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tommyboy

Obamacare: Obama just straight up lied to you, in your face

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So what can we do to get more young people signed up?

Lower the prices for them by expanding age bands and adding back in underwriting based pricing (as younger tend to be healthier). Wait....that's what we have today. Never-mind.

I don't know that you can expand the age bands much more than it already is, the only grouped band is 0 - 20. They would have to expand the allowable rating curve.

That's what I mean when I talk about "age bands". A 21 year old's policy and a 64 year old's policy are at most 3:1 in premium under ACA rule, while today you see 5:1 and even up to 7 or 8:1.

Uninsured % decreases the higher up the age brackets you go. Uninsured amount those in their 20s and early 30s is FAR higher than those in their 50s to Medicare age, and that's under today's 5:1 or 7:1 banding. When you shrink the curve, prices will go up drastically for the young (which we've seen), and come down a bit for the older. If we have the goal of getting more people covered, especially the young, I have no idea why this was changed.

So it may increase the premiums for the 62 year old grandmother? Well, she's only 3 years away from Medicare anyway. The 20some year old will have to deal with the age band shrinking (and it's higher prices) for the next 2 decades.....

[nitpick]

That is a rating curve, not an age band.

[/nitpick]

Technically, it's "age band rating". http://www.ahipcoverage.com/2011/03/16/health-insurance-premium-tax-tightened-age-rating-bands-essential-benefit-buy-ups-higher-costs/

http://healthreformgps.org/resources/sub-regulatory-guidance-regarding-age-curves-geographical-rating-areas-and-state-reporting/

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I'd be willing to pay a little more for my excellent insurance so that every American had a catastrophic insurance policy.

I'd vote for that.

Define "catastrophic insurance policy". What does it cover? What does it not cover?

I'm sure that could be easily legislated. But at the core you simply want to protect an individual from financial catastrophe due to their medical problems.

Look, almost 40 million people who currently have insurance through their employer will lose coverage because the policy doesn't cover acupuncture, which is necessary to be Obamacare compliant. We simply don't need that kind of stuff to be covered as a health care "right", but it's causing people to lose insurance they like. A simple run of the numbers shows that more people will be left without insurance (and basically be "priced out" of the market if they are on the financial edges) than will be insured under Obamacare. Epic fail.

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But lets get real. Any Obamacare fix is going to require that the idiot in chief admit that Obamacare is a big stinking pile of poo that needs to get fixed. Not happening.

Edit to add: I think that's a GOP requirement for their assistance, that during a press conference Obama calls Obamacare a big stinking pile of poo that needs to get fixed.

Edited by Statorama

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Does anyone have a legit list of the things most frequently missing from plans that make them noncompliant??

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I'd be willing to pay a little more for my excellent insurance so that every American had a catastrophic insurance policy.

I'd vote for that.

Define "catastrophic insurance policy". What does it cover? What does it not cover?

I'm sure that could be easily legislated. But at the core you simply want to protect an individual from financial catastrophe due to their medical problems.

Look, almost 40 million people who currently have insurance through their employer will lose coverage because the policy doesn't cover acupuncture, which is necessary to be Obamacare compliant. We simply don't need that kind of stuff to be covered as a health care "right", but it's causing people to lose insurance they like. A simple run of the numbers shows that more people will be left without insurance (and basically be "priced out" of the market if they are on the financial edges) than will be insured under Obamacare. Epic fail.

:shrug:

I can't be for or against it if I don't know what "it" is. Would it cover broken bones? X-Rays and MRIs to determine the extent of a typical sports injury? Surgery for a torn ACL? Organ transplants? Dialysis? Chemotherapy?

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So what can we do to get more young people signed up?

I already told you how to do this. At gunpoint, rhetorical or real. It's the only way to make it work as designed, through force.

Schlzm

Well...a mandate is exactly that. The Supreme Court ruled the mandate constitutional, in the form of a tax, right?

So, here are my three conclusions:

1. Obamacare is here to stay, for two reasons: first because of the politics which I have already discussed, and second because of the new enrollees. This is even more important than the politics- there are going to be millions of new enrollees once the website is fully functional, most of them older folks with pre-existing conditions that could not obtain insurance before (or at least for a reasonable price.) Once these newbies have insurance, no politician will be willing to take it away from them, just as they don't dare remove Medicare.

2. The new people with pre-existing conditions are going to drive up prices for the rest of us, and this along with cancellations, are going to cause much pain to the middle class.

3. The only way to alleviate that pain is to force young people to purchase insurance, hence the mandate. However, given the low fee and the question of how it will practically be enforced, it MAY make economic sense at this point for young people not to buy the insurance, and simply be fined.

Assuming these three points are correct, the only logical solution is to raise the penalty to a point where it is no longer economically feasible for a young person not to buy insurance. For instance, we have a $500 fine for every instance of littering- that for the most part causes people not to litter. Make the penalty greater than the cost of insurance- then of course they'll buy it because they have to.

Forcing people to buy insurance is not something that gives me any pleasure. But I don't see any other way out of this mess. If you disagree with any of these points, please let me know where I have gotten it wrong.

That is literally exactly what Generation Opportunity is doing, and you came down hard on them. Why the reversal of ideology here?

I can't blame young people for reaching this conclusion by themselves. It may be the best decision for THEM, but it is worse for us as a society if they don't join up. That's why I blame Generation Opportunity and the other conservative groups who are doing the same thing: I don't think young people should be ENCOURAGED not to join up. The conservative groups don't give a crap about the young people IMO; they're just out to damage Obamacare in any way they can, and they don't care who gets hurt in the process.

There are lots of small parts of the ACA that make insurance more attractive to young people. Wellness visits being covered with no co-pays. Birth control being completely covered. Maternity coverage being mandated.

All these small components begin to even out the risk/reward proposition and tilt the scales in favor of being insured.

This is true....the problem is they aren't attractive enough to warrant action on their part. Who needs a wellness visit if you don't go to the doctor anyway? Birth control and maternity coverage only apply to women etc etc. That's how they think.

Some folks definitely think that way and we'll never be able to change their minds. But the majority of young people want health insurance. They're more informed than we were, and many have seen a friend, relative, co-worker, etc. crushed by not being insured. It's become almost a negative social stigma to not be insured, especially if it's reasonably affordable.

I don't know where you live, but I can tell you here in the southeast, I'm comfortable saying most feel that way. The "I'm invincible" vibe definitely rules the roost around here followed by a distant "cost/benefit" group. I've not seen even the slightest indication of what you say here. Not calling you a liar, but what you posted is not the reality around here.

It's not the reality where he lives either, and I proved that above.

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Does anyone have a legit list of the things most frequently missing from plans that make them noncompliant??

https://www.healthcare.gov/glossary/essential-health-benefits/

A set of health care service categories that must be covered by certain plans, starting in 2014.

The Affordable Care Act ensures health plans offered in the individual and small group markets, both inside and outside of the Health Insurance Marketplace, offer a comprehensive package of items and services, known as essential health benefits. Essential health benefits must include items and services within at least the following 10 categories: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.

Insurance policies must cover these benefits in order to be certified and offered in the Health Insurance Marketplace. States expanding their Medicaid programs must provide these benefits to people newly eligible for Medicaid.

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Does anyone have a legit list of the things most frequently missing from plans that make them noncompliant??

https://www.healthcare.gov/glossary/essential-health-benefits/

A set of health care service categories that must be covered by certain plans, starting in 2014.

The Affordable Care Act ensures health plans offered in the individual and small group markets, both inside and outside of the Health Insurance Marketplace, offer a comprehensive package of items and services, known as essential health benefits. Essential health benefits must include items and services within at least the following 10 categories: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.

Insurance policies must cover these benefits in order to be certified and offered in the Health Insurance Marketplace. States expanding their Medicaid programs must provide these benefits to people newly eligible for Medicaid.

And of these, which ones are the most frequently missing? Didn't see that on the link.

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Does anyone have a legit list of the things most frequently missing from plans that make them noncompliant??

Specific coverage - not covering drug and alcohol rehab, and not having juvenile dental care included.

But even if both of those (and maternity) were included, if the carrier used anything more than a 3:1 age rating band/age rating curve factor, then they weren't compliant anyway.

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I can't blame young people for reaching this conclusion by themselves. It may be the best decision for THEM, but it is worse for us as a society if they don't join up. That's why I blame Generation Opportunity and the other conservative groups who are doing the same thing: I don't think young people should be ENCOURAGED not to join up. The conservative groups don't give a crap about the young people IMO; they're just out to damage Obamacare in any way they can, and they don't care who gets hurt in the process.

Ascribing motives again, are you?

Timschologic states that those trying to exploit the naive into overpaying for a product actually care about them and those trying to educate them about personal finance decisions instead of price-gouging them are the true bad guys.

As crazy as that sounds I have no doubt it makes perfect sense in his head.

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I'd be willing to pay a little more for my excellent insurance so that every American had a catastrophic insurance policy.

I'd vote for that.

As would I. That is a reasonable safety net.

Same here.

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I'd be willing to pay a little more for my excellent insurance so that every American had a catastrophic insurance policy.

I'd vote for that.

Define "catastrophic insurance policy". What does it cover? What does it not cover?

I'm sure that could be easily legislated. But at the core you simply want to protect an individual from financial catastrophe due to their medical problems.

Look, almost 40 million people who currently have insurance through their employer will lose coverage because the policy doesn't cover acupuncture, which is necessary to be Obamacare compliant. We simply don't need that kind of stuff to be covered as a health care "right", but it's causing people to lose insurance they like. A simple run of the numbers shows that more people will be left without insurance (and basically be "priced out" of the market if they are on the financial edges) than will be insured under Obamacare. Epic fail.

:shrug:

I can't be for or against it if I don't know what "it" is. Would it cover broken bones? X-Rays and MRIs to determine the extent of a typical sports injury? Surgery for a torn ACL? Organ transplants? Dialysis? Chemotherapy?

Do you know what catastrophic means? I'm talking long term financial ruin kind of stuff. Long term cancer treatment. The kinds of things that destroy you financially. Broken bones, not so much.

That's what I would pay a little extra for.

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Does anyone have a legit list of the things most frequently missing from plans that make them noncompliant??

Specific coverage - not covering drug and alcohol rehab, and not having juvenile dental care included.

But even if both of those (and maternity) were included, if the carrier used anything more than a 3:1 age rating band/age rating curve factor, then they weren't compliant anyway.

Are cosmetic procedures covered? Or only under reconstructive situations? I am just curious.

Schlzm

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I'd be willing to pay a little more for my excellent insurance so that every American had a catastrophic insurance policy.

I'd vote for that.

As would I. That is a reasonable safety net.

Same here.

Signed. i'll support anything that could potentially make a tea partier cry.

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I'd be willing to pay a little more for my excellent insurance so that every American had a catastrophic insurance policy.

I'd vote for that.

As would I. That is a reasonable safety net.

Same here.

Hear Hear

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So what can we do to get more young people signed up?

I already told you how to do this. At gunpoint, rhetorical or real. It's the only way to make it work as designed, through force.

Schlzm

Well...a mandate is exactly that. The Supreme Court ruled the mandate constitutional, in the form of a tax, right?

So, here are my three conclusions:

1. Obamacare is here to stay, for two reasons: first because of the politics which I have already discussed, and second because of the new enrollees. This is even more important than the politics- there are going to be millions of new enrollees once the website is fully functional, most of them older folks with pre-existing conditions that could not obtain insurance before (or at least for a reasonable price.) Once these newbies have insurance, no politician will be willing to take it away from them, just as they don't dare remove Medicare.

2. The new people with pre-existing conditions are going to drive up prices for the rest of us, and this along with cancellations, are going to cause much pain to the middle class.

3. The only way to alleviate that pain is to force young people to purchase insurance, hence the mandate. However, given the low fee and the question of how it will practically be enforced, it MAY make economic sense at this point for young people not to buy the insurance, and simply be fined.

Assuming these three points are correct, the only logical solution is to raise the penalty to a point where it is no longer economically feasible for a young person not to buy insurance. For instance, we have a $500 fine for every instance of littering- that for the most part causes people not to litter. Make the penalty greater than the cost of insurance- then of course they'll buy it because they have to.

Forcing people to buy insurance is not something that gives me any pleasure. But I don't see any other way out of this mess. If you disagree with any of these points, please let me know where I have gotten it wrong.

That is literally exactly what Generation Opportunity is doing, and you came down hard on them. Why the reversal of ideology here?

I can't blame young people for reaching this conclusion by themselves. It may be the best decision for THEM, but it is worse for us as a society if they don't join up. That's why I blame Generation Opportunity and the other conservative groups who are doing the same thing: I don't think young people should be ENCOURAGED not to join up. The conservative groups don't give a crap about the young people IMO; they're just out to damage Obamacare in any way they can, and they don't care who gets hurt in the process.

There are lots of small parts of the ACA that make insurance more attractive to young people. Wellness visits being covered with no co-pays. Birth control being completely covered. Maternity coverage being mandated.

All these small components begin to even out the risk/reward proposition and tilt the scales in favor of being insured.

This is true....the problem is they aren't attractive enough to warrant action on their part. Who needs a wellness visit if you don't go to the doctor anyway? Birth control and maternity coverage only apply to women etc etc. That's how they think.

Some folks definitely think that way and we'll never be able to change their minds. But the majority of young people want health insurance. They're more informed than we were, and many have seen a friend, relative, co-worker, etc. crushed by not being insured. It's become almost a negative social stigma to not be insured, especially if it's reasonably affordable.

I don't know where you live, but I can tell you here in the southeast, I'm comfortable saying most feel that way. The "I'm invincible" vibe definitely rules the roost around here followed by a distant "cost/benefit" group. I've not seen even the slightest indication of what you say here. Not calling you a liar, but what you posted is not the reality around here.

It's not the reality where he lives either, and I proved that above.

The young don't have the same perspective on time . I commonly plan 10 years into the future, in college I rarely planned outside of the next quarter (and I was cautious for a college student).

The only way to get them to pay for something that doesn't financially benefit them is to force them. The uninsured penalty will have to be enforced and get a lot steeper.

If the Democrats want to do that it's up to them to try and sell it to the public and get the law changed.

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I'd be willing to pay a little more for my excellent insurance so that every American had a catastrophic insurance policy.

I'd vote for that.

As would I. That is a reasonable safety net.

Same here.

Hear Hear

See, it's not difficult to get consensus rolling if the bill makes sense.

Ramming through a 2000 page bill on Christmas Eve that no one has read gives us situations like we find ourselves in today. Total chaos and partisan bloodbath.

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Does anyone have a legit list of the things most frequently missing from plans that make them noncompliant??

Specific coverage - not covering drug and alcohol rehab, and not having juvenile dental care included.

But even if both of those (and maternity) were included, if the carrier used anything more than a 3:1 age rating band/age rating curve factor, then they weren't compliant anyway.

Are cosmetic procedures covered? Or only under reconstructive situations? I am just curious.

Schlzm

Not sure.

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I'd be willing to pay a little more for my excellent insurance so that every American had a catastrophic insurance policy.

I'd vote for that.

Define "catastrophic insurance policy". What does it cover? What does it not cover?

I'm sure that could be easily legislated. But at the core you simply want to protect an individual from financial catastrophe due to their medical problems.

Look, almost 40 million people who currently have insurance through their employer will lose coverage because the policy doesn't cover acupuncture, which is necessary to be Obamacare compliant. We simply don't need that kind of stuff to be covered as a health care "right", but it's causing people to lose insurance they like. A simple run of the numbers shows that more people will be left without insurance (and basically be "priced out" of the market if they are on the financial edges) than will be insured under Obamacare. Epic fail.

:shrug:

I can't be for or against it if I don't know what "it" is. Would it cover broken bones? X-Rays and MRIs to determine the extent of a typical sports injury? Surgery for a torn ACL? Organ transplants? Dialysis? Chemotherapy?

Do you know what catastrophic means? I'm talking long term financial ruin kind of stuff. Long term cancer treatment. The kinds of things that destroy you financially. Broken bones, not so much.

That's what I would pay a little extra for.

No, I don't know what it means in this context, which was why I asked. Seems to me that it's a very subjective term, which is why it needs to be defined.

If you're arguing about things that would destroy you financially, I'd say a complex broken bone that racks up a $10K-$50K, or possibly more, in surgery bills would be pretty damn "catastrophic" for most people, no? I'd think a shredded knee with multiple surgeries and MRIs, plus physical therapy afterwards would be pretty catastrophic for most people.

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So what can we do to get more young people signed up?

That's the basic question underlying all marketing of any commercial product ever. How can we get people to buy something they don't really need?

If you can answer that, you will be a rich man.

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I'd be willing to pay a little more for my excellent insurance so that every American had a catastrophic insurance policy.

I'd vote for that.

As would I. That is a reasonable safety net.

Same here.

Hear Hear

See, it's not difficult to get consensus rolling if the bill makes sense.

Ramming through a 2000 page bill on Christmas Eve that no one has read gives us situations like we find ourselves in today. Total chaos and partisan bloodbath.

I'm for it.

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I'd be willing to pay a little more for my excellent insurance so that every American had a catastrophic insurance policy.

I'd vote for that.

As would I. That is a reasonable safety net.

Same here.

Hear Hear

See, it's not difficult to get consensus rolling if the bill makes sense.

Ramming through a 2000 page bill on Christmas Eve that no one has read gives us situations like we find ourselves in today. Total chaos and partisan bloodbath.

Even the ACA made sense when it was this far along with no details. The ACA started as "let's get everyone covered" and evolved into this, once the details started flying. The devil is always in the details.

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I'd be willing to pay a little more for my excellent insurance so that every American had a catastrophic insurance policy.

I'd vote for that.

Define "catastrophic insurance policy". What does it cover? What does it not cover?

I'm sure that could be easily legislated. But at the core you simply want to protect an individual from financial catastrophe due to their medical problems.

Look, almost 40 million people who currently have insurance through their employer will lose coverage because the policy doesn't cover acupuncture, which is necessary to be Obamacare compliant. We simply don't need that kind of stuff to be covered as a health care "right", but it's causing people to lose insurance they like. A simple run of the numbers shows that more people will be left without insurance (and basically be "priced out" of the market if they are on the financial edges) than will be insured under Obamacare. Epic fail.

:shrug:

I can't be for or against it if I don't know what "it" is. Would it cover broken bones? X-Rays and MRIs to determine the extent of a typical sports injury? Surgery for a torn ACL? Organ transplants? Dialysis? Chemotherapy?

Do you know what catastrophic means? I'm talking long term financial ruin kind of stuff. Long term cancer treatment. The kinds of things that destroy you financially. Broken bones, not so much.

That's what I would pay a little extra for.

No, I don't know what it means in this context, which was why I asked. Seems to me that it's a very subjective term, which is why it needs to be defined.

If you're arguing about things that would destroy you financially, I'd say a complex broken bone that racks up a $10K-$50K, or possibly more, in surgery bills would be pretty damn "catastrophic" for most people, no? I'd think a shredded knee with multiple surgeries and MRIs, plus physical therapy afterwards would be pretty catastrophic for most people.

If you can't recover financially from the bills of a broken leg, you should be on medicare.

edit: I understand the point you're making though. I also understand that my answer was intentionally antagonistic. I apologize for that.

The answer I guess is to set a limit. Is it 50K? You cover the first 50K during the year and the government (taxpayers) picks up the remainder of the tab. Where we set that number (and if metrics are involved) I think could be legislated far more easily than this dumpster fire of a bill.

Edited by Statorama

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Do you know what catastrophic means? I'm talking long term financial ruin kind of stuff. Long term cancer treatment. The kinds of things that destroy you financially. Broken bones, not so much.

That's what I would pay a little extra for.

No, I don't know what it means in this context, which was why I asked. Seems to me that it's a very subjective term, which is why it needs to be defined.

If you're arguing about things that would destroy you financially, I'd say a complex broken bone that racks up a $10K-$50K, or possibly more, in surgery bills would be pretty damn "catastrophic" for most people, no? I'd think a shredded knee with multiple surgeries and MRIs, plus physical therapy afterwards would be pretty catastrophic for most people.

If you can't recover financially from the bills of a broken leg, you should be on medicare.

Ah, I see, so your bill will give everyone "catastrophic coverage" and also greatly expand medicare/medicaid. Do all the same people as above still support it?

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Do you know what catastrophic means? I'm talking long term financial ruin kind of stuff. Long term cancer treatment. The kinds of things that destroy you financially. Broken bones, not so much.

That's what I would pay a little extra for.

No, I don't know what it means in this context, which was why I asked. Seems to me that it's a very subjective term, which is why it needs to be defined.

If you're arguing about things that would destroy you financially, I'd say a complex broken bone that racks up a $10K-$50K, or possibly more, in surgery bills would be pretty damn "catastrophic" for most people, no? I'd think a shredded knee with multiple surgeries and MRIs, plus physical therapy afterwards would be pretty catastrophic for most people.

If you can't recover financially from the bills of a broken leg, you should be on medicare.

Ah, I see, so your bill will give everyone "catastrophic coverage" and also greatly expand medicare/medicaid. Do all the same people as above still support it?

Doesn't expand medicaid at all. If you're poor, you should already be on medicaid. That's what it's there for.

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Do you know what catastrophic means? I'm talking long term financial ruin kind of stuff. Long term cancer treatment. The kinds of things that destroy you financially. Broken bones, not so much.

That's what I would pay a little extra for.

No, I don't know what it means in this context, which was why I asked. Seems to me that it's a very subjective term, which is why it needs to be defined.

If you're arguing about things that would destroy you financially, I'd say a complex broken bone that racks up a $10K-$50K, or possibly more, in surgery bills would be pretty damn "catastrophic" for most people, no? I'd think a shredded knee with multiple surgeries and MRIs, plus physical therapy afterwards would be pretty catastrophic for most people.

If you can't recover financially from the bills of a broken leg, you should be on medicare.

Ah, I see, so your bill will give everyone "catastrophic coverage" and also greatly expand medicare/medicaid. Do all the same people as above still support it?

Doesn't expand medicaid at all. If you're poor, you should already be on medicaid. That's what it's there for.

There are lots of people who most wouldn't consider poor that don't have $100K lying around.

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The Obama administration is being accused of giving labor groups "special treatment under the law" after formally proposing a change that could exempt union health plans from a pesky ObamaCare fee.

If there is an exemption for this "reinsurance fee" is that just going to cause everyone's premiums to go up even more next year to cover what was to be collected? If this fee was "to help pay for the cost of people with pre-existing conditions signing up for coverage through the ObamaCare exchanges." then why would it be a good thing to exempt unions and others other than political reasons?

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Do you know what catastrophic means? I'm talking long term financial ruin kind of stuff. Long term cancer treatment. The kinds of things that destroy you financially. Broken bones, not so much.

That's what I would pay a little extra for.

No, I don't know what it means in this context, which was why I asked. Seems to me that it's a very subjective term, which is why it needs to be defined.

If you're arguing about things that would destroy you financially, I'd say a complex broken bone that racks up a $10K-$50K, or possibly more, in surgery bills would be pretty damn "catastrophic" for most people, no? I'd think a shredded knee with multiple surgeries and MRIs, plus physical therapy afterwards would be pretty catastrophic for most people.

If you can't recover financially from the bills of a broken leg, you should be on medicare.

Ah, I see, so your bill will give everyone "catastrophic coverage" and also greatly expand medicare/medicaid. Do all the same people as above still support it?

Doesn't expand medicaid at all. If you're poor, you should already be on medicaid. That's what it's there for.

There are lots of people who most wouldn't consider poor that don't have $100K lying around.

Again, that's where we need to define the cost that is considered "catastrophic", and if there are metrics and baselines based on your net worth.

That's the kind of bill that could get settled in an afternoon committee session.

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A $2500 medical bill (the high end of your basic estimate) is by no means catastrophic. And if it is catastrophic, then you are probably already on medicaid. That's all I was saying.

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The Obama administration is being accused of giving labor groups "special treatment under the law" after formally proposing a change that could exempt union health plans from a pesky ObamaCare fee.

If there is an exemption for this "reinsurance fee" is that just going to cause everyone's premiums to go up even more next year to cover what was to be collected? If this fee was "to help pay for the cost of people with pre-existing conditions signing up for coverage through the ObamaCare exchanges." then why would it be a good thing to exempt unions and others other than political reasons?

because good things cant ever happen in this country if it inconveniences the rich.

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Do you know what catastrophic means? I'm talking long term financial ruin kind of stuff. Long term cancer treatment. The kinds of things that destroy you financially. Broken bones, not so much.

That's what I would pay a little extra for.

No, I don't know what it means in this context, which was why I asked. Seems to me that it's a very subjective term, which is why it needs to be defined.

If you're arguing about things that would destroy you financially, I'd say a complex broken bone that racks up a $10K-$50K, or possibly more, in surgery bills would be pretty damn "catastrophic" for most people, no? I'd think a shredded knee with multiple surgeries and MRIs, plus physical therapy afterwards would be pretty catastrophic for most people.

If you can't recover financially from the bills of a broken leg, you should be on medicare.

Ah, I see, so your bill will give everyone "catastrophic coverage" and also greatly expand medicare/medicaid. Do all the same people as above still support it?

Doesn't expand medicaid at all. If you're poor, you should already be on medicaid. That's what it's there for.

There are lots of people who most wouldn't consider poor that don't have $100K lying around.

Again, that's where we need to define the cost that is considered "catastrophic", and if there are metrics and baselines based on your net worth.

That's the kind of bill that could get settled in an afternoon committee session.

Nothing gets settled quickly any more. But, more to the point, how can you (and several others) say you support it when we haven't even defined what "it" is? Covering cancer versus covering cancer as well as broken bones, torn ACLs, etc. are two vastly different coverages, and likely vastly different costs.

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The Obama administration is being accused of giving labor groups "special treatment under the law" after formally proposing a change that could exempt union health plans from a pesky ObamaCare fee.

If there is an exemption for this "reinsurance fee" is that just going to cause everyone's premiums to go up even more next year to cover what was to be collected? If this fee was "to help pay for the cost of people with pre-existing conditions signing up for coverage through the ObamaCare exchanges." then why would it be a good thing to exempt unions and others other than political reasons?

because good things cant ever happen in this country if it inconveniences the rich.

Of course they can happen. Just as long as Democrat voters get an exemption from the inconveniences.

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A $2500 medical bill (the high end of your basic estimate) is by no means catastrophic. And if it is catastrophic, then you are probably already on medicaid. That's all I was saying.

$35K for a surgical break certainly is catastrophic for most people, even most people who aren't on Medicaid.

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You know what would probably make young people more likely to sign up for insurance is if you priced it appropriate to their level of risk rather than expecting them to be some sort of pool of money that subsidizes everyone else's care.

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Do you know what catastrophic means? I'm talking long term financial ruin kind of stuff. Long term cancer treatment. The kinds of things that destroy you financially. Broken bones, not so much.

That's what I would pay a little extra for.

No, I don't know what it means in this context, which was why I asked. Seems to me that it's a very subjective term, which is why it needs to be defined.

If you're arguing about things that would destroy you financially, I'd say a complex broken bone that racks up a $10K-$50K, or possibly more, in surgery bills would be pretty damn "catastrophic" for most people, no? I'd think a shredded knee with multiple surgeries and MRIs, plus physical therapy afterwards would be pretty catastrophic for most people.

If you can't recover financially from the bills of a broken leg, you should be on medicare.

Ah, I see, so your bill will give everyone "catastrophic coverage" and also greatly expand medicare/medicaid. Do all the same people as above still support it?

Doesn't expand medicaid at all. If you're poor, you should already be on medicaid. That's what it's there for.

There are lots of people who most wouldn't consider poor that don't have $100K lying around.
Isn't that the definition of poor?

Schlzm

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Nothing gets settled quickly any more. But, more to the point, how can you (and several others) say you support it when we haven't even defined what "it" is? Covering cancer versus covering cancer as well as broken bones, torn ACLs, etc. are two vastly different coverages, and likely vastly different costs.

The beauty is in it's simplicity. You don't define what's covered and what's not. It's a financial safety net that's in place to keep your family from financial ruin.

Define a standard point (say 40K) that you hit where the government takes over the bills. Define metrics for families where the standard rate would be ruinous. Offer people small interest (2%) long term loans that could only be used for medical expenses. There are all kinds of ways that this could be handled better than Obamacare.

Edited by Statorama
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So what can we do to get more young people signed up?

That's the basic question underlying all marketing of any commercial product ever. How can we get people to buy something they don't really need?

If you can answer that, you will be a rich man.

Anyone know if the dog that played Spuds MacKenzie is still alive???

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So what can we do to get more young people signed up?

That's the basic question underlying all marketing of any commercial product ever. How can we get people to buy something they don't really need?

If you can answer that, you will be a rich man.

Anyone know if the dog that played Spuds MacKenzie is still alive???

The dog's real name was Honey Tree Evil Eye (October 7, 1983 - May 31, 1993). She died of kidney failure in North Riverside, Illinois.

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So what can we do to get more young people signed up?

Remind them of why they voted for Obama in the first place?

"Yes we can!!!....ignore basic economics and human nature to create a better society by 'spreading the wealth around'".

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This whole thing kind of reminds me of a conversation I had back when I was like 24 - I'm working as a contractor and they try to hire me on full time. Position includes mandatory overtime, lower pay, but they do have a better benefits package (mostly health insurance related) which is what this guy is trying to sell me on. And I keep explaining that I'm 24 and I haven't been to the doctor in more than half a decade. Yeah my insurance isn't as awesome as yours, but I have it and your "better insurance" isn't worth me working harder for less.

You guys are trying to force these people to get this pricey coverage that they don't even need to subsidize a bunch of old people that are bent out of shape about paying the true cost of their care. And then "libertarians" like Tim are going to suggest we merely need to penalize them more to get them to take the crappy deal. What a joke. This discussion really makes me sick.

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Nothing gets settled quickly any more. But, more to the point, how can you (and several others) say you support it when we haven't even defined what "it" is? Covering cancer versus covering cancer as well as broken bones, torn ACLs, etc. are two vastly different coverages, and likely vastly different costs.

The beauty is in it's simplicity. You don't define what's covered and what's not. It's a financial safety net that's in place to keep your family from financial ruin.

Define a standard point (say 40K) that you hit where the government takes over the bills. Define metrics for families where the standard rate would be ruinous. Offer people small interest (2%) long term loans that could only be used for medical expenses. There are all kinds of ways that this could be handled better than Obamacare.

With a solution like this, now the legislators are arguing over a handful of things. What is the basic financial catastrophic limit? 10K? 30K?

Heck, it even gives whiny Democrats something to use as a wedge issue. "Republicans are trying to move the catastrophic insurance limit to 11K!!! It's like they think you have 11K laying around!!"

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I'd be willing to pay a little more for my excellent insurance so that every American had a catastrophic insurance policy.

I'd vote for that.

Define "catastrophic insurance policy". What does it cover? What does it not cover?

I'm sure that could be easily legislated. But at the core you simply want to protect an individual from financial catastrophe due to their medical problems.

Look, almost 40 million people who currently have insurance through their employer will lose coverage because the policy doesn't cover acupuncture, which is necessary to be Obamacare compliant. We simply don't need that kind of stuff to be covered as a health care "right", but it's causing people to lose insurance they like. A simple run of the numbers shows that more people will be left without insurance (and basically be "priced out" of the market if they are on the financial edges) than will be insured under Obamacare. Epic fail.

:shrug:

I can't be for or against it if I don't know what "it" is. Would it cover broken bones? X-Rays and MRIs to determine the extent of a typical sports injury? Surgery for a torn ACL? Organ transplants? Dialysis? Chemotherapy?

Do you know what catastrophic means? I'm talking long term financial ruin kind of stuff. Long term cancer treatment. The kinds of things that destroy you financially. Broken bones, not so much.

That's what I would pay a little extra for.

No, I don't know what it means in this context, which was why I asked. Seems to me that it's a very subjective term, which is why it needs to be defined.

If you're arguing about things that would destroy you financially, I'd say a complex broken bone that racks up a $10K-$50K, or possibly more, in surgery bills would be pretty damn "catastrophic" for most people, no? I'd think a shredded knee with multiple surgeries and MRIs, plus physical therapy afterwards would be pretty catastrophic for most people.

I have a "catastrophic" plan right now because I'm self-employed. It covers 80% of all hospitalization after my deductible. So anything that would require surgery or a hospital stay is covered. It also covers all preventive care 100%. If I get an ear infection and go to the doctor, none of that is covered. It only costs $200 a month for me and my husband combined with dental. Without the dental I think it would have been around $170 for the two of us. This is what I wanted. I wanted true "insurance" against a major health event, and I'd pay for anything else that may pop up. I could afford a full blown plan, but didn't want one. I'd rather keep the extra 100s of dollars a month and just pay my actual medical expenses when the need arises. There are other reasons I like this type of plan as well which I don't need to get too much into, but these plans are more flexible because they are not covering routine doctor visits. I'm not covered so I can go to Urgent Care at 9:00 PM and just pay instead of having to get an appointment at an in-network doctor's office, likely take off some work, to get a prescription for antibiotics. That's the kind of plan I want... I can do whatever I want, but if something major happens, I have insurance.

Also, I'm sure it will be getting canceled because it is not ACA compliant. Because I suppose someone knows better than I do what I need in my health insurance plan.

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This whole thing kind of reminds me of a conversation I had back when I was like 24 - I'm working as a contractor and they try to hire me on full time. Position includes mandatory overtime, lower pay, but they do have a better benefits package (mostly health insurance related) which is what this guy is trying to sell me on. And I keep explaining that I'm 24 and I haven't been to the doctor in more than half a decade. Yeah my insurance isn't as awesome as yours, but I have it and your "better insurance" isn't worth me working harder for less.

You guys are trying to force these people to get this pricey coverage that they don't even need to subsidize a bunch of old people that are bent out of shape about paying the true cost of their care. And then "libertarians" like Tim are going to suggest we merely need to penalize them more to get them to take the crappy deal. What a joke. This discussion really makes me sick.

The best part is that this is part of the new era of kids always being told how unique and special and wonderful they are and how they are deserving of everything and can't be responsible for their own actions because you know, society and it takes a villiage! Oh wait, you need to pay for all those sick and old people over there buy buying this crap you don't want, need, or will use any time soon! Laughable.

Schlzm

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Does anyone have a legit list of the things most frequently missing from plans that make them noncompliant??

Specific coverage - not covering drug and alcohol rehab, and not having juvenile dental care included.

But even if both of those (and maternity) were included, if the carrier used anything more than a 3:1 age rating band/age rating curve factor, then they weren't compliant anyway.

They don't have to have pediatric dental included, but if they don't there must be a stand alone pediatric dental plan available in their service area.

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So what can we do to get more young people signed up?

Remind them of why they voted for Obama in the first place?

"Yes we can!!!....ignore basic economics and human nature to create a better society by 'spreading the wealth around'".

Right, that's what "progressives" say. As long as it isn't their wealth, of course.

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Do you know what catastrophic means? I'm talking long term financial ruin kind of stuff. Long term cancer treatment. The kinds of things that destroy you financially. Broken bones, not so much.

That's what I would pay a little extra for.

No, I don't know what it means in this context, which was why I asked. Seems to me that it's a very subjective term, which is why it needs to be defined.

If you're arguing about things that would destroy you financially, I'd say a complex broken bone that racks up a $10K-$50K, or possibly more, in surgery bills would be pretty damn "catastrophic" for most people, no? I'd think a shredded knee with multiple surgeries and MRIs, plus physical therapy afterwards would be pretty catastrophic for most people.

If you can't recover financially from the bills of a broken leg, you should be on medicare.

Ah, I see, so your bill will give everyone "catastrophic coverage" and also greatly expand medicare/medicaid. Do all the same people as above still support it?

Doesn't expand medicaid at all. If you're poor, you should already be on medicaid. That's what it's there for.

There are lots of people who most wouldn't consider poor that don't have $100K lying around.

Again, that's where we need to define the cost that is considered "catastrophic", and if there are metrics and baselines based on your net worth.

That's the kind of bill that could get settled in an afternoon committee session.

It's already defined and there are already plans like this. My plan is called something like a Hospitalization/Preventive plan. If something happens that is bad enough to require a hospital visit, you are covered. If you just fracture your arm and go to your local doctor to set it, you are on the hook. However paying the $2500 in the rare chance this happens, vs. paying an extra $3K annually so you are covered, seems like a no-brainer to me. And TBH.. I'm not sure that if I broke my arm and went to the ER, I wouldn't be covered, because my plan covers all hospital visits. I'm not sure they wouldn't try to wiggle out of paying for the X-Rays and such saying I didn't have to go to the ER. But I've never gone down that path.

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Does anyone have a legit list of the things most frequently missing from plans that make them noncompliant??

Specific coverage - not covering drug and alcohol rehab, and not having juvenile dental care included.

But even if both of those (and maternity) were included, if the carrier used anything more than a 3:1 age rating band/age rating curve factor, then they weren't compliant anyway.

They don't have to have pediatric dental included, but if they don't there must be a stand alone pediatric dental plan available in their service area.

Off exchange here in VA, the largest carrier is requiring pediatric dental to be included. Direct from the application sitting on my desk "You must enroll in pediatric dental coverage unless you will be enrolled in a standalone dental plan that has been certified by a state Exchange"

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Nothing gets settled quickly any more. But, more to the point, how can you (and several others) say you support it when we haven't even defined what "it" is? Covering cancer versus covering cancer as well as broken bones, torn ACLs, etc. are two vastly different coverages, and likely vastly different costs.

The beauty is in it's simplicity. You don't define what's covered and what's not. It's a financial safety net that's in place to keep your family from financial ruin.

Define a standard point (say 40K) that you hit where the government takes over the bills. Define metrics for families where the standard rate would be ruinous. Offer people small interest (2%) long term loans that could only be used for medical expenses. There are all kinds of ways that this could be handled better than Obamacare.

Again, the devil is in the details. Is the government going to define the rates that can be charged for various procedures? If not, it seems like the obvious consequence of such a bill is doctors and hospitals inflating prices to make sure the treatment goes over the catastrophic amount. If so, seems like you've got Medicare all over again, with all its attendant issues with fraud, additional "treatments", etc. Either way, now we're back where we are now, where pretty much everyone agrees that one of the big cost drivers of health care is that providers are providing all sorts of care that may not be medically necessary.

Please note, I'm not suggesting that the ACA is better than this unwritten bill, only that this is probably a lot more complex than you make it out to be, and that's it possible that once you get into the details, you end up with something vastly different than what you intended.

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