles that are important considerations when considering what type of coverage to select.

The report shows that a 27-year old Kansan who makes $25,000 per year will pay $107 per month for the lowest cost bronze plan and $145 per month for the second-lowest cost silver plan, taking into account tax credits. For a family of four in Kansas with an income of $50,000 per year, the lowest bronze plan would cost $144 per month.

The new online marketplaces, opening for business Tuesday, will enable consumers to find out whether they qualify for premium assistance and compare plans side by side based on pricing, quality and benefits.

The CBO estimates the insurance marketplaces, which can be used by individuals and small businesses, will enroll 7 million people next year. Six million are expected to qualify for federal subsidies to purchase insurance. No one can be denied coverage because of a pre-existing condition.

The enrollment period runs through March 2014 and coverage starts as early as Jan. 1.

“In the past, consumers were too often denied or priced out of quality health insurance options, but thanks to the Affordable Care Act consumers will be able to choose from a number of new coverage options at a price that is affordable,” Sebelius said.

Critics say many will pay more than they would have otherwise.

Colyer, a physician, for example, said there are far cheaper rates available now from private online marketplaces. A search on one site showed 17 health plans from three companies, requiring participants to cover up to $5,000 a year in expenses, with lower premiums. One cost less than $41 a month.

“It’s pretty obvious that the exchange is very expensive for Kansas,” Colyer said.

Colyer said many Kansas consumers still will pay relatively high premiums for coverage on the exchange, particularly if they’re young and healthy. Even with dozens of plans available on the exchange, they will be offered by one of only two companies in 82 of the state’s 105 counties.

Colyer and other critics worry that mandates in the 2010 federal law overhauling health care will not only mean expensive exchange plans but boost costs in plans offered outside exchanges, in turn limiting choices everywhere.

But experts say the plans under the health care law have broader coverage and more protections for policyholders.

A key component of the ACA is expansion of Medicaid eligibility. The federal government has promised to pay the full costs of expansion for three years and then reduce that payment to 90 percent of the cost. Estimates have indicated expansion of Medicaid could cover approximately 88,000 additional low-income Kansans. Gov. Sam Brownback and the Republican-led Legislature have refused to do that in Kansas, saying they do not believe the federal government will come through with its funding promise.

Comments

Larry Moss 6 months, 3 weeks ago

The Devil is in the details. The details here come from the Devil herself. Wait til Jan. 2014 for the real numbers.

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James Minor 6 months, 3 weeks ago

Why does a young healthy person pay more? Shouldn't be the other way around? A person who smokes and/or drinks excessively should pay more than the healthy older person. Young people are told that there may not be Social Security when they retire, so they should start saving now. If they are being charged higher for health care than others, saving for retirement, paying back student loans, and working at a lower wage due to the job market, how will they survive financially?

The Republicans have the idea to defund until they can come up with their own plan then shove it down America's throat.

The ACA in some areas needs some work and should be revised, but not defunded. It needs to be flexible for future legislative and economic changes.

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LJ Whirled 6 months, 3 weeks ago

"Premiums lower than expected" means "Premiums not quite as much higher as previously feared" ... but, thanks for mindlessly regurgitating the spin.

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citizen1 6 months, 3 weeks ago

Rest assured, Obamacare is designed to fail & the result will be single payer, then no one gets their existing insurance they like.

When it totally collapses under its own weight the public will look to the government for the solution. That by the way will be the same government that created the chaos in the beginning.

It was our good friend & Obama advisor, Rahm Emanuel, who famously said: "Never let a good crises be wasted".

The crisis will come, it is just a matter of time.

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LJ Whirled 6 months, 3 weeks ago

More patients, less money, same number of doctors ... what could go wrong?

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Richard Payton 6 months, 3 weeks ago

If Congress and their staff like the Federal Employees Health Benefits Program and not Obamacare. Shouldn't the rest of us that pay taxes for these individuals to have that (FEHBP) plan be offered that plan as well?

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tomatogrower 6 months, 3 weeks ago

One thing missing from the ACA - If a company drops it's group insurance for their employees, they should be required to give their employees a raise equal to the what they were paying for the premium. But that's not going to happen, is it? They will pocket the money.

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citizen1 6 months, 3 weeks ago

FarleyM I agree with you & many people already are going cash VS insurance. The problem is Most folks can not do that,

They are enamored with the low premiums, but do not realize the cost of those low premiums are high deductibles & many non-covered procedures.

Just trying to get them to realize what they are in for. As I said earlier, people are all enamored with the subsidized premiums and ignoring the reality, just like they only look at the after tax portion of their pay check.

There are no free lunches, people will realize that only when it is too late for them.

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FarleyM 6 months, 3 weeks ago

Everybody on this thread is arguing over insurance and government intervention.

Keep your insurance. Insurance is a bet you'll get sick. Keep your government intervention. Intervention is an intrusion with mountains of paper work. Give me my qualified doctor that doesn't have 20 people waiting in line to see him. I pay cash.

Eventually, there will be cash lines and insurance, medicare, government intervention lines. More than likely, there will be doctors stream lining their operations by getting rid of the mountains of government intervention paper work and work on a cash only basis.

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Centerville 6 months, 3 weeks ago

“They’re going to be able to go to a computer, tap on the Web page and they’re going to be able to shop just like you shopped for an airline ticket or a flat-screen TV, and see what’s the best price for you, what’s the plan that’s best suited for you, and go ahead and sign up right there and then,” Obama [who allegedly graduated from high school] said.

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Larry Moss 6 months, 3 weeks ago

Odd, you'd think by this late date a more comprehensive cost structure would be available? And, most of the rate quotes are "after" the tax subsidy is applied. Meaning, you will be paying full price say $300.00 per month, all year. Then, get your "tax subsidy" when you file federal taxes. Maybe a comparable $200.00 a month credit. Which in the end, would equal a $100.00 insurance premium.

Problem is lots of people can't afford $300.00 upfront a month.

Many will choose to pay the penalty instead because it cost less. Then get sick and go to the emergency room for care and we're right back where we started.

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Centerville 6 months, 3 weeks ago

Yes, the most important thing is that everyone who has been buying their own health insurance will be paying at least $2,500 less for it next year. Therefore, a lot more people can afford it.

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jessie 6 months, 3 weeks ago

The premium listed is less than we have been paying for a family of 4 for the past 12 years or so.

I would have preferred single payer as the insurance companies are a big part of the problem. But the most important thing is that the previously uninsured will have options.

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Centerville 6 months, 3 weeks ago

Great news! So, rather than a $2,500 decrease in premium cost next year, for the same coverage, can I count on it being $3,000 less? Or, maybe, $4,000 less? That would be fabulous!

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purplesage 6 months, 3 weeks ago

The working poor can't afford this either! It is NOT the solution. Health care must be cost-contained - and that doesn't mean charging $10K,writing off $6K and suing for the rest of the co-pay and co insurance etc.

Anything the government has a hand in, and anything that can be financed or insured, costs more than it shoud. Consider concessions at the ballpark, with the government skimming some of the profits and limiting competition. Or, anything you can pay on installments.

Then, there's the absurd idea of a fine if you can't pay the premiums. Congress is of course, exempt. The only people who want this mess is those who don't have to accept it.

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Cait McKnelly 6 months, 3 weeks ago

OMGOMGOMG! We CAN'T have proof that the ACA, y'know, actually WORKS.

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citizen1 6 months, 3 weeks ago

overthemoon no I am not just making this up. It is reality.

For the past several years I have listened to the arguments & read articles in newspapers from across the nation. The truth is out there it just takes work to get to it.

I am a senior citizen on Medicare. I know the realities existing there. For years we have been picking our supplemental insurance & our prescription drug partD (drug coverage) thru what I am sure is a similar process as the exchanges being discussed. It takes lots of research & calling of companies to Verify what you are going to get & not get. I believe I was told a big story about my Part D coverage this year as it has not covered things the way it was presented. So watch the smoke screens.

Just so you know why so many doctors are leaving the system & going to direct pay vs filing insurance claims is because they are tired of not being paid fairly. Patients are either being dropped or new Medicare patients are not being taken on by doctors. This is because of the fee reimbursement & coverages decided by a cost managing panel. With the ACA some doctors are choosing not to participate.

Let me give you an example. I received a recap of my last months medical bills from Medicare. First Medicare only approved for reimbursement 78.9% of the doctors invoice amount. Medicare only paid 80% of the 78.9% & my supplemental insurance will only reimburse the doctor the remaining 20% of the 78.9% MEDICARE APPROVED.. The doctor is out roughly 21% of his fee.

I am sure some doctors can chime in based on their experience. Even Lawrence Memorial Hospital is making changes in staffing based on the ACA & it is not good.

THE ACA did not have to be passed. A law could be written that included a no previous condition clause, & also included allowing people to buy insurance across state borders to by the most competitive plans. IN this way you are dealing directly with an insurance company addressing what is and is not covered & if you do not like it you can move on to the next policy. Market choice has driven the healthcare business to be the best in the world. Advances cost more & a mechanism needs to be developed to allow the medical equipment & drug companies inventions to be rewarded with recouping their investment yet make them affordable in the market.

There is more, but I am going to bed for now. Catch you all in the AM>

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citizen1 6 months, 3 weeks ago

Just one more note about the so called death panels.

There may or may not be an overt individual decision that decides whether a given procedure is covered. That will already be decided when you purchase your individual plan.

When it will hit each of us, like a cold slap in the face, is when you are suddenly diagnosed with something severe or have a severe injury & you discover it is not covered, or barely covered. Then you realize that having an ACA plan is just like having no insurance at all. You can bet the petty/low cost stuff will be covered. Depending on when, not if, this happens to you, you will decide if these panels are death panels or just panels trying to reduce/control costs...you make the call.

You will care less about how our premiums are subsidized when you discover you can not pay the deductible or the medical care required by a non-covered illness or injury. Worse than death you may be faced with poverty for years, as declaring bankruptcy will not excuse medical bills. Even if you find a way to get them excused your credit is ruined.

Choose wisely what you purchase on the exchange. Choose even more wisely your support for the ACA. Remember there are no free lunches.

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smileydog 6 months, 3 weeks ago

my premium will more than triple. what up with that?

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citizen1 6 months, 3 weeks ago

Additionally the senior citizens get hurt with the ACA. To help pay for the ACA Medicare coverage is being reduced. That means higher premiums for their supplemental insurance or higher out of pocket expenses.

What people do not realize is if Medicare doesn't cover the condition then neither does there supplemental insurance. This will hurt everyone eventually.

And yes there are panels that decide coverage to help control costs. Call them Death panels if you wish. It impacts seniors first as their conditions & required procedures are the ones already on the chopping block with the reductions in Medicare.

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citizen1 6 months, 3 weeks ago

I agree with sunny...If Obamacare is so wonderful why are so many companies opting out? Why is congress and their staff requesting to opt out? Why are the unions vowing to kill the ACA unless they get to keep their "Cadillac" plans thru another wonderful exemption? I could go on but then I digress.

Nobody is taking about all these exemptions mean reduced revenue for the ACA thru greater subsidies & thus ultimately higher premiums or individual taxes.

So many of the posts only look at the "after-tax credit" premium. That is like looking only at your "after tax paycheck". You are ignoring the real cost that is ultimately paid thru our personal & sales taxes.

You all are also ignoring the taxes hidden in the ACA. All of us will be paying those taxes thru higher prices. All of this has already started & price creep will continue until costs & income are equalized at all of our expense. And those evil corporations are made whole again.

There is an old saying "There ain't no such think as a free lunch".

There has to be a better way to solve the healthcare issue besides the ACA.

When will all the ACA supporters wake up & realize this.

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love2fish_ks 6 months, 3 weeks ago

Rates were to go down - wrong, they are going up Heathcare was to get cheaper - wrong, it is going up You were to keep your current plan - wrong, new plans You were to keep your doctor - wrong, only if the new plan supports the Dr There was to be no rationing - wrong, rationing based on age and health

What we want is affordability and what we got was greater participation

2

sunny 6 months, 3 weeks ago

Why isn't congress, obuma or the others participating? You all are fools!

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sunny 6 months, 3 weeks ago

People are living pay check to pay check....every dollar counts! And you all think 'obumacare' is cheap! wow

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weeslicket 6 months, 3 weeks ago

2nd otq: did our governor not just get completely lapped? (more than once)? by our state's last two female insurance commissioners?

ouch

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weeslicket 6 months, 3 weeks ago

OFF TOPIC QUESTION: did governor brownback, via non-participation in ACA, actually provide better outcomes for kansans?

is he really that clever?

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leonardpike 6 months, 3 weeks ago

I buy insurance from the individual market (Coventry). I am self-employed. My wife has her own plan. I am over 30, take two medications and my premium is about $200.00 per month. Wife's plan is about the same. The deductible is $2,000.00 per year. 20% coinsurance. 50% coinsurance for out of network doctors. Drugs are $10 for generic, $45 brand name. I've had several fights with Coventry regarding coverage. I've met my deductible this year (had to get an MRI). Overall health care costs for the year are pretty high for our family when you consider we spend about $400 per month on coverage, have $4000.00 in deductibles, pay for drugs, etc. Health care costs are about $8K to $10K if we use up deductible.

According to the report, if I bought the same plan on the exchange, I'll save. Mine is a high deductible plan under the new rules. My premium would probably be around $130-ish. I make too much income for the subsidies.

I can't wait for Obamacare for two reasons. (1) I am excited about the option to shop for insurance on an exchange (and one day let providers compete for business) and also excited (2) about the fact my wife can get maternity coverage. Under current law, the Kansas legislature clearly forgot to require that insurance companies offer maternity coverage in legislating the "culture of life." We tried to buy maternity coverage but no insurance company currently offers it if you are purchasing on the individual market. Again, we tried to pay for it, but could not get it. We are not planning on having a kid soon, but want to be covered if we do. Seems like Obamacare is more in tune with the culture of life than the radicals running our state.

Pike. Out.

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cowboy 6 months, 3 weeks ago

Thank you President Obama for actually doing something for the people. The rest of the politicians should follow your example. Saw a blurb the other day suggested pols wear racing suits like Nascar drivers so we can actually see who has bought them off.

As one of the "pre existings" I will buy insurance on Oct 1st. Being self employed I let my insurance lapse for a few months during the slowdown / crash and when I went to re up lovely BSBS denied me , as did other KS carriers because I had an irregular heartbeat issue. Easily managed with some inexpensive medication I have been without insurance since 2009. Thank God nothing happened to me but it will be nice to have the peace of mind of being covered again. There are many like me. I make enuf not to get a subsidy but I can get insurance again.

Looks as thought the cost for a decent policy will be less than in the past which is good also. Insurance companies have been ripping off all of us for decades now so all of you anti Obamacare folks are truly doing the bidding of the Insurance industry.

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EveryMan 6 months, 3 weeks ago

The real issue is whether the cost will be more or less than it is now. Lower than the estimate is meaningless unless you are trying to trick the public.

The lowest rate now is $41 per month according to this story. The lowest rate under the new law is $107 per month according to this story. It's really not that complicated, unless you're using fuzzy math...

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LJ Whirled 6 months, 3 weeks ago

Which shell did you look under?

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bluefirebird 6 months, 3 weeks ago

These prices are about the same as I am paying now...since my health insurance went up $70 a month this year.

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Paul Silkiner 6 months, 3 weeks ago

Hillary................not electable. See how and why she was fired from Watergate and can you say Benghazi, Hillary and leave out liar? NO, it doesn't matter anymore............but it will........the ladies looney!

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mccabetherealtor 6 months, 3 weeks ago

I worked for one company for many years. They generated slightly over $50 million a year with approx. 250 employees.

Every year, our insurance costs went up and our choices narrowed. Every year....without skipping a beat. The last four years, our company switched insurance carriers 4 times in an effort to reduce the cost increases.

Sometimes, when I see these discussions and hear the inevitable Tea Party comparison of the president to Hitler, I wonder if this is what it felt like (just a little bit) for people involved in the Civil Rights movement. I can't even fathom how they held a conversation with people who felt that "separate but equal" was a really good solution.

It is literally bizarre to think that the richest nation in the world can't provide health care for all of its citizens, and even a few who aren't. The world is turning my friends....and heating up.....you can complain all you want but health care for every American is coming.....and so is Hillary :)

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Robert Kiefer 6 months, 3 weeks ago

Liberal lemmings drinking the administration kool-aid, Truth is we will not "see what's in it" till long after the chosen one & his lapdogs are long gone. See you all in the poorhouse!

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bjfisher 6 months, 3 weeks ago

You guys need to get your info correct. of course there's no such thing as Journalism anymore. My insurance, under Obamacare, (I call it something else, but unable to say here) is going up in price $932 each month. If you vote Democrat, I would refrain saying so when you're around me.

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Robert Kiefer 6 months, 3 weeks ago

Liberal lemmings drinking the admin Kool-aid, After a few years & the chosen one is long gone you will truly "see what's in it" See you all in the poorhouse

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toe 6 months, 3 weeks ago

Prepare for more thefts, burglaries, and home invasions as the vast uninsured try to raise money to get insurance.

1

Barry Watts 6 months, 3 weeks ago

Even though health insurance is going to be available, it does not mean people will actually purchase it. An individual making $25,000 a year is barely making it as it is. Now they are going to spend over $100 a month and be covered by a minimal healthcare plan? Most people I've spoken with lower incomes are appreciative of the opportunity to have healthcare, but are worried they cannot afford the plans that are going to be available. Many are actually fearful of the penalty for not purchasing a plan they feel they cannot afford. All this speculation means little and it will take time to know how/if this system will work.

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pigballin 6 months, 3 weeks ago

This article put out by LJW is a liberal BS slant... First off, why should anyone be FORCED to buy any health plan..Taking away freedom of self exercise of your own body. Hello? Marxism, pure to the core. So we the people have a marist president who is following in his Daddy's footsteps along with the democrats that passed that deceptive law.
This article is soooooooooo misleading..The Bronze plan , Silver plan, Gold plan. What do these plans cover and and what is the cost deductible,etc.? It is an incomplete article the LJW elected to put in press..How deceptive. I will add that the posters on here are not hearing from the LJW about how job hrs are being cut to less that 40 by companies because of this train wreck legislation that will further destroy the fragile economy. The buying power of the avg American will be reduced. If you elect to NOT buy the mandated obamacare insurance,, each individual will have to lay a tax(penalty).

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FarleyM 6 months, 3 weeks ago

My insurance premiums have drastically gone up per month. My friends business insurance for her employees have gone up. Please tell how this is a good deal? I would give details and amounts if I thought it would help me sleep better.

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down_the_river 6 months, 3 weeks ago

There is something left out here - "The report shows that a 27-year old Kansan who makes $25,000 per year will pay $145 per month for the second lowest cost silver plan, taking into account tax credits."

That is the cost ONLY to avoid the fine, and if you don't use the coverage. If you fully use the coverage, the cost for this individual goes up to $578 per month, taking into account limits on maximum out of pocket costs. It's well beyond what a typical 27 year old Kansan has available as monthly discretionary income. While each individual makes their own decision, I could imagine many 27 year olds opting to go for the $250 fine rather than the $6936 potential costs. They'll have to declare bankruptcy either way if they suffer serious medical expenses.

We'll know the crucial enrollment numbers for young people in six months.

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In_God_we_trust 6 months, 3 weeks ago

"The CBO estimates the insurance marketplaces, which can be used by individuals and small businesses, will enroll 7 million people next year. Six million are expected to qualify for federal subsidies to purchase insurance. "

Just looking at the math; if 6 million are going to need government help paying for insurance out of 7 million, the one million left are going to pay for the subsidies? Or the debt of our nation is going to go through the roof...

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Shelley Bock 6 months, 3 weeks ago

So, as the facts come forward, it can be asked why do Republican Tea Party types object to these changes. Is it because they see this as a mandated requirement for ALL Americans? Is it because the costs are so high? Because it's the only thing the Republican Party can generate as an issue? Is it because the advertisement industry needs more opportunities for "disinformation"? (Remember the Death Panels?) Or, because it places some significant limits on the income of the health care insurance industry?

But, then...the Koch Brothers are putting more of their money back into the economy.

I believe that there will be hiccups in the application of Obamacare, but if Republicans can focus on appropriate modifications instead of trying to damn the entire law, the US will benefit.

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BigDog 6 months, 3 weeks ago

What will the true monthly premiums be before the tax credits? This will give people the true cost because you don't get tax credits until you file taxes the following year.

So the person/family will pay the full premium throughout 2014 then file for the tax credit in 2015. As a result, a person/family will have to be able to afford the monthly premium upfront. Stating it will be $107 per month after tax credits is a bit misleading for an individual looking at this as an option.

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Bob Forer 6 months, 3 weeks ago

So much for the right wing garbage about the high costs. I am sure that families currently with no insurance will be very happy with the prices available.

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