Archive for Monday, September 30, 2013

What does the Affordable Care Act mean for you?

September 30, 2013


Obamacare is here.

A major piece of the 2010 Affordable Care Act will be rolled out Tuesday. But what does that mean for you, the Lawrence consumer? Here are answers to basic questions about the nation's new health care law.

What is the Affordable Care Act?

The 2010 health care law often called Obamacare, even by the president himself, aims to provide coverage to many of the estimated 48 million Americans without health insurance. It tries to accomplish that goal by expanding the Medicaid program for the poor, removing restrictions from who can buy insurance and requiring that all Americans carry some form of health coverage while subsidizing it for those who can't afford it.

Who will be affected?

The law will mainly impact people who don't currently have insurance through a job or government program (Medicare, Medicaid, Indian Health Service, Veterans Affairs). For instance, many of the 350,000 uninsured Kansans, including 15,200 in Douglas County, will now be eligible for tax credits to use toward purchasing coverage.

What starts Tuesday?

Beginning Tuesday, any Kansan, regardless of preexisting medical conditions, can obtain coverage on the insurance marketplace, at or by calling 800-318-2596. The open enrollment period lasts through March 31. The next open enrollment period is from Oct. 15, 2014, to Dec. 7, 2014. People can get insurance during closed enrollment only if they have a certain life-changing event, such as a marriage, birth of a child or loss of a job. The marketplace also lets you know if you qualify for Medicaid or the Children's Health Insurance Program.

Rosilyn Wells, right, discusses information regarding the Affordable Care Act with Lawrence Memorial Hospital personal care assistants Barbara Harris, left, and Debra Pacheco, center, during Saturday's LMH Health Fair. Wells will be the only full-time ACA navigator in Lawrence and will work out of Heartland Community Health Center. The online health-insurance marketplace — a major piece of the 2010 health care law — will be unveiled Tuesday.

Rosilyn Wells, right, discusses information regarding the Affordable Care Act with Lawrence Memorial Hospital personal care assistants Barbara Harris, left, and Debra Pacheco, center, during Saturday's LMH Health Fair. Wells will be the only full-time ACA navigator in Lawrence and will work out of Heartland Community Health Center. The online health-insurance marketplace — a major piece of the 2010 health care law — will be unveiled Tuesday.

But I thought Kansas wasn't participating in Obamacare?

The state has opted neither to expand Medicaid eligibility to 138 percent of federal poverty level nor create its own insurance marketplace. In the case of the latter, the federal government stepped in to design and operate Kansas' marketplace.

What kind of insurance can I buy on the marketplace?

The marketplace will offer a variety of plans from two insurers — Blue Cross Blue Shield and Coventry. The coverage options include bronze, silver, gold and platinum, ranging from the lowest premiums and coverage amounts (60 percent) to highest premiums and coverage amounts (90 percent). Catastrophic coverage will be available to Americans 30 and under or with low incomes.

Plans offered on the marketplace must cover 10 essential health benefits: outpatient care, emergency room visits, inpatient care, prescription drugs, maternity and newborn care, mental health and substance abuse treatment, preventive services and chronic disease management, lab testing, rehabilitation services, and pediatric dental and vision care.

The federal government has delayed for a month the rollout of a separate online marketplace on which small business owners can purchase subsidized coverage for their employees.

Who can buy insurance on the marketplace?

Any American citizen not in prison can shop for a plan on the marketplace. However, only people who make between 100 and 400 percent of the federal poverty level (between $11,490 and $45,960) will be eligible for tax credits, which can be used at the time of purchase, to offset the cost of the premiums. Also ineligible for the subsidies are those who are offered qualified insurance through their employer that doesn't exceed 9.5 percent of their income.

When am I required to have insurance under Obamacare?

Nearly every American will be required to have health insurance on Jan. 1. Plans have to be bought on the marketplace by Dec. 15 to kick in the first of next year. People who go without coverage in 2014 will be levied fines of $95 or 1 percent of their income — whichever is greater — on their tax returns. The fine will increase to $325 or 2 percent of income in 2015 and $695 or 2.5 percent of income in 2016.

Who is excluded from the mandate?

Those excluded from having to carry insurance are members of religious groups opposed to health insurance, undocumented immigrants, prisoners, Americans who either don't make enough money to file taxes or would have to spend more than 8 percent of their income on premiums, and American Indians eligible for care through the Indian Health Service.

Wasn't part of the law delayed?

The Obama administration pushed back for a year the provision of the law that required that businesses with more than 50 full-time employees provide them with health insurance.

Where can I get more information or help signing up for insurance?

Assistance will be available at various community agencies. Specially trained navigators, for instance, can provide information on and help people enroll in the marketplace.

Rosilyn Wells, a navigator based at Heartland Community Health Center, 1 Riverfront Plaza, Suite 100, can be reached at 785-841-7297, ext. 219, or Heartland also has certified application consultants (who, unlike navigators, cannot sign people up on the marketplace) available.

There will be three navigators at the Lawrence-Douglas County Health Department, 200 Maine St. For assistance, call 785-843-0721 or stop by the clinic between 8:30 a.m. and 5 p.m. on Mondays, Wednesdays, Thursdays and Fridays and 9:30 a.m. and 5 p.m. on Tuesdays. The clinic is closed daily between 11:30 a.m. and 1 p.m.

There are also several Affordable Care Act information forums planned, with dates and locations to be announced.


JayhawkFan1985 4 years, 8 months ago

Obamacare means... 1) No pre existing conditions. 2) kids can stay on parents insurance until age 26. 3) lower costs to society as a whole because everyone in insured. 4) more GOP circus acts as their party self implodes.

Cheryl Nelsen 4 years, 8 months ago

Really? Not my experience. My premiums aren't going up, and, as a matter of fact, my husband pointed out that we can both get our insurance under Obamacare for less.

JayhawkFan1985 4 years, 8 months ago

Big b, you don't know what you're talking about. I don't know if you made that up or if you have been brainwashed by Faux News, the tea party and the Koch brothers. Either way, it's just sad.

gecko0302 4 years, 8 months ago

" can stay on parents insurance until age 26." Surprise! My insurance just mailed me a letter stating that my 21 year old may stay on my plan up to age 26, however, she or I must pay an additional fee at a rate commensurate with what I pay for my existing plan. So sure, she is eligible up to age 26, but she has to pay. Pretty much like buying her own new insurance. What a deal. I guess the details we're really that importatnt and us.

JayhawkFan1985 4 years, 8 months ago

Gecko, you're right, the alternative is better. Punt your kid off your plan. File for bankruptcy if something bad happens, god forbid.

gr 4 years, 8 months ago

So what's the rate for Obamacare? I heard over $3,000 per person. Do you know it otherwise? What's the cost?

Looks like everyone paying more for their insurance will cost society as a whole more, not less.

By the way, none of this is about health. It's about sick-care.

jafs 4 years, 8 months ago

There isn't one "rate" - rates vary based on age, smoking, and geographical location.

$3,000/person a year translates into $250/month, which is very reasonable these days - many of us currently pay more than that for health insurance.

Analyzing the financial aspects of this is difficult, because they're complicated. But, it's certainly the case that ER treatment is much more expensive than regular routine medical care, and if more people do that because they have insurance there will be some savings from that.

Yes, our whole system of health care is actually more like "sick care" - we don't generally go to the doctor when we're healthy and feeling fine, although annual visits and lab work serve useful preventive and educational aspects.

gr 4 years, 8 months ago

What routine medical care would prevent ER treatment?

jafs 4 years, 8 months ago

Taking care of problems before they turn into bigger ones.

Going to your doctor for small issues instead of going to the ER.

Following your doctor's advice and preventing things like diabetes, so that you don't ever have the nasty and ongoing issues related to that.


gr 4 years, 8 months ago

Diabetes? Come now. Is there anyone now days who needs to go to the doctor to tell them how to not get diabetes? I suppose the "etc." includes telling you how not to get fat? And how has that doctor given advice been working out for the majority of the people? That's not very convincing of "routine medical care" preventing ER treatment.

jafs 4 years, 8 months ago

Other things include being able to control issues like diabetes, high blood pressure etc. with medication, which greatly reduces the risk of getting bigger problems later on.

If you don't think that regular routine health care can prevent larger problems from developing, then I suppose you can believe that, but it seems like an odd thing to believe.

Of course it's true that people can make bad decisions, and that doctors don't have complete control over what their patients do, but that's a different question.


tomatogrower 4 years, 8 months ago

The earlier you detect diabetes, the cheaper it is to treat it. Many people don't realize they have diabetes before it's too late. How are they suppose to know if they don't go in for a check up. How do you know you don't have diabetes. What's cheaper? Controlling high blood pressure to prevent a heart attack, or having a heart attack, that leave you unable to work, so you go on SSI disability or we pay your wife and children to support them when you die? Are you really young gr?

gr 4 years, 8 months ago

Jafs, it's simple to control non-genetic diabetes. Simple to cure diabetes. But it has to do with choice. Making good choices and not poor choices. You talk about medication. Why should the rest of us pay for someone who refuses to make good choices.

Tomatogrower, everyone should know by now that the choices they are making is causing them to most likely get diabetes, to have a heart attack. If they make poor choices and feel they need to check, then that is regular maintenance costs. Let them pay for it. Why should the rest of us pay for their "oil change"? How much does it cost for a diabetes test?

And no I'm not really young. I choose to make healthy choices. You sound like your resigned to have diabetes, high blood pressure, just a generally sick life. Sorry you are making those choices. You could choose differently. See Curing Diabetes in 30 days. Many other people are changing their poor choices and enjoying the benefits. Why not you?

jafs 4 years, 8 months ago

We're paying if we wait until they get diabetes and related complications that put them in the emergency room now.

It's cheaper and better in many ways to help them prevent that.

Also, I don't know why you're so strongly focused on that one example, there are numerous examples of health issues that are better and cheaper to detect early and treat, rather than waiting until they become emergencies.

It's also more humane.

High blood pressure is often hereditary, and treating it with generic medications is much cheaper than waiting until somebody has a heart attack or stroke, for example.

Are you really arguing that regular doctor's visits (annual physical) and lab tests aren't good ways to keep people healthy, and/or find issues when they can be treated relatively inexpensively? If so, I can't possibly figure out why you'd do that.

Perhaps you're just arguing for the sake of argument?

tomatogrower 4 years, 8 months ago

Do you know why WalMart can underprice Mom and Pop stores? It's because they can buy in volume. The more you buy the cheaper it gets. Do you know how insurance companies set their rates? They do not work on supply and demand. Let's say you work for a company who provides insurance for 100 employees. Just to make it simple I'll use rounded small numbers; obviously everything would cost more. Say they pay $100 a month for each employee's insurance. They are healthy employees, so for 5 years no one has to use their insurance, except for maybe checkups, and again keeping it simple the check ups cost $10. So the insurance company has gotten in 5 years $120,000 in premiums, but only paid out $5,000 in claims, so the insurance company might not need an increase, since they might have earned enough interest off the premiums and showed a profit which they shared with their investors and CEO. That's fair. But eventually someone is going to get sick and need more health care. In 1 year you get 1 person with a heart attack costing him $2000, another has to take cholesterol meds at $1000/year, 1 people get cancer and the treatments are now 10,000 total. Even though the insurance company has come out ahead every year for 5 years, they are going wait. We only took in 12,000 for this one year, but we have to pay out 13,000 in claims? Where's the profit? They are still getting interest from years of good health, but they don't see it as their profit. They raise the rates. But if in that year, the company has added another 100 employees to the plan, the insurance company got 24,000 that year, instead of 12,000, so maybe they don't see it as much of a loss.

To put it into simpler terms, in the past, the more people you had in your insurance pool the less the premiums were, because you can spread the risk. I realize you haven't had any experience with this sort of thing, so I hope this helped.

JayhawkFan1985 4 years, 8 months ago

The GOP once understood that "good government" does not equal "no government." They have lost their way. The politics of destruction can't build a society.

tomatogrower 4 years, 8 months ago

Hah!!! No all the deadbeats will have to buy insurance, instead of sponging off those of us who are responsible.

Lisa Medsker 4 years, 8 months ago

Well, no, because Congress has the option to "exempt themselves", so we'll still be paying for theirs. ALL of theirs.

racerx 4 years, 8 months ago

You already do. It's called employer-based health insurance and has been the American way of doing things for the past 70 years or so. Congressional representatives are federal employees...they work for us...we're just too stupid as a nation to fire their sorry butts.

ebyrdstarr 4 years, 8 months ago

That's just not true. But don't let facts get in the way.

Congress and their staffers have to buy health insurance on the exchanges. Sen. Grassley thought he was being clever by adding this, thought it would kill the ACA, but those in favor of the ACA embraced it.

But then they realized this would work out to a functional pay cut for staffers because they would be losing out on the employer contribution they've always gotten towards insurance as part of their employment perks. So Congress decided to get insurance through the exchanges but maintain the employer contribution in the form of a subsidy.

OlDan 4 years, 8 months ago

And you believe that it's fair for Congress and staffers to receive a susidy regardless of age or income when so many regular folks will be forced to take that "functional pay cut"?

ebyrdstarr 4 years, 8 months ago

Actually, yes, I do. The idea of the exchanges wasn't that people who are already covered through work would lose that coverage and move to the exchanges. It was to make it possible for uninsured people to finally have a market they could afford to participate in. I don't want to encourage any business making the cynical, mean-spirited choice to cancel health care coverage leading to functional pay cuts for their employees. Let Congress set the example that such behavior shouldn't be seen as acceptable.

We the taxpayers have always paid this employment benefit for Congressional staffers. I see no reason why that should change.

OlDan 4 years, 8 months ago

The avoidance of a "functional pay cut" for Congress and staffers amounts to nothing more than a work around to maintain their benefits. It was never intended to be an example to the nation as you have stated. This administration has provided exemptions, work arounds and illegally amended the the law to provide convenience and tax avoidance for those who are in favor with the current regime. Naturally, those who blindly or ideologically support Obama will put a positive spin on the unscrupulous actions of a corrupt political machine that is obsessed with wrecking the principles that made this country great.

ebyrdstarr 4 years, 8 months ago

Yes, the intention was to maintain the benefits federal employees have had for decades. I fail to see how this is unscrupulous. Seems to me like being decent employers.

I didn't say Congress intended to be an example to the nation; I said let them be, as in that's how all employers who have long provided health insurance as an employment benefit should behave.

You are wrong to assume all those who speak out in any small way against those who are opposed to the ACA must "blindly or ideologically support Obama." Again, that is part of the poisonous attitude that has taken over Capitol Hill.

Lisa Medsker 4 years, 8 months ago

I called Lynne Jenkins office, yesterday, and had a pretty good talk with one of her staff. He explained, without being condescending, (surprisingly), the Republican side had also presented a healthcare plan. He told me that it was "almost identical" to the ACA, but that nobody would be "forced" to carry insurance, and that everyone had to pay premiums. Um, that sounds to me like what is already in place, with the exception of doing away with the stipulations regarding "pre-existing conditions". I said that sounded great, especially for people just "struggling to make it on 172,000 per year. But what about the REST of us, making around 40,000, for whom your plan is going to cost just as much as getting insurance through an employer? I paid 300 per month for family coverage at my former place of employment. For many people making the same amount I do, that 300 per month will determine if they can have food or not, or make their rent or house payment, or pay to keep the lights on. You sound like you're just giving the American people a cookie to shut us up, so you can protect the profit margins of Big Business". He suddenly had to get off the phone. Hm. Weird.

tomatogrower 4 years, 8 months ago

Their insurance is already mostly paid for anyway. It's part of their job benefits. If you want to call that a subsidy, then fine. Does your employer provide you with insurance? Many places pay all or part of their employee's health insurance. It's a benefit. Do you know anything about insurance, OlDan? Do you even have insurance?

Fred Whitehead Jr. 4 years, 8 months ago

CNN is having a ball with this!! I don't think I have ever heard so many different ways to plot and twist statistics as they are showing tonight. What a show!!!.

Well, maybe this will show everyone what the tea party really is. I won't mention it, because it will probably get me deleated from this forum.

Armstrong 4 years, 8 months ago

It means in one way or another I (and you) will be paying for someone else's insurance.

ebyrdstarr 4 years, 8 months ago

Yeah. That's pretty much exactly how insurance works. We all pay into a pool. In our lifetimes, some of us will pull more money out of that pool than others. Like homeowners insurance. Say there are 20 of us on a block who all have insurance through the same insurer. We'll all pay premiums, maybe $1,000 a year. Most of us will never make a claim on that insurance. But maybe one of us will suffer a catastrophic house fire. What makes it possible for that one homeowner to receive a payout of $150,000 to rebuild her home is that we've all paid into the pool. So you and I and other neighbors have paid for that one homeowner's new home. Same with health care. That's the whole idea of insurance. Pool the resources so everyone gets covered.

tomatogrower 4 years, 8 months ago

Good post, ebyrdstarr. Some people just don't understand insurance at all.

progressive_thinker 4 years, 8 months ago

Very accurate summary. I for one, am glad to pay into an insurance pool, and hope that I never get to collect......

Mari Aubuchon 4 years, 8 months ago

Understanding is the better part of knowledge.

Shardwurm 4 years, 8 months ago

It's not that you're paying into the pool, it's how much you're paying that matters. If I have to pay more because I am forced to participate then I'm not happy about that. If you're excited about someone else taking money out of your pocket then good on you. That doesn't really appeal to me.

So I guess ultimately I want to know how much of my income is 'enough' to make everyone else happy? 80 percent? 90? I lose 50+ percent on taxes right now. I would like the Liberals to just tell me when they'll stop taking my money and re-distributing it. Give me a goal. Strangely, I can't get one of them to answer that query.

ebyrdstarr 4 years, 8 months ago

First, by taking potshot at "Liberals," you indicate you might not be interested in having a civil discussion, which is unfortunate. That kind of attitude, that all Liberals are of one mind, that they all want to take your money, that none of them will give you a straight answer, is part of the poisonous politics that are at the center of the shutdown.

As for paying into the pool, the more people who pay in, the better it is for everyone, of course. Yes, even the person who wasn't participating before. Why? Because those people were still participating in health care. Everyone does. The risk that those nonparticipants, as you would call them, carry for the rest of us is huge. One nonparticipant gets hit by a bus and the rest of us are out the hundreds of thousands in emergent, essential health care costs. That's hardly fair to the rest of us. Sort of sounds like the nonparticipants are ok taking my money for their own use, to make themselves happy...

Lisa Medsker 4 years, 8 months ago

I would MUCH rather pay to maintain the health of a "non-participant" (Good term!) than pay for catastrophic, all-at-once, avoidable issues. (Moves away from your bus metaphor, so I hope you, and everyone else see what my point is). I would rather pay for housing and healthy diets, check ups, dental care, mental health services than pay for once-in-a-while, catastrophic events. It just makes more sense.

OlDan 4 years, 8 months ago

"...some of us will pull more money out of that pool than others..."

And SOME of us will be forced to pay a lot more into that pool as a requirement of Obamacare. And ALL of us will be negatively impacted by this unconstitional law in one form or another.

Keith 4 years, 8 months ago

News flash, the Supreme Court says otherwise.

OlDan 4 years, 8 months ago

Newsflash...I don't care what SCOTUS said. The Constitution does not allow the government to mandate what you buy and how much you pay. Obama said this was not a tax, remember?

deec 4 years, 8 months ago

Actually, because the Supreme Court said it was constitutional, that makes it so whether you happen to agree with the decision or not. That's their job, to decide whether a law is constitutional or not.

I don't agree with some decisions, either, such as Citizens United or Kelo, but I don't pretend they aren't constitutional. These laws should be overturned legislatively, but until that happens, they are constitutional.

OlDan 4 years, 8 months ago

It's good that you accept the Citizens United decision, but that doesn't stop Obama from demanding Congress overturn the First Amendment. Immigration is also the law of the land, but that doesn't stop Obama from not enforcing it. And it doesn't stop him from suing states who attempt to do the job he chooses not to do. It seems that liberals always have a work-around.

deec 4 years, 8 months ago

You seem to be digressing. Your opinion and mine are irrelevant as to the constitutionality of a law. The only people whose opinion matters as to the constitutionality of a law are the Supreme Court.

I'm not sure why you keep trying to change the subject into an attack against Obama. Perhaps you could try citing some factual arguments about the actual content of the ACA, since that is the topic of the article.

Alyosha 4 years, 8 months ago

You are clearly out of your depth here. To care what SCOTUS says is, literally, to be a Constitutional American. You are proving yourself not to be.

Seth Peterson 4 years, 8 months ago

False - this is misinformation and ignorance.

Lisa Medsker 4 years, 8 months ago

Isn't that the point of taxes? The people who have more, pay a little more, so that everything stays functional? Must be Socialism. Can't have that.

OlDan 4 years, 8 months ago

Again, Obama said this is not a tax. Did he lie?

Lisa Medsker 4 years, 8 months ago

Corporate medical centers write off the emergency room bills of the people who don't have insurance and can't pay as a loss. We pick up the tab by funding their tax breaks with our taxes. Big Pharma and Big Insurance don't make their projected profit margins. The Government gives them unbelievable amounts of cash, more tax breaks, and subsidies. How do you think that gets paid without everyone being covered, and when people DON'T get sick? THAT is a tax. THIS is an insurance premium. It works the same way any insurance premium works, as was explained to you in another post.

Personally, I would rather pay my premiums, knowing I'm not going to get stuck with any of that.

Alyosha 4 years, 8 months ago

You seem unaware of how the determination of something being "unconstitutional" works. The Supreme Court, according to the Constitution, is the Supreme (go figure) Court of the land, and they have ruled that it is constitutional.

Perhaps you should try being a constitutional American.

JayhawkFan1985 4 years, 8 months ago

Old an, how is it unconstitutional exactly? The US Supreme Court ruled IT IS CONSTITUTIONAL. you're all blabber and no substance.

jafs 4 years, 8 months ago

There is a plausible argument that the "tax" on folks not buying health insurance is a "direct tax" and as such unconstitutional.

The founders didn't want the federal government to tax people unless they were engaged in an activity in which money changed hands. Not buying something is not that sort of activity.

JayhawkFan1985 4 years, 8 months ago

As I already said, the USSC has already ruled the affordable care act Constitutional. Therefore, unless another case is reviewed by the USSC, the act IS CONSTITUTIONAL and your argument is irrelevant.

jafs 4 years, 8 months ago

Well, thanks a lot!

Do you share the same feeling about the CU decision? It was also a SC decision.

The SC isn't infallible, and especially with 5-4 decisions, doesn't reflect much of a majority of even the justices. My argument isn't irrelevant to me, any more than the arguments of those who think the CU decision was wrong is - and I'm one of those as well.

On a practical level, it is right that SC decisions are what decide constitutionality legally. But, I think we all need to think for ourselves anyway, and question various ways of analyzing things. It's not "blabber and no substance" to present a plausible argument that 5 out of 9 justices were wrong in a certain case.

Do you have any logical argument as to why mine is incorrect?

Liberty275 4 years, 8 months ago

"We all pay into a pool."

Now we are forced into the pool. I like pools as much as the next guy, but what do you think will happen if someone comes up from behind and pushes me in?

ebyrdstarr 4 years, 8 months ago

I think the rest of us will be there to catch you and keep you from drowning. As opposed to the situation where you decline to participate so we go about our business with no idea of when you might fall in. We won't be prepared to help you and you just might take a few of us out with you.

jafs 4 years, 8 months ago

Since you're going to get insurance through your wife's employer, and would have gotten insurance anyway, nobody's pushing you into anything.

flloyd 4 years, 8 months ago

Yeah, but some neighbors don't pay in to the pool...

ebyrdstarr 4 years, 8 months ago

First, anyone who has a mortgage almost undoubtedly has insurance.

But the deal with homeowner's insurance is that, sure, if you don't have insurance, if you don't pay into that pool, you're on your own. No one will bring you that big check when your house burns down.

Here's where it's different from health care, though. If you're the person not paying into the health care pool and you have a heart attack requiring open heart surgery, you're still going to get treated. An ambulance will pick you up, transport you to the hospital, where you'll be seen in the ER before being taken to an operating room, filled with two surgeons (at least), an anaesthesiologist, nurses, etc, before being taken to an ICU room to recover. Then when you're all better, you'll get a bill for $200,000 that you can't begin to pay. You'll declare bankruptcy. And all the rest of us poor schmucks who have been paying into the pool will ultimately offset the costs you couldn't cover because you didn't want to pony up to join the pool in the first place.

Your house: your taxes will pay to put out the fire, but you'll be on your own, so it doesn't hurt the rest of us that you haven't paid into the pool.

avarom 4 years, 8 months ago

Insurance doesn't always work that way.....Katrina for example, many people who had flood insurance never received a penny, and the rub was....their flood insurance went up. Why do you think the Government took over FEMA, and yes the flood insurance premiums goes up every year. This is just a start with Obamacare, and premiums are going to go up, with so many variables, you can't accurately determine preimum levels at the first announcement. Let's all get with reality. And, the less you pay for premuims, the less the medical coverage from Obamacare, and the more you pay out of pocket. Follow the money...the premiums are already in the works to go up next year. They need metrics to really determine what you are going to pay in the future and it sure won't be less. And, who saying you don't have to pay back your tax credits, when you start back to work, receive a raise increase or get sicker or older.....You think your premiums are going to stay the same. The big question is....yes you can have insurance, but at what costs and will you garnish my wages, when I do start working. Nothing the government hands you is FREE! Those tax credits are like a bar tab at you local Pub, you drink for weeks, but then you have to pay up, before you can start drinking again. Follow the Money....

Patricia Davis 4 years, 8 months ago

We've been doing that for decades since our prices cover the non insurers at the most expensive point of purchase: emergency room care.

ThePilgrim 4 years, 8 months ago

And here is what will happen somewhere between October and January - Scenario 1: The young people who are being courted by ACA marketing will get on the exchange, and they will be infuriated that they have to pay more than $100 a month for insurance. (Don't believe me? My young daughters thought $75/mo was too high and chose to go without insurance). ACA doesn't guarantee lower premiums. The insurance company can't charge you higher for your pre-existing conditions, but they aren't going to charge you lower either. They will charge everyone higher to make up for it. Scenario 2: If you are a poor person, adult male or adult non-PG female who are not currently covered by Medicaid in KS, and you fall between the Kansas very low Medicaid poverty level and the point where Obamacare kicks in, you will be paying the premium. They call that the "doughnut hole". Kansas didn't expand Medicaid and Obamacare didn't expand lower to cover them, so they are paying their own premiums, sometimes without the tax credits to offset.

tomatogrower 4 years, 8 months ago

So do you think your daughter should just die if she gets sick, because she is too irresponsible to have insurance? Does she expect us to pay her hospital bills? Does she go to the emergency room when she doesn't feel well, then expects the hospital to write off her bills? How does she get her yearly female checkups, and if she doesn't why not? How old is your daughter? If she under 28, she can be on your insurance. If she is older, it's time for her to grow up! Childhood shouldn't be lasting into your 30's.

DanR 4 years, 8 months ago

Hopefully your daughters will educate themselves better than you have, pilgrim.

jgkojak 4 years, 8 months ago

That donut hole in Kansas was ENTIRELY the choice of Brownback, who chose to turn away millions of federal dollars to help KS expand. So blame Brownback, not Obama on that one.

jehaque 4 years, 8 months ago

Exactly how is your monthly premium going to go up? You can stay with the same plan you're on now with the same insurer. No one will force you to use the exchanges if the cost is higher than you're paying now. But, chances are you'll find a more affordable option on the exchanges.

waitjustaminute 4 years, 8 months ago

I just heard a drone fly overhead, despite the "no drone rule" soon to come to Lawrence. Obamacare is now in effect. (Move to the line on the left, keep your head down and nobody get's hurt.) Might be an IRS drone making sure we're all gunna sign up for the exchanges, ... or the NSA, making sure we're all keeping our noses clean, ... or perhaps, a Department of State drone looking for answers to solve the Benghazi mystery, ... or just your plain 'ol EPA drone looking for evidence of global warming / climate change / green house gases / or someone smoking. That's a government I can trust in. (I wonder what color of star you have to sew onto your coat if you don't sign up for health care?) Sleep well Lawrence, sleep well.

OlDan 4 years, 8 months ago

LOL, good one waitjustaminute! Spilled my coffee on this one.

avarom 4 years, 8 months ago

Or, Maybe they just tatoo on your forehead......"FOOLED YA"

nwtransplant 4 years, 8 months ago

If the lowest premium is $100.00 per month that would be $1200.00 per year. The maximum penalty for someone earning $46000.00 would only be $460.00 ($95.00 for the smallest penalty). I can see a lot of healthy Americans deciding to take a chance, just pay the penalty and pocket the $740.00 or $1102.00 savings. Healthcare for everybody is a great idea but there has to be a better way. Will I now have to provide proof to the IRS that I have health insurance?

LA 4 years, 8 months ago


Providing proof to the IRS will only begin with the filing of the 2014-1040 forms (Spring 2015). For those who ignored the Individual Mandate, the IRS-revised 1040 will guide you into self-assessing the Penalty. If you were going to get a refund, IRS will just deduct the ACA penalty first. Yes, you will have to provide proof that you have Health Insurance, and your carrier should provide a standardized form evidencing coverage.

jafs 4 years, 8 months ago

Yes, I think many will do just that.

Before the SC case, the penalties were higher, and served as more of an inducement to buy insurance, but the SC lowered those, which cuts into that effect.

Also, before that case, states would have been required to expand Medicaid, so that we wouldn't have had this hole for folks who didn't qualify for Medicaid but are too poor to qualify for subsidies on the exchanges (those start at 100% of the poverty level).

hillsandtrees 4 years, 8 months ago

People can only enroll for insurance during the 'open enrollment' period. For this first enrollment - Oct 1, 2013 to Mar 31, 2014. Next year and every year after it will be only 6 weeks - late Oct to early Dec. The exceptions are for a major life event - marriage, divorce, losing a job, etc. Getting sick or having an accident doesn't count. So, if someone does not enroll during the open enrollment, has a car accident that puts them in the hospital for 6 weeks, they are responsible for paying that themselves.

Silverhair 4 years, 8 months ago

I may have missed this in the article. Does anyone have the link to the Kansas Exchange website?

I know some folks without health insurance who do not have home internet access. I wonder if there Is a number that they can call to get a mailer that has the Kansas plans and enrollment information? I bet the health department isn't mailing anything out.

Shardwurm 4 years, 8 months ago

Since this is so good I'm looking forward to Obama Auto, Home, and Life Insurance.

Seriously. Think about it. We're giving everyone medical coverage. Why not help them out and pay for all forms of insurance? Between that and Welfare we'd have the richest and most well-provided for bums on the planet.

Surely the rich people who make more than $50,000 a year can give up more money in order to provide their neighbors with the same comforts they've earned. Why should someone pay for their car insurance? If we can get that covered then they could drive to the welfare office instead of walking!

Then, once we have the insurance in place, we can buy them all cars!

This is a GREAT idea! Who's with me?!?! Very excited - all we have to do is pool our money together and give it to other people! There is no limit to the amount of dollars in the pockets of the fat-cats who make over $50,000 a year! BOTTOMLESS PIT OF MONEY!!!!

FarleyM 4 years, 8 months ago

The Fed has been printing 85 billion dollars a month for years, giving it to Obama's Corportist cohorts on Wall Street. Why doesn't Obama print a few extra billions a month to pay for everyone's insurance.

OlDan 4 years, 8 months ago

Another coffee spliller from Shardwurm. Obamacare has one more negative impact for me. Some of you guys are causing my coffe budget to sky rocket (LOL!). Sometimes humor is the best remedy for bad situations.

geekin_topekan 4 years, 8 months ago

you are all paying for others healthcare in a broken system anyway.! fortunately, Indian Health Services exempts me from the tax. Tax i tell ya!

FarleyM 4 years, 8 months ago

Sorry to hear that you will not be able to enjoy the emotional satisfaction of partaking in the Obama solution for the poor.

Mike Ford 4 years, 8 months ago

wait until this do nothing congress and sequester funding affects IHS. Start hollering at the US Representative that does little or nothing in spite of all four tribes being in her district in Kansas. Tell her to stop franking mail and pass appropriation legislation since the US Congress has plenary power over Indian Affairs and they seem to act quicker when they're stealing Indian land or sovereignty than when they're not keeping their promises. Hoka hey!!!

In_God_we_trust 4 years, 8 months ago

Obamacare means:

10,000 pages of regulation

Will push about 7 million people out of their job based insurance

Signing up for Obamacare also affords the opportunity to sign up to vote

After expending $1.8 trillion for Obamacare, 30,000,000 people (by CBO projections), will still be uninsured

Young people may experience a doubling of cost on their policy - urban institute

Obamacare mostly supported by democrats

Source: Lou Dobbs

jafs 4 years, 8 months ago

You really should consider your sources - breitbart and dobbs aren't the most reliable ones.

In_God_we_trust 4 years, 8 months ago

I have found nothing unreliable about them.

chootspa 4 years, 8 months ago

And that pretty much sums up the problem with your analysis.

jafs 4 years, 8 months ago

Well, I imagine that a quick search on the internet should provide you with examples of that, if you're interested in finding out about them.

tomatogrower 4 years, 8 months ago

IGWT, if a company drops you from the insurance, they should give you the money they paid in premiums as a raise. Think that will trickle down? I doubt it. That's the one thing the ACA left out. But it might be nice for people just to have their own insurance, then a company can't make decisions to get a really lousy plan without even consulting their workers. And maybe they will stop hiring temps who want a little more job security.

akt2 4 years, 8 months ago

My daughter and I both have existing individual policies. I recently found out that some ACA benefits won't be allowed on an existing policy. Those policies are considered "grandfathered in" and if you have had the policy for years, certain benefits may not apply. So basically the insurance companies are still doing what they want to and finding loopholes wherever they can.

jafs 4 years, 8 months ago

I'm curious - what are those benefits if you're willing to share that information?

I haven't heard anything about that sort of "grandfather" clause.

Never mind - I looked it up and you're quite right. That's disturbing to me that simply by virtue of existing for a few years, insurance plans will be exempt from some ACA requirements.

Wally 4 years, 8 months ago

To quote the erudite philosopher: “Aunt Bea, call the man!”

state website:
phone number for Kansas residents that was supplied at the meeting in Topeka on Monday was 1-800-432-2482.

article in the LJW on Sept 30, about woman located in Lawrence who can answer questions:

article in LJW on Sept 28, that includes a brief synopsis of the ACA:

Centerville 4 years, 8 months ago

For me it means that I can continue my health isurance that will be accepted by my long-time family doctor,but in 2014 it will cost $2,500 less than this year. . That's the pomise but my navigator says such a thing doesn't exist. I think they need to educate these navigators. President Obama would never lie to me /hahahahahahahahahahah!

jafs 4 years, 8 months ago


That link says that if people got subsidies that they don't actually qualify for they should pay them back.

Do you disagree with that?

Mike Ford 4 years, 8 months ago

my father went by train from Kenora, Ontario, Canada, to Quebec City, Quebec, last summer. Canada has had a health system like this for five decades. It allows companies to leave the employee health care issues to someone else so that they can concentrate on business. General Motors plants in Ontario which I've visited in Oshawa, Ontario, didn't have any of the legacy healthcare costs that the GM plants in the US had because they have government healthcare in Canada. On this train trip my father had to convince many of the riders he talked with as a retired minister that this country wasn't entirely populated with adults acting like children that there were rational people who understood the premise that if more product is sold than the product becomes cheaper. After all, why do people shop at Wal-Mart? because they sell more products and the price becomes cheaper. DUH. As someone who has a minor pre existing condition I welcome the ACA. When my company healthcare was ended in February 2011, I was paying $273 a month. When I first enrolled in company provided healthcare my healthcare insurance was $136 a month. This was in late 1997-early 1998. I had to take on two jobs to pay for my health insurance and keep my overall budget functioning during the Bush years. I've always paid my way and I make less than $10 an hour. I'm a Democrat. I work hard and I call balderdash on the people who keep repeating the nonsense about hard working people like me who've paid taxes since my teens taking a handout. If anything I'm now paying taxes for something serving a humane purpose. No un-needed wars or no bid contracts to friends of W anymore getting my tax money. We have friends who are Canadian-Americans. They've gone back to either Toronto or Vancouver for healthcare from Lawrence prior to the passage of this bill in the last two years. Hopefully they don't have to do this anymore. Maybe the US can catch up with the rest of the world and stop looking like a bunch of people watching out for the people in the tv or black helicopters coming after them with their tin foil hats on in a shelter in their back yard. I can only hope.

gr 4 years, 8 months ago

"The coverage options include bronze, silver, gold and platinum, ranging from the lowest premiums and coverage amounts (60 percent) to highest premiums and coverage amounts (90 percent). Catastrophic coverage will be available to Americans 30 and under or with low incomes."

And how much will it cost?

$3,000+ and add another 40% if you need it?

What if all you want is Catastrophic coverage? Isn't that what the promoters were all talking about? That some incidence could wipe you out? Why would you need anything else?

FORCE is the name of the game.

jafs 4 years, 8 months ago

Young folks with low incomes will be able to only have catastrophic coverage, from what I've read.

gr 4 years, 8 months ago

Ah, from

Make $40,000 a year, 31 years old, premiums 199 / month = $2,388 per year.

Make $40,000 a year, 40 years old, premiums 219 / month = $2,628 per year.

make $40,000 a year, 46 years old, premiums 257/month = $3,084 per year.

Make $50,000 a year, 60 years old, premiums 466/month = $5,592 per year.

Make $35,000 a year, 60 years old, premiums 277/month (after subtracting a $188 tax credit later on) = $3,324 per year.

Talk about throwing grandma under the bus!

I also notice that different counties have different rates. Equal and fair is not what ObamaCare is.

tomatogrower 4 years, 8 months ago

60 year old grandma, earning any amount of money - more likely to get breast cancer $150,000 a year. 60 year old grandpa, - more likely to get prostate cancer $75,000 a year. Most people by the time they are 60 learn to appreciate health insurance.

gr 4 years, 8 months ago

So they are costing the rest of us. Is that fair? Do you suggest they need an "End of Life Plan"?

Since you seem to be about FORCE, it won't surprise me. Increase the income, decrease the expenses, huh?

tomatogrower 4 years, 8 months ago

I am saying that grandma and grandpa are adult enough to probably already have insurance, and if they don't want it.

gr 4 years, 8 months ago

"As for paying into the pool, the more people who pay in, the better it is for everyone, of course. Yes, even the person who wasn't participating before. Why? Because those people were still participating in health care. Everyone does. The risk that those nonparticipants, as you would call them, carry for the rest of us is huge. One nonparticipant gets hit by a bus and the rest of us are out the hundreds of thousands in emergent, essential health care costs. That's hardly fair to the rest of us. Sort of sounds like the nonparticipants are ok taking my money for their own use, to make themselves happy..."

Well, if it's about minimizing risk, then us healthy people should have something to say about those who take unnecessary risks. The burden is huge on all of us. This would mean no smoking, no drinking, no soft drinks, no sugar including no candy, no meat, no packaged foods.

Because.... people who do those things make it "hardly fair to the rest of us."

FORCE! Yes! Force people to do what certain ones want them to do!

Richard Payton 4 years, 8 months ago

Free health care if you get thrown in prison. Granny said she doesn't have to worry about the cost of a nursing home now LOL!

John Graham 4 years, 8 months ago

Insurance premiums almost double. Deductible increases from $2650 per year to $6350 per year. Thank you President Obama and Democrats. ACA really makes healthcare affordable for me. By the way I do not qualify for any subsidy.

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