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All TopicsForum: Employment, Insurance, and Other Financial Issues → Topic: SCOTUS Upholds Affordable Care Act!

Topic: SCOTUS Upholds Affordable Care Act!

Forum: Employment, Insurance, and Other Financial Issues —

Employment, insurance, and financial concerns are common. Meet others here to discuss and for support.

Posted on: Jun 28, 2012 07:28AM

pupmom wrote:

This is a good day for Americans, and especially we cancer patients! Now hopefully there will be no more heartwrenching tales of woe, from sisters and brothers with this devastating disease who can't afford their treatments. Thank you Justice Roberts! Without his yea vote the ACA would have gone down.

Life is what happens while we're making other plans. Dx 10/18/2011, IDC, 1cm, Stage IIA, Grade 1, 2/21 nodes, ER+/PR+, HER2-

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Jun 28, 2012 07:48AM pupmom wrote:

Kayb, yes indeed. The act needs a lot of tweaking, but we had to start somewhere.

Life is what happens while we're making other plans. Dx 10/18/2011, IDC, 1cm, Stage IIA, Grade 1, 2/21 nodes, ER+/PR+, HER2-

Jun 28, 2012 07:49AM 1openheart wrote:

Like!  My husband and I both have pre existing conditions and we are self employed.   No insurance company would write us a policy, not even a major medical with us paying for the day to day things.  

Yes, this law is not perfect, but it is a start.   

"The wound is the place where the light enters you." ~ Rumi Dx 4/28/2011, DCIS, 1cm, Stage 0, Grade 3, 0/1 nodes, ER+/PR+ Surgery 6/15/2011 Lymph node removal: Left, Sentinel; Mastectomy: Left; Reconstruction (left): Nipple reconstruction

Jun 28, 2012 08:01AM peggy_j wrote:

I just saw this news and logged in to share it with everyone. I'm sure you've seen other articles but this is the one I read.

http://news.yahoo.com/blogs/ticket/supreme-court-issue-obamacare-decision-135554880.html

You know you're a cancer patient when reading news like this makes you weep with relief. (seriously, tears are streaming down my face as I write it.) I was 46 at the time of my Dx and while my DH's company has fantastic health insurance coverage, knowing that I now had a serious pre-existing condition made me worried that I could one day be without. I never thought John Roberts would be the one to help me. Thank god! Really. (agreed, it's not perfect but a big step forward in the right direction).


Dx 2/2011, IDC, <1cm, Stage IA, Grade 1, 0/3 nodes, ER+/PR+, HER2-

Jun 28, 2012 10:30AM Jules59 wrote:

Hallelujah!!!

Many republicans in congress, as well as Mitt Romney vow to pass legislation to do away with the ACA.  Here's hoping they don't succeed.

Jules Dx 1/24/2011, IDC, 1cm, Stage IIIA, Grade 3, 7/17 nodes, ER+/PR-, HER2-

Jun 28, 2012 10:39AM pupmom wrote:

I don't think they will. They're just bloviating to rile up their base! Laughing
Life is what happens while we're making other plans. Dx 10/18/2011, IDC, 1cm, Stage IIA, Grade 1, 2/21 nodes, ER+/PR+, HER2-

Jun 28, 2012 12:08PM Chickadee wrote:

That's why we should never let one party control both house and the presidency. The more they gridlock, the less damage they do. Until they can learn to work together for the country and not their own greedy benefactors, gridlock it is.

I'm in such bad shape, I'm wearing prescription underwear." Phyllis Diller 1917-2012 Dx 9/1/2009, IDC, 1cm, Stage IV, Grade 3, mets, ER+/PR+, HER2-

Jun 28, 2012 12:17PM 3monstmama wrote:

I think I would have been happy-happy today even if I weren't a cancer patient but as a cancer patient, as a woman who did "everything" right, I am so much happier. 

No one goes into life thinking they will get cancer  (or any other major illness) and yet so many get whacked with the cancer stick and find themselves dealing with insurance and financial issues in ways that keep them from focusing on their cancer and getting well.   Then there's that whole preexisting condition thing and what to do about your young adult children who don't have insurance.

As for those claiming its a "bad law," I'll listen to their views as soon as I see the signed sworn statements of each giving up their own federal insurance.

Pain is inevitable. Suffering is optional.

Jun 28, 2012 12:31PM bevin wrote:

I am not sure this is good news. They upheld it as a tax. So it will be one more tax we all have to pay. I'm not sure this will make me happy.

Age 45, Oncotype 11, Primary Tumor 2.1 cm, smaller satellite tumor nearby Dx 8/8/2010, IDC, 2cm, Stage II, Grade 3, 0/5 nodes, ER+/PR+, HER2- Surgery 8/10/2010 Lumpectomy: Right; Lymph node removal: Right, Sentinel Radiation Therapy 10/10/2010 Breast

Jun 28, 2012 12:46PM - edited Jun 28, 2012 12:46PM by Cindyl

It's only a tax you have to pay if you choose not to carry insurance.  So if you are covered by your employers plan, or can join a high risk pool you don't pay the tax. (which I understand is 1% of your income) So if you make 50,000 a year and choose not to carry insurance you will be taxed $500.  I think that is not unfair at all.  The folks who choose to gamble and go without insurance frequently end up costing the system money when they end up in the ER.  But this plan should assure that there are affordable options for those of us who have lost/never had insurance.
Stay calm, have courage and watch for signs. Dx 2/11/2012, IDC, 3cm, Grade 1, 0/7 nodes, ER+/PR+, HER2- Surgery 3/1/2012 Lumpectomy: Right; Lymph node removal: Right, Sentinel, Underarm/Axillary Radiation Therapy 4/16/2012 Hormonal Therapy 5/23/2012

Jun 28, 2012 01:06PM 1Athena1 wrote:

Today is a great day that finally brings our country into the club of truly civilized nations which regard healthcare as a fundamental right. IMO, the fact that SCOTUS labels it a tax sort of reaffirms healthcare's position as a cornerstone of our society, like roads, bridges and schools. And that is exactly where it belongs. Millions of American will feel more security, and far fewer people will have to make the choice between food and medicine.

Proud to be a member of a truly developed nation.

And now for some frivolity: Give a hand to Linda Greenhouse, NYT columnist, who observed Roberts's deference for federal power and fully predicted today's decision in today's paper....and give a thumbs down to Fixed Noise and Cretin News Network, both of whom got the news wrong for the first few minutes and reported that the law had been struck down because the court rejected the government's central argument defending the mandate under the Commerce Clause. See here: http://tpmdc.talkingpointsmemo.com/2012/06/cnn-fox-news-supreme-court-coverage.php

Anyone diagnosed with cancer should learn to have a healthy disrespect for statistics. Statistics are maths. It's the science which still eludes us. Dx 3/2009, IDC, 3cm, Stage IIB, Grade 3, 3/8 nodes, mets, ER+/PR+, HER2-

Jun 28, 2012 01:11PM 1Athena1 wrote:

bevin: the health care law doesn't change one iota based on how SCOTUS upheld it - although the SCOTUS arguments could affect other legal rulings on other issues. I am actually glad the court rejected the Commerce Clause argument - I always found it to be a flimsy one.

Anyone diagnosed with cancer should learn to have a healthy disrespect for statistics. Statistics are maths. It's the science which still eludes us. Dx 3/2009, IDC, 3cm, Stage IIB, Grade 3, 3/8 nodes, mets, ER+/PR+, HER2-

Jun 28, 2012 02:03PM Chris13 wrote:

I also heard a commentator say that the "tax" is unenforcable, ie the IRS is prohibited from garnishing wages, etc. to collect it, as they can do for other tax deadbeats (or those who sadly are in such terrible financial shape they skip paying taxes to buy food.)

 Now that we all have a pre-existing condition, as least we know (after 2014) we cannot be denied coverage. And oh, how insurance companies love to deny coverage. 

"To attend to the moment is to attend to eternity." 2 ILC tumors 1.6. 1/4 positive nodes. Oncotypes 8 & 15. No rads/chemo. Dx 2/24/2012, ILC, 1cm, Stage IIA, Grade 1, 1/4 nodes, ER+/PR+, HER2- Surgery 5/1/2012 Reconstruction (right): DIEP flap Surgery 5/1/2012 Lymph node removal: Right, Sentinel; Mastectomy: Right Hormonal Therapy 8/1/2012 Arimidex (anastrozole)

Jun 28, 2012 02:19PM pupmom wrote:

Lol! Reminds me of that famous picture of Truman who, after winning the presidency, held up a newspaper with the headline "Dewey Defeats Truman." That paper was of course prematurely released. The editor was a die hard Dewey supporter. 

Life is what happens while we're making other plans. Dx 10/18/2011, IDC, 1cm, Stage IIA, Grade 1, 2/21 nodes, ER+/PR+, HER2-

Jun 28, 2012 02:29PM DucorpsToo wrote:

I'm also happy about nixing the pre-existing condition clauses as well as the lifetime caps on insurance. The ACA  is  a very good first start. However I'm somewhat concerned about the ACA financing.  Theoretically, if everyone "chips into the pool" so to speak, then healthcare costs should be lower. But as it stands, who's to say that the insurance companies won't jack up the prices -and still make the premiums unaffordable? In an event like this, we "technically" cannot be denied coverage due to a pre-existing condition, yet we still wouldn't be able to afford premium.  Are there any provisions in the ACA that regulate how much these companies can charge?
"Man lives in the sunlit world of what he believes to be reality. But... there is, unseen by most, an underworld, a place that is just as real, but not as brightly lit.....a Darkside" Dx 8/4/2010, IDC, Right, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2-

Jun 28, 2012 02:41PM pupmom wrote:

DucorpsToo, I just read that under ACA insurance companies cannot raise rates on JUST people with pre-existing conditions. However, they can raise rates in general. Of course they already can do that. It's a big improvement that they can't just screw the sick anymore.

Life is what happens while we're making other plans. Dx 10/18/2011, IDC, 1cm, Stage IIA, Grade 1, 2/21 nodes, ER+/PR+, HER2-

Jun 28, 2012 02:48PM DucorpsToo wrote:

So if they can raise rates on the general poplace, just as they're doing currently, then that certainly doesn't ensure that such rates would be affordable to the general population. As we well know, there are plenty of folks out there with no pre-existing condition that cannot afford the rates that these companies are charging. That's why  I think that another major tweak to the ACA should be some sort of regulation to these companies.  I remember a couple of years ago that Anthem Blue Cross (here in California) had hiked up rates as much as 30%! -however they were "called on the carpet" for that move...

"Man lives in the sunlit world of what he believes to be reality. But... there is, unseen by most, an underworld, a place that is just as real, but not as brightly lit.....a Darkside" Dx 8/4/2010, IDC, Right, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2-

Jun 28, 2012 02:53PM pupmom wrote:

I don't know if this is relevant, but under ACA insurance companies are required to apply 80% of premiums to medical care only. 20% goes to administrative costs and profits. If they don't spend all of the 80% they must issue refunds to their policy holders. That money cannot be pocketed by the companies.

Life is what happens while we're making other plans. Dx 10/18/2011, IDC, 1cm, Stage IIA, Grade 1, 2/21 nodes, ER+/PR+, HER2-

Jun 28, 2012 03:08PM Trisha-Anne wrote:

Hope you ladies don't mind an Aussie chiming in here. 

Our health system is based on tax.  We all pay 1.5% of our income towards Medicare.  That comes out of our paypacket along with our income tax.  This entitles all Australians to go to a hospital and be treated, tested, operated on etc at no personal cost at all.

We can also pay for private health insurance, and if we earn over a certain amount and don't have private health insurance we are taxed at a higher rate because of it.  The Australian Government also pays a subsidy of 30% of the cost of the private health insurance.  The private health insurance means that we can choose our own doctor and go into a private hospital to shorten waiting times in the public system.  I pay private insurance and for a couple it is around $190 per month.  I don't pay for "extras" insurance that covers dentists, glasses or chiropractors etc.  No private insurer can charge you more for insurance with pre-existing conditions - there may be a waiting period of up to a year though (for new joiners) where they aren't covered for a pre-existing condition.  But everyone gets charged the same amount.

I used a private hospital for my mx and my port placement and deporting (lol) and my health insurance paid all the hospital accommodation costs.  Doctor's bills rebates are a bit more difficult to explain, but there was still some out of pocket costs - and it depends on the doctor you choose and how much they charge as to how much out of pocket you are.  But Medicare and the health insurer pay some of their costs.

I use the public system for my oncology visits and scans etc.  They cost me nothing at all - everything is covered by Medicare.  So MUGA scans, mamograms, u/s, brain scans etc are all free for me.

It's a great system - it does have it's flaws, all systems do - but no-one is denied good quality care.  Women who can't afford health insurance (because they don't have a high enough income) can get a mx, and pretty much all the treatment and scans they need without paying a cent.

I hope you ladies benefit from the changes in your health system - it's worked so well for many countries, and cancer patients will be the big winners I hope.

Trish

I have made a long journey and been to a strange land and I've seen the dark man very close ... Thomas Wolfe Dx 9/17/2010, ILC, <1cm, Grade 1, ER+/PR+, HER2- Dx 9/17/2010, IDC, 2cm, Stage IIA, Grade 3, 1/6 nodes, ER+/PR+, HER2+ Dx 11/4/2015, IDC, Right, 2cm, Grade 3, 0/5 nodes, ER-/PR-, HER2-

Jun 28, 2012 04:06PM o2bhealthy wrote:

I just hope we can afford the rates...yeah,  they cannot deny us coverage, but there is currently no cap to what they can charge for the coverage...

Michelle ~ DCIS and IDC - Thyroid Cancer dx 10-27-10, partial thyroidectomy 11-23-10 Dx 5/15/2009, IDC, 1cm, Stage I, Grade 3, 0/3 nodes, ER+/PR-, HER2+ Surgery 6/23/2009 Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Targeted Therapy 7/19/2009 Herceptin (trastuzumab) Chemotherapy 7/19/2009 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 11/12/2009 Reconstruction (left); Reconstruction (right) Hormonal Therapy 12/1/2009

Jun 28, 2012 05:11PM - edited Jun 28, 2012 05:11PM by bevin

Well, all I  know is nothing is free, so all those coverages and payments for them will need to come from somewhere; our government will tax us to pay for it. Well, I geuss they will tax those of us who work. Those who don't work, since they pay no tax, and since the IRS  (as stated above) cant enforce it, those people I assume will get free health care; paid for by the taxes of those who do work.

Ugh, so not on board yet.  I agree the commerce clause was wrong and I'm glad that wasn't allowed to be used as the bases for law.

Age 45, Oncotype 11, Primary Tumor 2.1 cm, smaller satellite tumor nearby Dx 8/8/2010, IDC, 2cm, Stage II, Grade 3, 0/5 nodes, ER+/PR+, HER2- Surgery 8/10/2010 Lumpectomy: Right; Lymph node removal: Right, Sentinel Radiation Therapy 10/10/2010 Breast

Jun 28, 2012 06:31PM CLC wrote:

It is very rare that I feel proud of the decisions made by our government.  Today, I feel proud.  The ACA is not ideal.  It is not the plan I wanted at all, but it is finally a real attempt to get decent health care for all Americans, even those who are poor.  It is unconscionable that poor families don't get decent preventative care.  It is even just plain old stupid, because we have all been paying for the follow up care that results from the failure to prevent.  It is about time that we all carry the responsibility for the welfare of all our fellow human beings.  It is just the right thing to do.

Turn your face to the sun and the shadows fall behind you. ~Maori Proverb Surgery 10/29/2010 Lumpectomy: Left Dx 9/15/2011, DCIS, Stage 0, Grade 1, 0/1 nodes, ER+/PR+ Surgery 10/7/2011 Mastectomy: Left

Jun 28, 2012 11:43PM riverhorse wrote:

When you control prices (limit premiums) and expand demand (heathcare for everyone) eventually you reduce supply. Doesn't matter if it is health care or potatoes. In this case when supply becomes limited the government will need to either raise prices (allow increases in premiums) or allocate available supply by some criteria (regulate what insurance companies must provide and what they cannot provide). It seems unlikely that the government regulators will allow much in the way of price increases.

It wiil be most sensible to apply cost effectiveness to determine which treatments benefit the largest number. IMHO that will mean reduced availability of expensive treatments that benefit only a small percentage of patients. Of course it is also likely that there will be fewer expensive treatments around as the incentives to develop specialized treatments will be gone as the ACA will dictate what insurers can cover. Hope I am wrong!!

Dx 11/22/2011, ILC, 2cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR-, HER2-

Jun 29, 2012 07:59AM Chickadee wrote:

Perhaps now would be a good time to look closely at Massachusetts (w/o the political spin) and determine what has worked well and what needed attention. I knew one person who lived in Mass. and worked, like me, as a FEMA reservist with no insurance until this came along. She was very glad of it and had no complaints.

I would expect the states to be looking at the structure and determining their setups

I personally feel this a good thing.

I'm in such bad shape, I'm wearing prescription underwear." Phyllis Diller 1917-2012 Dx 9/1/2009, IDC, 1cm, Stage IV, Grade 3, mets, ER+/PR+, HER2-

Jun 29, 2012 08:07AM pupmom wrote:

I think a lot of the costs will be contained when people without insurance stop using the ER for medical care.

Life is what happens while we're making other plans. Dx 10/18/2011, IDC, 1cm, Stage IIA, Grade 1, 2/21 nodes, ER+/PR+, HER2-

Jun 29, 2012 08:45AM - edited Jun 29, 2012 09:27AM by riley702

Sorry to jump in late, but I read the most thorough explanation on reddit. It's pretty long, so I'll just put a link, but they include lots of reference links for everything they say. It's also purposely NOT written in confusing terms (I think the asker said "explain it to me like I'm 5.")

http://www.reddit.com/r/explainlikeimfive/comments/vb8vs/eli5_what_exactly_is_obamacare_and_what_did_it/c530lfx

Carolyn - 6 months neoadjuvant chemo (clinical trial), BMX and rads. Dx'd and treated as TN. After MX, I was informed my tumor was weakly ER+ after all (8%) Dx 1/26/2010, IDC, 4cm, Stage IIA, Grade 3, 0/2 nodes, ER+/PR-, HER2- Targeted Therapy 2/8/2010 Avastin (bevacizumab) Chemotherapy 2/8/2010 Adriamycin (doxorubicin), Cytoxan (cyclophosphamide), Taxotere (docetaxel), Xeloda (capecitabine) Surgery 9/4/2010 Lymph node removal: Left, Sentinel; Mastectomy: Left Radiation Therapy 10/18/2010 Breast, Lymph nodes Surgery 12/13/2010 Prophylactic mastectomy: Right Hormonal Therapy 12/31/2010 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Hormonal Therapy 8/7/2011 Aromasin (exemestane) Hormonal Therapy 9/30/2011 Aromasin (exemestane)

Jun 29, 2012 09:29AM alexandria58 wrote:

So pleased about this decision!  The law isn't exactly what I'd have chosen - I'm a big fan of single payer - but it's a huge step in the right direction.  Way to go, Roberts.  Actually upholding the rule of law!!!

 On cost  the most expensive type of care is emergency room care.  There are people with conditions and illnesses that are not treated until it's an emergency situation because they don't have insurance.  Getting those people into doctors' offices alone will be a big cost reduction.

 Here's my other 2 cents on reducing costs. Prevention.  Get people moving.  Get people on proper diets.  And let's tax sugar products - the way we tax tobacco.  If we can just cut back on the number of people with preventable diseases, such as diabetes 2, our health care costs will go way down - without cutting back on any of the care for cancer or any other disease.

Dx 2/22/2011, DCIS, Stage 0, Grade 3, ER+/PR+

Jun 29, 2012 09:38AM 1Athena1 wrote:

A great site on the law and how you can find out what is available in your state is:

www.healthcare.gov - it also has a timeline.

Anyone diagnosed with cancer should learn to have a healthy disrespect for statistics. Statistics are maths. It's the science which still eludes us. Dx 3/2009, IDC, 3cm, Stage IIB, Grade 3, 3/8 nodes, mets, ER+/PR+, HER2-

Jun 29, 2012 09:39AM - edited Jun 29, 2012 12:15PM by riley702

From the above excerpt re: the "mandate" or tax on those declining to purchase insurance. Per the link provided:

  • The penalty (or annual tax) would start at $95, or up to 1 percent of income, whichever is greater, and rise to $695, or 2.5 percent of income, by 2016. This is the individual limit; families have a limit of $2,085 or 2.5 percent of household income, whichever is greater.
Carolyn - 6 months neoadjuvant chemo (clinical trial), BMX and rads. Dx'd and treated as TN. After MX, I was informed my tumor was weakly ER+ after all (8%) Dx 1/26/2010, IDC, 4cm, Stage IIA, Grade 3, 0/2 nodes, ER+/PR-, HER2- Targeted Therapy 2/8/2010 Avastin (bevacizumab) Chemotherapy 2/8/2010 Adriamycin (doxorubicin), Cytoxan (cyclophosphamide), Taxotere (docetaxel), Xeloda (capecitabine) Surgery 9/4/2010 Lymph node removal: Left, Sentinel; Mastectomy: Left Radiation Therapy 10/18/2010 Breast, Lymph nodes Surgery 12/13/2010 Prophylactic mastectomy: Right Hormonal Therapy 12/31/2010 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Hormonal Therapy 8/7/2011 Aromasin (exemestane) Hormonal Therapy 9/30/2011 Aromasin (exemestane)

Jun 29, 2012 11:29AM Chris13 wrote:

Thanks for the breakdown, Riley. Now I don't have to read the 900 plus pages of the decision.Cool
"To attend to the moment is to attend to eternity." 2 ILC tumors 1.6. 1/4 positive nodes. Oncotypes 8 & 15. No rads/chemo. Dx 2/24/2012, ILC, 1cm, Stage IIA, Grade 1, 1/4 nodes, ER+/PR+, HER2- Surgery 5/1/2012 Reconstruction (right): DIEP flap Surgery 5/1/2012 Lymph node removal: Right, Sentinel; Mastectomy: Right Hormonal Therapy 8/1/2012 Arimidex (anastrozole)

Jun 29, 2012 11:42AM BarbaraJo50 wrote:

Gals,

Thanks for putting the correct information about the ACA on this forum. I hope that the people who are questioning or are misinformed will feel much better when they read and understand the truth.

Dx 4/15/2009, IDC, 6cm+, Stage IIIB, Grade 3, 1/27 nodes, ER-/PR-, HER2-

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