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ACA Running Thread

CHDeac said:
I have no issues with the mandate but I do object to covering many of these services at no cost to the patient. But remember, most all insurance covered these services pre ACA. The ACA just mandated it and removed cost share for some services. I'd suspect very few groups actually opt out of this. We will see.
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Most all? I mean only 85% of large firms covered them pre ACA. Obviously no one can be sure what will happen, but at least one survey suggests 11% would definitely drop coverage, and another 29% aren't sure. And that's without even considering the benefits of the cost share reductions.

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tiltdeac said:
Most all? I mean only 85% of large firms covered them pre ACA. Obviously no one can be sure what will happen, but at least one survey suggests 11% would definitely drop coverage, and another 29% aren't sure. And that's without even considering the benefits of the cost share reductions.

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A couple of thoughts. This is for 1st dollar 100% coverage, not will they be covered at all. Its also for groups over 200 employees which is not a good representation of total #s possibly impacted as uber large groups very unlikely to do this.

I've also seen countless surveys like this on a host of things and at these %s, very few will actually act IMHO. There is always more bark than bite, esp when you see the cost savings (small). This data pretty much sums up what Id expect. This will have little actual impact.

Not sure I understand your last statement.

Im also unaware of the 85% stat. Where is that from?
 
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LCDeacon said:
CHIP is not the same as Medicaid. CHIP is for people who have more income that what qualifies for Medicaid. In NC, the max income for Medicaid for a family of 4 is $4,305 if the kids are under 5 years old, and $2,727 if they are between 6-18.

https://dma.ncdhhs.gov/medicaid/get...ce/medicaid-income-and-resources-requirements

CHIP comes into play when incomes are above that amount. The benefits are great, but those kids would also be eligible for an ACA plan with significant tax credits and also very good ACA benefits (with a cost-share reduction) and the parents are generally upset that they cannot add the kids to their family plan, which could have been done at no cost, or even lowered the household premiums (if they were not eligible for CHIP). If the government says you are eligible for CHIP then you are not allowed to buy a subsidized ACA plan.
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This is not true in all states - like NC, especially where states refused the federal funding for medicare expansion.

The first year of the ACA, my kids were 4, 6, and 8. The youngest qualified for CHIP. But since he qualified for CHIP, he was not eligible for any benefits through the ACA. My oldest two fell through the cracks, where we made too much money for them to qualify for CHIP, not not enough for them to be included on our ACA plan (the marketplace said that they should be covered by CHIP in NC, but they were denied). There was a gap between what NC would cover through CHIP and what it should have covered. For that year, we had to carry 4 insurance plans. Youngest on CHIP, An ACA plan for my wife and me, and then my two older children had individual High Deductible plans (that were grandfathered in and still considered ACA compliant that year). It was a nightmare.
 
So many uninformed people on here (CH not among them), but incredibly opinionated.

Edited to say I originally said "stupid" people but they are just uninformed and over opinionated.
 
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IamThunderbolt said:
This is not true in all states - like NC, especially where states refused the federal funding for medicare expansion.

The first year of the ACA, my kids were 4, 6, and 8. The youngest qualified for CHIP. But since he qualified for CHIP, he was not eligible for any benefits through the ACA. My oldest two fell through the cracks, where we made too much money for them to qualify for CHIP, not not enough for them to be included on our ACA plan (the marketplace said that they should be covered by CHIP in NC, but they were denied). There was a gap between what NC would cover through CHIP and what it should have covered. For that year, we had to carry 4 insurance plans. Youngest on CHIP, An ACA plan for my wife and me, and then my two older children had individual High Deductible plans (that were grandfathered in and still considered ACA compliant that year). It was a nightmare.
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Without knowing the particulars I can't say for sure that you got bad information (there is certainly a gap for people who make too much for Medicaid and not enough for a tax credit), but in general the marketplace says lots of stuff that is incorrect, and it is very aggravating and has cost many people to lose or not get insurance at all. The call script for certain states that did not expand Medicaid was laughable. We cannot stress enough to clients to avoid the marketplace unless absolutely necessary, call the more knowledgeable person who assisted with the enrollment.
 
In the meantime, Michael Jordan steps up and focuses on actual healthcare instead of Obama's insurance distraction.

http://abcnews.go.com/Sports/wireStory/hornets-jordan-donates-million-build-medical-clinics-50372293

A release from Novant stated the clinics will provide an avenue to affordable, high-quality care — including behavioral health, physical therapy, social work, oral health and family planning — to individuals in the community who have little or no health care.

The clinics have the potential to decrease emergency room utilization by 68 percent and decrease hospitalization by 37 percent for the residents of these neighborhoods, according to Novant.

Novant added that the clinics are projected to care for nearly 35,000 children and adults who do not currently have access to primary and preventive care or who use the emergency room for non-urgent medical needs.
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Well, if we improved our health insurance and care systems we wouldn't have "at risk" and "most vulnerable" communities...that's code for folks with inadequate access to good care.

In the meantime...good for Jordan/Novant.
 
What's funny about that is Novant is trying to fend off Carolinas Healthcare, which just joined with UNC's healthcare system. Doesn't Jordan love his alma mater?
 
tiltdeac said:
Yes, the premise that it is failing is false. I do understand if your head was inside an ass, or you were constantly blowing someone, it would be tough to evaluate it critically. But any fair read of the data we have shows it is clearly not a dumpster fire. In fact, the markets were stabilizing quite well on their own this year (LINK). That's not to say there aren't problems that can be fixed. And if this administration wants to actively sabotage it, they can. But this death spiral stuff was just nonsense.

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LCDeacon said:
Analyzing First Quarter data (as the article states) is not an accurate portrayal of the claims or margins. The article explains why the data is flawed, so I wonder if they will be creating similar 2nd quarter charts soon. I also don't think it mentioned how much costlier people are that enroll outside of the first quarter, I think those claims were like 3 times as high, but I can't remember the exact number. If the insurance companies only insured people who were on the books during the 1st quarter then the financials would be vastly different.
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Second quarter numbers are out and look similarly positive. We'll see what the extent of the sabotage the white house rolls out later this week I guess.

https://www.kff.org/health-reform/issue-brief/individual-insurance-market-performance-in-mid-2017/

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Defintely good news that MLRs are improving (the much better stat to look at that vs what was in the chart). Id expect most ACA insurers will come close to break even / make $ in 2017 as a result of the premium increases over the past 3 years since 2014. Id argue that a profitable insurance sector for the ACA doesn't equate to long term sustainability of the ACA. As rates continue to rise, we will hit a point where people will drop coverage due to affordability. That day is coming and when it hits, its hard to stop.

The issue to watch with Trump is CSR funding. If CSR funding goes away, rates could be underfunded by 15% or more. We filed a 15% rate increase to cover this. Thi sis by far the #1 fear with trump.
 
LCDeacon said:
Without knowing the particulars I can't say for sure that you got bad information (there is certainly a gap for people who make too much for Medicaid and not enough for a tax credit), but in general the marketplace says lots of stuff that is incorrect, and it is very aggravating and has cost many people to lose or not get insurance at all. The call script for certain states that did not expand Medicaid was laughable. We cannot stress enough to clients to avoid the marketplace unless absolutely necessary, call the more knowledgeable person who assisted with the enrollment.
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LCDeacon is very much on the front lines of this battle and has added some great insights & experience. Thanks for that.

LC, I hope to get to a Deacon game this Fall and will let you know as I owe you a beer!
 
CHDeac said:
The issue to watch with Trump is CSR funding. If CSR funding goes away, rates could be underfunded by 15% or more. We filed a 15% rate increase to cover this. Thi sis by far the #1 fear with trump.
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Totally agree, and your numbers seem right in line with what is being done across the country.

30_states_pie_chart.jpg
 
CHDeac said:
LCDeacon is very much on the front lines of this battle and has added some great insights & experience. Thanks for that.

LC, I hope to get to a Deacon game this Fall and will let you know as I owe you a beer!
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Let me know if you can make it over this way! I will probably need a keg by the time December 15th rolls around.
 
OK, so what's Trump going to do to ruin healthcare access today?
 
Allowing people to "buy across state lines". This is a scam that will devastate consumers in many states that don't have good protections. The big boys will buy up every small provider and more states will become monopolies. Insurers will do like credit card companies who moved their HQs to states that little to no protections.
 
BTW, Trump has closed cut open enrollment advertising, cut the enrollment period and closed HHS on Sundays.

Who gives a fuck if a bunch don't get covered and die or go BK?
 
While y'all are whining about the small minority on Obamacare, President Trump is actually out there fixing things that matter

Specifically, the President is directing the Labor Department to study how to make it easier for small businesses, and possibly individuals, to join together and buy health insurance through nationwide association health plans, a senior administration official said Thursday. The department could give employers in the same industries more flexibility to offer group coverage across state lines, providing them with a broader range of policies at lower rates.
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