this post was submitted on 09 Nov 2024
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[–] IDKWhatUsernametoPutHereLolol@lemmy.dbzer0.com 4 points 5 days ago (15 children)

I genuenly don't know how ACA works. Most people get insurance through their employer, is that affected by ACA? Not sure of the exact search terms to find the answer for it.

[–] BartyDeCanter@lemmy.sdf.org 32 points 5 days ago (11 children)

The ACA is a massive bill that affects basically every part of healthcare in the US. That being said, here are some of the major parts that affect people who get their coverage through their employer:

  1. Minimum coverage standards - The ACA sets minimums about what must be covered by employer insurance, including drugs, procedures, family planning and mental health care.
  2. No lifetime caps - Before the ACA insurers could set a lifetime cap on how much they would pay out for any individual. This meant that people who had long term chronic or very expensive medical needs would get kicked off their insurance eventually and have to figure something else out. Or, more likely, either go into massive medical debt or forego care, or both.
  3. Pre-existing coverage - Before the ACA insurers could choose not cover issues that you got before you signed up with that insurer. So, again, if you had a chronic condition and changed jobs, you could lose all coverage for those treatments.

There is probably a lot more, but those are the big ones for most people.

[–] IDKWhatUsernametoPutHereLolol@lemmy.dbzer0.com 12 points 5 days ago (9 children)

Oh fuck so my depression could be considered a pre existing condition then. Im currently on my parents insurance plan since I'm still a dependent, but when I eventually have to get my own insurance, thats a pre existing condition according to the prospective new insurer?

Fuck. Im kinda pre-diebetic since my depression fucked with my will to live, soon I might be diabetic and without ACA protection I'm kinda fucked when insurance eventually decide to not insure diabetic people.

My parents have some investments, but even if I inherit some of it, not sure if that would cover expensive big pharma bills.

I'mma go cry in a corner. (actually im too numb from the horrors on tuesday, too sad to even cry 😥)

[–] thesohoriots@lemmy.world 7 points 5 days ago

Here’s what happened to me before the ACA: I started grad school at ange 22 in a state where my parents’ coverage didn’t work, and therefore had to buy into the school plan through Blue Cross (may they forever burn in hell). For an entire year, I paid for all medical care out of pocket PLUS paid for an insurance plan, so that after a year Blue Cross would go “ok, I guess you paid enough to get on our plan for next year.” This is to say nothing of the ensuing years spent fighting tooth and fucking nail with Blue Cross over literally every medical decision my providers made. Absolutely nothing went without needing an appeal or a peer-to-peer due to “pre-existing condition.” The ACA made some of this easier, but Blue Cross figured out they could do stuff like drop drug coverage from their formulary to “pass on savings,” which brought back the need to do peer-to-peer on literally everything to get a high-copay “formulary exemption,” etc. It’s going to be a nightmare you can’t possibly imagine.

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