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1. Embed this notice
   Jennifer (jennifer@m.ai6yr.org)'s status on Friday, 06-Dec-2024 21:43:41 JST Jennifer

   I decided to see what ACA plans cost next year, this is the cheapest one. So once again I can't afford to restart my consulting business. My annual reminder of why I hate the ACA. American health insurance is a legal mafia. #HealthInsurance #ACA

   • Embed this notice
     Jennifer (jennifer@m.ai6yr.org)'s status on Friday, 06-Dec-2024 21:43:40 JST Jennifer

     in reply to

     • Asheville Charlie

     @avlcharlie it's totally pointless to even have it if they don't pay anything until you hit $9000. That to me is just a catastrophic plan and should only cost $100/month because you will never use it unless something really bad happens. The older you get the more expensive it gets. So people my age and older get super screwed.

   • Embed this notice
     Rich Felker (dalias@hachyderm.io)'s status on Friday, 06-Dec-2024 21:43:40 JST Rich Felker

     in reply to

     • Asheville Charlie

     @Jennifer @avlcharlie It's absolutely NOT pointless. If you show up needing care and have insurance, they treat you and send you a bill for the cost the insurance didn't cover later. And you ignore the bill until the statute of limitations runs out.

     If you show up without insurance they ask you for cash up-front, and send you away when you don't cough it up.

     Also, with insurance you're charged a halfway-real cost for treatment. Without insurance, you're charged 3-20x as much.

   • Embed this notice
     Asheville Charlie (avlcharlie@mastodon.social)'s status on Friday, 06-Dec-2024 21:43:41 JST Asheville Charlie

     in reply to

     @Jennifer
     Every time I think about health insurance it sends me into a rage fest. While mine was cheaper it also had a $9,000 deductible which made paying them for the privilege to pay for my own healthcare really didn't make sense.

   • Embed this notice
     Rich Felker (dalias@hachyderm.io)'s status on Friday, 06-Dec-2024 21:50:45 JST Rich Felker

     in reply to

     @Jennifer Is this because income is unpredictable, or because the premium is too great a portion of reliably predictable income? During COVID we got a stealth fix for the subsidy cliff, so things are a little bit more viable for independent folks, but yeah it's still bad. Curious what ways are most affecting folks now.

   • Embed this notice
     Asheville Charlie (avlcharlie@mastodon.social)'s status on Friday, 06-Dec-2024 21:54:35 JST Asheville Charlie

     in reply to

     • Rich Felker

     @dalias @Jennifer
     My insurance premium with deductible for a year is more than half of my income. I could be homeless with insurance I guess.. I do see your point and if you have the resources that is definitely the way to go.

   • Embed this notice
     Rich Felker (dalias@hachyderm.io)'s status on Friday, 06-Dec-2024 21:54:35 JST Rich Felker

     in reply to

     • Asheville Charlie

     @avlcharlie @Jennifer That's not supposed to be legal under ACA. I know insurance companies are utter scum and happy to break the law, but it might be worth checking if the subsidy is not being calculated right. Things are probably worst tho if you're living somewhere where low-six-figure income can still be "poor" due to cost of living.

   • Embed this notice
     Rich Felker (dalias@hachyderm.io)'s status on Friday, 06-Dec-2024 22:07:31 JST Rich Felker

     in reply to

     • Asheville Charlie

     @Jennifer @avlcharlie The plans with lower deductibles are just scams. The difference in premium cost is several times the big deductible. The only winning move is to take the plan with high deductible and either budget to spend it (if you have that kind of money) or plan not to pay your big medical bills (and spread them out enough between providers that it's not worth their time trying to sue you).

   • Embed this notice
     Jennifer (jennifer@m.ai6yr.org)'s status on Friday, 06-Dec-2024 22:07:32 JST Jennifer

     in reply to

     • Rich Felker
     • Asheville Charlie

     @dalias @avlcharlie the ACA destroyed my career. What I meant was for most people like me it's pointless to try to find an affordable plan and we should just get a job that provides affordable insurance. I had to close my small biz and return to the corporate world solely for affordable insurance. Yes the cheapest (but still expensive) and shittiest option that cover nothing until you hit a $9000 deductible is only a set percentage of your income, but to get a plan that actually pays for anything is wildly unaffordable and the prices just get worse the older you are. And the new administration will probably get rid of subsidies so nobody will be able to afford it.

   • Embed this notice
     Rich Felker (dalias@hachyderm.io)'s status on Friday, 06-Dec-2024 22:12:14 JST Rich Felker

     in reply to

     • Asheville Charlie

     @Jennifer @avlcharlie My rule of thumb: pay PCP and specialists really working for you & your health. Don't pay hospitals or anesthesiologists or any overpriced diagnostic labs etc.

   • Embed this notice
     Asheville Charlie (avlcharlie@mastodon.social)'s status on Friday, 06-Dec-2024 22:15:10 JST Asheville Charlie

     in reply to

     • Rich Felker

     @dalias @Jennifer
     I had a serious ongoing problem for a while. What I did was pay $70 a month to a local physicians group who provided incredible oversight and care and acted as my advocate in the main medical system. They placed referrals and worked the system for me where I got a surgery for free. I felt like I got my money's worth but when the problem was over I no longer needed them and haven't for quite a few years. I would do the same again though.

   • Embed this notice
     Jennifer (jennifer@m.ai6yr.org)'s status on Friday, 06-Dec-2024 22:18:52 JST Jennifer

     in reply to

     • Rich Felker

     @dalias also bet you the new administration won't get rid of the ACA, but they'll just axe all subsidies and make everyone pay the full price.

   • Embed this notice
     Rich Felker (dalias@hachyderm.io)'s status on Friday, 06-Dec-2024 22:18:52 JST Rich Felker

     in reply to

     @Jennifer I think it's far more likely that they'd axe rules on preexisting conditons than the subsidies. They LIKE scams that make their stupid base feel like they have a chance to win financially - see for example the Texas "gamble on your electric bill" thing.

   • Embed this notice
     Jennifer (jennifer@m.ai6yr.org)'s status on Friday, 06-Dec-2024 22:18:53 JST Jennifer

     in reply to

     • Rich Felker

     @dalias the monthly cost of the premium, and because it wouldn't pay for anything up to $9200, is waaaaay more than my mortgage payment. I'd have to pay $17,000 a year before insurance paid for anything. And plans with more reasonable deductibles are well over $1100 a month. And there's no guarantee if something really bad happened that the insurance would actually pay out and not leave me with a huge bill. My state has a farm bureau health insurance plan that's affordable, around $300/month, and grandfathered in that can still deny plans to people with preexisting conditions, but it's managed by... United Healthcare.

   • Embed this notice
     Jennifer (jennifer@m.ai6yr.org)'s status on Friday, 06-Dec-2024 22:32:43 JST Jennifer

     in reply to

     • Rich Felker
     • Asheville Charlie

     @avlcharlie @dalias the high deductible plans are probably affordable for people in their 20s. I'm in my 50s so even though I'm healthy the prices are jacked up. I also live in a rural county and the prices here are a lot higher than the neighboring county with a large city. The county line is two miles from my house.

   • Embed this notice
     Rich Felker (dalias@hachyderm.io)'s status on Friday, 06-Dec-2024 22:32:43 JST Rich Felker

     in reply to

     • Asheville Charlie

     @Jennifer @avlcharlie If you're between 125% and 200% of poverty level income, even at age 50 bronze plans are basically free (fully subsidized). I just ran some numbers on the KFF calculator and they seem to agree.

     Of course when you have significant income but also need that income for housing or other big expenses, it gets a lot messier. 🤬