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ACA Running Thread

I know it's only a ballpark now. But about how much is the difference between health insurance for a 27 year old minus the tax?
 
ArlingtonDeac said:
I think the GOP regularly and systematically underestimates them, and that's why the lose.

And GOP parents, though loudly rooting against this legislation, will be quietly signing their kids up for cheap insurance, or advising that they do so themselves. That's why this campaign will lose. It's illogical and anti-personal responsibility. Very few with any sense are going to turn down being covered for peanuts over not having a safety net at all, when it comes to their own personal needs.

You can only sell something ridiculous so much.
Click to expand...

Statistically it is not that ridiculous. There is a reason you need young people in the exchanges...because they overwhelmingly pay for insurance that they don't need or use. Don't get me wrong....I am a health insurance guy. I would not go a day without it even when I was younger. But if you are playing by the numbers (and I don't like to do that with my health) it is a bad investment for young healthy person to buy health insurance (and it is a very low risk to go without).

That is why I think our whole health insurance system (including the ACA) is unsustainable. We should move to a very high detectable disaster policy that gets a lower deductible and more expensive as you get older. Everything else pre-tax savings accounts. That would do much more for costs than anything we have now and it would be MUCH easier to subsidize poorer people.
 
PhDeac said:
I know it's only a ballpark now. But about how much is the difference between health insurance for a 27 year old minus the tax?
Click to expand...

I thought I heard the tax was as low as 95 bucks a year. Can't remember where I heard that so it might be 100% false.
 
Lots of misinformation out there as this article discusses:
http://www.latimes.com/business/hiltzik/la-fi-mh-debunked-20131030,0,6010994.story#axzz2jPxgHaWz

I talked with Cavallaro, 60, after her CNBC appearance. Let's walk through what she told me.

Her current plan, from Anthem Blue Cross, is a catastrophic coverage plan for which she pays $293 a month as an individual policyholder. It requires her to pay a deductible of $5,000 a year and limits her out-of-pocket costs to $8,500 a year. Her plan also limits her to two doctor visits a year, for which she shoulders a copay of $40 each. After that, she pays the whole cost of subsequent visits.

This fits the very definition of a nonconforming plan under Obamacare. The deductible and out-of-pocket maximums are too high, the provisions for doctor visits too skimpy.

As for a replacement plan, she says she was quoted $478 a month by her insurance broker, but that's a lot more than she'll really be paying. Cavallaro told me she hasn't checked the website of Covered California, the state's health plan exchange, herself. I did so while we talked.

Here's what I found. I won't divulge her current income, which is personal, but this year it qualifies her for a hefty federal premium subsidy.

At her age, she's eligible for a good "silver" plan for $333 a month after the subsidy -- $40 a month more than she's paying now. But the plan is much better than her current plan -- the deductible is $2,000, not $5,000. The maximum out-of-pocket expense is $6,350, not $8,500. Her co-pays would be $45 for a primary care visit and $65 for a specialty visit -- but all visits would be covered, not just two.

Is that better than her current plan? Yes, by a mile.

If she wanted to pay less, Cavallaro could opt for lesser coverage in a "bronze" plan. She could buy one from the California exchange for as little as $194 a month. From Anthem, it's $256, or $444 a year less than she's paying now. That buys her a $5,000 deductible (the same as she's paying today) but the out-of-pocket limit is lower, $6,350. Office visits would be $60 for primary care and $70 for specialties, but again with no limit on the number of visits. Factor in the premium savings, and it's hard to deny that she's still ahead.
 
SkinsNDeacs said:
Statistically it is not that ridiculous. There is a reason you need young people in the exchanges...because they overwhelmingly pay for insurance that they don't need or use. Don't get me wrong....I am a health insurance guy. I would not go a day without it even when I was younger. But if you are playing by the numbers (and I don't like to do that with my health) it is a bad investment for young healthy person to buy health insurance (and it is a very low risk to go without).

That is why I think our whole health insurance system (including the ACA) is unsustainable. We should move to a very high detectable disaster policy that gets a lower deductible and more expensive as you get older. Everything else pre-tax savings accounts. That would do much more for costs than anything we have now and it would be MUCH easier to subsidize poorer people.
Click to expand...

All insurance is a "bad" investment. That's not the point of insurance.

Most young people are like you and I were. They want to be insured, even if they don't really think they'll need it. The people that the exchanges need to attract are smart enough to do simple cost-benefit analysis. They've got a little money, and they'd like to not lose it all on a (e.g.) skiing accident. In the past they may not have bothered to get tangled up in the complicated and more expensive HC system, but once the government gets the damn website working, it's going to be a simple matter to sign up for cheap insurance. And when you're looking at a penalty anyway -- one that comes with no coverage -- I highly doubt those young people are going to say "I'll just pay the penalty for $200 less (or whatever), and not worry that it comes with zero coverage." They are much more likely to say, "Shit, I guess I'll just sign up then, it doesn't cost much any way. At least i'm covered now. What's that damn website again?"

I just think the GOP plan to convince young people to eschew personal responsibility and good decision-making is doomed to fail, because the smart decision is relatively easy to see.
 
The two most shocking things from that article were (1) a 60 year old woman thought a plan that limited her to 2 doctor visits a year with $40 copay each was a good plan and (2) she's done numerous news interviews and nobody did any background to see if she actually was getting a raw deal from Obamacare.
 
PhDeac said:
Lots of misinformation out there as this article discusses:
http://www.latimes.com/business/hiltzik/la-fi-mh-debunked-20131030,0,6010994.story#axzz2jPxgHaWz

I talked with Cavallaro, 60, after her CNBC appearance. Let's walk through what she told me.

Her current plan, from Anthem Blue Cross, is a catastrophic coverage plan for which she pays $293 a month as an individual policyholder. It requires her to pay a deductible of $5,000 a year and limits her out-of-pocket costs to $8,500 a year. Her plan also limits her to two doctor visits a year, for which she shoulders a copay of $40 each. After that, she pays the whole cost of subsequent visits.

This fits the very definition of a nonconforming plan under Obamacare. The deductible and out-of-pocket maximums are too high, the provisions for doctor visits too skimpy.

As for a replacement plan, she says she was quoted $478 a month by her insurance broker, but that's a lot more than she'll really be paying. Cavallaro told me she hasn't checked the website of Covered California, the state's health plan exchange, herself. I did so while we talked.

Here's what I found. I won't divulge her current income, which is personal, but this year it qualifies her for a hefty federal premium subsidy.

At her age, she's eligible for a good "silver" plan for $333 a month after the subsidy -- $40 a month more than she's paying now. But the plan is much better than her current plan -- the deductible is $2,000, not $5,000. The maximum out-of-pocket expense is $6,350, not $8,500. Her co-pays would be $45 for a primary care visit and $65 for a specialty visit -- but all visits would be covered, not just two.

Is that better than her current plan? Yes, by a mile.

If she wanted to pay less, Cavallaro could opt for lesser coverage in a "bronze" plan. She could buy one from the California exchange for as little as $194 a month. From Anthem, it's $256, or $444 a year less than she's paying now. That buys her a $5,000 deductible (the same as she's paying today) but the out-of-pocket limit is lower, $6,350. Office visits would be $60 for primary care and $70 for specialties, but again with no limit on the number of visits. Factor in the premium savings, and it's hard to deny that she's still ahead.
Click to expand...

Are we supposed to be cheering about all the people supposedly getting better deals under the ACA simply because the taxpayers are subsidizing a portion (and in some cases, all) of the bill? Color me unimpressed.
 
Well, I'll cheer that people are now guaranteed access to decent insurance.
 
Here's a happy group: Sex workers embrace Obamacare

131031191525-n-sex-workers-obamacare-00000815-620x348.jpg
 
ArlingtonDeac said:
All insurance is a "bad" investment. That's not the point of insurance.

Most young people are like you and I were. They want to be insured, even if they don't really think they'll need it. The people that the exchanges need to attract are smart enough to do simple cost-benefit analysis. They've got a little money, and they'd like to not lose it all on a (e.g.) skiing accident. In the past they may not have bothered to get tangled up in the complicated and more expensive HC system, but once the government gets the damn website working, it's going to be a simple matter to sign up for cheap insurance. And when you're looking at a penalty anyway -- one that comes with no coverage -- I highly doubt those young people are going to say "I'll just pay the penalty for $200 less (or whatever), and not worry that it comes with zero coverage." They are much more likely to say, "Shit, I guess I'll just sign up then, it doesn't cost much any way. At least i'm covered now. What's that damn website again?"

I just think the GOP plan to convince young people to eschew personal responsibility and good decision-making is doomed to fail, because the smart decision is relatively easy to see.
Click to expand...

A couple of quick points...

The crazies saying don't buy are just that, crazy. Wont argue anything less here.

That being said, you'd be very surprised just how hard it is to get someone to spend $ on insurance when they are young and healthy or even middle ages and healthy. Its even harder when they aren't subsidized (though the working poor are a hard nut to crack too). I've done this a long time and trust me, its a lot harder than it looks and sane, rational behavior doesn't exist. Plus, a lot of folks think they can wait until they get sick to buy but they can't.

The real issue on the term policies is for folks who aren't subsidy eligible and have basic, but comprehensive plans. We can go find a myriad of examples to show this plan is better than that one or whatever, I get that, but the bulk of people who were on these discontinued plans were on plans whose OOP limits exceeded the ACA limits. These folks wanted to keep their plans, were told they could, only to find out they can't. They don't have any low cost remedies other than to go uninsured.
 
I hear you, and that is very good post.

I think the mandate will push a greater percentage of those young people into buying the insurance, and getting something, over paying the penalty and getting nothing. For the first time it's now a case where you're going to lay out some money one way or the other. I feel confident that the majority of those people will want something back in return, especially when it's the also sensible thing to do. The mandate should spur rational behavior, I think.

That seems like a glitch that would fixed be made by a sensible bipartisan agreement, if were lived under a government that could function properly.
 
Well, if they aren't subsidy eligible and choose to go uninsured rather than pay for the minimal ACA plan, that's their choice. But it seems a poor and unsympathetic choice to me.


Of course, they should've never been told they could keep their old plan if/as that wasn't going to be the case.
 
CH, question for you (I don't know exactly what you do but obviously you're in the health insurance industry in some way).

If someone is forced out of a non-complying (if that's the right term) plan with insurance company A and onto an ACA exchange plan with insurance company B, I guess this is a loss for company "A".

What's the situation in NC and more broadly...are most companies in the position of "A" also on the exchanges? Or not?
 
CHDeac said:
A couple of quick points...

The crazies saying don't buy are just that, crazy. Wont argue anything less here.

That being said, you'd be very surprised just how hard it is to get someone to spend $ on insurance when they are young and healthy or even middle ages and healthy. Its even harder when they aren't subsidized (though the working poor are a hard nut to crack too). I've done this a long time and trust me, its a lot harder than it looks and sane, rational behavior doesn't exist. Plus, a lot of folks think they can wait until they get sick to buy but they can't.

The real issue on the term policies is for folks who aren't subsidy eligible and have basic, but comprehensive plans. We can go find a myriad of examples to show this plan is better than that one or whatever, I get that, but the bulk of people who were on these discontinued plans were on plans whose OOP limits exceeded the ACA limits. These folks wanted to keep their plans, were told they could, only to find out they can't. They don't have any low cost remedies other than to go uninsured.
Click to expand...

Well, they can now, but they couldn't before. Watch how many realize that paying the penalty (and how few actually will pay one even if there is a sincere effort to do so) and then thrusting yourself and your subsequently acquired pre-existing condition on an insurer who has to take you is a lot better option than paying premiums every month when you're healthy. Nothing would have encouraged the decision to get insurance more than the failure to acquire it after you have a preexisting condition (which is now gone).

ArlingtonDeac said:
I hear you, and that is very good post.

I think the mandate will push a greater percentage of those young people into buying the insurance, and getting something, over paying the penalty and getting nothing. For the first time it's now a case where you're going to lay out some money one way or the other. I feel confident that the majority of those people will want something back in return, especially when it's the also sensible thing to do. The mandate should spur rational behavior, I think.

That seems like a glitch that would fixed be made by a sensible bipartisan agreement, if were lived under a government that could function properly.
Click to expand...

Young people need the catastrophic, high deductible, low cost policies that no longer meet minimum standards. There is no meaningful penalty when you can't be denied coverage for a preexisting condition (especially when the so-called penalty is never actually going to cost people anything in real life, when compared to monthly insurance coverage premiums).
 
Enrollment periods are not continuous, so it would seem wiser to just sign up before you need it. If you aren't insured by choice and incur unexpected big expenses (say from an accident) it's not likely you can just sign up in the ambulance on the way to the hospital.

Of course some will take that chance, but it's not a good choice IMO.
 
ConnorEl said:
CH, question for you (I don't know exactly what you do but obviously you're in the health insurance industry in some way).

If someone is forced out of a non-complying (if that's the right term) plan with insurance company A and onto an ACA exchange plan with insurance company B, I guess this is a loss for company "A".

What's the situation in NC and more broadly...are most companies in the position of "A" also on the exchanges? Or not?
Click to expand...

I think there are only 3 providers in NC so company A and company B are likely the same. Therefore net gain for the company on terms of revenue (probably net loss in terms of margin).
 
ConnorEl said:
Enrollment periods are not continuous, so it would seem wiser to just sign up before you need it. If you aren't insured by choice and incur unexpected big expenses (say from an accident) it's not likely you can just sign up in the ambulance on the way to the hospital.

Of course some will take that chance, but it's not a good choice IMO.
Click to expand...

Don't you agree that the new law makes that more likely, since the biggest deterrent of all has been removed? When you take away the preexisting condition denial, you'd have to ratchet the penalty above the cost of insurance premiums to draw the attention of a rational actor, no? I get what you mean about open enrollments...but those people are already running the risks you say that they might later choose to avoid. Why would they change when you've dulled the teeth on the saw of deterrence?
 
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