ConnorEl
Well-known member
if the penalty for not being enrolled is close enough to the cost of the least expensive plan and if you are getting subsidies to pay for that plan I think you would enroll, or stay enrolled.
if the penalty for not being enrolled is close enough to the cost of the least expensive plan and if you are getting subsidies to pay for that plan I think you would enroll, or stay enrolled.
A few things quickly come to mind:
Strengthen the mandate (a lot).
Support the subsidies.
Shorten enrollment period, incentivize continuous coverage and disincentivize dropping out.
Not that these things solve all our health care problems. But I'm pretty sure they'd help the exchanges.
What happens to the people who get fired or can't afford the premiums? Remember, the GOP doesn't want to have subsidies. Also remember in the House bill (and likely in the Senate bill) many basic services for plans are not included. Hell, even covering visits to the ER (which is a top reason for young people to have insurance) isn't even covered.
The plan the House put forth is like buying a chassis for a car with the doors, windows, hood, seats and more as options. Of course their "coverage" is cheaper, but it doesn't cover anything.
A good start. I do think we need pay docs differently for this thing to work.
What's not accurate? If your objection is to one word, give me a break.
Here’s a rundown of what they are:
http://www.nbcnews.com/health/health-care/gop-health-care-debate-what-are-essential-benefits-n737646
Outpatient care — This covers most scheduled doctor visits, such as to check a rash, or a non-emergency stomach ache. Insurance companies negotiate deals for these and often designate "networks" of doctors and clinics with approved charges. Individuals who walk in without coverage pay much, much more.
Emergency room trips — Insurance policies cover both the ER visit and ambulance trips. Otherwise people can get socked with bills totaling tens of thousands of dollars, perhaps incurred while they were unconscious.
In-hospital care — All care people get as hospital patients, such as surgery. Some conservatives argue that people should be able to choose to opt out of this type of coverage and pay lower premiums. Most health policy experts say this is a gamble. “One answer is because someday you may be sick and that’s the way that insurance works,” says David Cutler, a Harvard University economics professor who helped design the Affordable Care Act.
Pregnancy, maternity and newborn care — This one’s controversial to some, who ask why men should pay for a service they’ll never use. “It is true that women get pregnant but men kind of help them get pregnant,” Cutler said. Pre-ACA, 62 percent of people with non-group policies had no maternity benefit.
Mental health and substance abuse disorder services — This particular benefit has gotten some attention with the ongoing opioid epidemic. Before the ACA, 18 percent of non-group policies left off mental health benefits.
Prescription drugs — Insurance companies usually negotiate discounts. Out of pocket costs for many drugs can be much higher than what an insurer pays for them.
Rehabilitative services and habilitative services. These include help recovering from an injury or illness, but also treatment for kids with autism or cerebral palsy.
Lab tests
Preventive services — This includes vaccines, cancer screenings such as mammograms and colonoscopies and, controversially, coverage of birth control.
Pediatric services — Including dental and vision care for childre
rj, that link is almost three months old and references "one proposal".
rj, that link is almost three months old and references "one proposal".
Much, if not all of that, is in the bill. As shown here, on May 4 after the bill was passed:
https://thinkprogress.org/house-rep...e-health-insurance-from-millions-7eabb99d5251
"Since then, the legislation has been tweaked to allow states to opt out of Obamacare’s essential health benefits mandate, which requires health plans to cover some pretty basic services: things like hospitalizations, emergency room visits, prescriptions, and maternity care."
Exactly how valuable is insurance that doesn't cover the part in red? This is what I posted. No matter what CH wants to say, the new policies are dramatically less coverage than under ACA. Those will still have coverage will be at much greater health and financial risks.
Plenty of movement in that direction built into the ACA. See my post top of last page--link to nejm article.
Yes, payment for services (not just to docs) needs to change from where we've been.
As I've said elsewhere on this thread, providers of care (individual and institutional) need to be incentivized to provide better quality care more efficiently (or...value). Not merely to do more stuff.
Health insurance can be made less expensive by lessening its benefits or by broadening the pool of participants to include more lower utilizers. Since I favor a healthcare system that we all (as reasonably able) pay into and that is there throughout our lives to reasonably facilitate the meeting of our needs as they arise (primary and preventive, acute, and long-term), I favor by far the latter approach rather than the former. Pubs seem to favor the former.
Well said. Getting more into the pool will help as will changing how we pay docs. The group pool is large and well rounded risk wise yet still has significant trends. Paying for performance is a move we need to accelerate.
Well said. Getting more into the pool will help as will changing how we pay docs. The group pool is large and well rounded risk wise yet still has significant trends. Paying for performance is a move we need to accelerate.
Plama, where are you getting your ACA enrollment numbers? 150 million? There were 12.7 million people with an ACA plan in 2016.
https://www.fool.com/investing/gene...-final-tally-for-obamacare-enrollment-in.aspx