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ACA Repeal

short+sassyshort+sassy member
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in Wedding Woes

I know, I know.  This is a hot button issue.  But I just can't stay silent anymore.

Listening to some of these Republican leaders talk about what will happen in repealing the ACA is just too incredulous to believe.  Yet it is happening.  I know they are politicians but this is too much, TOO MUCH, for even them to say with a straight face.  Yet it is happening.  Here is what we are actually being told to believe:

  • We will be repealing the ACA by the end of the year.  We don't have a replacement plan in place yet but, don't worry America, we'll figure something out by then.
  • The ACA took years to put together and was solely a clusterf**k because...Democrats.  But we'll smoothly transition 20 MILLION people from their current ACA plans to our...as yet to be developed...revamped program.  Easy as pie.  Why is everyone worried?  NBD.
  • We'll make healthcare affordable.  Because great solutions that no one every thought of before are magically going to appear.  I mean, they haven't appeared yet (see points 1 and 2).  But we're sure of it.

Or, what is actually going to happen.  They'll repeal the ACA and could care less about the 20M people who lose their healthcare.  Or the millions of people who can't buy insurance...at all...on the open market because they coughed twice last year.  Or the children stricken with cancer who already met their lifetime max for medical insurance payouts before their 5th birthday.  You know, the bad old days.

Don't get me wrong.  The ACA needs serious tweaks.  It isn't affordable coverage for many people.  But healthcare should be a RIGHT for people.  Not a luxury that only the wealthy or those with good group policies can afford.  So can we please not throw the baby out with the bath water.  And especially not tell outrageous, patronizing lies to the American public that "Sure, it will be replaced with something better.  Someday.  We just don't know what, when, or how."

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Re: ACA Repeal

  • Ro041Ro041 member
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    edited January 2017
    There isn't even a budget for Fiscal Year 2017 which began on October 1, 2016....we are operating on a continuing resolution of last fiscal year's budget.

    Edited (October 1 and not 2).


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  • VarunaTTVarunaTT member
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    I'm real excited to have "being female" be a pre-existing condition again.

    K is worried b/c she's not sure if she will be kicked off her parent's plan, if when that maybe happens it will be a qualifying event or not so she can get on her own, and the fact that she had a very specific eye cancer as a baby that only happens to babies will now be a pre-existing condition for her.  She's looking into going onto her own through work, but it's kind of a crappy plan when she has a really good one, cheaper, through her mother.

    But I'm sure it's be terrific, just terrific /sarcasm.
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  • kimmiinthemittenkimmiinthemitten member
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    I don't understand how they think they can keep the parts they like, without paying for it with things they don't.  I'm going to end up with $140 month out of pocket costs for BC again.

    And naturally, party of the failures of the ACA is a result of GOP Governors who refused to expand Medicare in their states.  Our Congressman made the mistake yesterday of not fully understanding social media and how it can bite you in the ass.  He asked for our thoughts, the page was immediately shared to the local Pantsuit Nation spin off page, and he was flooded with responses from people who want to keep ACA.

    I added:  Protecting social security, disability, food assistance and Medicare programs- especially for senior and disabled Americans who live below the poverty level at no fault of their own because of the GOP's disdain for "entitlement programs."

    Creating a voucher program, privatizing or worse yet, block granting Medicare would be disastrous in the future for my Deaf/Blind mother. It's bad enough she has minimal eye vision insurance, but block grants would remove in home healthcare for thousands upon thousands of people who depend on it.  For her, that means no at home cane training and other occupational therapies medicare currently does cover for people losing their vision.
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  • PrettyGirlLostPrettyGirlLost member
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    kimmiinthemitten said:
    I don't understand how they think they can keep the parts they like, without paying for it with things they don't.  I'm going to end up with $140 month out of pocket costs for BC again.
    Just go to PP. . .oh, wait ><

    I love having free BC- one less rx to pay for- but I never understood *why* it became free. . .what was the rationalization?  We have co-pays on all the other rx we need.

    "Love is the one thing we're capable of perceiving that transcends time and space."


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  • short+sassyshort+sassy member
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    Heffalump said:
    short+sassy said:

    Don't get me wrong.  The ACA needs serious tweaks.  It isn't affordable coverage for many people.  But healthcare should be a RIGHT for people.  Not a luxury that only the wealthy or those with good group policies can afford.  So can we please not throw the baby out with the bath water.  And especially not tell outrageous, patronizing lies to the American public that "Sure, it will be replaced with something better.  Someday.  We just don't know what, when, or how."

    1. Totally agreed, but look at how many preposterous claims were put out there during the election that people bought hook, line, and sinker.  "I have a great plan for reducing all the gun violence in Chicago.  48 hours after I'm elected, I'll have this fixed."  "I know more about ISIS than all of our generals do, believe me.  I have a plan."  "We're going to build a wall, a great wall, and we're going to get Mexico to pay for it."  I mean, vague promises of something better with no real details have sort of become their stock in trade, and it defies logic, but it doesn't seem to be slowing them down any.  I figure it's only a matter of time until we get the secret plan to fight inflation.

    Image result for secret plan to fight inflation
    Image result for secret plan to fight inflation

    2. Everything I have read suggests that it is impossible to keep all the benefits while reducing the outlay.  And I kind of can't believe that we need all kinds of analyses to confirm this, but whatever.

    3.  When I worked with Germans, they were baffled by our system.  One of my colleagues kept asking me questions, and when I would answer ("No, you lose your coverage if you lose your job.  Unless you sign up for COBRA, which typically costs almost as much as your get in unemployment insurance." "No, if you have a job that doesn't offer health insurance, you either have to pay a ton of money for a private plan with limited benefits, or you go without and hope you stay healthy."), every. damn. time. he was like "I am sorry, I do not think I explained my question very well."  No, dude, I understood you perfectly, that was just the reality of the situation ca. 2008.

    3. Single. Payer. 

    My response, "I understand how baffling it must be to people from other countries.  That a prosperous and industrialized country like the United States is so barbaric with its citizens' health.  Unfortunately, they are.  It's baffling to us also."

    Really, though.  Some of it isn't baffling.  The American people want affordable healthcare for everyone, but not at the cost of having their taxes raised one iota.  Of course, I'm speaking in generalities, but that is the sentiment I usually see.  This attitude severely hampers what our Congress people can do and still please the majority.

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  • CharmedPamCharmedPam member
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    PrettyGirlLost said:
    kimmiinthemitten said:
    I don't understand how they think they can keep the parts they like, without paying for it with things they don't.  I'm going to end up with $140 month out of pocket costs for BC again.
    Just go to PP. . .oh, wait ><

    I love having free BC- one less rx to pay for- but I never understood *why* it became free. . .what was the rationalization?  We have co-pays on all the other rx we need.
    but not everyone who was covered had free bc, right? I was.  But when I was talking to my friend about it, she told me she still had to pay for hers and has very good insurance too.   I didn't understand that.

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  • short+sassyshort+sassy member
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    CharmedPam said:
    PrettyGirlLost said:
    kimmiinthemitten said:
    I don't understand how they think they can keep the parts they like, without paying for it with things they don't.  I'm going to end up with $140 month out of pocket costs for BC again.
    Just go to PP. . .oh, wait ><

    I love having free BC- one less rx to pay for- but I never understood *why* it became free. . .what was the rationalization?  We have co-pays on all the other rx we need.
    but not everyone who was covered had free bc, right? I was.  But when I was talking to my friend about it, she told me she still had to pay for hers and has very good insurance too.   I didn't understand that.

    Not personal experience, one of those "I've heard", that many insurance companies try to limit the BC pills to only 1-2 brands.  And if a person wants a different brand or just doesn't know, they are told they have to pay out of pocket or pay their deductible (if applicable).  However, usually if the claimant fights it with their insurance, they will often win.

    To me, it sounds like the typical insurance shell game.  They say "no" and many people just accept that, move on, and don't fight it.  But if they do fight it, than the insurance company will sometimes approve it.

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  • CharmedPamCharmedPam member
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    short+sassy said:
    CharmedPam said:
    PrettyGirlLost said:
    kimmiinthemitten said:
    I don't understand how they think they can keep the parts they like, without paying for it with things they don't.  I'm going to end up with $140 month out of pocket costs for BC again.
    Just go to PP. . .oh, wait ><

    I love having free BC- one less rx to pay for- but I never understood *why* it became free. . .what was the rationalization?  We have co-pays on all the other rx we need.
    but not everyone who was covered had free bc, right? I was.  But when I was talking to my friend about it, she told me she still had to pay for hers and has very good insurance too.   I didn't understand that.

    Not personal experience, one of those "I've heard", that many insurance companies try to limit the BC pills to only 1-2 brands.  And if a person wants a different brand or just doesn't know, they are told they have to pay out of pocket or pay their deductible (if applicable).  However, usually if the claimant fights it with their insurance, they will often win.

    To me, it sounds like the typical insurance shell game.  They say "no" and many people just accept that, move on, and don't fight it.  But if they do fight it, than the insurance company will sometimes approve it.

    Interesting! I wish I had known that to tell her that. 

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  • cupcait927cupcait927 member
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    CharmedPam said:
    short+sassy said:
    CharmedPam said:
    PrettyGirlLost said:
    kimmiinthemitten said:
    I don't understand how they think they can keep the parts they like, without paying for it with things they don't.  I'm going to end up with $140 month out of pocket costs for BC again.
    Just go to PP. . .oh, wait ><

    I love having free BC- one less rx to pay for- but I never understood *why* it became free. . .what was the rationalization?  We have co-pays on all the other rx we need.
    but not everyone who was covered had free bc, right? I was.  But when I was talking to my friend about it, she told me she still had to pay for hers and has very good insurance too.   I didn't understand that.

    Not personal experience, one of those "I've heard", that many insurance companies try to limit the BC pills to only 1-2 brands.  And if a person wants a different brand or just doesn't know, they are told they have to pay out of pocket or pay their deductible (if applicable).  However, usually if the claimant fights it with their insurance, they will often win.

    To me, it sounds like the typical insurance shell game.  They say "no" and many people just accept that, move on, and don't fight it.  But if they do fight it, than the insurance company will sometimes approve it.

    Interesting! I wish I had known that to tell her that. 
    You can find out exactly what types and brands of BC your insurance covers by looking in the prescription drug formulary. Insurance companies typically provide the formulary right on their website or you can call and request it. Not all insurance companies will cover all types of birth control in full so at least you can find out what ones are covered before you are surprised with a cost share.
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  • kimmiinthemittenkimmiinthemitten member
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    CharmedPam said:
    short+sassy said:
    CharmedPam said:
    PrettyGirlLost said:
    kimmiinthemitten said:
    I don't understand how they think they can keep the parts they like, without paying for it with things they don't.  I'm going to end up with $140 month out of pocket costs for BC again.
    Just go to PP. . .oh, wait ><

    I love having free BC- one less rx to pay for- but I never understood *why* it became free. . .what was the rationalization?  We have co-pays on all the other rx we need.
    but not everyone who was covered had free bc, right? I was.  But when I was talking to my friend about it, she told me she still had to pay for hers and has very good insurance too.   I didn't understand that.

    Not personal experience, one of those "I've heard", that many insurance companies try to limit the BC pills to only 1-2 brands.  And if a person wants a different brand or just doesn't know, they are told they have to pay out of pocket or pay their deductible (if applicable).  However, usually if the claimant fights it with their insurance, they will often win.

    To me, it sounds like the typical insurance shell game.  They say "no" and many people just accept that, move on, and don't fight it.  But if they do fight it, than the insurance company will sometimes approve it.

    Interesting! I wish I had known that to tell her that. 
    The rule as I understand it is basically if there is a generic available, the company has to provide the generic for free and can apply co pays or charge 100%.  However, if there is no generic or alternative available, they must provide that free of charge.

    For example, I use the Nuvaring.  There is no alternative to it.  For the first year (or two) under ACA I had to pay for it until I met my prescription deductible.  My insurance company was sued and lost based on the above rule and now I no longer pay out of pocket for it.
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  • MesmrEweMesmrEwe member
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    At the end of the day "Something needs to be done" - especially when you have people like MN's super-left Governor Dayton flat out calling the ACA that HE and the DFL Legislature here at the time put into place, is Unaffordable and unsustainable in its current form.  Now what - PP will still be around, if you like it, donate.  The "We have to pass it to find out what's in it" mentality is what got us into this mess of turning family premiums from about $500-800/mo which was unaffordable to many, into $1500/mo plus insane deductibles for plans that don't cover nearly what they did before, but because certain things are now mandated, the cost went up.  When the insurance, not the care, is costing households $1500/mo, there's a problem that needs to be fixed.  Think about the size of house one could gain equity on for $1500/mo., something's wrong with this system and it needs to be addressed with nothing being considered a "Sacred cow" during the process.  Most people can agree "eliminate preexisting conditions as disqualifying/uninsurable criteria; take care of those who cannot take care of themselves; allow health insurance and care portability (i.e. you choose your doctors whether you want to see someone in Minnesota at Mayo or Texas Children's); Only you and your doctor(s) know what is your best health care; mental health care is health care too; and make it so you can cross state lines to purchase insurance.", from there, the question is "what next", and this all needs far more vetting than what the ACA got with the less than a few hours after being behind closed doors "pass it to find out what's in it" for the replacement...  Remember - Trump called for single-payer before single-payer was cool... 
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  • drunkenwitchdrunkenwitch member
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    It's obvious, Trump's new health plan is leeches, bloodletting and a hysterectomy for uppity women.

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  • GBCKGBCK member
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    I think 'dismantle, and we'll find a solution" is probably slightly MORE stupid than 'pass and we'll find out what's in it' (both are stupid, FWIW.  However one was/is dealing with a crisis in our country, the other is taking the finger out of the dyke and bringing the crisis back to a head)

    I think saying trump supports or has ever supported a single payer system is disingenuous.  At random points in the past, Trump has come out marginally pro-single payer system.  At random points in the much more recent past, he has come out pretty vocally anti-single payer system.  So I don't think it's unreasonable to consider Trump the candidate (vs. Trump the...whaever the hell he was before) anti single-payer system. 
    And it's hella reasonable to consider him an unpredictable loose cannon who'd be willing to let millions of people be left swinging in the wind.

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  • kimmiinthemittenkimmiinthemitten member
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    Insurance premiums rose 113% in the 10 years before Obamacare passed. Our out of pocket costs are rising, and Obamacare may not have stopped it like people had hoped, but it's not the only reason people saw hikes either. 

    The good news is the ACA changed the conversation from "should everyone have healthcare," to "what kind of healthcare should everyone have."  That change in perception is huge win, IMO. What's troubling is some people think the answer to the second question is HSAs independent from an insurance plan, block granting public health and forcing people with preexisting conditions to either have insurance for life, or pay up (so basically if you're sick- never ever leave your job because that 90 day grace period will cost you!) is the answer. 
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  • kimmiinthemittenkimmiinthemitten member
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    FYI for anyone who hasn't seen the news, it started in the Senate around 1am Thursday morning.  They passed a budget that under-funds it, and voted down every single amendment the dems introduced including expanding coverage to 26, banning companies from charging women more than men, protecting pre-existing conditions, guaranteeing maternity coverage, no co-pay preventive maintenance services, and of course, the no co-pay for birth control.

    They also voted down a bill to allow Canadian drug imports, but 13 dems voted against that too.
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  • short+sassyshort+sassy member
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    edited January 2017
    kimmiinthemitten said:
    FYI for anyone who hasn't seen the news, it started in the Senate around 1am Thursday morning.  They passed a budget that under-funds it, and voted down every single amendment the dems introduced including expanding coverage to 26, banning companies from charging women more than men, protecting pre-existing conditions, guaranteeing maternity coverage, no co-pay preventive maintenance services, and of course, the no co-pay for birth control.

    They also voted down a bill to allow Canadian drug imports, but 13 dems voted against that too.

    Thanks for the update.

    I don't even understand the bolded.  And, unfortunately, it VERY GREATLY affects me. 

    I'm going to rant for a sec about why I'm upset.  So, I've occasionally mentioned I'm a Type I Diabetic.  I currently have insurance, but it's a $6800 deductible before it pays anything.

    Without going into a lot of boring detail, there are essentially two kinds of (faster acting) insulin I can take.  One kind is called "R".  It's $26 for one vial (retail).  Low cost, but it is a VERY OLD FASHIONED insulin.  The one I currently take is called Kwikpen.  It's much faster acting and comes in a convenient pen.  Love that pen style so much more.

    With that insulin it is amazing....cannot stress that enough...how much better I can control my blood sugar levels.  And controlling blood sugar is the name of the game to stave off the very serious complications that this disease can bring on over time.  Except this insulin is $550 (retail) for 5 pens...which lasts me a whopping 3 weeks.  Except there is one online Canadian pharmacy that sells it for $135 for 5 pens.  They are my godsend to still be able to use the type of insulin I should be using, because I can't afford it without them.

    What has been outlined above is

    • Whenever I switch insurance plans, I won't be covered at all for my pre-existing condition for one year.  That's how it used to be.  Or maybe now it is just never.
    • So, my insurance won't help me pay for my incredibly expensive medication.  Oh but wait...now I can't buy it out-of-pocket from Canada either!!!!  Why?!?!  Because some a-hole pharma companies have a bunch of politicians in their pocket?  There is just no point to that whatsoever.
    • I'll be forced to go back to "R" insulin, which will hurtle me faster from a manageable disease that is low in cost...compared to the f**king complications of kidney failure, blindness, and heart failure.  Just to name a few.

    I wonder if it just can't be shipped over the border?  But I could go to Canada, but it and bring it back with me.  If I bought a year's supply at a time, that would STILL be in my budget (including the travel) and be RADICALLY cheaper than buying it locally.  How pathetic is that! 


    ***A big thank you to you, @kimmiinthemitten.  I was just about to place another order.  I'm going to buy a bajillion boxes before my window closes.  I realize it might be awhile before the legislation takes effect, but I want to be prepared.

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  • sparklepants41sparklepants41 member
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    kimmiinthemitten said:
    FYI for anyone who hasn't seen the news, it started in the Senate around 1am Thursday morning.  They passed a budget that under-funds it, and voted down every single amendment the dems introduced including expanding coverage to 26, banning companies from charging women more than men, protecting pre-existing conditions, guaranteeing maternity coverage, no co-pay preventive maintenance services, and of course, the no co-pay for birth control.

    They also voted down a bill to allow Canadian drug imports, but 13 dems voted against that too.
    Thank you for posting this. 

    And may I also add: WHAT THE ACTUAL FUCK, SENATE?!" 

    Yes, I was shouting. Because JFC. WHERE IS THE HUMANITY? WHERE ARE THEIR CONSCIENCES?????
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  • kimmiinthemittenkimmiinthemitten member
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    @short+sassy from what I read when I couldn't sleep last night most likely employer provided insurance can place a one year hold for insurance while private insurance can deny someone outright.  It's really, really awful that health insurance can hold someone hostage.  Unless of course the new plan that is TBD adds that back into the program.  Who knows, it hasn't been written yet.

    I've noticed a lot of women are calling their legislators because of all the things this does to women specifically. I encourage everyone who cares enough themselves to make sure at minimum their partner calls too.  Clearly, politicians don't care about a bunch of women calling and advocating for themselves, but they'll take note when even men are calling about our health too.

    @sparklepants41 - it's locked in their safety deposit box, right next to the sponsorship money they've been bought with.  I'm really disappointed in Cory Booker especially.  From what I read Canada is actually more stringent on drug regulations than the USA so clearly, voting that amendment down wasn't about safety like he claims.

    If you have time, watch the video from CSPAN.  Each time a Senator got up to vote against it, they added a sentence or two as to why, and each and every time they were gaveled out to drown out their voices.  It's really quite something to see, and not in a positive way.
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  • *Barbie**Barbie* member
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    My insurance stopped covering my migraine abortives (well maybe they did, who in the actual fuck knows anymore - they told me something about preauthorization expiring so since it was renewed in december maybe they will cover it? nobody at cigna can tell me anything until the next time i try to fill it and we'll see if it goes through. really helpful.) 

    I asked my neuro to look into other options when i saw him in Nov since they gave me advance notice of the possible cancellation of this medicine. I've been stockpiling, but if i get a bad spell, i'll go through the pills pretty fast. The medicine I take is a combo drug, so he gave me a drug from each family. (one of them didn't work in the past, but he said that the 2nd drug amplifies it, which is probably why the combo worked.) Ok, great. So I have him send a 1 month supply to Walgreens (I usually do mail order 90 days) - just to try it out. If the combo worked, i could just transition to that and get a longer script. 

    ...except the insurance refused to cover one of the drugs. so i called and asked about it. and they were like, acceptable families are ... (name 1, name 2, name 3) - and i was like, "hold on, the one i am trying to get that you won't cover is in name 2 family, so how is it not covered? what in the actual fuck do you cover, so i can give my doctor a list of options. i'm already not looking forward to treatment roulette, and you're making this needlessly difficult." so then they determined that since i got my old medicine preauth passed that they might cover that one, but couldn't tell me anything because it wasn't available in their system. (and still isn't - when i use the estimate tool, they tell me it's not covered, except maybe if it is, in which case the cost is ?)

    !!!

    yeah, a 1 month supply of this stuff (18 pills - which could treat from 9-18 headaches) costs something like $4600 retail. I was paying $50 for a 3 month supply from the home delivery pharmacy. 
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  • cowgirl8238cowgirl8238 member
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    kimmiinthemitten said:
    FYI for anyone who hasn't seen the news, it started in the Senate around 1am Thursday morning.  They passed a budget that under-funds it, and voted down every single amendment the dems introduced including expanding coverage to 26, banning companies from charging women more than men, protecting pre-existing conditions, guaranteeing maternity coverage, no co-pay preventive maintenance services, and of course, the no co-pay for birth control.

    They also voted down a bill to allow Canadian drug imports, but 13 dems voted against that too.


    That is just so sad.  I will never understand how the government can get away with such blatant bullshit! 

    My DH is outraged too, he made the point yesterday that I would like to share. "So the government doesn't want to supply birth control to prevent pregnancy, doesn't want to allow abortions to terminate a pregnancy, doesn't want to give women maternity leave once they have said baby, and don't want to fund any of the social programs that help people who have had children and need assistance.  But the second that child turns 18 they want to send them off to war and collect taxes too!" 

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  • levioosalevioosa member
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    My heart is so heavy.  And this is just the beginning.  


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  • kimmiinthemittenkimmiinthemitten member
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    Ugh, the House just passed Budget Reconciliation too.
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  • MesmrEweMesmrEwe member
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    sparklepants41 said:
    kimmiinthemitten said:
    FYI for anyone who hasn't seen the news, it started in the Senate around 1am Thursday morning.  They passed a budget that under-funds it, and voted down every single amendment the dems introduced including expanding coverage to 26, banning companies from charging women more than men, protecting pre-existing conditions, guaranteeing maternity coverage, no co-pay preventive maintenance services, and of course, the no co-pay for birth control.

    They also voted down a bill to allow Canadian drug imports, but 13 dems voted against that too.
    Thank you for posting this. 

    And may I also add: WHAT THE ACTUAL FUCK, SENATE?!" 

    Yes, I was shouting. Because JFC. WHERE IS THE HUMANITY? WHERE ARE THEIR CONSCIENCES?????
    Humanity does not exist in politics - special interests do.  Showboating does.  George Carlin nailed it all!  Both wings come from the same bird..  
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