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ACA Running Thread

Received a notice from BCBSNC that my premium will increase about 50% next year. Thanks Obama.

Hard to tell what to make of this without more information about your existing plan. If you had a high-deductible plan that isn't compliant with ACA, your premium is going up but you are also getting more coverage. If your plan was already compliant, then the NC regulators would have had to approve a rate increase and I would be interested to know what the basis was for approving a 50% increase. I may be missing some of the details.

When talking about rate increases one has to remember to compare apples to apples plans. What is happening in NC is partly the result of the monopoly that BCBS has on the exchanges (so no price competition) and partly on having to offer compliant plans that cost more than the currently available bargain-basement catastrophic care plans. I don't know why UHC, the other major player in NC, didn't get into the exchanges. Do you know CH?

Does anyone know how health insurance premiums in NC compared to the rest of the country pre-ACA? UHC and BCBS were pretty much the only games in town in NC then and now. I always have thought that getting some more competition by allowing insurance companies to compete across state lines would help drive cost down some.
 
What kind of rate increases are they predicting out in California?
 
Hard to tell what to make of this without more information about your existing plan. If you had a high-deductible plan that isn't compliant with ACA, your premium is going up but you are also getting more coverage. If your plan was already compliant, then the NC regulators would have had to approve a rate increase and I would be interested to know what the basis was for approving a 50% increase. I may be missing some of the details.

When talking about rate increases one has to remember to compare apples to apples plans. What is happening in NC is partly the result of the monopoly that BCBS has on the exchanges (so no price competition) and partly on having to offer compliant plans that cost more than the currently available bargain-basement catastrophic care plans. I don't know why UHC, the other major player in NC, didn't get into the exchanges. Do you know CH?

Does anyone know how health insurance premiums in NC compared to the rest of the country pre-ACA? UHC and BCBS were pretty much the only games in town in NC then and now. I always have thought that getting some more competition by allowing insurance companies to compete across state lines would help drive cost down some.

Actually, that increase is probably largely attributable to the ACA (+ of course medical trend). Folks getting higher increases may be hit by plan changes to get them to 'bronze'...This is all pre-subsidy though. Always have to remember that family of 4 gets help at $94,000.

The feeling was there were a lot of competitors coming but only 3 showed up, BCBS in all 100 counties, Coventry in 39 counties and 1st Carolina Care in 6. FCC dropped a few weeks ago as they had higher prices and lots of tech issues so they were going to find themselves in a poor market position (IMHO)....HOWEVER, there is a viable off exchange market...Subsidies are pretty much the only reason to buy an exchange product so expect to see a lot of competition off (like United, Humana, Cigna, etc). The buy across state lines is really a red herring, esp. when you have national pricing rules. There are something like 20 carriers in NC today, many nationals...A topic for another day.

Coventry (now owned by Aetna) is #2 in U65 and #3 in SG...Minor point but worth noting. I can only guess as to why some didn't join but plugging into exchanges is really hard work. Doing it in 50 states? Insanity. There is a lot of speculation that the big for profits were scared of the risk and the implementation so they focused their efforts on other segments (Sr, large group). They will see how market settles 14-16 then move in.
 
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Coventry (now owned by Aetna) is #2 in U65 and #3 in SG...Minor point but worth noting. I can only guess as to why others didn't join but plugging into exchanges is really hard work. Doing it in 50 states? Insanity. There is a lot of speculation that the big for profits were scared of the risk and the implementation so they focused their efforts on other segments (Sr, large group). They will see how market settles 14-16 then move in.

that makes a lot of sense. thanks.
 
“If you think health care is expensive now, wait until you see what it costs when it's free.”

― P.J. O'Rourke
 
My firm's group plan is down about 5% year over year. Thanks, Obama!

I'm honestly curious how this is possible. Nothing I'd like more than a 32 win basketball team, eight win football team and affordable health care, but there are very few things I believe are less plausible.

How does this law actually bring costs down, when it essentially forces uninsurable risk on insurers? How is the individual mandate actually going to get enforced? On the tax returns of...people who don't pay anyway? Half of the country doesn't pay any income tax at all...how can cost go down when demand is going to sky rocket against static supply?
 
I'm honestly curious how this is possible. Nothing I'd like more than a 32 win basketball team, eight win football team and affordable health care, but there are very few things I believe are less plausible.

How does this law actually bring costs down, when it essentially forces uninsurable risk on insurers? How is the individual mandate actually going to get enforced? On the tax returns of...people who don't pay anyway? Half of the country doesn't pay any income tax at all...how can cost go down when demand is going to sky rocket against static supply?

Here is one way....Very sick group gets community rated where all groups pay the same amount. Of course, there is a healthy group out there whose rates went the other way...

Here is another way...Group had better experience (independent of the ACA) and rates got lower despite overall trend.

One more way...Group grew 2 members and got reclassified as a large group and thus wasn't subject to SGR rules.

I have about 30 others...
 
If you ever brought up the good things about ACA, you might not look like as much of a shill.
 
Here is one way....Very sick group gets community rated where all groups pay the same amount. Of course, there is a healthy group out there whose rates went the other way...

Here is another way...Group had better experience (independent of the ACA) and rates got lower despite overall trend.

One more way...Group grew 2 members and got reclassified as a large group and thus wasn't subject to SGR rules.

I have about 30 others...

I think this part is my point, and I don't see anyway around it. Somebody is going to have the pay the bill for all of the previously uninsured people who suddenly get coverage. If there is a movement between groups, that's just moving the burden around, not erasing it. This thing has shell game written all over it.
 
If you ever brought up the good things about ACA, you might not look like as much of a shill.

Covering more people is a good thing. A really good thing. Uniform Essential health benefits is a good thing. Standardized age curves and regions factors are a pretty good thing. Unisex rates are an ok thing. Some of the transparency rules are good things. Waiving pre-ex is a good thing in theory but the practice left a lot to be desired. Tobacco use rating a good thing.

Good things don't always translate into the right thing to do over the long run. Filling the doughnut hole, while good for Srs, has other consequences, some very bad.

You might want to look at this concept.
 
I think this part is my point, and I don't see anyway around it. Somebody is going to have the pay the bill for all of the previously uninsured people who suddenly get coverage. If there is a movement between groups, that's just moving the burden around, not erasing it. This thing has shell game written all over it.

A lot of these aren't just moving the uninsured to insured. Its sick-healthy being smooshed into 1 pool with 1 rate.
 
A lot of these aren't just moving the uninsured to insured. Its sick-healthy being smooshed into 1 pool with 1 rate.

Right, but how does that bring down costs? It seems to me that it would simply off-load the costs of the sick onto the healthy. Where are the efficiencies? I see the moral argument for setting a minimum standard of care, but that's not an economic argument.

I don't find the Administration's attempts to exempt itself and its friends from the implementation of this act to be particularly confidence inspiring, and the same goes for the repeated delays in its roll out until after the midterm elections. If this thing is good, then get on with it.

The hand-selected exemptions seem recklessly indifferent to the credibility of this law.

P.S. If FB statuses ruled the world, all of my pub friends' health insurance premiums are going up, and all of my dem friends' premiums are going down. A lot of people seeing what they want to see. I'm open minded to reform since our current system sucks, but the repeated attempts to exempt and delay by its authors do very little to answer the concerns being raised (including the self-evident ones I'm pointing out about the lack of clarity on the efficiencies).
 
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Monday numbers: Posted on 9/30/2013 by Chris Fitzsimon


Quote:
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1,346,603—number of people in North Carolina who are currently uninsured and eligible to enroll for coverage in the Health Insurance Marketplace beginning October 1 under the Affordable Care Act (“How the Health Care Law is Making a Difference for the People of North Carolina,” U.S. Department of Health and Human Services)

73—percentage of people in North Carolina who are currently uninsured and eligible to enroll for coverage in the Health Insurance Marketplace who have a full-time worker in their family (Ibid)

4,099,922—number of non-elderly North Carolinians who have some type of pre-existing health condition that because of the Affordable Care Act can longer be used by insurance companies to deny them coverage beginning January 1, 2014 (Ibid)

539,092—number of children in North Carolina with a pre-existing condition already protected from being denied coverage because of a pre-existing condition (Ibid)

379—amount in dollars of the cost of the monthly premium for a mid-range health insurance plan in North Carolina on the Health Insurance Marketplace for people not eligible for subsidies (U.S. Department of Health and Human Services)

869,000—estimated number of North Carolinians eligible for a subsidy in the Health Insurance Marketplace under the Affordable Care Act (“New Health Insurance Tax Credits in North Carolina,” Families USA)

88—amount in dollars of the actual cost of the monthly premium for basic health coverage in the Marketplace for 27-year-old in North Carolina who earns $25,000 a year (U.S. Department of Health and Human Services)

74—amount in dollars of the actual cost of the monthly premium for basic health coverage in the Marketplace for a family of four that earns $50,000 a year (U.S. Department of Health and Human Services)

6.4 million—number of people nationwide eligible to buy insurance who will be able to buy a basic plan in the Marketplace for less than $100 a month (“Under Obamacare, Millions of Americans Will Pay Less Than $100 Per Month For Health Insurance, Think Progress, September 17, 2013)

12.4—number of currently uninsured Americans in the 25 states that have elected to expand Medicaid who will pay less than $100 a month for coverage (“For millions, insurance will cost less than $100/month,” USA Today, September 23, 2013)

24 billion—amount in dollars of the increase of the federal deficit if the Affordable Act is repealed (Congressional Budget Office)

14 million—number of additional people who would be left without health insurance next year if the implementation of the Affordable Care Act was delayed by a year (Ibid)

42—number of times the U.S. House has voted to repeal the Affordable Care Act as of Monday morning (Center for American Progress)
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Monday numbers: Posted on 9/30/2013 by Chris Fitzsimon


Quote:
----------
1,346,603—number of people in North Carolina who are currently uninsured and eligible to enroll for coverage in the Health Insurance Marketplace beginning October 1 under the Affordable Care Act (“How the Health Care Law is Making a Difference for the People of North Carolina,” U.S. Department of Health and Human Services)

73—percentage of people in North Carolina who are currently uninsured and eligible to enroll for coverage in the Health Insurance Marketplace who have a full-time worker in their family (Ibid)

4,099,922—number of non-elderly North Carolinians who have some type of pre-existing health condition that because of the Affordable Care Act can longer be used by insurance companies to deny them coverage beginning January 1, 2014 (Ibid)

539,092—number of children in North Carolina with a pre-existing condition already protected from being denied coverage because of a pre-existing condition (Ibid)

379—amount in dollars of the cost of the monthly premium for a mid-range health insurance plan in North Carolina on the Health Insurance Marketplace for people not eligible for subsidies (U.S. Department of Health and Human Services)

869,000—estimated number of North Carolinians eligible for a subsidy in the Health Insurance Marketplace under the Affordable Care Act (“New Health Insurance Tax Credits in North Carolina,” Families USA)

88—amount in dollars of the actual cost of the monthly premium for basic health coverage in the Marketplace for 27-year-old in North Carolina who earns $25,000 a year (U.S. Department of Health and Human Services)

74—amount in dollars of the actual cost of the monthly premium for basic health coverage in the Marketplace for a family of four that earns $50,000 a year (U.S. Department of Health and Human Services)

6.4 million—number of people nationwide eligible to buy insurance who will be able to buy a basic plan in the Marketplace for less than $100 a month (“Under Obamacare, Millions of Americans Will Pay Less Than $100 Per Month For Health Insurance, Think Progress, September 17, 2013)

12.4—number of currently uninsured Americans in the 25 states that have elected to expand Medicaid who will pay less than $100 a month for coverage (“For millions, insurance will cost less than $100/month,” USA Today, September 23, 2013)

24 billion—amount in dollars of the increase of the federal deficit if the Affordable Act is repealed (Congressional Budget Office)

14 million—number of additional people who would be left without health insurance next year if the implementation of the Affordable Care Act was delayed by a year (Ibid)

42—number of times the U.S. House has voted to repeal the Affordable Care Act as of Monday morning (Center for American Progress)
----------

I've yet to doubt that the ACA is going to do some good things, but it's got about as much a chance of bringing down the health care costs for my family as the BzzDeacons have to bring down the nets in April. The President isn't delaying its implementation until after the next election and exempting his family and friends b/c it's all sunshine, roses and cupcakes for everyone, is he?
 
I've yet to doubt that the ACA is going to do some good things, but it's got about as much a chance of bringing down the health care costs for my family as the BzzDeacons have to bring down the nets in April. The President isn't delaying its implementation until after the next election and exempting his family and friends b/c it's all sunshine, roses and cupcakes for everyone, is he?


I think the President it trying to make healthcare reform (most manifest now by the ACA) work. To be successful in the long run it will help greatly to be successful in the short run. He and his party want reform to succeed in ways that benefit the lesser fortunate/successful among us and our society as a whole. Let's try to work towards a system that is more unified, more efficient, and better at delivering decent healthcare to our society as a whole. So he is doing what he can to try and make this happen. Pubs, OTOH, want...??? It can be argued that in their minds (fantasyland to many) they also want some kind of "success" for all. But their ideas of reforming the healthcare system differently (from the ACA) are pretty ill defined partly because they're largely already in the ACA. They oppose it, it seems, b/c they think that's somehow a better "strategy" for them politically. They want it to fail. They don't want Obama/Dems to get credit in the end for any success. They have established themselves FIRMLY as the opposition to this fair enough (IMO) effort. They hope to pin all perceived problems with everything domestic going forward on "Obamacare". They are cynical assholes, IMO.
 
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Ronald Reagan confidently predicts that Medicare will lead to a socialist dictatorship: http://www.youtube.com/watch?v=Bejdhs3jGyw

Look, if the Pubs genuinely believe that ACA is a bad bill that will hurt America then their duty is to do something about it. But whatever they do needs to be done within the reasonable bounds of our system and in a way that doesn't cause massive collateral damage to the economy. They failed to win at SCOTUS, they failed to get Romney elected in 2012, they failed to take the Senate in 2010 or 2012. I'm not saying this means they should give up, but to try and get what they want by shaking the faith of world markets in the credit of the United States could damage the country for generations in ways that make ACA pale in comparison.
 
And they need to offer something better than what they're trying to destroy/derail. And, I think, they are failing.
 
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