• Welcome to OGBoards 10.0, keep in mind that we will be making LOTS of changes to smooth out the experience here and make it as close as possible functionally to the old software, but feel free to drop suggestions or requests in the Tech Support subforum!

ACA Running Thread

bcobbdeacs said:
Define performance
Click to expand...

Outcomes. Both cost and quality. Programs vary on speciality and location. Control for risk differences. Part of broader move to value. MACRA has fired first shots for Medicare FFS.

Simple ones include dings for readmission, medication adherence, HEDIS measures, etc.
 
RJKarl said:
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.
Click to expand...

Sigh. We shall see what states do.

FWIW, in NC, the EHB package was largely based off a Blue Cross plan. What was added? Pediatric dental and vision coverage. All of the other EHB categories were already available pre ACA (albeit maternity was a rider). I think many insurers may lobby against states changing EHBs. Will be interesting to see how this plays out but the law doesn't automatically lower benefits. It just provides the states the option to. Thats a big difference.

I have no issues with mandating EHBs for the most part.
 
CHDeac said:
Sigh. We shall see what states do.

FWIW, in NC, the EHB package was largely based off a Blue Cross plan. What was added? Pediatric dental and vision coverage. All of the other EHB categories were already available pre ACA (albeit maternity was a rider). I think many insurers may lobby against states changing EHBs. Will be interesting to see how this plays out but the law doesn't automatically lower benefits. It just provides the states the option to. Thats a big difference.

I have no issues with mandating EHBs for the most part.
Click to expand...

What this would do is allow states to be the final say in whether or not they want to fuck over their citizens. If state legislatures decide to opt out of essential health benefits, then there will likely be a huge backlash against those states. Would be a good way to get a foothold in some state legislatures that have been gerrymandered to death.
 
Good grief, I have read some of the reviews about the new Trumpcare...shameful
 
Trump's constant nonsense is really distracting from the giant redneck garbage pile piece of shit person that is Mitch McConnell.

 
ConnorEl said:
CHART: Who Wins, Who Loses With Senate Health Care Bill


Obamacare v Republican plan compared


Highlights, some details not exactly accurately described, but I think mostly the highlights are fairly described.
Click to expand...

Basically, health insurers are going to be able to offer a bunch of really crappy plans at low rates. People might think that's awesome until they realize their plan is crap. Meanwhile, tax cuts for the rich and corporations who no longer have to subsidize better health plans. In the name of free markets and individual choice, Republicans are allowing Americans to have the right to choose completely awful health care plans.

Insurers made record profits last year overall, although lost a bit on their plans offered through the Obamacare exchange.
 
ConnorEl said:
CHART: Who Wins, Who Loses With Senate Health Care Bill


Obamacare v Republican plan compared

Women's healthcare

Obamacare: Insurance companies prohibited from charging women more than men for the same health plan and must provide core services including maternity care and contraceptives.

Republican plan: Insurance companies still banned from charging women more, but states could allow insurers to drop maternity care and contraceptives from basic benefits. Also bans women from using federal tax credits to buy a plan that covers abortion.
Click to expand...

Highlights, some details not exactly accurately described, but I think mostly the highlights are fairly described.
Click to expand...

I think this one is good for debate. I don't think its fair to "force" a private industry to charge the same for women as it is for men, as it absolutely costs more to insure a woman than it does a man. Drop the maternity care portion of the coverage and you also start to add some probably helpful "personal responsibility" in there where people gotta be ready financially to have kids, which helps society.
 
MichDeac25 said:
Basically, health insurers are going to be able to offer a bunch of really crappy plans at low rates. People might think that's awesome until they realize their plan is crap. Meanwhile, tax cuts for the rich and corporations who no longer have to subsidize better health plans. In the name of free markets and individual choice, Republicans are allowing Americans to have the right to choose completely awful health care plans.

Insurers made record profits last year overall, although lost a bit on their plans offered through the Obamacare exchange.
Click to expand...

I would choose a really crappy plan with low rates, and just put some money in an HSA, as would most any responsible affluent educated healthy person would. Since graduating college my employers have spent $50k on my health insurance. I've gone to the hospital once for an hour. If I was paying for it myself, I'd rather have the $50k. Especially given the one bad year can easily be covered by like $5k in an HSA.

Again as posted elsewhere "record profits" is about 5% profit margin.
 
palmab03 said:
I would choose a really crappy plan with low rates, and just put some money in an HSA, as would most any responsible affluent educated healthy person would. Since graduating college my employers have spent $50k on my health insurance. I've gone to the hospital once for an hour. If I was paying for it myself, I'd rather have the $50k. Especially given the one bad year can easily be covered by like $5k in an HSA.

Again as posted elsewhere "record profits" is about 5% profit margin.
Click to expand...

I wouldn't gamble with potentially unlimited losses. It's like shorting a stock you have limited information on. I'd take lower return for a guaranteed ceiling on out of pocket.
 
dot com said:
I wouldn't gamble with potentially unlimited losses. It's like shorting a stock you have limited information on. I'd take lower return for a guaranteed ceiling on out of pocket.
Click to expand...

Well I didn't grow up wealthy like most wake kids, so I ain't got no trust fund to lose. I'm not talking about having a $100k out of pocket, but $10-15k for about a $100-150 premium makes quite a bit of sense.

People who complain about "record profits" and then not wanting people to have the ability to reduce said profits by having a higher deductible option seems silly.
 
Last edited:
palmab03 said:
I would choose a really crappy plan with low rates, and just put some money in an HSA, as would most any responsible affluent educated healthy person would. Since graduating college my employers have spent $50k on my health insurance. I've gone to the hospital once for an hour. If I was paying for it myself, I'd rather have the $50k. Especially given the one bad year can easily be covered by like $5k in an HSA.

Again as posted elsewhere "record profits" is about 5% profit margin.
Click to expand...

I don't think your demographic is really the concern. You have health insurance through your employer and are a healthy male. The real concern are more at-risk individuals and families. They're going to be forced to buy some healthcare or be taxed 30% more. They'll opt for a cheap crappy plan and then it won't provide much coverage.
 
MichDeac25 said:
I don't think your demographic is really the concern. You have health insurance through your employer and are a healthy male. The real concern are more at-risk individuals and families. They're going to be forced to buy some healthcare or be taxed 30% more. They'll opt for a cheap crappy plan and then it won't provide much coverage.
Click to expand...

taxed 30% more for one year. Under Obamacare, if you can't afford food you aren't going to buy health insurance no matter what, so the poor are just going to take the small Obamacare penalty, which doesn't even make them spend money to get insurance because assuming they have a job it just means their yearly check from the government from the EITC and others will be like $4,500 instead of $5,000.
 
palmab03 said:
taxed 30% more for one year. Under Obamacare, if you can't afford food you aren't going to buy health insurance no matter what, so the poor are just going to take the small Obamacare penalty, which doesn't even make them spend money to get insurance because assuming they have a job it just means their yearly check from the government from the EITC and others will be like $4,500 instead of $5,000.
Click to expand...

They're only taxed if they actually enroll in health care. Why would they enroll if they can't afford a 30% penalty? Obamacare also provided subsidies, which would now be on their way out.
 
We need a system that we all reasonably pay into that will be there to meet our basic healthcare needs; preventive, maintenance, acute, and chronic.

ACA was best effort to date to move us towards this. Pub plans are a step backwards--will leave more people again more vulnerable to a lack of adequate, available, affordable care.
 
You must log in or register to reply here.
Back
Top