ACA Running Thread

[CHDeac]

http://www.forbes.com/sites/scottatl...ung-americans/

"The Obama administration is rightfully very worried about the uninsured younger generation not participating in signing up for insurance, but not because they actually need comprehensive health insurance. The facts about health care usage by younger Americans indicate the opposite – that buying comprehensive health insurance under the dictates of this law would be an unwise financial decision. ObamaCare forces young, healthy people to buy expensive health coverage costing several thousands of dollars per year, yet they use only hundreds of dollars of health care annually, including only $56 per year in total emergency room care.

Flying in the face of those facts, President Obama and the administration will now aggressively campaign to convince young people to sign up for his exchanges..."

I am often accused (at least by two experts on this forum) of being a lackey/tool/shill . But, the law did allow for an Under 30 catastrophic plan (3 OVs at a copay everything else subject to a $6000+ ded). Its not eligible for subsidies but we will see these plans for under $100/month. And the idea of insurance being a bad deal for most is why we call it insurance. Its supposed to be. Im waiting for the president to tell everyone its their duty to buy.

The bigger issue is that there is a market for low cost, high cost share plans. But other than this plan, which is limited to who can buy it, aren't allowed.

We no longer have catastrophic insurance. We have pre-paid financing. And that will drive trend.

[Spot the Wonder]

I think they would love that. Unfortunately the democrats aren't interested in a republican fix anymore than the pubs are interested in a democratic fix.

They don't have a fix. Obamacare IS their plan. Any decent reform package will end lifetime limits, preexisting conditions, and all that unpleasentness. So to do that, you have to get more healthy people into the system. Therefore, mandates. Once you mandate coverage, you have people who can't afford it. So you have subsidies and Medicaid expansion. You have to have all three of it doesn't work.

They've been talking about repeal and replace for years and they have nothing to replace it with. Because PPACA is THEIR plan.


The Republicans have nothing. Nothing

[Deacon923]

They don't have a fix. Obamacare IS their plan. Any decent reform package will end lifetime limits, preexisting conditions, and all that unpleasentness. So to do that, you have to get more healthy people into the system. Therefore, mandates. Once you mandate coverage, you have people who can't afford it. So you have subsidies and Medicaid expansion. You have to have all three of it doesn't work.

They've been talking about repeal and replace for years and they have nothing to replace it with. Because PPACA is THEIR plan.


The Republicans have nothing. Nothing

I don't understand why they don't try to resurrect something similar to the 2008 McCain plan. http://money.cnn.com/2008/03/10/news...hcare.fortune/

It has some issues too but it hits all the Republican free-market buttons. They have not talked about it since the second Tuesday in November, 2008.

[ONW]

I don't understand why they don't try to resurrect something similar to the 2008 McCain plan. http://money.cnn.com/2008/03/10/news...hcare.fortune/

It has some issues too but it hits all the Republican free-market buttons. They have not talked about it since the second Tuesday in November, 2008.

Damn you Palin!!!!

[WFFaithful]

I am not sure it will. Presenting their own plan just creates something to be ridiculed in an election. Condemning the status quo and hoping you can get a president in office is probably a better plan to get what they want (which is neutering/abolishing ACA).

Then it's a catch-22. Look crazy for voting over 40 times to do something that is impossible or look crazy for presenting your own horrible bootstraps plan. Either way, you get ridiculed.

[Wrangor]

Then it's a catch-22. Look crazy for voting over 40 times to do something that is impossible or look crazy for presenting your own horrible bootstraps plan. Either way, you get ridiculed.

I am not saying it is a great plan. It is just what they are going with. The only people ridiculing the symbolic votes (which is all they are) are people who want ACA enacted and think it is a good idea. All these votes don't mean anything and the Pubs know that as well. The new guys just want to be on record and so they allow it.

[RJKarl]

In two years when the plan in place and millions are benefiting, the idiot Republicans who wanted to be "on record" will be paraphrasing Lionel Ritchie:

I was once, twice
forty times an idiot
a partisan hack
Yes once, twice
forty times an idiot
becauue I hated Obama

[09deaconX]

RJ, thanks for your musical contribution here; really adds to the discussion. Did you ever get around to responding to this?

There are some major misinterpretations here.

Lets start with the idea that 40% of Americans will save 18%. Um, no. Lets look at NY. The rate discussions being discussed in NY are for the Individual market which is a fraction of the market (less than 7% nationally). In NY, the individual market has shrunk 96% since 1994 when many of the NY mandates kicked it so NY is even smaller. Plus, we just did some quick actuarial analysis and the feds didn't really do an apples to apples comparison (i.e. comparing an expensive NY policy to a less reach exchange plan). So I question just how much was "saved".

There's also a lot of chatter around how regulators are beating down prices for PR reasons. The trouble with this? Well, there are reinsurance programs that are federally funded that will make up the projected shortfalls. Lets see how many "refunds" we will get next year. This will neve rake the headlines but masks the real costs.

On the Part D doughnut hole side, I can assure you someone (often other Srs) are paying for this. This was a benefit mandate and it was priced, directly and indirectly. There are no savings here, just switching it from one place to another. Totally mis-leading to say these are "savings". If anything, it increases spend as folks use benefits MORE when they are free. Novel idea.

On the bankruptcy side, the idea that its lifetime caps causing this is just wrong. I've worked in this industry for ~20 years and we've had 5 people hit it. 5. People go into bankruptcy often b/c they can't work when they get this ill and thus can't pay their bills. Obamacare doesn't necessarily fix this problem.

I'm sure you will call me names, a shill, whatever, but your points here are inaccurate.

[RJKarl]

"On the bankruptcy side, the idea that its lifetime caps causing this is just wrong. I've worked in this industry for ~20 years and we've had 5 people hit it. 5."

Posts like this show CH to be a shill for the industry.

The # 1 reason for personal bankruptcies is medical bills. He'll dance around saying "it's not the same", but to many it is. Caps on coverage cause people to over huge amounts.

Wrong link sorry

here it is

http://www.cnbc.com/id/100840148

[09deaconX]

Briefly skimmed your link, I'm not sure I follow how the rate of executive orders has to do with this discussion.

Also not sure where you're citing your "#1 reason for bankruptcy claim" from, but this typically comes from a Himmelstein et al. research paper from '05 with very shaky research methods. Where are you getting your figures?

[RJKarl]

I gave you a link from a 2013 article.

Here's one from 2009

http://www.businessweek.com/bwdaily/...064_666715.htm

"Medical problems caused 62% of all personal bankruptcies filed in the U.S. in 2007, according to a study by Harvard researchers. And in a finding that surprised even the researchers, 78% of those filers had medical insurance at the start of their illness, including 60.3% who had private coverage, not Medicare or Medicaid."

It's crap to say medical bills don't cause personal bankruptcy. In the Harvard study shows 78% of those who filed because of medical expenses had insurance.

[WFU71]

http://money.cnn.com/2013/08/06/news...ums/index.html

"While many residents in New York and California may see sizable decreases in their premiums, Americans in many places could face significant increases if they buy insurance through state-based exchanges next year.

That's because these people live in states where insurers were allowed to sell bare-bones plans and exclude the sick, which has kept costs down. Under Obamacare, insurers must offer a package of essential benefits -- including maternity, mental health and medications -- and must cover all who apply. But more comprehensive coverage may lead to more expensive insurance plans..."

[RJKarl]

The only problem with that premise is there are no states that have published such rate versus states as diverse as CA, NY, AL, MD, MT and about ten others that have published rates that will go into effect that are lower.

There's a huge difference between "could face significant increases" and "will see sizable decreases".

This could be a defining moment in American politics and even in general marketing. If ACA works will millions of Americans continue to hate Obama and the Dems to vote against their own personal self-interests just out of spite and hate.

[WFU71]

There's nothing wrong with the premise. It's pretty simple - states that have allowed cheaper, less comprehensive health care plans will have higher initial rate increases due to the tightening of the minimum plan requirements. That's the main point of the article.

Did you even read the link?

[WFU71]

http://www.webmd.com/health-insuranc...ate-variations

"As the Oct. 1 launch of the new health insurance Marketplaces draws near, states are beginning to release the premiums that some Americans will pay starting in 2014. Depending on who you talk to, the numbers are great -- or grim -- and everything in between..."

[RJKarl]

If you look at your article's #1-most people won't be effected. What will over 150M who aren't impacted think of the GOP's gloom and doom assessments when none of it happens to them?

[WFU71]

rj, I think it's hard to predict what the overall impact on insurance costs. You want to paint a rosy picture while the conservatives predict doom and gloom. For the most part, I'm simply posting articles that are informative. Some of them may prompt discussion.

The two articles I've posted this morning seem pretty balanced. There will be winners and losers and we'll just have to wait to see how many of each there are

[WFU71]

http://www.boston.com/lifestyle/heal...70CO/blog.html

"The Medicare rule requires recipients to be admitted as a hospital inpatient for at least three days before the federal health insurance program for seniors and the disabled will pay for follow-up nursing home care. The problem is that an increasing number of patients are spending days in the hospital under “observation’’ status, often without realizing they were never officially admitted.

Medicare does not cover the cost of nursing home care in these cases, and neither do most supplemental insurance policies, advocates say, leaving surprised recipients to pay thousands of dollars out of their own pockets for rehabilitation, the Globe reported Sunday."


I posted a similar link a week or two ago. The overuse of observation days by hospitals is a growing problem as hospitals try to avoid penalties for readmissions.

[WFU71]

http://www.forbes.com/sites/theapoth...average-of-24/

"In less than four weeks—on October 1, 2013—Obamacare’s subsidized insurance exchanges are supposed to be fully on-line. But as of today, the relevant governmental agencies have only made public the insurance carrier filings for 13 states and the District of Columbia. In other words, we’re still waiting for important information on health insurance premiums from nearly three-fourths of the states.

As of September 4, the bulk of the data we have is from the subset of Democratic-leaning states that decided to set up their own insurance exchanges, instead of letting the federal government do so on their behalf."

I don't think this guy is a big fan of ACA. I wonder if the increased minimum coverage requirements affects his numbers.

[Wrangor]

CNN headline.

"CNN/ORC poll: Proportion of people saying they favor all or most of Obamacare drops to 39%, down from 51% in January." -- CNN