Shorty
Boomer Boy
This could cost the democrats 200 seats. Or 300.
ACA Running Thread
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"We'll be greeted as liberators." #endemic
They may have to add another 100 seats, just so it could cost them 400.
dmcheatw
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no, but that was literally the "patriot" act
Exactly.
With even more people in this plan, costs could actually go down. This would also take the states out of the middle.
Those who get subsidies would have the choice of regular insurance or a Medicare policy. The infrastructure is already in place. Whether you like it or not, seniors think it's very efficient.
Why have the states as middlemen? People could signup online or by mail. It would save a level of bureaucracy.
When the grandfathering guidance was issued 3 years ago, I read all several hundred pages and it was apparent that they wanted to make it difficult to keep your plan. The reason is simple...They wanted as many people moved into the new pool to keep rates down as the current pool was much healthier than the new entrants.
The political spin on this is misleading. There are certainly people on crappy insurance but the overwhelming majority of people were on perfectly good plans that offered comprehensive coverage. And they wanted to keep their plans.
It is silly to say people couldn't keep their plans. We absolutely could have and should have allowed people to stay in their plans regardless of when they bought or if they made a benefit change since March 2010. This is a huge indirect tax on people and will also result in people leaving the pool.
The political spin on this is misleading. There are certainly people on crappy insurance but the overwhelming majority of people were on perfectly good plans that offered comprehensive coverage. And they wanted to keep their plans.
It is silly to say people couldn't keep their plans. We absolutely could have and should have allowed people to stay in their plans regardless of when they bought or if they made a benefit change since March 2010. This is a huge indirect tax on people and will also result in people leaving the pool.
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ConnorEl
Well-known member
Well, I've always thought the idea was to "get" people shifted over time into the exchanges. Hook or crook, it makes sense to me from an insurance perspective. Of course, I'd prefer legitimate carrot and stick policy. Which I think the ACA is.
Why does anyone here think the O folks thought it was necessary or important to trot out the "you can keep your insurance" line? I mean, apart from the stupid answer that the allegedly knew they were foisting upon us some doomsday machine, etc. Assume they believe the ACA is good/desirable policy and that many would be, umm, compelled off their old plans onto new ones--ones that for many will be better and less expensive, though not for all. Why not say this up front?
CH, of course some/many could've kept their old plans. But every month of every year people have been forced out of their old plans whether or not they liked 'em. Not a new phenomenon.
Yes, Medicare for all would've been far simpler. But probably politically more difficult, I'm guessing.
Why does anyone here think the O folks thought it was necessary or important to trot out the "you can keep your insurance" line? I mean, apart from the stupid answer that the allegedly knew they were foisting upon us some doomsday machine, etc. Assume they believe the ACA is good/desirable policy and that many would be, umm, compelled off their old plans onto new ones--ones that for many will be better and less expensive, though not for all. Why not say this up front?
CH, of course some/many could've kept their old plans. But every month of every year people have been forced out of their old plans whether or not they liked 'em. Not a new phenomenon.
Yes, Medicare for all would've been far simpler. But probably politically more difficult, I'm guessing.
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ConnorEl
Well-known member
This piece seems a fair analysis...Health Policies Canceled in Latest Hurdle for Obamacare
SkinsNDeacs
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Maybe I am too skeptical but I think they knew it was majorly flawed bill and they were more invested in "winning". The "you can keep yours" argument was to win over people who did not trust the purposed legislation.
Not sure I follow why getting people into the exchanges is a good thing. Many people think these products will have much higher MLRs and medical trends than off exchange, but allowable plans. I agree with this.
I also don't agree with the second bolded part if you mean to say this is a frequent occurrence. Its not.
Obama was clearly downplaying the impact of the ACA on the masses expect for the freebies they promoted (parents plan to 26, free preventive care, etc). I can only imagine the firestrom if it widely explained that millions would be forced into a new plan on 1.1.14.
One last thing, Medicare A/B wouldn't be an allowable plan under the ACA for non Medicare eligible people.
Just an interesting tidbit. Tons of other issues with expanding it to the U65 market. Would be a cost disaster.
Just an interesting tidbit. Tons of other issues with expanding it to the U65 market. Would be a cost disaster.
ConnorEl
Well-known member
Of course not. It wasn't designed for the same population.
As for why it was desirable to compel folks into the exchanges: just as you said...one "reason is simple...They wanted as many people to be forced into the new pool to keep rates down as the current pool was much healthier than the new entrants."
And the fact that the new exchanges would be at risk to collect a less healthy population...well, that does speak to those that weren't able to find/keep a plan before the ACA.
And as to people being generally empowered to purchase/retain decent insurance...I'm pretty sure they'll have a better chance of this moving forward than in the past. Just sayin'
As for why it was desirable to compel folks into the exchanges: just as you said...one "reason is simple...They wanted as many people to be forced into the new pool to keep rates down as the current pool was much healthier than the new entrants."
And the fact that the new exchanges would be at risk to collect a less healthy population...well, that does speak to those that weren't able to find/keep a plan before the ACA.
And as to people being generally empowered to purchase/retain decent insurance...I'm pretty sure they'll have a better chance of this moving forward than in the past. Just sayin'
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EatLeadCommie
Tommy Elrod
Are you really attempting to justify the administration knowing in advance that up to 93 million people would be forced off their insurance? This "greater good" justification scares the piss out of me, frankly. If they had been up front about it, nobody would have been on board for it because it would've been a political disaster. The ACA would've never come close to passing. So why did they lie about it? I think you're way too dismissive of the "doomsday machine" theory (your term). They knew this would happen, and therefore must've known that it would be a mess. The government created the mess, and thus the government will be called upon to fix it, which will be an excuse to move more toward single payer. You're already seeing it on the liberal blogs and among the pundits.
Deadbolt
Well-known member
Big O is bringing in his buddies from Silicon Valley to save the day: http://gizmodo.com/googles-coming-t..._source=gizmodo_twitter&utm_medium=socialflow
Deacon923
Scooter Banks
it takes about one minute to create an account on Amazon.com or overstock.com or google.com or any other significant player in the internet commerce space. I cannot comprehend why the gummint didn't just license that kind of setup to begin with.
I understand there is a complex backend issue of getting that data to the insurers etc, but the inability to even create a damn account is just inexcusable.
I understand there is a complex backend issue of getting that data to the insurers etc, but the inability to even create a damn account is just inexcusable.
And another win for the ACA! The hits just keep coming. Those Bad Apple Hospital systems (like Hopkins and the Cleveland Clinic)!!!!
this law was a disaster from the beginning, but our pres thought that a political win was more important that addressing the true problem.
Top Hospitals Opt Out of Obamacare
Americans who sign up for insurance on the state exchanges may not have access to the nation's top hospitals, Watchdog.org reports.
By WATCHDOG.ORG
October 30, 2013 RSS Feed Print
Though top-ranked hospitals like Case Medical Center accept plans from dozens of private insurers, if you buy your insurance on the Obamacare exchanges your options for treatment may be limited.
The Obama Administration has been claiming that insurance companies will be competing for your dollars under the Affordable Care Act, but apparently they haven't surveyed the nation's top hospitals.
Americans who sign up for Obamacare will be getting a big surprise if they expect to access premium health care that may have been previously covered under their personal policies. Most of the top hospitals will accept insurance from just one or two companies operating under Obamacare.
[CHART: Which Top Hospitals Take Your Insurance Under Obamacare?]
"This doesn't surprise me," said Gail Wilensky, Medicare advisor for the second Bush Administration and senior fellow for Project HOPE. "There has been an incredible amount of focus on the premium cost and subsidy, and precious little focus on what you get for your money."
Regulations driven by the Obama White House have indeed made insurance more affordable – if, like Health and Human Services Secretary Kathleen Sebelius, you're looking only at price. But responding to Obamacare caps on premiums, many insurers will, in turn, simply offer top-tier doctors and hospitals far less cash for services rendered.
Watchdog.org looked at the top 18 hospitals nationwide as ranked by U.S. News and World Report for 2013-2014. We contacted each hospital to determine their contracts and talked to several insurance companies, as well.
The result of our investigation: Many top hospitals are simply opting out of Obamacare.
Chances are the individual plan you purchased outside Obamacare would allow you to go to these facilities. For example, fourth-ranked Cleveland Clinic accepts dozens of insurance plans if you buy one on your own. But go through Obamacare and you have just one choice: Medical Mutual of Ohio.
And that's not because their exchanges don't offer options. Both Ohio and California have a dozen insurance companies on their exchanges, yet two of the states' premier hospitals – Cleveland Clinic and Cedars-Sinai Medical Center – have only one company in their respective networks.
A few, like No. 1-rated Johns Hopkins in Maryland, are mandated under state law to accept all insurance companies. Other than that, the hospital with the largest number of insurance companies is University Hospitals Case Medical Center in Cleveland with just four. Fully 11 of the 18 hospitals had just one or two carriers.
http://health.usnews.com/health-news/hospital-of-tomorrow/articles/2013/10/30/top-hospitals-opt-out-of-obamacare
this law was a disaster from the beginning, but our pres thought that a political win was more important that addressing the true problem.
Top Hospitals Opt Out of Obamacare
Americans who sign up for insurance on the state exchanges may not have access to the nation's top hospitals, Watchdog.org reports.
By WATCHDOG.ORG
October 30, 2013 RSS Feed Print
Though top-ranked hospitals like Case Medical Center accept plans from dozens of private insurers, if you buy your insurance on the Obamacare exchanges your options for treatment may be limited.
The Obama Administration has been claiming that insurance companies will be competing for your dollars under the Affordable Care Act, but apparently they haven't surveyed the nation's top hospitals.
Americans who sign up for Obamacare will be getting a big surprise if they expect to access premium health care that may have been previously covered under their personal policies. Most of the top hospitals will accept insurance from just one or two companies operating under Obamacare.
[CHART: Which Top Hospitals Take Your Insurance Under Obamacare?]
"This doesn't surprise me," said Gail Wilensky, Medicare advisor for the second Bush Administration and senior fellow for Project HOPE. "There has been an incredible amount of focus on the premium cost and subsidy, and precious little focus on what you get for your money."
Regulations driven by the Obama White House have indeed made insurance more affordable – if, like Health and Human Services Secretary Kathleen Sebelius, you're looking only at price. But responding to Obamacare caps on premiums, many insurers will, in turn, simply offer top-tier doctors and hospitals far less cash for services rendered.
Watchdog.org looked at the top 18 hospitals nationwide as ranked by U.S. News and World Report for 2013-2014. We contacted each hospital to determine their contracts and talked to several insurance companies, as well.
The result of our investigation: Many top hospitals are simply opting out of Obamacare.
Chances are the individual plan you purchased outside Obamacare would allow you to go to these facilities. For example, fourth-ranked Cleveland Clinic accepts dozens of insurance plans if you buy one on your own. But go through Obamacare and you have just one choice: Medical Mutual of Ohio.
And that's not because their exchanges don't offer options. Both Ohio and California have a dozen insurance companies on their exchanges, yet two of the states' premier hospitals – Cleveland Clinic and Cedars-Sinai Medical Center – have only one company in their respective networks.
A few, like No. 1-rated Johns Hopkins in Maryland, are mandated under state law to accept all insurance companies. Other than that, the hospital with the largest number of insurance companies is University Hospitals Case Medical Center in Cleveland with just four. Fully 11 of the 18 hospitals had just one or two carriers.
http://health.usnews.com/health-news/hospital-of-tomorrow/articles/2013/10/30/top-hospitals-opt-out-of-obamacare
Pushing people into a higher cost product/pool is not a prudent way to manage overall health care spend. I am really worried about trend.
We've had HIPAA and Guaranteed Renewability since 1997. While I agree it will be easier to keep coverage each year (exchange & cost issues aside), the idea that lots of people routinely got forced out of their policy is fallacy.
ONW
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CH, wouldn't for profit hospitals kind of be shooting themselves in the foot by opting out of the ACA?
ConnorEl
Well-known member
Renewability but at what cost if you get sick/file too many claims? And if you get insurance via an employer, you can only chose from whatever your employer offers, which can change year to year substantially. Then if you lose your job, or quit, apart from cobra (expensive and limited) you've got to hope you can purchase on the individual market...
Anyhow, are we really doubting that people have reason to need more portable and obtainable reasonable quality health insurance?
Pretty sure the ACA includes a significant effort to shift the rewards for care more away from fee for service to value/quality. Not easy stuff and will take a while to get there, but probably the right way to go...
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ConnorEl
Well-known member
Pretty sure I'm trying to understand rather than justify. So you think we are going to see a planned/intended disaster that will be "corrected" by the move to single payer? Interesting.