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ACA Running Thread

ConnorEl said:
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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No. Im not arguing that improved portability isn't a good thing. It is. I was merely noting that the idea that keeping an individual plan, which is really what this issue is all about, really was under the consumers total control in virtually all cases.
 
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Sgt Hulka said:
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
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It would be sad if there are patients under care at those hospitals who will be forced into the exchanges due to their policies being cancelled by ACA edict.
 
ONW said:
CH, wouldn't for profit hospitals kind of be shooting themselves in the foot by opting out of the ACA?
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My sense is that they are higher cost providers and insurers cut them out to hit price points on the exchange and/or that they simply didn't want to lower their costs to hit the needed price point...Im also guessing these folks don't need the volume so why would they lower prices. Hopefully, as the market stabilizes, we will see ACO based relationships that improve some access and cost. But, I think we are headed back into a more managed care like era.
 
TownieDeac said:
I'm all for only letting CHDeac post on this thread from here on. It's rare we get someone so knowledgeable whose interests are "just the facts" and not scoring political points. I wanna reiterate how nice it's been for me to read your stuff CH, instead of rj's confirmation bias/denial strategy and jhmd's tripe.
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So true
 
CHDeac said:
No. Im not arguing that improved portability isn't a good thing. It is. I was merely noting that the idea that keeping an individual plan, which is really what this issue is all about, really was under the consumers total control in virtually all cases. There was no reason we needed to kill these products other than to push people into the ACA pool. And if thats what we needed to do (I disagree that we do) then HHS and the WH should have just said it.
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Well, I agree they should've said it.
 
Obamacare enrollments got off to very slow start, documents show

The website launched on a Tuesday. Publicly, the government said there were 4.7 million unique visits in the first 24 hours. But at a meeting Wednesday morning, the war room notes say "six enrollments have occurred so far."

They were with BlueCross BlueShield North Carolina and Kansas City, CareSource and Healthcare Service Corporation.

By Wednesday afternoon, enrollments were up to "approximately 100." By the end of Wednesday, the notes reflect "248 enrollments" nationwide.
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Yikes

I talked to a guys with BlueCross BlueShield NC this weekend. He told me they have signed up 4 people so far.
 
It's stunning that nobody has resigned or been fired over this fiasco. Six enrollees in the first day?

That's Blutarsky bad.
 
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TownieDeac said:
I'm all for only letting CHDeac post on this thread from here on. It's rare we get someone so knowledgeable whose interests are "just the facts" and not scoring political points. I wanna reiterate how nice it's been for me to read your stuff CH, instead of rj's confirmation bias/denial strategy and jhmd's tripe.
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Somebody's butthurt...
 
CHDeac said:
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.
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Just playing devil's advocate here - if people had no health insurance or insurance so crappy that it didn't actually do anything for them, they would be unlikely to access preventive care or be able to manage chronic conditions. This would result in higher spending on emergency room visits and procedures to deal with the fallout when their unmanaged conditions reach crisis. So, isn't it possible that forcing these people to get better insurance (supported by subsidies) would, over time, reduce per capita health care spending since an ounce of prevention and diabetes management is worth a pound of ER visits and foot amputations?
 
TownieDeac said:
I'm all for only letting CHDeac post on this thread from here on. It's rare we get someone so knowledgeable whose interests are "just the facts" and not scoring political points. I wanna reiterate how nice it's been for me to read your stuff CH, instead of rj's confirmation bias/denial strategy and jhmd's tripe.
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What denial? I said they screwed up the rollout.

John Roberts made a brilliant political move to allow ACA to stand and thus avoiding going down in history as total partisan and the guy who killed healthcare for millions while totally emasculating the program to try to kill it. Very few people realized what he did at the time in letting states not participate.

Could you imagine what would have happened had Warren told states they didn't have to participate in Medicare? Or any SC doing the same regarding Social Security?
 
RJKarl said:
What denial? I said they screwed up the rollout.

John Roberts made a brilliant political move to allow ACA to stand and thus avoiding going down in history as total partisan and the guy who killed healthcare for millions while totally emasculating the program to try to kill it. Very few people realized what he did at the time in letting states not participate.

Could you imagine what would have happened had Warren told states they didn't have to participate in Medicare? Or any SC doing the same regarding Social Security?
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The difference being, of course, that states don't actually participate in Medicare or Social Security.
 
Deacon923 said:
Just playing devil's advocate here - if people had no health insurance or insurance so crappy that it didn't actually do anything for them, they would be unlikely to access preventive care or be able to manage chronic conditions. This would result in higher spending on emergency room visits and procedures to deal with the fallout when their unmanaged conditions reach crisis. So, isn't it possible that forcing these people to get better insurance (supported by subsidies) would, over time, reduce per capita health care spending since an ounce of prevention and diabetes management is worth a pound of ER visits and foot amputations?
Click to expand...

This highlights the failure of the Obama Administration that I have been talking about since 2009. Their messaging and information sharing about ACA from before it passed makes [Redacted] look like the John Wooden of the ACC.

It's unimaginable how a group that took a first term, black senator to victory over Hillary Clinton's machine. Then laid waste to John McCain was so unprepared and failed so miserably at get the story of ACA out to the public. They didn't get decent info out and when they when were attacked they cowered in the corner.

People love many of the pieces of this. Further had they structured expectations properly, it would be going much smoother. Even something as simple as "your current insurance policy was created to protect the insurance company not you. Our basic policy was created with your family's needs in mind" would have averted a lot of headaches.

Had they done even a gentleman's C graded job of this, many of the current fuckups wouldn't be as bad.
 
Deacon923 said:
The difference being, of course, that states don't actually participate in Medicare or Social Security.
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For the first three years, the states wouldn't be picking up a penny of the expansion either. With just marginal economic growth during the next three years, almost all of those covered in the expansion would have employer or other coverage due having a lower unemployment rate.

States would also be saving billions in having to cover costs who don't have insurance and would be covered for their ER and other needs.
 
RJ,
In addition our Hospitals, which are really struggling now would have additional paying customers that are now being treated Gratis to help them cover the reimbursement drop from the medicare cut that was a part of ACA.
 
RJKarl said:
This highlights the failure of the Obama Administration that I have been talking about since 2009. Their messaging and information sharing about ACA from before it passed makes [Redacted] look like the John Wooden of the ACC.

It's unimaginable how a group that took a first term, black senator to victory over Hillary Clinton's machine. Then laid waste to John McCain was so unprepared and failed so miserably at get the story of ACA out to the public. They didn't get decent info out and when they when were attacked they cowered in the corner.

People love many of the pieces of this. Further had they structured expectations properly, it would be going much smoother. Even something as simple as "your current insurance policy was created to protect the insurance company not you. Our basic policy was created with your family's needs in mind" would have averted a lot of headaches.

Had they done even a gentleman's C graded job of this, many of the current fuckups wouldn't be as bad.
Click to expand...

Yeah it's amazing that a guy that had no real record as a politician other than his ability to campaign could run a successful campaign and then suck donkey balls at his actual job.
 
Deacon923 said:
Just playing devil's advocate here - if people had no health insurance or insurance so crappy that it didn't actually do anything for them, they would be unlikely to access preventive care or be able to manage chronic conditions. This would result in higher spending on emergency room visits and procedures to deal with the fallout when their unmanaged conditions reach crisis. So, isn't it possible that forcing these people to get better insurance (supported by subsidies) would, over time, reduce per capita health care spending since an ounce of prevention and diabetes management is worth a pound of ER visits and foot amputations?
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So once we force them to have the coverage, are we also going to force them to go get the checkups and other preventative care that is covered? If they refuse are we going to tax/penalize them further?
 
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