Report your experience with getting insurance via ACA (1 Viewer)

[Ramsay Hunt Experience]

An individual mandate without concomitant provisions applying to insurance providers would be a disaster (it would also have been completely impossible to pass through Congress). It wouldn't address the cost of insurance for those working poor who actually ARE priced out of insurance (and they are certainly not a trivial percentage of the uninsured). It wouldn't provide any relief for those unlucky uninsured who have pre-existing conditions, who would face a mandate to purchase insurance that nobody will give them (or nobody will give them affordably). And it wouldn't address the poor sap who possibility obeys the mandate, purchases insurance, and then runs up against a lifetime cap on drugs or something.

Also, how many of those people are "priced out" or "uninsurable" because of per-existing conditions that they themselves are responsible for? What if they are uninsurable because their BMI is 25 or 30 or above? Why should I be forced to step in and provide help to people who won't help themselves? How about someone who's smoked for 20 years and now has emphysema? Again, why should I help those who choose not to help themselves?

The answer to that is that even if you deny insurance to those uninsured who have pre-existing conditions, you haven't decreased their impact on the price of health care. Because we don't turn sick people out into the streets. If I get Type 2 diabetes, nobody presses a button so that I'm just erased from existence. I continue to generate health care costs.

On the internet, I'm sure there are there are people who take the position that those sick people should just get no care. But nobody who actually has to run for office, even the craziest conservative or libertarian politician I can think of, takes that position. So it doesn't matter if that position is repellent or not. Because it's just not a possibility. It would be like me arguing that the government should take centralized control of the economy and run a Marxist state. Certain situations, on either side, are out of play.

So the way to understand the ACA is to understand that (in theory) it's only marginally a social welfare/safety net program. Instead, it's meant to be a health care cost control program. And that's what we should be arguing about. Unfortunately, very few people in here seem to understand the program well enough to even have that discussion. Because we haven't even really been arguing over whether the ACA lowers (or constrains the rise) in all health insurance costs, much less health care costs. Instead, most of the focus has been a potential rise in one small subset of health insurance premiums (which are proving mostly through quotes and not actual costs).

I posted this last night, but I'm sure it got missed. http://kaiserfamilyfoundation.files.wordpress.com/2013/08/8466-employer-health-benefits-2013_summary-of-findings2.pdf

This is a link to some current cost data about the typical total cost of health insurance in 2013. It's a nice baseline, because it gives us the average total cost of insurance for group insurance, which is what most of the insured in America are on. And it's a much better baseline to work off of than ehealth quotes.

 

[matttyl]

Chaka...I wanted to personally thank you as well as anyone else paying a little bit more to help pay for my gold plan insurance premiums next year.

You're welcome I think, but I really have no idea what point you are trying to make with that comment.

The amount I'll be paying each month will be going down. I guess technically my comment was incorrect because my base rate is also going up, so I'm in the group paying more to help others. It's just that someone will be paying a nice portion of my monthly premium.

So if/when you get a bump in pay (or if you or a spouse becomes eligible for group coverage) you will then be in the group who is actually paying more to help others. You still going to be fine with it then?

 

[TheIronSheik]

An individual mandate without concomitant provisions applying to insurance providers would be a disaster (it would also have been completely impossible to pass through Congress). It wouldn't address the cost of insurance for those working poor who actually ARE priced out of insurance (and they are certainly not a trivial percentage of the uninsured). It wouldn't provide any relief for those unlucky uninsured who have pre-existing conditions, who would face a mandate to purchase insurance that nobody will give them (or nobody will give them affordably). And it wouldn't address the poor sap who possibility obeys the mandate, purchases insurance, and then runs up against a lifetime cap on drugs or something.

Also, how many of those people are "priced out" or "uninsurable" because of per-existing conditions that they themselves are responsible for? What if they are uninsurable because their BMI is 25 or 30 or above? Why should I be forced to step in and provide help to people who won't help themselves? How about someone who's smoked for 20 years and now has emphysema? Again, why should I help those who choose not to help themselves?

The answer to that is that even if you deny insurance to those uninsured who have pre-existing conditions, you haven't decrease their impact on the price of health care. Because we don't turn sick people out into the streets. If I get Type 2 diabetes, nobody presses a button so that I'm just erased from existence. I continue to generate health care costs.

On the internet, I'm sure there are there are people who take the position that those sick people should just get no care. But nobody who actually has to run for office, even the craziest conservative or libertarian politician I can think of, takes that position. So it doesn't matter if that position is repellent or not. Because it's just no a possibility. It would be like me arguing that the government should take centralized control of the economy and run a Marxist state. Certain situations, on either side, are out of play.

So the way to understand the ACA is to understand that (in theory) it's only marginally a social welfare/safety net program. Instead, it's meant to be a health care cost control program. And that's what we should be arguing about. Unfortunately, very few people in here seem to understand the program well enough to even have that discussion. Because we haven't even really been arguing over whether the ACA lowers (on constrains the rise) in all health insurance costs, much less health care costs. Instead, most of the focus has been a potential rise in one small subset of health insurance premiums.

You guys keep saying that over time, the prices will go down.

The problem is, that's never going to happen. In theory, it sounds great. But why would these companies pass the savings on to you? What's their incentive?

 

[matttyl]

The problem is, that's never going to happen. In theory, it sounds great. But why would these companies pass the savings on to you? What's their incentive?

What companies? What savings?

 

[Ramsay Hunt Experience]

An individual mandate without concomitant provisions applying to insurance providers would be a disaster (it would also have been completely impossible to pass through Congress). It wouldn't address the cost of insurance for those working poor who actually ARE priced out of insurance (and they are certainly not a trivial percentage of the uninsured). It wouldn't provide any relief for those unlucky uninsured who have pre-existing conditions, who would face a mandate to purchase insurance that nobody will give them (or nobody will give them affordably). And it wouldn't address the poor sap who possibility obeys the mandate, purchases insurance, and then runs up against a lifetime cap on drugs or something.

Also, how many of those people are "priced out" or "uninsurable" because of per-existing conditions that they themselves are responsible for? What if they are uninsurable because their BMI is 25 or 30 or above? Why should I be forced to step in and provide help to people who won't help themselves? How about someone who's smoked for 20 years and now has emphysema? Again, why should I help those who choose not to help themselves?

The answer to that is that even if you deny insurance to those uninsured who have pre-existing conditions, you haven't decrease their impact on the price of health care. Because we don't turn sick people out into the streets. If I get Type 2 diabetes, nobody presses a button so that I'm just erased from existence. I continue to generate health care costs.

On the internet, I'm sure there are there are people who take the position that those sick people should just get no care. But nobody who actually has to run for office, even the craziest conservative or libertarian politician I can think of, takes that position. So it doesn't matter if that position is repellent or not. Because it's just no a possibility. It would be like me arguing that the government should take centralized control of the economy and run a Marxist state. Certain situations, on either side, are out of play.

So the way to understand the ACA is to understand that (in theory) it's only marginally a social welfare/safety net program. Instead, it's meant to be a health care cost control program. And that's what we should be arguing about. Unfortunately, very few people in here seem to understand the program well enough to even have that discussion. Because we haven't even really been arguing over whether the ACA lowers (on constrains the rise) in all health insurance costs, much less health care costs. Instead, most of the focus has been a potential rise in one small subset of health insurance premiums.

You guys keep saying that over time, the prices will go down.

The problem is, that's never going to happen. In theory, it sounds great. But why would these companies pass the savings on to you? What's their incentive?

The same reason any other company passes savings on to the consumer. Because so long as there is a surplus, that company can lose market share by being undercut on price. That's what market theory is. Obviously there are all kinds of market inefficiencies that come into play, but the entire idea behind keeping an insurance market is to keep price competition.

 

[Woogie Lee]

I know this isn't going to be the most popular opinion, but at some point I do say #### the poor because supporting everyone else is degrading MY quality of life.

Schlzm

Yes....poor you.

 

[Ramsay Hunt Experience]

You guys keep saying that over time, the prices will go down.


The problem is, that's never going to happen. In theory, it sounds great. But why would these companies pass the savings on to you? What's their incentive?

Just curious. You seem pretty convinced that the cost of your insurance is more under the ACA than the hypothetical state without the ACA. What has persuaded you of this?

 

[matttyl]

You guys keep saying that over time, the prices will go down.


The problem is, that's never going to happen. In theory, it sounds great. But why would these companies pass the savings on to you? What's their incentive?

Just curious. You seem pretty convinced that the cost of your insurance is more under the ACA than the hypothetical state without the ACA. What has persuaded you of this?

Guaranteed issue and the elimination of pre-ex. Every single time those two factors have been introduced into a previously underwritten health insurance market place, prices go up for the already insured.

 

[TheIronSheik]

The problem is, that's never going to happen. In theory, it sounds great. But why would these companies pass the savings on to you? What's their incentive?

What companies? What savings?

I was referring to people saying that in the long run, premiums will go down because people without insurance will now be covered. I don't get why people are convinced that premiums would go down for anyone over time.

 

[matttyl]

The problem is, that's never going to happen. In theory, it sounds great. But why would these companies pass the savings on to you? What's their incentive?

What companies? What savings?

I was referring to people saying that in the long run, premiums will go down because people without insurance will now be covered. I don't get why people are convinced that premiums would go down for anyone over time.

They won't. It was just a promise to get this law passed.

 

[Schlzm]

I know this isn't going to be the most popular opinion, but at some point I do say #### the poor because supporting everyone else is degrading MY quality of life.

Schlzm

Yes....poor you.

Not yet, but after enough of these "little increases" and paying my "fair share" I will be.Schlzm

 

[Ramsay Hunt Experience]

You guys keep saying that over time, the prices will go down.


The problem is, that's never going to happen. In theory, it sounds great. But why would these companies pass the savings on to you? What's their incentive?

Just curious. You seem pretty convinced that the cost of your insurance is more under the ACA than the hypothetical state without the ACA. What has persuaded you of this?

Guaranteed issue and the elimination of pre-ex. Every single time those two factors have been introduced into a previously underwritten health insurance market place, prices go up for the already insured.

So no actual data?

Leading health economists predict this will constrain costs. Forbes, who is obviously against the plan, seems to concede that it will lower premiums for most people (they predict higher deductibles and co-pays, which seems like a safe guess because the movement to higher deductible plans seems be inevitable anyway).

I took the challenge. I created by healthcare.gov account and shopped around at policies on the DC site. For reference, I am covered by my wife's insurance. We have a moderately high deductible plan. Under the exchanges, I could get a Gold level plan that is roughly comparable for a bit less than the total cost of that insurance (including firm contribution) in 2013. That gold level plan was also less than the average total cost of insurance for a family plan reported in the Kaiser Family survey I posted above.

As I mentioned last night, the plans were much higher than some quotes from ehealth. Unfortunately, I can't buy the exchange plan at the quoted price and the ehealth plan at the quoted price, complete my application and report as to the actual cost I would pay. My suspicion is that ehealth quotes deviate pretty sharply from the actual cost (as I said last night, if they don't then all the smart people who select health insurance plans for Fortune 100 companies and sophisticated law firms are apparently idiots). But I obviously don't KNOW that and can't prove that. The point is that it doesn't matter. Because individually purchased underwritten insurance represents a very small slice of the health insurance that is currently possessed by Americans. Most people don't have those plans, so we can't argue that most people's costs will rise based upon what happens with those plans.

 

[Chaka]

So I am reading this as you being opposed to providing food, shelter, clothing, water and medical care to the most desperate American citizens? And this is because you think the market and private charity will provide for them?

Where do you stand on police protection, fire protection and education of America's youth?

No, I'm not opposed to any of it (in general). I was really just asking where we draw the line. We need to protect, educate, feed, shelter and so forth for our population. Is health insurance a "right"? Is it also a requirement? Where does freedom of choice come in? If someone's freedom of choice has left them overweight and uninsurable, why is that my problem to resolve (pay for)?

You do realize that you are still paying for the overweight & uninsurable, right?

I also hope you realize that all medical problems are not a result of choice.

 

[Chaka]

I know this isn't going to be the most popular opinion, but at some point I do say #### the poor because supporting everyone else is degrading MY quality of life.

Schlzm

Ya know, I'm sure it could have been said a little more eloquently, but I tend to agree with you.

And this is why private charity/market based solutions have failed.

It is shameful that a country as prosperous as ours has homeless, starving citizens who cannot afford health care.

 

[Woogie Lee]

I know this isn't going to be the most popular opinion, but at some point I do say #### the poor because supporting everyone else is degrading MY quality of life.

Schlzm

Yes....poor you.

Not yet, but after enough of these "little increases" and paying my "fair share" I will be.Schlzm

Keep us posted.

~Woogie~

 

[Chaka]

An individual mandate without concomitant provisions applying to insurance providers would be a disaster (it would also have been completely impossible to pass through Congress). It wouldn't address the cost of insurance for those working poor who actually ARE priced out of insurance (and they are certainly not a trivial percentage of the uninsured). It wouldn't provide any relief for those unlucky uninsured who have pre-existing conditions, who would face a mandate to purchase insurance that nobody will give them (or nobody will give them affordably). And it wouldn't address the poor sap who possibility obeys the mandate, purchases insurance, and then runs up against a lifetime cap on drugs or something.

Also, how many of those people are "priced out" or "uninsurable" because of per-existing conditions that they themselves are responsible for? What if they are uninsurable because their BMI is 25 or 30 or above? Why should I be forced to step in and provide help to people who won't help themselves? How about someone who's smoked for 20 years and now has emphysema? Again, why should I help those who choose not to help themselves?

The answer to that is that even if you deny insurance to those uninsured who have pre-existing conditions, you haven't decrease their impact on the price of health care. Because we don't turn sick people out into the streets. If I get Type 2 diabetes, nobody presses a button so that I'm just erased from existence. I continue to generate health care costs.

On the internet, I'm sure there are there are people who take the position that those sick people should just get no care. But nobody who actually has to run for office, even the craziest conservative or libertarian politician I can think of, takes that position. So it doesn't matter if that position is repellent or not. Because it's just no a possibility. It would be like me arguing that the government should take centralized control of the economy and run a Marxist state. Certain situations, on either side, are out of play.

So the way to understand the ACA is to understand that (in theory) it's only marginally a social welfare/safety net program. Instead, it's meant to be a health care cost control program. And that's what we should be arguing about. Unfortunately, very few people in here seem to understand the program well enough to even have that discussion. Because we haven't even really been arguing over whether the ACA lowers (on constrains the rise) in all health insurance costs, much less health care costs. Instead, most of the focus has been a potential rise in one small subset of health insurance premiums.

You guys keep saying that over time, the prices will go down.

The problem is, that's never going to happen. In theory, it sounds great. But why would these companies pass the savings on to you? What's their incentive?

The cost of medical care under the "old" model wasn't exactly dropping.

 

[matttyl]

You guys keep saying that over time, the prices will go down.


The problem is, that's never going to happen. In theory, it sounds great. But why would these companies pass the savings on to you? What's their incentive?

Just curious. You seem pretty convinced that the cost of your insurance is more under the ACA than the hypothetical state without the ACA. What has persuaded you of this?

Guaranteed issue and the elimination of pre-ex. Every single time those two factors have been introduced into a previously underwritten health insurance market place, prices go up for the already insured.

So no actual data?

I'm sorry, I gave you the data - every single state that has gone to a guaranteed issue and no pre-ex has had prices rise. Look at New York. Look at Massachusetts. Look at Maine. Look at Vermont. Kentucky and New Hampshire both went guaranteed issue, and had to repeal the law. South Dakota had to as well after their individual market literally collapsed on itself.

Good reading - http://ahipcoverage.com/wp-content/uploads/2012/03/Updated-Milliman-Report.pdf

 

[Schlzm]

I know this isn't going to be the most popular opinion, but at some point I do say #### the poor because supporting everyone else is degrading MY quality of life.

Schlzm

Ya know, I'm sure it could have been said a little more eloquently, but I tend to agree with you.

And this is why private charity/market based solutions have failed.It is shameful that a country as prosperous as ours has homeless, starving citizens who cannot afford health care.

That is not why charity is trailing off. The more people are forced to give the less likely they will volentarily give. I would blame greed, inefficiency and mismanagement of government programs at all levels as the primary driver for why there are still so many people barely surviving. Also there will always be that portion of society who choose to be where they are, other than prison there is no way to change that.Schlzm

 

[matttyl]

You do realize that you are still paying for the overweight & uninsurable, right?

I also hope you realize that all medical problems are not a result of choice.

On the first part - honestly and seriously, explain to me how I still pay that.

On the second part - Over 50% are. Studies show that.

 

[Ramsay Hunt Experience]

The problem is, that's never going to happen. In theory, it sounds great. But why would these companies pass the savings on to you? What's their incentive?

What companies? What savings?

I was referring to people saying that in the long run, premiums will go down because people without insurance will now be covered. I don't get why people are convinced that premiums would go down for anyone over time.

I think it's more accurate to say that they think that costs will be constrained. If premiums rise 2% a year for the next five years, that's a constraint on cost because they've been rising faster than that for the last decade. One reason people think that premiums will fall in the non-group market is because that's what's happened in Massachusetts (at least in the individual market).

But mostly, they think that costs will go down because competition will increase. By most estimates, the ACA puts 30 million new consumers in the individual market. With thirty million more consumers to chase, more firms will enter the individual market (and we've already seen that, as many insurance carriers that had only been in the group market have moved into the individual market).

FWIW, here is a decent, only semi-technical read on the subject from an economist at MIT. http://economics.mit.edu/files/6829

 

[BassNBrew]

Chaka...I wanted to personally thank you as well as anyone else paying a little bit more to help pay for my gold plan insurance premiums next year.

You're welcome I think, but I really have no idea what point you are trying to make with that comment.

The amount I'll be paying each month will be going down. I guess technically my comment was incorrect because my base rate is also going up, so I'm in the group paying more to help others. It's just that someone will be paying a nice portion of my monthly premium.

So if/when you get a bump in pay (or if you or a spouse becomes eligible for group coverage) you will then be in the group who is actually paying more to help others. You still going to be fine with it then?

Real estate depreciation is the key to avoiding this. I not sure that's what they had in mind for health care reform.

 

[Chaka]

You do realize that you are still paying for the overweight & uninsurable, right?

I also hope you realize that all medical problems are not a result of choice.

On the first part - honestly and seriously, explain to me how I still pay that.

On the second part - Over 50% are. Studies show that.

On the first one the costs get passed on and medical costs rise. You act like medical costs had been dropping before the ACA.

On the second one you are going back to the notion that because some things are a choice then #### everyone. Nice.

 

[BassNBrew]

The System is down at the moment.We're working to resolve the issue as soon as possible. Please try again later.

 

[Schlzm]

You do realize that you are still paying for the overweight & uninsurable, right?

I also hope you realize that all medical problems are not a result of choice.

On the first part - honestly and seriously, explain to me how I still pay that.On the second part - Over 50% are. Studies show that.

On the first one the costs get passed on and medical costs rise. You act like medical costs had been dropping before the ACA.On the second one you are going back to the notion that because some things are a choice then #### everyone. Nice.

You shoot yourself in the foot intentionally I'm not paying for it. Stop using the all or nothing argument for this, it's weak at best. "Oh so because you don't want to pay for some lazy fat smoker to stay a lazy fat smoker then I guess you would rather we have death squads roaming the streets killing off anyone and everyone who can't take care of themselves you hearltess monster!"Schlzm

 

[BassNBrew]

Just submitted my application and it took. The eligibility result link wouldn't work. I called the market place and they said it was a glitch and to try back in a couple of days. They did confirm that I'm getting a $290 subsidy.

I guess I'll be able to look at my options once that's working. I had thought I would be able to keep something that resembled my previous plan, but that may not be case. I may lose grandfathered status by taking a subsidy.

 

[Ramsay Hunt Experience]

You guys keep saying that over time, the prices will go down.


The problem is, that's never going to happen. In theory, it sounds great. But why would these companies pass the savings on to you? What's their incentive?

Just curious. You seem pretty convinced that the cost of your insurance is more under the ACA than the hypothetical state without the ACA. What has persuaded you of this?

Guaranteed issue and the elimination of pre-ex. Every single time those two factors have been introduced into a previously underwritten health insurance market place, prices go up for the already insured.

So no actual data?

I'm sorry, I gave you the data - every single state that has gone to a guaranteed issue and no pre-ex has had prices rise. Look at New York. Look at Massachusetts. Look at Maine. Look at Vermont. Kentucky and New Hampshire both went guaranteed issue, and had to repeal the law. South Dakota had to as well after their individual market literally collapsed on itself.

Good reading - http://ahipcoverage.com/wp-content/uploads/2012/03/Updated-Milliman-Report.pdf

Based upon a quick review of the executive summary and the entry for Massachusetts, you seem to be misreading this report. From what I see, that report isn't evaluating systems like the ACA at all. It is evaluating the implementation of Guaranteed Issue and Community Rating in several states in the 1990s. As the report states, "[g]uaranteed issue encourages people to wait until they have health problems to buy insurance." This was a big problem with many 1990s reforms, including one in Massachusetts. But Massachusetts instituted another reform, RomneyCare, in 2006. As people may gather, one feature of RomneyCare, which is shared by the ACA, is designed to directly address the chief problem with Guaranteed Issue. The free rider problem identified above. That feature is the individual mandate.

I can find very little criticism of RomneyCare from you own source. When discussing the 2006 Massachusetts reform the paper states, "[v]arious reports indicate a reduction of the individual market premium, due to the merger with the small group market, ranging from 20% to 33%."

I can find several other sources that report the same thing. Individual insurance premiums in Massachusetts have gone down at a time when they have increased throughout the country.

I'll read the other case studies a bit more closely, but I'm reasonably certain that Massachusetts was the first, and the only, state to enact an individual mandate. Which makes your source not particularly useful to this discussion.

 

[Chaka]

You do realize that you are still paying for the overweight & uninsurable, right?

I also hope you realize that all medical problems are not a result of choice.

On the first part - honestly and seriously, explain to me how I still pay that.On the second part - Over 50% are. Studies show that.

On the first one the costs get passed on and medical costs rise. You act like medical costs had been dropping before the ACA.On the second one you are going back to the notion that because some things are a choice then #### everyone. Nice.

You shoot yourself in the foot intentionally I'm not paying for it. Stop using the all or nothing argument for this, it's weak at best. "Oh so because you don't want to pay for some lazy fat smoker to stay a lazy fat smoker then I guess you would rather we have death squads roaming the streets killing off anyone and everyone who can't take care of themselves you hearltess monster!"Schlzm

"shoot yourself in the foot intentionally" Huh? Wow.

That is not at all what I am saying and I am pretty sure you know that.

I see the position as you "don't want to pay for the lazy fat smoker AND you don't want to pay for the person with brain cancer, or the person who was hit by a drunk driver." Nothing about death panels or killing people, just not wanting to pay for anyone else's medical care. Is that an incorrect conclusion from those posts?

Tell me where the argument was made that you "don't want to pay for the lazy fat smoker BUT here are my ideas for caring for those with non-preventable medical problems." I am interested in hearing those solutions.

 

[Schlzm]

You do realize that you are still paying for the overweight & uninsurable, right?

I also hope you realize that all medical problems are not a result of choice.

On the first part - honestly and seriously, explain to me how I still pay that.On the second part - Over 50% are. Studies show that.

On the first one the costs get passed on and medical costs rise. You act like medical costs had been dropping before the ACA.On the second one you are going back to the notion that because some things are a choice then #### everyone. Nice.

You shoot yourself in the foot intentionally I'm not paying for it. Stop using the all or nothing argument for this, it's weak at best. "Oh so because you don't want to pay for some lazy fat smoker to stay a lazy fat smoker then I guess you would rather we have death squads roaming the streets killing off anyone and everyone who can't take care of themselves you hearltess monster!"Schlzm

"shoot yourself in the foot intentionally" Huh? Wow.That is not at all what I am saying and I am pretty sure you know that.

I see the position as you "don't want to pay for the lazy fat smoker AND you don't want to pay for the person with brain cancer, or the person who was hit by a drunk driver." Nothing about death panels or killing people, just not wanting to pay for anyone else's medical care. Is that an incorrect conclusion from those posts?

Tell me where the argument was made that you "don't want to pay for the lazy fat smoker BUT here are my ideas for caring for those with non-preventable medical problems." I am interested in hearing those solutions.

You're the only one making the implication that it's an all or nothing decision. See what you typed in bold above. Pretty much everyone else involved in this discussion is saying #### *that* guy for eating poison and smashing bottles over his head, everyone else who is just in a really unfortunate situation, come over here and let's see what we can do.Schlzm

 

[Chaka]

You do realize that you are still paying for the overweight & uninsurable, right?

I also hope you realize that all medical problems are not a result of choice.

On the first part - honestly and seriously, explain to me how I still pay that.On the second part - Over 50% are. Studies show that.

On the first one the costs get passed on and medical costs rise. You act like medical costs had been dropping before the ACA.On the second one you are going back to the notion that because some things are a choice then #### everyone. Nice.

You shoot yourself in the foot intentionally I'm not paying for it. Stop using the all or nothing argument for this, it's weak at best. "Oh so because you don't want to pay for some lazy fat smoker to stay a lazy fat smoker then I guess you would rather we have death squads roaming the streets killing off anyone and everyone who can't take care of themselves you hearltess monster!"Schlzm

"shoot yourself in the foot intentionally" Huh? Wow.That is not at all what I am saying and I am pretty sure you know that.

I see the position as you "don't want to pay for the lazy fat smoker AND you don't want to pay for the person with brain cancer, or the person who was hit by a drunk driver." Nothing about death panels or killing people, just not wanting to pay for anyone else's medical care. Is that an incorrect conclusion from those posts?

Tell me where the argument was made that you "don't want to pay for the lazy fat smoker BUT here are my ideas for caring for those with non-preventable medical problems." I am interested in hearing those solutions.

You're the only one making the implication that it's an all or nothing decision. See what you typed in bold above. Pretty much everyone else involved in this discussion is saying #### *that* guy for eating poison and smashing bottles over his head, everyone else who is just in a really unfortunate situation, come over here and let's see what we can do.Schlzm

So if not the ACA then what can we do for them?

 

[tommyGunZ]

Scoob, it's great to have you back. You were missed.

 

[Schlzm]

You do realize that you are still paying for the overweight & uninsurable, right?

I also hope you realize that all medical problems are not a result of choice.

On the first part - honestly and seriously, explain to me how I still pay that.On the second part - Over 50% are. Studies show that.

On the first one the costs get passed on and medical costs rise. You act like medical costs had been dropping before the ACA.On the second one you are going back to the notion that because some things are a choice then #### everyone. Nice.

You shoot yourself in the foot intentionally I'm not paying for it. Stop using the all or nothing argument for this, it's weak at best. "Oh so because you don't want to pay for some lazy fat smoker to stay a lazy fat smoker then I guess you would rather we have death squads roaming the streets killing off anyone and everyone who can't take care of themselves you hearltess monster!"Schlzm

"shoot yourself in the foot intentionally" Huh? Wow.That is not at all what I am saying and I am pretty sure you know that.

I see the position as you "don't want to pay for the lazy fat smoker AND you don't want to pay for the person with brain cancer, or the person who was hit by a drunk driver." Nothing about death panels or killing people, just not wanting to pay for anyone else's medical care. Is that an incorrect conclusion from those posts?

Tell me where the argument was made that you "don't want to pay for the lazy fat smoker BUT here are my ideas for caring for those with non-preventable medical problems." I am interested in hearing those solutions.

You're the only one making the implication that it's an all or nothing decision. See what you typed in bold above. Pretty much everyone else involved in this discussion is saying #### *that* guy for eating poison and smashing bottles over his head, everyone else who is just in a really unfortunate situation, come over here and let's see what we can do.Schlzm

So if not the ACA then what can we do for them?

First off we shouldn't pass laws and then let people <entities> buy their way out of them. Also there are portions of the ACA that are a pretty good start at getting our healthcare system where it functions at it's best, however there are also huge parts that really don't help anyone long term or based on a series of speculations and what if's, which if don't come to fruition really jeapordize the entire system. Also to truly get things in line we need to look at how many other areas of our country are run, not just the healthcare sectors.Schlzm

 

[Statorama]

I took the challenge. I created by healthcare.gov account and shopped around at policies on the DC site.

CBS reports: Healthcare.gov gives out wrong information on its estimated insurance costs

Prices for everyone in the 49-or-under group are based on what a 27-year-old would pay. In the 50-or-older group, prices are based on what a 50-year-old would pay.

CBS News ran the numbers for a 48-year-old in Charlotte, N.C., ineligible for subsidies. According to HealthCare.gov, she would pay $231 a month, but the actual plan on Blue Cross and Blue Shield of North Carolina's website costs $360, more than 50 percent higher. The difference: Blue Cross and Blue Shield requests your birthday before providing more accurate estimates.

The numbers for older Americans are even more striking. A 62-year-old in Charlotte looking for the same basic plan would get a price estimate on the government website of $394. The actual price is $634.

 

[Chaka]

You do realize that you are still paying for the overweight & uninsurable, right?

I also hope you realize that all medical problems are not a result of choice.

On the first part - honestly and seriously, explain to me how I still pay that.On the second part - Over 50% are. Studies show that.

On the first one the costs get passed on and medical costs rise. You act like medical costs had been dropping before the ACA.On the second one you are going back to the notion that because some things are a choice then #### everyone. Nice.

You shoot yourself in the foot intentionally I'm not paying for it. Stop using the all or nothing argument for this, it's weak at best. "Oh so because you don't want to pay for some lazy fat smoker to stay a lazy fat smoker then I guess you would rather we have death squads roaming the streets killing off anyone and everyone who can't take care of themselves you hearltess monster!"Schlzm

"shoot yourself in the foot intentionally" Huh? Wow.That is not at all what I am saying and I am pretty sure you know that.

I see the position as you "don't want to pay for the lazy fat smoker AND you don't want to pay for the person with brain cancer, or the person who was hit by a drunk driver." Nothing about death panels or killing people, just not wanting to pay for anyone else's medical care. Is that an incorrect conclusion from those posts?

Tell me where the argument was made that you "don't want to pay for the lazy fat smoker BUT here are my ideas for caring for those with non-preventable medical problems." I am interested in hearing those solutions.

You're the only one making the implication that it's an all or nothing decision. See what you typed in bold above. Pretty much everyone else involved in this discussion is saying #### *that* guy for eating poison and smashing bottles over his head, everyone else who is just in a really unfortunate situation, come over here and let's see what we can do.Schlzm

So if not the ACA then what can we do for them?

First off we shouldn't pass laws and then let people <entities> buy their way out of them. Also there are portions of the ACA that are a pretty good start at getting our healthcare system where it functions at it's best, however there are also huge parts that really don't help anyone long term or based on a series of speculations and what if's, which if don't come to fruition really jeapordize the entire system. Also to truly get things in line we need to look at how many other areas of our country are run, not just the healthcare sectors.Schlzm

Thanks for telling us what's wrong with the ACA, how about telling us how you plan to help the people we are talking about absent the ACA? I have other options but I am curious to hear yours.

 

[Schlzm]

You do realize that you are still paying for the overweight & uninsurable, right?

I also hope you realize that all medical problems are not a result of choice.

On the first part - honestly and seriously, explain to me how I still pay that.On the second part - Over 50% are. Studies show that.

On the first one the costs get passed on and medical costs rise. You act like medical costs had been dropping before the ACA.On the second one you are going back to the notion that because some things are a choice then #### everyone. Nice.

You shoot yourself in the foot intentionally I'm not paying for it. Stop using the all or nothing argument for this, it's weak at best. "Oh so because you don't want to pay for some lazy fat smoker to stay a lazy fat smoker then I guess you would rather we have death squads roaming the streets killing off anyone and everyone who can't take care of themselves you hearltess monster!"Schlzm

"shoot yourself in the foot intentionally" Huh? Wow.That is not at all what I am saying and I am pretty sure you know that.

I see the position as you "don't want to pay for the lazy fat smoker AND you don't want to pay for the person with brain cancer, or the person who was hit by a drunk driver." Nothing about death panels or killing people, just not wanting to pay for anyone else's medical care. Is that an incorrect conclusion from those posts?

Tell me where the argument was made that you "don't want to pay for the lazy fat smoker BUT here are my ideas for caring for those with non-preventable medical problems." I am interested in hearing those solutions.

You're the only one making the implication that it's an all or nothing decision. See what you typed in bold above. Pretty much everyone else involved in this discussion is saying #### *that* guy for eating poison and smashing bottles over his head, everyone else who is just in a really unfortunate situation, come over here and let's see what we can do.Schlzm

So if not the ACA then what can we do for them?

First off we shouldn't pass laws and then let people <entities> buy their way out of them. Also there are portions of the ACA that are a pretty good start at getting our healthcare system where it functions at it's best, however there are also huge parts that really don't help anyone long term or based on a series of speculations and what if's, which if don't come to fruition really jeapordize the entire system. Also to truly get things in line we need to look at how many other areas of our country are run, not just the healthcare sectors.Schlzm

Thanks for telling us what's wrong with the ACA, how about telling us how you plan to help the people we are talking about absent the ACA? I have other options but I am curious to hear yours.

How do I plan on helping out people who actually need it? I'll keep paying my ever increasing monetary obligations as dictated by those who feel they are above such petty nonsense. I will keep voting for laws and people that I think will properly balance needs and means vs. methods and actions. I will continue to be active in debate while also keeping myself educated about what is actually happening as opposed to being told what is happening. I will continue to do these things until the weight of doing so is unbearable, at that point I am planning on selling everything I can't take with me and buying a nice boat and becoming a carribean nomad taking money where I can.Schlzm

 

[Schlzm]

I know this isn't going to be the most popular opinion, but at some point I do say #### the poor because supporting everyone else is degrading MY quality of life.

Schlzm

Yes....poor you.

I've decided to revisit this, since beer sampler etc... But seriously, I can try and lookout for my fellows but not at the livelyhood expense of me and my own, I already do that in other ways that the majority in this country aren't willing to do. Yeah it's really easy for you to to say "poor you" in this environment, but we don't know eachothers realities so honestly keep laughing, but I'm not going to put up with this #### for long if we keep trending this way. How long to you expect the people who actually pay for this crap to keep paying for this crap? How long until the bearers of the burden just say enough is enough?Schlzm

 

[avoiding injuries]

I took the challenge. I created by healthcare.gov account and shopped around at policies on the DC site.

CBS reports: Healthcare.gov gives out wrong information on its estimated insurance costs

Prices for everyone in the 49-or-under group are based on what a 27-year-old would pay. In the 50-or-older group, prices are based on what a 50-year-old would pay.

CBS News ran the numbers for a 48-year-old in Charlotte, N.C., ineligible for subsidies. According to HealthCare.gov, she would pay $231 a month, but the actual plan on Blue Cross and Blue Shield of North Carolina's website costs $360, more than 50 percent higher. The difference: Blue Cross and Blue Shield requests your birthday before providing more accurate estimates.

The numbers for older Americans are even more striking. A 62-year-old in Charlotte looking for the same basic plan would get a price estimate on the government website of $394. The actual price is $634.

It's one thing for this roll out to be incompetent. It's on a completely different level if it is also dishonest and misleading.

 

[Ramsay Hunt Experience]

I took the challenge. I created by healthcare.gov account and shopped around at policies on the DC site.

CBS reports: Healthcare.gov gives out wrong information on its estimated insurance costs

Prices for everyone in the 49-or-under group are based on what a 27-year-old would pay. In the 50-or-older group, prices are based on what a 50-year-old would pay.

CBS News ran the numbers for a 48-year-old in Charlotte, N.C., ineligible for subsidies. According to HealthCare.gov, she would pay $231 a month, but the actual plan on Blue Cross and Blue Shield of North Carolina's website costs $360, more than 50 percent higher. The difference: Blue Cross and Blue Shield requests your birthday before providing more accurate estimates.

The numbers for older Americans are even more striking. A 62-year-old in Charlotte looking for the same basic plan would get a price estimate on the government website of $394. The actual price is $634.

That's describing shop and browse, the new anonymous shopper component. I created an account.

 

[Foosball God]

I took the challenge. I created by healthcare.gov account and shopped around at policies on the DC site.

CBS reports: Healthcare.gov gives out wrong information on its estimated insurance costs

Prices for everyone in the 49-or-under group are based on what a 27-year-old would pay. In the 50-or-older group, prices are based on what a 50-year-old would pay.

CBS News ran the numbers for a 48-year-old in Charlotte, N.C., ineligible for subsidies. According to HealthCare.gov, she would pay $231 a month, but the actual plan on Blue Cross and Blue Shield of North Carolina's website costs $360, more than 50 percent higher. The difference: Blue Cross and Blue Shield requests your birthday before providing more accurate estimates.

The numbers for older Americans are even more striking. A 62-year-old in Charlotte looking for the same basic plan would get a price estimate on the government website of $394. The actual price is $634.

This is only with the new "anonymous shopper" tool, not for people who actually entered their information.

 

[Ramsay Hunt Experience]

For fun, I just played around with the shop and browse feature on the DC site. It definitely did make a huge change between entering my real age (41) and then using 50. When I entered my real age, the quotes were around what I saw on ehealth (I suspect this trick of putting the age into large pots is common on web-based quotes). When I entered 50, the quotes were indeed much larger. For a single plan the quotes were a bit above the national group plan average (a bit under $6K) for total cost of insurance. Interestingly, when I entered my wife and I both at 50 years old, the quotes using the shop and browse for a "Gold" level family plan was still slightly under the national group plan average.

So I don't endorse the the shop and browse feature. I understand that HHS heard complaints from people who thought it was wrong to have create an account to see the plans (some people complained about that on this board). I think HHS should have stood their ground. They implemented a misleading quote system that seems to be used in the industry, but I expect more from government.

 

[Ramsay Hunt Experience]

You guys keep saying that over time, the prices will go down.


The problem is, that's never going to happen. In theory, it sounds great. But why would these companies pass the savings on to you? What's their incentive?

Just curious. You seem pretty convinced that the cost of your insurance is more under the ACA than the hypothetical state without the ACA. What has persuaded you of this?

Guaranteed issue and the elimination of pre-ex. Every single time those two factors have been introduced into a previously underwritten health insurance market place, prices go up for the already insured.

So no actual data?

I'm sorry, I gave you the data - every single state that has gone to a guaranteed issue and no pre-ex has had prices rise. Look at New York. Look at Massachusetts. Look at Maine. Look at Vermont. Kentucky and New Hampshire both went guaranteed issue, and had to repeal the law. South Dakota had to as well after their individual market literally collapsed on itself.

Good reading - http://ahipcoverage.com/wp-content/uploads/2012/03/Updated-Milliman-Report.pdf

Based upon a quick review of the executive summary and the entry for Massachusetts, you seem to be misreading this report. From what I see, that report isn't evaluating systems like the ACA at all. It is evaluating the implementation of Guaranteed Issue and Community Rating in several states in the 1990s. As the report states, "[g]uaranteed issue encourages people to wait until they have health problems to buy insurance." This was a big problem with many 1990s reforms, including one in Massachusetts. But Massachusetts instituted another reform, RomneyCare, in 2006. As people may gather, one feature of RomneyCare, which is shared by the ACA, is designed to directly address the chief problem with Guaranteed Issue. The free rider problem identified above. That feature is the individual mandate.

I can find very little criticism of RomneyCare from you own source. When discussing the 2006 Massachusetts reform the paper states, "[v]arious reports indicate a reduction of the individual market premium, due to the merger with the small group market, ranging from 20% to 33%."

I can find several other sources that report the same thing. Individual insurance premiums in Massachusetts have gone down at a time when they have increased throughout the country.

I'll read the other case studies a bit more closely, but I'm reasonably certain that Massachusetts was the first, and the only, state to enact an individual mandate. Which makes your source not particularly useful to this discussion.

I'm bumping this because I'd like to give matty the ability to show how the analysis in his posted whitepaper relates to the ACA.

I'm trying to not assume the worst out of posters, but it's a little strange to see that he had no answer for why his posted white paper would support his claim that premiums are going to rise in this thread, but has since repeated his very specific claim that rates will rise "80%" in the thread about the website problems.

I'm sure he just missed this and isn't being a weasel by posting about in another thread that isn't even supposed to be about the cost of premiums.

 

[matttyl]

But mostly, they think that costs will go down because competition will increase. By most estimates, the ACA puts 30 million new consumers in the individual market. With thirty million more consumers to chase, more firms will enter the individual market (and we've already seen that, as many insurance carriers that had only been in the group market have moved into the individual market).

FWIW, here is a decent, only semi-technical read on the subject from an economist at MIT. http://economics.mit.edu/files/6829

Sounds great in theory, unfortunately the exact opposite has actually occurred. Carriers which had been in the individual market are leaving that market now. Aetna has dropped out of a handfull of states, including the very state they are based in. Other carriers are doing the same.

 

[Ramsay Hunt Experience]

But mostly, they think that costs will go down because competition will increase. By most estimates, the ACA puts 30 million new consumers in the individual market. With thirty million more consumers to chase, more firms will enter the individual market (and we've already seen that, as many insurance carriers that had only been in the group market have moved into the individual market).

FWIW, here is a decent, only semi-technical read on the subject from an economist at MIT. http://economics.mit.edu/files/6829

Sounds great in theory, unfortunately the exact opposite has actually occurred. Carriers which had been in the individual market are leaving that market now. Aetna has dropped out of a handfull of states, including the very state they are based in. Other carriers are doing the same.

Here's what Aetna said.

"We have spent considerable time identifying those states in which we can be competitive and add the most value to the market."

So they've dropped out of some state exchanges because the competition was too good. I fail to see how we should consider that a bad thing for consumers.

 

[matttyl]

You do realize that you are still paying for the overweight & uninsurable, right?

I also hope you realize that all medical problems are not a result of choice.

On the first part - honestly and seriously, explain to me how I still pay that.

On the second part - Over 50% are. Studies show that.

On the first one the costs get passed on and medical costs rise. You act like medical costs had been dropping before the ACA.

On the second one you are going back to the notion that because some things are a choice then #### everyone. Nice.

On the first, no I'm not. I'm acknowledging that prices have been increasing. As for me paying for it already - that's fine and apparently I'm doing so at $112 a month which my individual (not group) coverage costs me now. So why will my premium double when I will still be paying for them? That's my point. If I'm already paying for them, then why are my prices now all of a sudden going to double when I'm still paying for them?

On the second part - yes, very much so. I take care of myself, my BMI is in a very healthy range. In my younger days I even ran marathons as a hobby. I'm very fit and make health lifestyle choices. Shouldn't I pay less for health insurance than someone who doesn't take care of themselves, drinks too much, does drugs, has a BMI over 30 and can't walk up a flight of stairs because of their choices?

On that same line of thinking, do you believe that people with multiple DUIs should pay the same for auto insurance than someone with a clean record? Do you believe that someone who drives a H2 Hummer should pay the same for gas each month to drive 1,000 miles as someone driving a Prius? We all make choices, and those choices have consequences.

 

[matttyl]

Just submitted my application and it took. The eligibility result link wouldn't work. I called the market place and they said it was a glitch and to try back in a couple of days. They did confirm that I'm getting a $290 subsidy.

I guess I'll be able to look at my options once that's working. I had thought I would be able to keep something that resembled my previous plan, but that may not be case. I may lose grandfathered status by taking a subsidy.

You will most definitely without a doubt lose grandfathered status if you receive a subsidy. You can stay on your grandfathered plan and pay the full rate, but if you go to an ACA plan and get a subsidy, you can never go back to your grandfathered plan. Proceed with care.....

 

[oso diablo]

HealthCare.gov pricing feature can be off the mark

Well yeah, if you don't put in your actual information then you're not going to get your actual rate. If some assumptions have to be made then sometimes those assumptions will be wrong for a particular person/enrollment group.

an auto insurer who tried this stunt with online quoting would get run out of business

 

[Ramsay Hunt Experience]

Apropos of nothing, it's not at all clear that someone who runs marathons will generate lower health care costs than someone with a high BMI. Endurance training has been linked to a weakening of the heart muscle and a higher incidence of many cancers. And that's leaving aside the studies that have found that lifetime health care costs for the obese were less because they incurred less of the health care costs that otherwise healthy people incur when they get old and unhealthy (because I understand that there are studies going both ways).

 

[TheIronSheik]

Apropos of nothing, it's not at all clear that someone who runs marathons will generate lower health care costs than someone with a high BMI. Endurance training has been linked to a weakening of the heart muscle and a higher incidence of many cancers. And that's leaving aside the studies that have found that lifetime health care costs for the obese were less because they incurred less of the health care costs that otherwise healthy people incur when they get old and unhealthy (because I understand that there are studies going both ways).

 

[oso diablo]

Is it just the ACA or are some people simply opposed to the greatest nation in world history providing health care to all her citizens?

We already do through Emergency Rooms is not an acceptable answer.

i support grown-ups taking responsibility for themselves, and providing for their own health protection. I don't see why that needs to be socialized.

 

[oso diablo]

On a related note: What is the opposition to a single payer health care system?

if said single-payer is the same entity that cannot build a functioning website with 3 years to plan, and $500 million to spend?

also, in general, monopolies are bad

 

[oso diablo]

Private charity has failed. I am fairly certain you understood that point.

There really just seems to be a general feeling of #### the poor from a couple of you.

if that is true, why would we turn instead to a worse form of charity: government "charity"?