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Insured Shocked They Have To Pay Co-Pays For O-Care

From a deeply concerned New York Times:

Newly Insured, Many Now Face Learning Curve

By ABBY GOODNOUGH | August 2, 2014

PHILADELPHIA — Advocates of the Affordable Care Act, focused until now on persuading people to buy health insurance, have moved to a crucial new phase: making sure the eight million Americans who did so understand their often complicated policies and use them properly.

The political stakes are high, as support for the health care law will hinge at least partly on whether people have good experiences with their new coverage. Advocates of the law also say teaching the newly insured how to be smart health care consumers could advance the law’s central goal of keeping costs down, such as by discouraging emergency room visits, while still improving care.

And never mind we were told that passing Obama-Care would do that automatically. In fact, that was supposed to be a major selling point. And yet ER visits are way up.

For those reasons, hospitals, clinics, insurers and health advocacy groups around the country are organizing education efforts, aimed particularly at lower-income people who might not have had insurance in years, if ever. The Centers for Medicare and Medicaid Services has jumped in, too, with a project called “From Coverage to Care,” which provides educational materials to community groups and medical providers who are trying to teach health and insurance literacy…

In other words, this is yet another way for the Democrats to pour more taxpayer money into their street army. Like the ACORN types who are working as navigators for Obama-Care.

Last week, Salwa Shabazz arrived at the office of a public health network here with a bag full of paperwork about her new health insurance — and an unhappy look on her face… “I’ve had one doctor appointment since I got this insurance, and I had to pay $60,” Ms. Shabazz…  “I don’t have $60.” … “None of that was explained when I signed up,” she said. “This is the first I’m hearing it.” …

Ms. Shabazz’s problem is she thought Obama-Care would be free. Getting her premiums practically for free ($32 a month) is not enough. She wants us to pay for her modest co-pay ($60) to see a $500 dollar a visit specialist, too.

Many people who signed up for private coverage through the new marketplaces had never had health insurance, and even the basics — like what a premium is and why getting a primary care doctor is better than relying on the emergency room — are beyond their experience….

And yet by law this same people can’t be discriminated against when they apply for a job.

Ms. Shabazz, 38, paid only about $32 a month in premiums, with federal subsidies of $218 covering the rest. But she could not afford the $60 co-payments to see her specialists on her annual income of $19,000.

Her financial situation worsened when she had to quit her job at the Pennsylvania Liquor Control Board in June because of the epilepsy, she said… With no more paychecks, she had fallen into the so-called coverage gap, earning too little to keep qualifying for the subsidies that made her premiums affordable, but likely still not qualifying for Medicaid because Pennsylvania has not expanded that program, as 26 states have under the Affordable Care Act. “You’ll probably have to cancel your plan,” he said.

So it turns out this article is yet another push to force states like Pennsylvania, where Ms. Shabazz lives, to expand Medicaid by raising the income restrictions. And never mind that every state that has expanded Medicaid is now facing serious budget problems.

Ms. Shabazz’s mother, Waheedah Shabazz-El, who had accompanied her to the appointment, shook her head as her daughter wiped away tears. “There are so many layers to this,” Ms. Shabazz-El said.

Ms. Shabazz said she was relieved to finally figure out her plan, even though she would not be keeping it. “I have a much clearer understanding now,” she said. “But I’m still kind of sad. I’m worried.”

She has nothing to worry about. She is a protected class. She will always be taken care of. As long as she can vote.

This article was posted by Steve Gilbert on Monday, August 4th, 2014. Comments are currently closed.

One Response to “Insured Shocked They Have To Pay Co-Pays For O-Care”

  1. BannedbytheTaliban

    If Ms. Shabazz actually exists, and has no form of income because she had to quit her cushy government job at the liquor board (also, why is a Muslin working on the liquor board, doesn’t their religion frown on drinking?) she would easily qualify for Medicaid even before the expansion. I smell made up NYT push piece.




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