Health insurance individual enrollment for 2014 - deadline in a week

Under 2010's Patient Protection and Affordable Care Act (aka ACA), several reforms have been or are being put into place in the U.S. One of them, the so-called individual mandate, has a key deadline in one week.

The ACA reform most important to me personally, now that I'll forever have had a thyroid cancer diagnosis, is that it is now illegal for any health insurance company to refuse insurance policy coverage to me for having a pre-existing condition. We can no longer ever be dropped from or denied an insurance policy because of our thyca.

Also beneficial, I believe, in the uneven insurance landscape, is that quality of insurance must now meet certain minimum requirements: companies may not impose an annual or lifetime cap on payouts for healthcare (i.e., no so-called junk insurance); 80% or more of premiums must be spent on actual healthcare; preventive care must be fully covered; kids' dental and vision must be covered; and young adults must be allowed to be covered on a parent's plan up to age 26.

The individual mandate is the part that is coming due in one week for those who are not already covered by an employer, by Medicare, or otherwise. This, the so-far most visible and talked-about part of the reforms, involves the state-based health insurance exchanges. These are marketplaces, accessed online, via call center, and via in-person outreach by community-based navigators, where individuals may purchase private health insurance policies. Many states provide new Medicaid subsidies for low-income residents. The exchanges for each state (and the federal exchange for people in any state that did not set up its own exchange) can be accessed via healthcare.gov. Individuals don't have to use the exchanges and can sign up for insurance privately, but must have coverage by April 1 to avoid penalties, due in 2015, under the ACA's individual mandate.

March 31 is the enrollment deadline for 2014 coverage. The next enrollment period starts Nov. 15, for 2015. If you do not have health insurance currently, or know somebody who doesn't, it is timely to go to healthcare.gov. I believe the federal website, in contrast to its rocky rollout six months ago, as well as most of the states' websites, are working fine, but if planning to shop there, I wouldn't wait til the very last possible minute to test out that theory. :)

All the best of health, healthcare, and health insurance coverage to you. I will break with my objective statements above and let my progressive self share and opine a bit with my fellow thyca travelers that when I first was diagnosed with thyroid cancer last summer and was coping with the news with some difficulty, that I cried a few grateful tears for the healthcare coverage that meant that this disease, while it could potentially kill me, could not take our home out from under us or bankrupt us, and simultaneous angry tears against anybody anywhere in any official capacity using their power to try to deny any fellow American who is sick and overwhelmed that same human dignity of healthcare coverage without the fear or reality of that family's simultaneous financial devastation. Ok, deep breath, end of rant. Be well, and be excellent to one another!

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I hope that this will make it easier for people to get decent healthcare.

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I'm one of the millions of American that is not able to keep my health insurance that I liked. I'm losing my great plan. I'm going from a 90/10 to an 80/20 policy for the same price. My deductible is going up by $800 per person(x4). So I'm not saving $2500 a year as promised. Yes, I'm very lucky to have great insurance but the ACA or Obamacare is not wonderful for everybody. Thanks for letting me vent.

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One serious concern is that many doctors are not accepting the plans affiliated with the ACA. Check with your doctors before you sign. Also, because a doctor takes it now is no guarantee. My doctor had a disclaimer for me to sign.

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Am not entirely convinced ACA is the cause of all the various plan changes by private insurance companies, which occur to some degree every year, even though at the present moment there is a sense of something external to attribute them to. (No doubt it was all also messaged and promised in a wrong and simplistic way.) Sometimes also out of pocket differences in deductibles may be offset by payout rates for e.g. newly free preventive health or other newly required payout benefits.

Regarding docs not taking the many new Medicaid patients, this is absolutely a problem, and there are multiple reasons why this is. Medicaid (government paid health care for low income and disabled Americans, recently expanded under ACA) does not pay out at the rate as Medicare (universal healthcare for 65+), so docs get less for these patients. On top of that, these newly insured low-income Americans under Medicaid expansion are often sicker and more difficult cases in the clinic, with pent-up healthcare needs and conditions made significantly worse by prior lack of healthcare. Compound that with less reimbursement, not more, and you can see how these patients are less desirable for providers to serve in significant numbers.

To bring the thyca perspective to this issue: One in our local support group had a thyroid mass which grew unchecked while he was uninsured for a couple years, and which was at 6cm (softball size) when he finally got insurance, with worse complications in terms of both vocal and shoulder nerve resections and their resulting problems, not to mention potential prognostic concerns. He is amazingly even-keeled though it all but everything would have been better for having insurance sooner. That to me is the heart of the problem we are starting to (imperfectly) solve.

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I was not referring to Medicaid. Many doctors are not accepting any plans from the ACA Exchanges because they can't afford to.

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I had 100% coverage on preventive care before the change. Don't get me wrong, there are a few good parts of this law, children covered until age 26( my son was on my insurance when he had thyca at age 22), pre-exsisting conditions etc, but the whole system doesn't need to be changed for a few people. If you want real reform, you need to change the payment system, an outcome base scale should be used.

This is a very heated, political subject and I feel this forum is not the place for it.

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Are you saying I should be blessed that my health care insurance premiums jumped $960 a year while those who are irresponsible get to go for free? BTW, do you even know what a deductible is? obamacare was nothing but a scheme to allow the social program frauds/abusers into our doctors offices paid for by those who are young and forced to buy it.

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Under similar government health care programs (Military, Tri-Care & VA), doctors did not diagnose my cancer for over 12 years even after nodules were noted in 1999. In just three months with our newly gotten health care with my job, the cancer was diagnosed, surgery performed, radiation given, and body scans taken. obamacare doctors will be no different from those who take medicaid or medicare, and our health care system will be brought down to its knees. It is nothing but the socialist dream of staying in power. Thanks to the government, my cancer had spread to my lymph nodes. AND DO YOU KNOW HOW MUCH TAX DOLLARS HAVE ALREADY BEEN SPENT WITH MINIMAL SIGN-UPS WHO WILL PAY?

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And now obama wants to tax the health care benefit given to me by my job, IS THAT SUPPOSED TO MAKE ME HAPPY!

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obamacare is a socialist dream of ensuring people don't have to work.

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Insurance is supposed to be gotten BEFORE you have an illness, NOT after you are diagnosed. Again this is just another socialist feel good program that obama and the democrats use to stay in power and keep people clueless. The bait was all the little goodies that they gave out prior to making everyone pay for the medicaid style system, and now it is time to pay and it will get more and more expensive with the government running it. You can use fancy words like exchanges, but it all ends up being government run failures.

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I have deeply mixed feelings about this thread and discussion and strong but nuanced feelings about and a fact-seeking interest in the topic. In seeking to support thycans who may not have insurance, perhaps a few who may be newly eligible for healthcare under ACA, with a deadline to enroll or wait seven additional months for healthcare, I think that this basic announcement could potentially help a few people on this forum.

Beyond just the enrollment stuff, I also think there is a simultaneous opportunity to provide a few simple facts about it which are often forgotten (e.g., pre-existing conditions now non-disqualifying) in a lot of negative air and profound cynicism about this subject. I'm an optimist and reform-minded on many things, and in my view, the law is deeply flawed, in part because of how hard it is to get anything changed in an unevenly dysfunctional system. In general, I think that interested, compassionate, and reason-based discussion is healthy here and elsewhere, and I do think it is specifically relevant to our specific patient population, based on my personal experience.

Much more personally, and thyca-specifically, I had never really been subject to having a health rap sheet of any significance before my thyca diagnosis, or ever using health insurance in anywhere near as profound an economic way as has been the case in the past eight challenging months. I mean it when I say that the new provision of ACA on pre-existing conditions gives me far more assurance that we won't lose our house because of this journey in cancerland. My TT -- just the surgery within a 29-hour hospital stay -- was billed at six figures and paid for in very large part by health insurance. I don't know if that is a typical fee for a TT and lymphadenectomy. But cancer, workup, surgery, healing, coping, and so on was more than plenty to deal with without a financial go/no-go on healthcare choices.

It only really hit me at the time of my TT just how profound this healthcare debate really is. At that time, I personally had a really strong emotional reaction, one of -- what? anger? grief? not sure exactly, it was an overwhelming time -- when I realized that there are haves and have-nots of healthcare, and some of the haves, people with power over others in fact, whether insurance bureaucrats or elected officials or whoever, would be heartless enough to actually actively enable more people suffer economic or health disaster for the crime of getting cancer. I may now already have consumed more healthcare dollars than I have paid into any system over the years. But major illness is why we have any sort of mutual system of insurance, whether private/premium-based or public/taxation-based or both, and I would gladly choose to be on the side of the well and the net-paying-in -- rather than the sick and the net-using -- any day of the week, if I could.

It is hard to understand the ramifications amidst a complex system and short media attention spans and many and various vested interests and biases, and in trying to understand it I really do think it is fair to say that a lot of things are attributed to the law which are due to some mix of the following: 1) the law's actual inherent bad compromises, 2) the year-on-year change that happens in plans, providers, and prices, including high healthcare inflation over many years, regardless of and not addressed by the ACA's reforms, and 3) private insurance and provider re-negotiation and opportunism in the context of grappling with ACA's changes. I do think that a lot of the ammunition fired by ordinary citizens at ACA is a sort of a latent anger and frustration at a complex and unwieldy system of private insurance and irrational hospital and medical charges and so on.

I personally hope that at least some of this highly justifiable anger can be directed toward better solutions based on compassion and the notion that it's nobody's fault they got thyroid cancer, and neither me nor any of our fellow thycans should have to face bankruptcy vs. forgoing healthcare due to the misfortune of getting thyroid cancer.

I apologize for any upset I have created on this treasured forum. From a housekeeping perspective, I could delete the diary, and I will reconsider that if asked, but since its title is plain enough, members can choose whether to visit it and whether to participate. (I also would make anyone aware you can block a user; we won't see each other's posts, but that's part of how the site works and it's a very well-run place very free of trolls.) But I hope I'm being both fair-minded and compassionate even if we disagree and come from divergent perspectives. Challenging stuff. I hope I can convey that I offer all of this in good faith and in the spirit of both truth and compassion and I hope that it's received in kind. Thank you all for reading and thoughtfully participating.

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Our health care system was NOT based on wealth, it was based on RESPONSIBILITY. Now obama, and yes it is called OBAMACARE will ensure those who are irresponsible will stay that way. Just like all other programs liberals/progressives/democrats come up with, this is a scam and does not make this country a better place, it just makes the government control even more. It is funny how they can have all the other luxuries this country has to offer, but they won't buy a decent health care insurance policy. obamacare is in no way a decent health care policy.

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There's something that worries me about this too. In 2008 I read a few areas of the bill and not sure if they amended it or not, but doctors are to be penalized if they can't diagnose and correct health issues after so many visits. What about chronic health issues, like no thyroid we are chronically hypoT without treatment. I am diagnosed (going to Mayo to confirm) with MS. This is supposed to be incurrable. Will doctors stop seeing me because they will get penalized?

2 years ago I had bad Celiac symptoms (TMI problems). Had a colonspcopy and was diagnosed - TMI issues were due to the constipation from the solution I had to drink for the colonscopy. WHAT? I had the colonscopy because of issues before I drank the solution and I was not constipated. This doctor gave me a bogus diagnosis to not see me anymore. My bowel issue resolved with allergen elimination.

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Fresno2550 is right on the money, to bad this person has used ThyCa to promote their socialist views, but I would bet the Government has invaded all sites like this with the same message.

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I am not upset that emmaleah has discussed their feelings about obamacare, but how this new social program has been lied about, failed to be truthfully covered by the media, and how people didn't do their research when obama himself said, "If you like your health care plan, if you like your doctor, YOU CAN KEEP THEM. PERIOD!" For the minimal amount of irresponsible people who were diagnosed with a disease that didn't have insurance, we all have to suffer. For it is the liberal/progressive way of trashing our country. For all you men out there, doesn't it feel good that you too are also covered for women issues.

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It is indeed challenging to have a meaningful discussion on this topic in the context of strong strains of cynicism all around. My own cynicism is directed more toward some of the large institutions in the insurance, hospital, and pharmaceutical industries, often with lobbying staffs and campaign contribution budgets, than toward laws or government programs or health insurance expansion initiatives per se. But I also think the media so often either utterly fails to do its job, or in some outlets, actively stirs up resentment and contempt for those weaker or poorer than ourselves, and it feels like there's some negatively hyped reporting out there that I feel is rather wrong-headed and/or mean-spirited. Still, there is plenty of reasonable cynicism to go around, and "congress" and "insurance companies" both rank extremely low in terms of the extent to which people put any trust in either institution, with "the media" probably somewhere quite low on people's list too. With good faith, I personally think divergent views are just fine. We have thyca in common, but we have many different backgrounds and viewpoints. All the best of strength and fortitude to all on our shared involuntary journey in healthcare land.

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We live in America where there are no "weaker or poorer", but a whole lot of irresponsible people who are getting worse with the programs of the compassionate who like to spend other people's hard earned money. One thing that obamacare has done is have the businesses shed employees as they hire part-time workers or temporary employees. This is from personally meeting with the numerous businesses in the area. Temp agencies are making a killing right now. What do you think the $15/hour minimum wage will do to employees? There is nothing good about obamacare for it is all lies and pandering.

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I was turned down for health insurance 3.5 years ago now because thyca.

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Did you have any kind of health insurance before the cancer was diagnosed?

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