The ACA for 2018- What To Expect

[the_real_Barleycorn]

So 10 milion more people got health insurance than before. At what cost? Bilions of dollars? Tens of billions? Hundreds of billions? How much does that come out to per person? More than enough to give each of those people gold plated coverage with a flex account for day to day needs. Giving each person a high deductible with catestrophic insurance would have been far cheaper and with less red tape. Obamacare is going to go down as one of the biggest boondoggles and errors in this country's history.

[LexusLover]

Originally Posted by the_real_Barleycorn

Obamacare is going to go down as one of the biggest boondoggles and errors in this country's history.

Well, not quite .... Electing its name-sake twice was.

Give discredit where discredit is due!

[flghtr65]

Originally Posted by Unique_Carpenter

Umm, wrong.
Individually purchased health insurance is in a totally and legally separated risk pool than employer group health plans.
But thank you for causing me to get my first laugh of the day.
Group policy cost is up due to health care costs.
Individual policy costs are up even more, due to that, plus the inclusion of high risk folks in the pool.

And for your post just above, why should taxpayer dollars pay for someones health insurance?
That's a huge issue that you're ignoring.



Here's the rest of my bit,

My two closest hospitals do not deal with the Obamacrap insurance. Why: The insurance reimbursement offers do not cover actual costs. I have a bunch of clients at one and a few friends at the other. Similar to myself they are all thankful that their employer has group insurance and can pretty much drive to any hospital, or doctor, they wish.

As Jackie mentions at post 3, employer's that have group plans have had premium issues also. Luckily, a decent employer realizes the value of long term employees.

Yes, the added high risk individual mandate has sent the experience rating through the roof. Yes, some insurance cos think that they can mandate reimbursement rates. But when a large professionally run operation (hospital) says no more bullshit and tells insurance cos to get stiffed on the individual plans, and when one of the largest primary insurance company for individual policies pulls out of most everywhere for individual policies (Anthem/Blue Cross/Blue Shield) the failure verdict is in.

Of course the risk pools are separate, that is why a group health insurance policy will always be cheaper than the same policy that is sold in the individual market. Jackie's cost went up because most health insurance companies are selling health insurance in both markets (for accounting purposes in a different division). The increased risk in the individual market has an effect on the gross profit of a health insurance company that is doing business in that market. The health insurance companies accountants know where the increased cost is coming from. In order to maintain the same profit level the cost of all products sold will go up. United Health Care and Aetna reduced the number of states that they were selling individual plans in because of unbalanced risk pools (that they did not think would get better). Prior to 2010 Jackie's insurance cost was not going up at the rate that it is going up now. What changed? In 2010 the ACA became a law.

Why should taxpayers pay to help other people pay for their health insurance? For the same reason we help seniors pay for their prescriptions (Medicare - Part D, signed into law by Bush43).

Obamacare health insurance ( a certain plan) is accepted at Childrens Hospital in Houston, one of the best hospitals in the state of Texas.

There is no perfect system to deal with people in the individual market WHO ARE ALREADY sick. The bottom line is since the ACA has been passed 92% of all citizens under age 65 have some type of health insurance in one of four ways.

Employer Group Health Insurance

Individual Market (Government Exchanges , Individual broker)

Expanded Medicaid

Original Medicaid ( Signed into law by LBJ in 1965 but only covers people below the poverty level)

I don't have time to get into the rest of your conversation.

[flghtr65]

Originally Posted by the_real_Barleycorn

So 10 milion more people got health insurance than before. At what cost? Bilions of dollars? Tens of billions? Hundreds of billions? How much does that come out to per person? More than enough to give each of those people gold plated coverage with a flex account for day to day needs. Giving each person a high deductible with catestrophic insurance would have been far cheaper and with less red tape. Obamacare is going to go down as one of the biggest boondoggles and errors in this country's history.

The ACA has two parts. Individual private plans sold on the government exchange and the expanded Medicaid. Twenty Million more people became insured, 10 million from the exchanges and 10 million from the Expanded Medicaid ( 31 states took the expanded Medicaid deal with the Fed Gov and 19 did not).

The cost of the ACA is 800 billion over a ten year period, same cost for Medicare - Part D which was signed into law by Bush43.

[Unique_Carpenter]

Originally Posted by flghtr65

Of course the risk pools are separate,

Then why do you keep mashing the different profit centers together? Insurance cos don't blend anything over different plans. State laws requires separation of rates specific to each plan.

Originally Posted by flghtr65

I don't have time to get into the rest of your conversation.

[Unique_Carpenter]

Originally Posted by flghtr65

Of course the risk pools are separate,

Then why do you keep mashing the different profit centers together? Insurance cos don't blend anything over different plans which are the risk pools, etc. State laws requires separation of rates specific to each plan.

Originally Posted by flghtr65

I don't have time to get into the rest of your conversation.

[flghtr65]

Originally Posted by Unique_Carpenter

Then why do you keep mashing the different profit centers together? Insurance cos don't blend anything over different plans which are the risk pools, etc. State laws requires separation of rates specific to each plan.

This is not Accounting 101. There is no need to get into that kind of detail. The bottom line is before the ACA became law people who had pre-existing conditions or who were already sick could not purchase a health insurance policy in the individual market. If your fasting Glucose was > 220 milligrams/ml, no health insurance company would sell you a health insurance policy (you were deemed to high a risk).

You write a book and you expect someone to address every sentence?

[dilbert firestorm]

Originally Posted by bambino

I expect the ACA to be gone as we know it by the end of 2018.

no, not by 2018; by 2019.

[flghtr65]

Originally Posted by dilbert firestorm

no, not by 2018; by 2019.

Not unless the Senate has more republicans get elected who do not care about the Expanded Medicaid in their state ( which is why the Senators from Maine and Alaska voted against the skinny repeal and the very last bill that was up for a vote). Currently the Senate has 52 republicans and 48 democrats. If it stays like that repeal and replace won't work in 2019 either.

[dilbert firestorm]

the 2018 math doesn't favor senate democrats as they have a lot of seats to defend. DNC at this point is useless.

I don't know how many pick ups republicans will get, but its likely they'll get at least 2 - 4 seats with a 54/56 - 46/44 math.

[garhkal]

Originally Posted by flghtr65

Everyone should have health insurance, a young person can get sick ( the risk is not as high as older person). The fact is before the ACA became law 82% of the population had insurance now it's 92%. That is an increase of 10%. I don't think the USA needs a single payer system. However, group health insurance from the employer needs to be supplemented with something for the individual market. Before the ACA was passed there were to many uninsured people who wanted health insurance.

So you think that the answer is to FORCE everyone to get that health insurance via taxing them/fining them if they don't get it?

Do you want FEMA to continually subsidize the Flood Insurance industry in this region?

No. Just like i hate it when those in tornado alley get hit time and time again, and expect FEMA to pay them to rebuild..
IF YOU DON'T have insurance, don't expect everyone else to foot the bill to repair your house..

[flghtr65]

Originally Posted by garhkal

So you think that the answer is to FORCE everyone to get that health insurance via taxing them/fining them if they don't get it?

If the government is going to ask the Health Insurance companies to sell health insurance to people who "ARE ALRADY SICK" then yes, low risk as well as high risk people need to be insured. The health insurance companies would simply go out of business if a majority of their customers are already sick. No insurance company will make a profit on a negative risk pool.

In the individual market what has happened so far is the mix of low risk to high risk customers is about 25%. It needs to be around 35% for the health insurance companies to continue to sell health insurance in the individual market.

The reason United Health Care and Aetna reduced the number of states they were selling in for the individual market was due to an unbalanced risk pool.

[flghtr65]

Originally Posted by LexusLover

In all your infinite wisdom over these many years you have studied the health insurance "risk" and "coverage" business ....

LL, are you trying give me a complement? You don't give out complements often in this forum.

[dilbert firestorm]

Originally Posted by dilbert firestorm

the 2018 math doesn't favor senate democrats as they have a lot of seats to defend. DNC at this point is useless.

I don't know how many pick ups republicans will get, but its likely they'll get at least 2 - 4 seats with a 54/56 - 46/44 math.

btw, forgot to mention this.

if there is a pick up of any sort, it will be in the House.

Republicans will be defending at least 27 open seats to Democrats 7 open seats.

[flghtr65]

Originally Posted by LexusLover

You keep beating your head against a scheme that the original "architects" never expected to work .... without government subsidies .... because every friggin' one of them wanted a "one-payer" system so they wanted to get companies and people dependent upon taxpayer money to get coverage and keep it .... KNOWING that the system would collapse in time on its own weight!

The reason the subsidy is needed is because the government is asking the health insurance companies to sell health insurance policies to people "WHO ARE ALREADY SICK". This alone is driving up cost for a health insurance company to conduct business. So, prior to 2010 before the ACA became law, health insurance companies simply did not sell health insurance to people with pre-existing conditions or people who were already sick in the Individual market.

The ACA is doing what it is suppose to do, get more people insured. Premium spikes that we have seen in some states will level off as the risk pools become more balanced.

The ACA is not collapsing under its own weight. Health insurance companies filed there rate increases with the commissioner of insurance for each state that they plan to do business in. In 2017 there was at least one provider in every county of the USA. Each state had more that one health insurance provider.

Last thing, the Obamacare plans sold on the Government Exchange is "REAL INSURANCE" and is accepted at good hospitals like Children's Hospital in Houston, Texas. (One of the best hospitals in the state)