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Trumpcare- Passed the House and onto the Senate; will it pass there? And what will it finally look like? (1 Viewer)
- Thread starter timschochet
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TheMagus
Footballguy
I'm not mistrusting your judgment here, but I don't understand it. The insurance companies are losing money right now on the individual market in many cases. So given that, why are you assuming that they would work out a 5:1 formula that results in the exact same revenue they are currently bringing in? Why wouldn't they just keep the 21 year old at $300 and raise the 64 year old to $1500?
I guess somewhere in there there is a theory that if the cost is lower, more younger people will sign up. The ACA seems to have provided evidence that may not be a solid assumption and with the elimination of the personal mandate, many of those may actually drop out.
Grace Under Pressure
Footballguy
Agreed. I am reading the bills themselves (well the House bill and the Senate reconciliation technically), and have provided links here for those that want the source not the spin. As for a media source that will summarize the bill accurately, if I see an article that outlines the facts without bias I'll post it. For full disclosure I lean a bit left-of-center, but on this topic I endeavor to call it straight from the horses mouth based on the actual bills at hand.
Ilov80s
Footballguy
proteus126
Footballguy
Excellent.
So, any idea if more catastrophic plans will be available? I'd prefer to just pay for the routine stuff, but have a high cap on annual expenses for a bad year. Actual insurance, in other words.
Grace Under Pressure
Footballguy
The Kaiser Family Foundation and Kaiser Health News, while technically affiliated with an insurance company, provide a decent summary article and in general have a wealth of information on the health insurance law (both the ACA and the current proposals).
Here's the Kaiser Health News summary:
Kaiser Health News
And a link to their site which has tons of info:
Kaiser Family Foundation
The Commish
Footballguy
When does the CBO score on this latest iteration come out? I am REALLY hoping they break out those they estimate will choose to walk away and those who will be turned away because the law says so in their projections. It's an important distinction IMO.
The Commish
Footballguy
Paul, Cruz and a couple others aren't happy with it. Should be entertaining to watch 
whoknew
Footballguy
matttyl
Footballguy
Ok, right now (or at least in my initial example) it's $10,800 a year in a market where prices are going up 25% a year and carriers are dropping out left and right. That's BS, too. That's my point. I'm not saying one's better or worse, just different - and frankly both suck in a lot of ways.
The General
Footballguy
Just for the cameras and get a little press. This thing is a done deal.Paul, Cruz and a couple others aren't happy with it. Should be entertaining to watch
matttyl
Footballguy
I'm assuming the same 1,200 coming in to the carrier (from the example of only 2 insured, one age 21 and one age 64) so that it's constant, I'm trying to remove as many variables as I can. But you do bring up a solid point in the first bolded part - the insurance carriers are losing money in most cases (not many). That obviously results in premium increases, which we've seen already and will continue to see no matter what the age ratio is (either 3:1 or 5:1).
But let's hash that out a bit - say they put a 20% increase on both from my prior examples. At the 3:1 age bands the 21 year old goes from $300 to $360 and the 64 year old goes from 900 to 1,080. At the 5:1 age bands the 21 year old goes from 200/m to $240 and the 64 year old goes from 1,000 to 1,200. I think you'll gain a lot more 21 year olds signing up (and really anyone under age 40) dropping prices from $360 to $240 (a 33% reduction) than you will lose 64 year olds going from 1,080 to 1,200 (an 11% increase). Either way the prices are too high if we're being honest, but you'll get a lot more younger folks (which are needed for a stable pool) signing up at a 5:1 band.
matttyl
Footballguy
Yes, those would be more prevalent under an AHCA system. So for instance you as a guy (and your wife, I assume) in your 50s won't have to buy coverage that has maternity covered, for instance. You could also get a plan that has maybe a $10k deductible without "up front benefits" for you once a year office visit - and the costs will drop considerably.
If you're "reasonably healthy" and planning to retire around age 50, I'd say you'd more than likely want to do so under an AHCA environment than a ACA environment - but even then there are a lot of moving pieces with subsidy structure and such from what I've seen. Really just too hard to tell.
Phil Elliott
Footballguy
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ffldrew
Footballguy
Who is retiring at 50 and worrying about insurance? You are already in the 1% if that's the case - no need for subsidies or any help.
the rover
Footballguy
Dedfin
Footballguy
McConnell is a powerful man and knows this game as well as anyone. He wouldn't let it get this far without knowing how the vote goes.
SaintsInDome2006
Footballguy
Hey Matty I think the FFA has been pretty lucky to have your input on this issue over time. I used to enjoy your points, and those of BFS, Rich, Commish, TGunz and Max in the old thread. I feel like I learned a lot from everyone.
Are you personally thumbs up or down on this bill? Just curious.
Gachi
Footballguy
This bill is so bad Obama even released a statement. 
I ask myself this every day: what the hell happened to our government?
I think about crucial times in our nation's history where dems & republicans came together. 13th, 14th & 15th amendments; civil rights legislation; etc. it's unheard of these days.
I ask myself this every day: what the hell happened to our government?
I think about crucial times in our nation's history where dems & republicans came together. 13th, 14th & 15th amendments; civil rights legislation; etc. it's unheard of these days.
SaintsInDome2006
Footballguy
Well if it makes you feel any better (prolly not...) politically this HC law will probably be just as politically toxic for the GOP as the last round was for the Dems. I think the people want a consensus bill with a system that works. Impossible to do that with just one side crafting things.
Ilov80s
Footballguy
I want health care that works, I don't care how it impacts either of these dumb ### parties.
Anthony Borbely
Footballguy
proteus126
Footballguy
I should probably forego SS too.
We are DINK saver types. 1% would be awesome, but we aren't in that crowd unfortunately. Important to know your expenses in retirement. Thanks, Matty.
That's not how it works. Most people do the math on how much money they need the rest of their lives and back into how many years they have left to work. That math not only includes the cost of health care, but, health care is one of the bigger factors for obvious reasons. I was once planning on retiring at 50, now it looks more like 55 and I'm not in the 1%.
I've found that 1%ers actually work longer because they have more liability to the company.
matttyl
Footballguy
Go ask @proteus126 He brought it up. And from the sounds of it he's not in the 1% my any means. He's just trying to retire early, and from the sounds of it the ACA would have helped him do that a lot, due to it's structure (he'd have been doing so with very large subsidies).ffldrew said:
matttyl
Footballguy
That's a tough question. I'm for certain parts of it. Just like I'm for certain parts of the ACA. I'm also for certain parts of the system we had before the ACA/Obamacare.SaintsInDome2006 said:
Also something to keep in mind about this bill - much of how it (should it pass) will play out will be determined by how the states themselves implement it. So they could try it one way in which I'd give it a "thumbs up", or they could try it another in which case I'd give it a big "thumbs down". Overall, as I understand it today, it would likely be a thumbs down (just like I am on the ACA [specifically the individual market]).
Bottomfeeder Sports
Footballguy
Seems the big question is does Mitch have something up his sleeve with next week"s CBO numbers? Something that will allow the moderates to say, well this isn't nearly as bad as I thought? Maybe a changed "existing law" assumption that was possible from "the additional time" since the House scoring.
We shall see...
TobiasFunke
Footballguy
I would be very surprised if this doesn't pass. There are needlessly cruel and unpopular things in there that seem to exist entirely so moderates can claim they won concessions when they get them removed. And they're close to 50 already, there's only a handful of potential nos. And McConnell is way better at this game than Ryan. The only really vulnerable GOP senator in 2018 is Heller in Nevada, they'll promise him some plum job if he loses and get everyone in line.
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matttyl
Footballguy
Thought I'd let you know about one part of this bill that you might find particularly interesting from your prior posts. If this bill does pass, which you apparently believe it will (I'm personally not holding my breath) - then those CSR payments you've discussed will be fully funded and guaranteed for both 2018 and 2019. You've discussed the unknown nature of those CSR payments being a likely reason for up to 2/3rds of the recent rate requests. So if they are fully funded and guaranteed (as much as a guarantee is worth from our government in this situation), should we expect those rate hike requests to drop by 2/3rds? I wouldn't hold my breath for that, either.
TobiasFunke
Footballguy
Yeah, I saw that. IIRC the 2/3rds was also due to uncertainties of lax enforcement of the individual mandate (it wasn't me making the arguments, it was an accounting/consulting firm I think). If they remove that entirely I assume that will also have an impact.
Also I believe they are cutting off the CSR payments entirely after 2019; no idea how insurers account for that. Maybe they try to smooth the increases? I don't know how that would work.
matttyl
Footballguy
True, there would still be "uncertainty" due to the mandate (technically it would be a certainty that it wouldn't exist, but an uncertainty of how exactly that would affect the market).
Yes, they could cutt off CSR payments (on ACA individual plans) after 2019 as ACA individual plans would no longer exist. They'd all be AHCA (or whatever it's called) individual plans. Insurers would just price people in that income segment just they are pricing people who are currently outside of that segment. But that won't happen till 2020 - but my question would still stand about premium increases in 2018 and 2019. I believe that carriers were simply using that uncertainty as a rational for their absurdly high premium hike requests. If that uncertainty (about CSRs specifically is no longer there and they will be paid in full), I'm doubting that the carriers simply say - "oh, well then, we can lower our request from 30% down to 10%." Most are still losing money, or at least aren't making much. They are still seeing horrible adverse selection, and people continue to game the system. Those huge rate requests are still justified.
TobiasFunke
Footballguy
I'm not sure I understand your question. I assume the premium increases would be relatively lower with the guaranteed payments, but it wasn't my data or argument. I was relying on experts. If you're asking how much change to expect that would be a question for them.
Dedfin
Footballguy
This can and will be blamed on immigrants. Much of my family are recipients of CHIPS, Medicaid, many forms of governmental help. These are also people that are huge Trumpkins. I know other people in the same shoes as my family as well. Their common line is that if we didn't give all this money to immigrants, then there would be enough to go around for the white folks. They won't even entertain the idea that conservative lawmakers are screwing them.
Ilov80s
Footballguy
Yeah I saw the American Academy of Pediatrics came out against the bill
What groups have come out in favor of the bill?
matttyl
Footballguy
I think you fully understand the question, you even partially answer it with your second sentence. On June 16th you came in this thread and posted a link, and a exert from it showing that the majority of the recent and upcoming rate hikes from carriers in the individual market were due to uncertainty about CSR payments in particular. And some of these recent rate hikes are huge - 30.6% request in my home state of VA, 43.5% in Iowa, 22.3% in Washington State, 33.6% in Delaware, 25.3% in Michigan, 34.8% in Maine.
For some additional clarity, the think tank who you quoted said that the CSR payment question would along lead to 11-20% rate hikes, and the individual mandate would be around 9%. So, should this bill pass, and because this think tank came to the conclusion that 11-20% of those hikes were due to CSR uncertainty alone - should we expect those large rate hike requests above (and those yet to come) to drop by 11-20%? Or do you not agree with the conclusion that the think tank came to, that you decided to go and post here?
matttyl
Footballguy
Not sure this is true. That's roughly to the total number of children currently enrolled on Medicaid and CHIP in that state. I'm not sure this bill would eliminate 100% of their coverage. Yes, this bill will cut Medicaid funding, I get that, but not 100% of it.
Yeah, they'd be hard pressed to sell the immigrant thing here.
SC will get hit really hard with this. http://www.postandcourier.com/features/your_health/south-carolina-identified-as-a-state-that-will-struggle-most/article_e3562d10-52ac-11e7-b401-bff4668d2665.html
Dedfin
Footballguy
Ilov80s
Footballguy
Not true, everything I have seen shows insurance companies oppose it (maybe their public opinion differs from their private opinion)
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Dedfin
Footballguy
That's good, but the reasons my family/other people has don't have to make sense. None of it makes sense. The immigrant is a boogeyman anyway.
TobiasFunke
Footballguy
To the extent that the bill does nothing else to alter their figures, then obviously you would expect the rates would drop by whatever percentage they attributed to CSR uncertainty. Of course the bill does do other things to alter their figures, namely killing the individual mandate instead of just creating uncertainty about its enforcement. I'm sure there's other things in there that would alter the numbers as well. But yes, if you could hypothetically isolate the analysis to determine what would happen if legislation guaranteed CSR payments and did nothing else, you would assume rate hikes in 2018 and 2019 would be reduced accordingly.
You seem awfully defensive and confrontational, and I have no idea why. All I did was post information from an accounting firm about various causes of rate hikes. Take it easy.
Dedfin
Footballguy
If you really care about this point (I don't) I'm afraid you'll have to zoom in on the group I was referencing, because I didn't see it in your link.
Ilov80s
Footballguy
matttyl
Footballguy
I didn't mean to be confrontational or anything, just making sure I was asking the proper question, and that you understood exactly what I was asking. Since Trump was elected I thought that insurance companies would use it to blame their high rate requests on. They thought that since no one (or hardly any) people really really like Trump, he'd make a perfect scapegoat. I mean they blamed much of their earlier rate hikes on some particular things that Obama did as well (transitional plans and such).
I just mean that if Trump had come out and said that the CRS would be fully funded for as long as needed and that he would take the same stance on the mandate as Obama did (which lets be honest, wasn't that strict) that these rate hikes would still be ridiculous, because quite frankly they need to be due to the system we have.
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