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Thread: Questions For Americans About New Health Insurance Exchanges

  1. #31
    Senior Member Flixy's Avatar
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    2) They should consider that they are being used as pawns in a desperate political numbers game.
    Not just them

  2. #32
    Go, Go USA #1!

    (sorry, couldn't resist )




    It's interesting, and worth exploring, what "young" people like Loki and Dread portend for their own parents as they age. Are your folks like every other ageing Baby Boomer (relying mainly on SS and Medicare in their Golden Years) or are they among the "privileged few" who have a guaranteed pension and/or an investment portfolio nest egg....or a home with enough equity to sustain their standard of living for at least a decade by borrowing against that collateral (or more, using a Reverse Mortgage)?

    If/When your folks fall ill or become incapacitated....are they simply "on their own"?
    Last edited by GGT; 09-29-2013 at 09:25 PM.

  3. #33
    Quote Originally Posted by EyeKhan View Post
    The cheaper majority pays for the expensive minority with the understanding some of them will at some point join that minority. Better?
    [...]
    Or buy an insurance plan, after they look at the plans in detail, if they find one that gives them benefits they could use for a reasonable price. Right???
    Remove the government coercion, benefit-defining and price fixing and we have a deal.

    My point to them was focused on the fact that they are mostly concerned with astronomical catastrophic medical expenses. But most of the plans they are being forced to buy won't really cover that much. So they may as well get a catastrophic plan, stay away from this weird new political instrument and call it a day.

  4. #34
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    Gosh, all that's missing is a demand to defund the whole thing.
    Congratulations America

  5. #35
    Quote Originally Posted by Dreadnaught View Post
    Remove the government coercion, benefit-defining and price fixing and we have a deal.
    Wait, in the other thread (Tea Party solutions) you advocated for regulatory re-writes....but here you say remove government coercion. Are you suggesting that the Insurance Industry can/should regulate themselves, without 'coercion' from federal agencies or gov't legislation? History proves otherwise.

    And if you want to remove benefit-defining constraints, that sounds more like Universal Care, or that SSSocialized medicine you rant against. The price fixing comment is just another talking point, mixed up with cost-containment and affordability. Drive-by-posting

    My point to them was focused on the fact that they are mostly concerned with astronomical catastrophic medical expenses. But most of the plans they are being forced to buy won't really cover that much. So they may as well get a catastrophic plan, stay away from this weird new political instrument and call it a day.
    In other words, you're counseling people to avoid the ACA Marketplace/Insurance Exchanges, because you don't fully understand them, and are suspicious that they're "weird, new, political instruments"?

  6. #36
    Back to (constructive) questions. Now that the Exchanges are up-and-running, people are beginning to take this seriously. Some folks report their premiums have gone up, or their employer contribution has gone down (well, duh, that's been happening for over a decade).

    One thing I learned today: any worker, whose share of employer-subsidized premiums exceeds 10% of their income, can transfer to the Marketplace and buy the same (or better) coverage for less.

  7. #37
    Another question: the ACA law mandates insurance companies (1) can't deny coverage for pre-existing conditions, or (2) can't cancel policies based on illness/disease, or (3) put lifetime dollar caps on coverage. Check.

    But as far as I can tell -- there's no limit to how much insurers can charge for premiums, loopholes they can create for 'qualified deductible costs', or any cap on OOP liability costs -- unless or until those policies are offered on the Marketplace Exchanges. Not sure if I'm reading it right, but it sounds like ONLY the exchange policies will protect people from those things (?)

  8. #38
    Sorry for being obnoxious at this point, but I have many questions.

    I'm wondering if the ACA will effect peoples' Credit Ratings somehow. That could be good or bad, depending on how they're measured and used, and by whom. We already know that a credit card is required to get a hotel room or rent a car. And we know that Millions of people put medical charges on their credit cards....and rack up tons of medical debt that eventually leads to medical bankruptcy.

    We also know that employers, universities, medical providers, and banks routinely use credit checks to screen people. Whether it's for a job, college admission, doctor visits, buying or renting a home, or getting a credit card......the concept is supposedly based on actuarial/insurance risk models.

    That angle seems more important (and perplexing) than IRS tax-related impacts. Does the ACA law have some provision that addresses this? Should it?

  9. #39
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    Quote Originally Posted by GGT View Post
    Sorry for being obnoxious at this point, but I have many questions.

    I'm wondering if the ACA will effect peoples' Credit Ratings somehow. That could be good or bad, depending on how they're measured and used, and by whom. We already know that a credit card is required to get a hotel room or rent a car. And we know that Millions of people put medical charges on their credit cards....and rack up tons of medical debt that eventually leads to medical bankruptcy.

    We also know that employers, universities, medical providers, and banks routinely use credit checks to screen people. Whether it's for a job, college admission, doctor visits, buying or renting a home, or getting a credit card......the concept is supposedly based on actuarial/insurance risk models.

    That angle seems more important (and perplexing) than IRS tax-related impacts. Does the ACA law have some provision that addresses this? Should it?
    I don't really think this forum is th place to ask them though.
    Congratulations America

  10. #40
    Yeah, maybe not. I thought our policy wonks would be interested in the details, and figured those railing about how horrible and doomed for failure the ACA is might be armed with some facts, and answers.

  11. #41
    Quote Originally Posted by Loki View Post
    Remind me how making insurance twice as expensive for young people
    Detailed source please.
    "One day, we shall die. All the other days, we shall live."

  12. #42
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    Quote Originally Posted by GGT View Post
    Yeah, maybe not. I thought our policy wonks would be interested in the details, and figured those railing about how horrible and doomed for failure the ACA is might be armed with some facts, and answers.
    I am pretty certain that for insurance wonks this law is too complicated to understand all intricacies, let alone for people who are merely interested in it from a political angle.

    Aimless, it wouldn't surprise me if for the class of immortals the new system actually works out a bit more expensive initially. That's why ACA introduces the mandate; to avoid that young healthy people who can afford insurance but don't want it opt out of the system so that the goverment needs to pick up the tab for the part of society that is aware of its own mortality. Most people only like spreading the risk if it means the money is coming their way.
    Congratulations America

  13. #43
    Quote Originally Posted by Aimless View Post
    Detailed source please.
    I linked to two sources on this already...
    Hope is the denial of reality

  14. #44
    Quote Originally Posted by Loki View Post
    I linked to two sources on this already...
    Indeed you did and those sources don't tell me for example how many "young people" would see their insurance costs double after taking into consideration subsidies and the ability to be covered by their parents' plans. Nor do they show how actual healthcare spending would be influenced (eg. by accounting for the costs associated with getting sick while being uninsured). They don't account for the actual or expected value. They don't account eg. for the savings to be made from getting access to maternal care etc. So, once again: detailed sources please.
    "One day, we shall die. All the other days, we shall live."

  15. #45
    And surely this is research that should have been carried out by the proponents of Obamacare before implementing the policy...
    Hope is the denial of reality

  16. #46
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    Quote Originally Posted by Loki View Post
    And surely this is research that should have been carried out by the proponents of Obamacare before implementing the policy...
    Eh, no it isn't. It's not even unintentional; young healthy people not being part of the system is one of the problems that needs to be fixed. Like putting an end to the cherry picking by insurers.
    Congratulations America

  17. #47
    And yet the main result of the program is that insurance rates are moving toward a midpoint, meaning that young people (who typically paid much lower insurance) are going to pay more while older people (who typically paid higher insurance premiums) will pay less. Some of that increase for young people will be offset for those who are earning poverty wages. But your average adult in their 20s and 30s is going to get royally screwed.

    The only way that Obamacare works is if healthy young people are entered into the same pool as the elderly, with absolutely no advantage to the former.
    Hope is the denial of reality

  18. #48
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    Quote Originally Posted by Loki View Post
    And yet the main result of the program is that insurance rates are moving toward a midpoint, meaning that young people (who typically paid much lower insurance) are going to pay more while older people (who typically paid higher insurance premiums) will pay less. Some of that increase for young people will be offset for those who are earning poverty wages. But your average adult in their 20s and 30s is going to get royally screwed.

    The only way that Obamacare works is if healthy young people are entered into the same pool as the elderly, with absolutely no advantage to the former.
    Yes, and again; none of that is unintended. Young healthy people probably can live without the insurance and now are being forced into one. Thus not facing doubled premiums but premiums they never intended to pay. Mutualization of the risk is what the whole thing is about. Some people paying more than they are paying now, and others paying less or seeing premiums come inside their reach is not an accident.
    Congratulations America

  19. #49
    You're still ignoring the effect on the much larger share of young people who already had insurance.
    Hope is the denial of reality

  20. #50
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    No I am not, I also refered to them when I mentioned the cherry picking by insurance companies. People who only pay premiums and don't use services are money trees for insurance companies even at excessively low premiums. They are just a sub-group of the demographic you need to include in a working mutualized health care insurance.

    For Pete's sake, how hard is it to understand in a situation where they are even willing to put a fine on not getting insurance.
    Congratulations America

  21. #51
    Quote Originally Posted by Loki View Post
    And surely this is research that should have been carried out by the proponents of Obamacare before implementing the policy...
    so you pulled this claim completely out of your ass.

    anyone shocked by this totally not normal loki behavior?

  22. #52
    Are you on drugs? I provided two sources. Just because they don't take every single factor into account doesn't make them worse than the non-existent sources showing the opposite...
    Hope is the denial of reality

  23. #53
    Quote Originally Posted by Loki View Post
    And yet the main result of the program is that insurance rates are moving toward a midpoint, meaning that young people (who typically paid much lower insurance) are going to pay more while older people (who typically paid higher insurance premiums) will pay less.
    What Hazir said.

    Loki, insurance rates had been increasing for everyone for years, with 10-20% hikes per year the last decade or so. Millions of people became uninsured when PT work outpaced FT positions (with no benefits), and buying insurance was unaffordable or had pitiful coverage. The young people (you say typically paid lower rates) were likely subsidized by a university, or employer, that could absorb or diffuse rising costs in many ways -- increase employee contributions, reduce salary, cut coverage; raise tuition, hit up state tax payers, close college health clinics, etc. Reminder: your healthcare has been "subsidized" by others your entire life.

    FYI: Some of those "low rates" for young people are absorbed by 40-60 year olds, who typically use hospital and speciality services more often. That's how/where delivery profits are captured. But it's not sustainable to keep raising those premiums, even though that demographic typically earns more money. They're likely to have more OOP medical costs, plus financial obligations to children, or even elder parents.

    Some of that increase for young people will be offset for those who are earning poverty wages. But your average adult in their 20s and 30s is going to get royally screwed.
    How do you figure that? The 'average' young adult can now remain on their parents' policy until age 27, if needed. The 'average' full-time employee in their 30's will still have access to special group rates, and employer-subsidized premiums. If they're PT, self-employed, free-lance or contract workers, the Exchanges will give them access to affordable insurance, based on their income, for the first time ever. And if they work for a small business that offers insurance, but their employee contributions exceed 10% of their income, the Exchanges have cheaper options.

    The only way that Obamacare works is if healthy young people are entered into the same pool as the elderly, with absolutely no advantage to the former.
    That's the rationale for a single-payer system or a NHS. Too many Americans have decided that would be SSSocialized medicine, and would turn the US into a welfare state, or Europe, or something horrible. No politician dares touch the third rail of Medicare, pooling the whole nation regardless of age, since that would be Communism! The ACA did the next best thing that was politically viable -- by including healthy people in the same pool as the unhealthy. Many young people have very expensive care needs, from premature births to pediatric cancers, Type I Diabetes, spinal cord injuries, Autism, early onset MS.....

    Quote Originally Posted by Loki View Post
    You're still ignoring the effect on the much larger share of young people who already had insurance.
    If they already had insurance, and liked its pricing and coverage, they don't need to use the ACA exchanges.

  24. #54
    Quote Originally Posted by Loki View Post
    Just because they don't take every single factor into account doesn't make them worse than the non-existent sources showing the opposite...

    So you know that the information you're using is incomplete, that a fuller picture could very well disprove your claim, but since the research isn't there yet, you're going to take what is available and twist it into what you want it to be.
    Without going into detail for why the articles aren't what you think they are, they are discussing monthly premiums, not total insurance costs. Not once have you mentioned the difference, even though 3 people responding to you have.

    stupid low premiums are a great way to get younger people into the system without expecting to pay out. You only need to make sure out of pocket expenses are just out of reach.

    Yet dread claims the aca is what's going to kill people
    Last edited by Ominous Gamer; 10-03-2013 at 04:54 PM.

  25. #55
    So what's the prognosis for the Medicaid doughnut hole?
    "One day, we shall die. All the other days, we shall live."

  26. #56
    Quote Originally Posted by Aimless View Post
    So what's the prognosis for the Medicaid doughnut hole?
    Did you mean the Medicare donut hole -- or the states who didn't want to expand Medicaid using federal funds?

    Medicare D gaps still exist, but there are Medicare supplemental policies folks can buy to help off-set their Rx costs. There are tons of adverts for them, not sure how effective they are, though. Certain pharmacies (like Walmart ) have set low OOP prices on a list of commonly used meds, that probably helps a lot to get a month's BP med for ten dollars.

    The Medicaid gaps have yet to play out, since the MarketPlace exchanges are in the initial registration phase. After that, people can enroll and shop, comparing insurance carriers, policies, prices, tax credits. <I've heard that people are expected to visit the websites ~18 times before they actually purchase a policy.>

    Will be interesting to watch southern (R) states, especially Texas. 25% of Texans are uninsured, they have high numbers of working poor/children living in poverty, but they refused federal Medicaid expansion assistance and starting their own state Exchange. It would be one thing if they had a different plan to get more Texans health care, but they don't.

  27. #57
    It's both interesting and confounding to watch the national Republican party, and certain Republican states denounce the PPACA. They're basically saying that ~ 50 million Americans shouldn't have equal access to health insurance....because that might increase employer-subsidized/employee premiums. They're hot to trot about .gov web site glitches, after limiting congressional funding, and/or refusing to set up their own state exchanges.

    Should we discuss losing sight of the forest, because of the trees?

  28. #58
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    Today joined a preventive health program. Filled out a form about lifestyle etc and provided them with some blood and other bodily excretions for testing. For my bloodpressure I got a (free of charge) bloodpressure meter; I was honestly surprised at how perfectly my measurements were within the parameters for a healthy person, given that I am way too heavy.
    Congratulations America

  29. #59
    Quote Originally Posted by GGT View Post
    It's both interesting and confounding to watch the national Republican party, and certain Republican states denounce the PPACA. They're basically saying that ~ 50 million Americans shouldn't have equal access to health insurance....because that might increase employer-subsidized/employee premiums. They're hot to trot about .gov web site glitches, after limiting congressional funding, and/or refusing to set up their own state exchanges.

    Should we discuss losing sight of the forest, because of the trees?
    Yes, those who don't support massive unaffordable welfare programs and crony capitalism (AKA Obamacare) just want to masturbate to people rotting in the streets.

    How dare anyone question the wisdom of the bureaucrats who are here to save us from ourselves!

  30. #60
    Quote Originally Posted by Dreadnaught View Post
    Yes, those who don't support massive unaffordable welfare programs and crony capitalism (AKA Obamacare) just want to masturbate to people rotting in the streets.
    Newly created Health Insurance Exchanges aren't "welfare programs". To the contrary, they're meant to give options to the uninsured: those who don't have employer-subsidized insurance, don't qualify for Medicaid "welfare", are too young or 'healthy' for Medicare.....but have been blocked from buying affordable health insurance....by the Insurance Industry and their political cronies.

    If we really wanted to get rid of Crony Capitalism in Healthcare, we'd be less accommodating to the private, for-profit Insurance Industry, and their lobbyists....and move toward a single-payer system. Ah, but people like you would call that SSSocialized medicine.

    How dare anyone question the wisdom of the bureaucrats who are here to save us from ourselves!
    Question bureaucrats all you want. Complain to your heart's content. Frame it as masturbating to people rotting on the streets. None of that qualifies as having better, alternative options. Being against something, and constantly saying No, without proffering what you're For and how to achieve that...is a losing strategy/tactic.

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