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SousaphoneColossus posted:Well, yeah, exactly, which is why I think it makes sense that we're not going to see a drastic increase next year in people dropping insurance to take advantage of the lack of penalty. The people who don't think it's worth it by and large seem to already be uninsured (as opposed to people who HAD insurance and will now drop it because the penalty is zero). 2017 ended with approximately 8 million people covered by marketplace plans (as opposed to the 23 million that the CBO had figured would be the number by now). There's not a lot more room for diluting the pool. But in addition to the young healthies who've gone without coverage and will continue to do so, there will prolly be more young healthies going without & dropping coverage absent a mandate penalty. (eta: For several years the government marketplace and most state marketplaces have auto-enrolled people in their prior year's plans, thus distorting enrollment numbers at the beginning of the year. End-of-year enrollment figures have always dropped off since this mechanism began; not everyone who technically "enrolls" during open enrollment has pro-actively signed on for that coverage and pays their premiums till the end of the year.) There will likely also be more pre-Medicare, lower-income olds who go without coverage absent a mandate penalty because the 3x cost multiplier enshrined in the ACA makes it really tough to afford the premiums, especially for plans with lower out-of-pocket costs. Willa Rogers fucked around with this message at 23:59 on Nov 15, 2018 |
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Nov 15, 2018 23:54
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I’m phone posting so I can’t quote properly, but Willa you said that individual state level mandates hurt the poor. Could you expand on that? Why is that? I don’t disbelieve you, I am just curious.
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Nov 15, 2018 23:56
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Willa Rogers posted:2017 ended with approximately 8 million people covered by marketplace plans (as opposed to the 23 million that the CBO had figured would be the number by now). There's not a lot more room for diluting the pool. In 2014 Ezekiel Emanuel predicted that by 2025 80% of American employers would shift their employees onto exchange plans: quote:In it, Mr. Emanuel argues that in the next two or three years, “a few big, blue-chip companies will announce their intention to stop providing health insurance. Instead, they will raise salaries substantially or offer large, defined contributions to their workers. Then the floodgates will open.” He says that few small businesses will join the SHOP exchanges set up for them and that most of those that offer coverage are even more likely than big companies to drop it, since those who employ fewer than 50 workers face no mandate to offer it in the first place, which Mr. Emanuel thinks is fine. Unfortunately, since most of the plans are total dogshit and employees would revolt if they were dumped on exchanges no "blue chips" have stopped paying most of their their employees' healthcare bills for them.
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Nov 16, 2018 00:05
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Lightning Knight posted:I’m phone posting so I can’t quote properly, but Willa you said that individual state level mandates hurt the poor. Could you expand on that? Why is that? I don’t disbelieve you, I am just curious. Willa opposes the mandate in general. However, if you read her post closely, she concedes the effectiveness of a mandate, just claims the Obamacare mandate was too weak to work.
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Nov 16, 2018 00:07
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^^^ lol, I do no such thing.Lightning Knight posted:I’m phone posting so I can’t quote properly, but Willa you said that individual state level mandates hurt the poor. Could you expand on that? Why is that? I don’t disbelieve you, I am just curious. Requiring people who make $19,000/year to purchase private insurance that comes with high out-of-pocket costs or face a penalty for not being able to afford that coverage seems pretty self-apparent as being horrible for poors. Whether there's a federal mandate or a state mandate you're penalizing the poor. And that's not even getting into the cost equalizations that the IRS levies at tax time; eg, if you think you're going to make $19,000 the year following the open-enrollment period, but you actually end up making $21,000, you're going to have to pay the difference (usually hundreds of dollars) between what you thought you could afford and what the government determines you're able to afford, as set by that convoluted "second lowest-cost silver plan" nonsense. Given that most Americans don't have access to $1000 in case of an emergency, high out-of-pocket costs = bankruptcy (as do narrow networks that end up leaving patients fully responsible for, say, out-of-network practitioners during a hospitalization). So it kinda rings hollow to tell the working poor just getting by on their incomes that it's worth being insured to shield against high medical costs... bankruptcy is bankruptcy--whether it arises from a $1,000,000 hospitalization if uninsured, or from not being able to pay a "surprise" $5,000 bill from some out-of-network randos who scanned your hospital barcode or from out-of-network labs when you do have "coverage." Willa Rogers fucked around with this message at 00:12 on Nov 16, 2018 |
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Nov 16, 2018 00:10
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Don't forget the debacle of ACA COOPs going belly up after the democrats surrendered control of congress to republicans Perhaps when you push through a law so complex and boondoggly that it has to function exactly perfectly or large parts of it start to collapse a different approach was needed.
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Nov 16, 2018 00:12
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So effectively, means-testing is a core problem of Obamacare in your opinion? I think I understand the argument, I’m just clarifying.
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Nov 16, 2018 00:14
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CAPS LOCK BROKEN posted:Don't forget the debacle of ACA COOPs going belly up after the democrats surrendered control of congress to republicans Yah; the co-ops were supposed to be a de facto public option but ended up being an underfunded boondoggle. When the Land of Lincoln co-op went belly-up in the summer of 2015 in Illinois, they just abruptly closed shop, leaving hundreds of thousands of people uninsured. The response to this was that such an action qualified as a special enrollment period, and people insured by LoL were able to enroll in other plans, but if they had already fulfilled some or all of their annual deductibles the new insurer could reset the deductible to whatever the new plan required. In other words, if you'd already paid $7,000 in deductibles toward your LoL plan, your new plan would require you to spend another $7,000 deductible for the remaining six months of the year.
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Nov 16, 2018 00:17
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Lightning Knight posted:So effectively, means-testing is a core problem of Obamacare in your opinion? I think I understand the argument, I’m just clarifying. Yes, very much so--whether it's the $1 cliff that means the difference between qualifying for expanded Medicaid or for insurance subsidies, or the unrealistic expectations that politicians and administrators had for what is "affordable" for the working poor. "Surprise" medical bills because of high out-of-pocket costs and ultra-narrow networks emphasize this gulf even more, because there's not a pol who voted for the ACA who doesn't have the means to cover an unexpected medical bill, yet this is the no. 1 concern of voters, who know they risk bankruptcy with just about any medical emergency for which they have private coverage. eta: This is one of the things that's so horrible about that Medicare Extra bullshit plan; although Medicare recipients with higher incomes already pay higher premiums, the thresholds are pretty high income-wise, whereas Medicare Extra would impose even more means-testing and subvert Medicare into an ACA gently caress-the-poors-and-near-poors program. I'm guessing it would also allow "surprise" and balance billing, whereas current Medicare does not allow those. Willa Rogers fucked around with this message at 00:29 on Nov 16, 2018 |
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Nov 16, 2018 00:24
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Willa Rogers posted:Yes, very much so--whether it's the $1 cliff that means the difference between qualifying for expanded Medicaid or for insurance subsidies, or the unrealistic expectations that politicians and administrators had for what is "affordable" for the working poor. So, let’s pretend for a moment that the political will is not there for Medicare for All, in the short term at the national level. If I were say, a state legislator in a purple state, what should I do to stem the bleeding for now? Maybe this is bad phrasing on my part.
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Nov 16, 2018 00:28
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Lightning Knight posted:So, let’s pretend for a moment that the political will is not there for Medicare for All, in the short term at the national level. If I were say, a state legislator in a purple state, what should I do to stem the bleeding for now? The bleeding for consumers? I think the closest to a solution, absent state- or federal-based single-payer--is something along the lines of what Pritzker has proposed for Illinois: any individual would be able to purchase Medicaid, and if they're above the Medicaid threshold, then subsidies will be provided to buy into the Medicaid program as they're now provided for private insurers. Medicaid has no or very modest ($10 co-pays) point-of-service costs. Medicaid doesn't allow balance billing, nor "surprise" billing. The cost of Medicaid coverage to governments is much lower (up to half) of what private insurers cost them. And Medicaid is profitable to private insurers who administer Medicaid plans, so a plan like Pritzker's would likely face less donor blowback in our regulatory-captured political system. Seems like win-win to me, and would have the added political benefit of being a plan that voters would want to protect.
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Nov 16, 2018 00:36
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Willa Rogers posted:The bleeding for consumers? I think the closest to a solution, absent state- or federal-based single-payer--is something along the lines of what Pritzker has proposed for Illinois: any individual would be able to purchase Medicaid, and if they're above the Medicaid threshold, then subsidies will be provided to buy into the Medicaid program as they're now provided for private insurers. Can state governments do this without federal support? Is Medicaid not a federal program? I suppose it's administered by state governments, that must be why. I guess I'm just thinking in terms of, "if I were going to write letters to my state legislator, what would I ask them to do?" The state legislator I vote for in my home district is a Republican but the one for the college town I live in is a nice Democratic old lady who was receptive to my left-wing policy suggestions when I met her. 
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Nov 16, 2018 00:46
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Lightning Knight posted:Can state governments do this without federal support? Is Medicaid not a federal program? I suppose it's administered by state governments, that must be why. Medicaid is primarily funded by states. It'd prolly take federal action to convert the subsidies now paid for by the feds for private insurance to subsidies for a public program like Medicaid, but it'd be in the best interests of both the feds and the states to shift from subsidizing private insurance to subsidizing Medicaid because of Medicaid's much-lower costs. That assumes there's a political party not beholden to donors over voters, or a political party willing to cut subsidies to private insurers, so as long as we're in never-ever-gonna-happen-land, I'll continue advocating for our country to join the rest of the world in having a system for which the government regulates insurance, provider and pharma costs.
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Nov 16, 2018 00:59
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Willa Rogers posted:^^^ lol, I do no such thing. I genuinely do not understand why people think they can lie about what they posted that day. This is the paragraph where you do precisely that; most likely from being accidentally honest. Willa Rogers posted:The problem is that most of those who are likely to drop the premium--younger, healthy people who don't see a value in paying $300/month for policies with $7,000 annual deductibles--are the ones most needed by private insurers to balance the risk pools. It's been apparent from the beginning of individual marketplaces that the penalty was low enough that many people chose to pay it rather than paying for private insurance with low out-of-pocket costs. CAPS LOCK BROKEN posted:Don't forget the debacle of ACA COOPs going belly up after the democrats surrendered control of congress to republicans The basic mistake Democrats made was that in the past, with things like Social Security, Medicare, or Medicaid, it was routine to pass legislative fixes once a bill was passed, even if it was harshly fought over. People would recognize they lost, and allow the fixes to go through. This kind of endless resistance and open sabotage is relatively new and was not planned for. Democrats also didn't think they'd get wiped out in the House until very late in the term, so they didn't think they needed a bill that would withstand the level of sabotage that was targeted at the ACA. Plus, once Scott Brown got elected, there was a limit to the fixes that could be made in the reconciliation bill (for example, nobody could have fixed the missing severability clause that nearly gave the conservatives on the Supreme Court a chance to overturn the entire law).
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Nov 16, 2018 01:05
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Willa Rogers posted:Medicaid is primarily funded by states. It'd prolly take federal action to convert the subsidies now paid for by the feds for private insurance to subsidies for a public program like Medicaid, but it'd be in the best interests of both the feds and the states to shift from subsidizing private insurance to subsidizing Medicaid because of Medicaid's much-lower costs. More importantly, and something you knew but intentionally ignored, it would take an administration who was not devoted to harming the public interest and doing things against the federal interest as long as it would hurt obamacare and anything like obamacare. Trump's HHS would never grant such a waiver. Anything that requires federal action to counteract Trump sabatoge is basically by definition DOA because you're asking the Trump Administration to OK your workaround of the Trump administration's sabatoge. You know this, yet you're deliberately trying to hide the ball on it.
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Nov 16, 2018 01:08
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Willa Rogers posted:Medicaid is primarily funded by states. It'd prolly take federal action to convert the subsidies now paid for by the feds for private insurance to subsidies for a public program like Medicaid, but it'd be in the best interests of both the feds and the states to shift from subsidizing private insurance to subsidizing Medicaid because of Medicaid's much-lower costs. They can capture the CSR subsidy (if it ever gets paid again) that's used in places like Minnesota to create a basic health plan (medicaid buy in for people with incomes up to 167% of FPL) plus come up with money somewhere else to do an universal medicaid buy in. Countycare here in Chicago seems like it is well liked, one of my friends is making just enough now where she's blown past the medicaid expansion limit and CSR-land into full "gently caress you" individual plan territory. Letting anyone who wants to buy into countycare on an income sliding scale is a wonderful idea.
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Nov 16, 2018 01:09
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^^^ Great point!evilweasel posted:I genuinely do not understand why people think they can lie about what they posted that day. This is the paragraph where you do precisely that; most likely from being accidentally honest. The ACA is dead whether there's a mandate or not. I was just stating the reality that (a) young healthies never bought into the stupid "young invincibles" social-responsibility argument and that the mandate penalties weren't so high as to impel them to, and (b) the Dems' only solution to this problem is "make the mandate penalties more punitive" which is a political thing that will happen... never. This is one of the reasons why the ACA has been a failure: It tried to thread the needle between forcing people to buy private insurance and if they didn't, well, then they'd have to pay a fine of a few hundo. The GOP removing the mandate penalty will further decimate an already decimated market. As I pointed out, for several years the marketplace stats have come in as about 1/3 of what had originally been projected. If it now drops to 6 million rather than 8 million, it's still a decimated market. It's too late to talk about legislative fixes if Dems continue to insist on punishing the poor even more than the original ACA did, or refuse to lift a donor-controlled finger to regulate insurer, provider or pharma costs. Willa Rogers fucked around with this message at 01:24 on Nov 16, 2018 |
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Nov 16, 2018 01:22
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Willa Rogers posted:The GOP removing the mandate penalty will further decimate an already decimated market. As I pointed out, for several years the marketplace stats have come in as about 1/3 of what had originally been projected. If it now drops to 6 million rather than 8 million, it's still a decimated market. The whole idea was that employers would have started dumping people onto exchanges by now and use the shared responsibility payments they would have paid otherwise as a backdoor tax to fund "improvements" to the overall ACA framework, but that's likely never to happen.
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Nov 16, 2018 01:31
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Willa Rogers posted:The ACA is dead whether there's a mandate or not. objectively false; part of your pattern of intentional lying. l Willa Rogers posted:I was just stating the reality that (a) young healthies never bought into the stupid "young invincibles" social-responsibility argument and that the mandate penalties weren't so high as to impel them to, and (b) the Dems' only solution to this problem is "make the mandate penalties more punitive" which is a political thing that will happen... never. This is why the ACA has been a failure: It tried to thread the needle between forcing people to buy private insurance and if they didn't, well, then they'd have to pay a fine of a few hundo. you accidentally admitted that yes, the mandate is necessary, but that this particular one was too weak. the rest of your argument is utterly incoherent because we're discussing a state that passed a replacement mandate. so we know that there's a political will! it is literally a thing that happened and you are trying to claim is a bad thing and oppose. then you accidentally admit "well actually yes, its a good thing", deny it, are confronted with your own words, and claim now that "oh it's just recognizing that it's impossible to pass a better mandate." but you, personally, are opposing one and alternating between claiming it does nothing, and admitting it does a lot. the difference between six million and eight million is a lot. also, I will once again point out your habit of repeating republican lies about obamacare when you view it as expedient. the exchanges have a lot less people than expected...but medicaid has a lot more. republicans, and you, leave out that last part. the medicaid expansion is part of obamacare! it is one of the key pillars of obamacare. that people are on medicaid instead of exchanges is fine, a thing we are ok with. and there are massively more people on it despite all the republican states that refused to expand where there's populations that badly need it. Willa Rogers posted:It's too late to talk about legislative fixes if Dems continue to insist on punishing the poor even more than the original ACA did, or refuse to lift a donor-controlled finger to regulate insurer, provider or pharma costs. and here we're back to the actual reality, and the reason for the intentional lying. anyone reading your posts needs to understand that you feel no obligation to stick to the truth and feel not only entitled to lie, but that it's important to lie; as long as you think that lie serves the goal of getting people to believe what you want them to. like, this is why i legitimately despise you as a poster: there's the people who are just dumb but you actually know that you're lying and do it on purpose. the question was, how do states deal with the trump administration's sabotage of Obamacare? you don't like this question; you think people should think about something else instead, so you just lie. democrats have an obligation to try to keep the heath care system running against trump's sabatoge. lying about what the effect of fixes for sabotage will do, because you don't care about the sabotage and actually kind of support it, is obnoxious. a state individual mandate is a useful tool to try to respond to republican sabatoge. there are others; we can discuss them; but a discussion that involves you dropping in and proposing solutions that require a federal waiver (which cannot be gotten while Trump is president) or federal legislation (ditto) but then claiming the reason it's not being done is corrupt democrats is just poisoning the discussion.
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Nov 16, 2018 01:42
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evilweasel: the ACA is not dead!!! also evilweasel: the ACA needs a mandate to work!!! eta: You must've missed the zillion posts in which I cited the single-payer component the one resounding success of the ACA. Sucks to make $17,000+ and thus be subjected to the horrible private plans, though. Willa Rogers fucked around with this message at 01:52 on Nov 16, 2018 |
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Nov 16, 2018 01:45
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Willa Rogers posted:evilweasel: the ACA is not dead!!! i'm kind of glad you make these posts, because they demonstrate the complete lack of good faith in your discussions of health care. the trump administration is repeatedly trying to sabotage obamacare to create a death spiral. that has not happened. good people - people who actually care, who are not you - have been working very hard to prevent it. states found workarounds to prevent the trump administration's withholding of CSR subsidies from causing a death spiral. states like new jersey are trying to counteract the sabatoge of the market via eliminating the mandate. now, we can debate the effectiveness of the obamacare mandate. but you, personally, already gave up the game - you identified a problem with the mandate as that it was too weak to work effectively, and to the extent that the removal of the mandate doesn't actually cause a death spiral that's because the mandate was ineffective before and it was "priced in" already (and is one of the reasons insurance costs are higher). now there are lots of potential solutions that may work better than a punitive mandate; automatic opt-in to a plan is something that's been proposed. there's probably others. however, to the extent that those alternatives require federal legislation, they can't be done while Trump is in office. a state mandate absolutely can be done, and if it needs to be made stronger that is a debate to be had honestly, with the benefits and the drawbacks discussed honestly instead of lying about it, as is your habit. there are other things we can discuss about how to respond to trump sabotage for the next two years; that discussion can happen in parallel with what should be done after 2020 (if Dems can take the Presidency and the Senate). trying to lie about the former because you only want to discuss the latter is obnoxious. Willa Rogers posted:eta: You must've missed the zillion posts in which I cited the single-payer component the one resounding success of the ACA. Sucks to make $17,000+ and thus be subjected to the horrible private plans, though. i am aware you know about the medicaid expansion. what i am annoyed about is that you knowingly repeat the republican propaganda that relies on ignoring that the vast majority of the "missing" people on the exchanges are actually on medicaid, not just uninsured, precisely because i know you know about the medicaid expansion.
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Nov 16, 2018 01:52
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quote:there are other things we can discuss about how to respond to trump sabotage for the next two years; that discussion can happen in parallel with what should be done after 2020 (if Dems can take the Presidency and the Senate) Why not discuss them, then, instead of posting walls-o-text about how awful a person Willa Rogers is? Because since the ACA was passed, the sole proposals I've seen come from dem pols is "make the mandate more punitive" and "shovel more money to insurers." Are any elected Dems talking about regulating the price of drugs, insurance or providers, even in states where Dems have super-majorities? Do you think more punitive mandates would "stablilize the market" and result in political wins for Dems, even if implemented at the state level? Set aside that personal rage and start discussing what you propose as solutions, instead of resurrecting your 10-year-old hate-posts against Willa.
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Nov 16, 2018 02:04
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How do you propose to fix the provider payments from Medicaid? https://www.google.com/amp/www.latimes.com/local/california/la-me-ln-medi-cal-lawsuit-20170711-story.html%3foutputType=amp Etc. Insurers may be making money off the population, but it pays less than cost for providers in most states. Last time I looked at the medpac reports (2015?), the national average for Medicaid SNF payments was something like under 80% of cost. Zauper fucked around with this message at 02:35 on Nov 16, 2018 |
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Nov 16, 2018 02:32
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ACA is so fiendishly complicated that it exists only in a rump state where it's kept on life support by hacks like the silver plan thing It was both a material improvement in coverage but also resulting in some fantastically bad consequences like premium inflation Scrap it and expand medicaid upward and Medicare downward until they meet
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Nov 16, 2018 04:06
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Zauper posted:How do you propose to fix the provider payments from Medicaid? Maybe give Medicare parity rates to Medicaid forever, as the ACA did during only the first year of expanded Medicaid. Or create a hybrid of the two but standardize them and make them permanent. There don't seem to be doctor shortages or patient lawsuits when it comes to Medicare patients, and it's pretty lovely that our system is set up for incentives to providers for treating olds more than poors because of the difference in reimbursement rates.
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Nov 16, 2018 04:46
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Willa Rogers posted:Maybe give Medicare parity rates to Medicaid forever, as the ACA did during only the first year of expanded Medicaid. Or create a hybrid of the two but standardize them and make them permanent. Currently, MediCal pays roughly 50% of Medicare rates. https://www.google.com/amp/s/www.forbes.com/sites/sallypipes/2018/07/23/californias-costly-inaccessible-healthcare-system/amp/ MediCal is currently roughly 50% of the California state budget. They don't have the money to double rates. (There are PCP shortages on Medicare rates, but not specialists) https://www.aarp.org/health/medicare-insurance/info-03-2013/how-to-beat-doctor-shortage.html The situation with the doc fix also is pushing PCPs to not accept Medicare patients.
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Nov 16, 2018 07:29
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Malcolm XML posted:ACA is so fiendishly complicated that it exists only in a rump state where it's kept on life support by hacks like the silver plan thing this but just expand medicaid upward until it crashes into medicare, it's a better program on most levels
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Nov 16, 2018 07:32
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Medicaid is a better program or Medicare? Because, um. Being on both, I can say, no, Medicaid sucks.
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Nov 16, 2018 12:35
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Lest we forget that Republicans are still trying to murder you by abolishing Medicaid:quote:CMS is developing a rule that could curtail Medicaid transportation access https://www.modernhealthcare.com/article/20181107/NEWS/181109932 This is almost a backdoor abolishment of Medicaid for adults in rural states. If you can't get to your appointments, Medicaid doesn't have to pay for them! Hieronymous Alloy fucked around with this message at 15:18 on Nov 16, 2018 |
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Nov 16, 2018 15:15
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Spacewolf posted:Medicaid is a better program or Medicare? They're overlapping and mutually complementary. Medicaid has a lot of issues (low rates, too much state level discretion, means testing) but it covers things Medicare doesn't and vice versa. For example, Medicaid covers long term care, while Medicare does not.
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Nov 16, 2018 15:16
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I'm treating this as an E/N healthcare thread for a moment, so sorry in advance. Last weekend, I had a $600 vet bill because my dumb dog got into a lindt dark chocolate bar. So there goes my spending money for a while. Well. Today I fer ll down the stairs and rolled my ankle really bad. Like I'm pretty sure I heard something snap and my mom (who is an occupational therapist) said the swelling is about as bad as she's ever seen. If I go to the hospital, it's gonna cost me thousands even with insurance so I'm lying in bed with an ACE bandage and ice, popping Tylenol 300 w codeine like they're pez and hoping I can get someone to bring me a couple grams of weed so I can get some sleep tonight before I cross shop for the cheapest x-ray clinic in network. gently caress this country's healthcare system. gently caress this country's healthcare system.
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Nov 18, 2018 00:40
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My insurance just doubled the price of my medication from let's say $50 to $100 per month for no reason on my end, they just decided the contracted pharmacy price will double. I go on goodRx and pay for it out of pocket for $40. Thank You Cigna Very Cool!
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Nov 18, 2018 00:57
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Alastor_the_Stylish posted:My insurance just doubled the price of my medication from let's say $50 to $100 per month for no reason on my end, they just decided the contracted pharmacy price will double. When you’re paying $300 a month for $7000 deductible insurance that increases the cost of your prescriptions it’s hard to call that anything other than being totally ripped off.
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Nov 18, 2018 01:36
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my mother recently got a bill from a doctor she had never heard of before, but with seemingly correct information and with the letterhead of the hospital she has made an appointment at. the number listed on it is for a doctors office in a different state that closed in 2017.
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Nov 18, 2018 05:01
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Anything less than single-player universal care is quite frankly immoral
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Nov 18, 2018 15:09
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Hieronymous Alloy posted:They're overlapping and mutually complementary. Medicaid has a lot of issues (low rates, too much state level discretion, means testing) but it covers things Medicare doesn't and vice versa. For example, Medicaid covers long term care, while Medicare does not. True. Better example: Medicaid covers Non-emergency medical transportation (transportation to, say, get you to the doctor), Medicare does not. This is boneheaded as a thing Medicare doesn't cover, because an absurd number of Medicare eligible folks are either disabled, old enough they shouldn't really be driving if they don't have to, or both. (On that note: Does *any* commercial insurance or Medicare Advantage plan cover NEMT? Asking for myself, not even "a friend".)
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Nov 18, 2018 15:16
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Spacewolf posted:True. Better example: Medicaid covers Non-emergency medical transportation (transportation to, say, get you to the doctor), Medicare does not. Medicare folks that are disabled are dual eligible and also on Medicaid, which means they should be getting NEMT covered that way. Medicare does cover NEMT, but in limited fashion -- you need a doctor's note and maybe some other stuff? Medicare is also testing expanded NEMT coverage in these states, so it may be coming in the future: New Jersey Pennsylvania South Carolina Maryland Delaware District of Columbia Virginia West Virginia North Carolina As far as MA is concerned; that's a needle in a haystack question. Maybe, but probably not? It would depend heavily on county and the ability of the plans to add services at no cost to the beneficiary, and then whether they think that's a benefit that would attract people vs things like dental (without screwing up case mix? I'm guessing the case mix of folks who want NEMT is going to be 'worse', which may make the population undesirable from an actuarial standpoint) Similarly, I'd be surprised if there was a standalone insurance that covered it.
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Nov 18, 2018 15:44
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GoluboiOgon posted:my mother recently got a bill from a doctor she had never heard of before, but with seemingly correct information and with the letterhead of the hospital she has made an appointment at. the number listed on it is for a doctors office in a different state that closed in 2017. That beats mine but I bet your mother had a similar reaction of "What the everloving gently caress?" Earlier this year I received an additional bill from an anesthesiologist for surgery in 2017. I was pissed since I'd paid them some amount 2-3 months after the work when all of the other co-pay bills came in. And here was a bill for $2500. I raised hell with them and my insurance took care of it. My belief is that my surgeon died suddenly at the end of 2017, these fuckers were trying to squeeze patients they could tie to him. If it was only for $50, I probably would have shrugged and paid it. And maybe the timing was just coincidental and there was a "valid" reason for the bill coming when it did, a full year after the surgery. gently caress this country's healthcare system anyway.
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Nov 18, 2018 16:37
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Cheesus posted:gently caress this country's healthcare system anyway.
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Nov 18, 2018 16:45
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I've found myself in a position where I have to turn down employment because of the fact that the benefits are awful and the lovely pay would put me sometimes just above the Medicaid Plus (has some vision and dental benefits) threshold. I currently pay one single dollar per month as my contribution, but the max is $20. That is the end of the elasticity... if I earn more than I think $1406 per month, I can't just pay more of a monthly contribution, I just lose my benefit - period. Basically, the only jobs I can take are PT ones with no benefits that pay almost nothing or wait until I find a job that actually pays a living wage and has decent benefits. I refuse to have anything to do with the exchange, which is an insult to human decency.
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Nov 18, 2018 17:50
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