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Obamacare: Obama just straight up lied to you, in your face (3 Viewers)
- Thread starter tommyboy
- Start date
timschochet
Footballguy
I got nervous last night seeing the headline that Congress was getting ready to repeal ACA...but it turns out it will be a bill to repeal the device tax- apparently that's the only thing Republicans could agree on by themselves to send to Obama's desk for a veto.
So I'm still safe. After November and all of their announcements how a repeal of Obamacare was going to be "first thing on their list!" I was pretty certain I'd be writing a check out to tommyboy any day. But it's already June and nothing has happened. Putting aside the wager, it's extraordinary how ineffective this Republican congress has been.
So I'm still safe. After November and all of their announcements how a repeal of Obamacare was going to be "first thing on their list!" I was pretty certain I'd be writing a check out to tommyboy any day. But it's already June and nothing has happened. Putting aside the wager, it's extraordinary how ineffective this Republican congress has been.
SaintsInDome2006
Footballguy
All judgements aside, it is worth noting that while the ACA was created by reconciliation, it's apparently not allowed to be repealed by reconciliation.
http://www.politico.com/story/2015/06/republicans-obamacare-repeal-118472.html
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timschochet
Footballguy
Thats a fascinating article, thanks.
matttyl
Footballguy
Yes, that number is from the end of March. From there, I'm just kinda guessing that as many people have had a qualifying event and joined the ranks of those covered via the exchange as have canceled their coverage.
It's interesting because the original projection was 13m, and 24m next year. No chance that either of those numbers are hit.
Bottomfeeder Sports
Footballguy
The creator of this thread is not going to be pleased with your misrepresentation of how the ACA was passed in the senate. Of course the house votes for the ACA were very likely dependent on the separate Health Care and Education Reconciliation Act of 2010.
Bottomfeeder Sports
Footballguy
Well the CBO projected that 58 million (non seniors) would be uninsured in 2015 absent the ACA and the ACA would reduce the number by 20 million for 38 million uninsured. Using RAND's February numbers for those 18 to 64 the number uninsured was 25.8 and then adding the Urban Institute's (older Jun 2014) 7 million children and the 32,8 million uninsured is certainly better than the 38 million projected. Of course there are issues with mixing and matching these numbers but the CDC number of 36,8 for the first 9 months of 2014 seems ballpark.*
So if the number of uninsured is really fewer than the Feb 2013 CBO projection then I'm not so sure it is a negative that the mix is off - assuming its not all Medicaid. Assuming that 33 million is ballpark for the number uninsured for 2015 then while an additional 12 million on the market place in 2016 is unlikely, 3 million gaining insurance for 2 million less uninsured seems less of a reach.
Of course (for Saints) the census bureau alone was responsible for about 6 million fewer uninsured between 2012 and 2013,
*For those interested an example of the concerns with mixing and matching numbers is that the RAND number finds a growth in ESI of about 8 million that doesn't seem repeated in other surveys (except Snogger's employer) and is about 8 million off from the CBO projection.
Bottomfeeder Sports
Footballguy
Assuming that the ACA sticks around for a while and that there will be individuals shopping for their own coverage then Health Insurance Literacy (HIL) will be important. Otherwise the newly insured will keep using the ER as their primary care.
Some nuggets
Some nuggets
- We found that newly enrolled individuals were more knowledgeable about the Affordable Care Act (ACA) than the remaining uninsured [this one could be abused.]
- almost 90 percent of marketplace enrollees wanted more information about how to use their coverage.
- Simply providing written information in plain language is not enough to move the needle on HIL.
MaxThreshold
Footballguy
The Commish
Footballguy
Yeah, education seems to be lacking. I was sorta bewildered by the lack of knowledge, but then tried to think back to when I first got my own insurance. It's really not as logical or straight forward as one would think. I had to learn a lot about insurance, my plan, how it worked, what was covered etc. Sometimes it felt like an exercise in futility because (like the tax code) it seemed there were always a ton of exceptions to the general rule. All these caveats made it maddening to try and figure out what the charges were going to be.Bottomfeeder Sports said:
matttyl
Footballguy
I guess what I can't seem to follow is that they didn't hit their goal of exchange enrollment, employer coverage (except for the RAND survey) doesn't show a huge gain in size, but they were still able to reduce the projected number of uninsured by "nearly 20 million"? That just goes to show you that they far overestimated the number of uninsured before the ACA, and I honestly believe are now underestimating it. As I said before, the change in the total number of uninsured due to the ACA is likely in the 12m range - which is nothing to scoff at, but isn't what was "projected".Bottomfeeder Sports said:Well the CBO projected that 58 million (non seniors) would be uninsured in 2015 absent the ACA and the ACA would reduce the number by 20 million for 38 million uninsured. Using RAND's February numbers for those 18 to 64 the number uninsured was 25.8 and then adding the Urban Institute's (older Jun 2014) 7 million children and the 32,8 million uninsured is certainly better than the 38 million projected. Of course there are issues with mixing and matching these numbers but the CDC number of 36,8 for the first 9 months of 2014 seems ballpark.*matttyl said:
So if the number of uninsured is really fewer than the Feb 2013 CBO projection then I'm not so sure it is a negative that the mix is off - assuming its not all Medicaid. Assuming that 33 million is ballpark for the number uninsured for 2015 then while an additional 12 million on the market place in 2016 is unlikely, 3 million gaining insurance for 2 million less uninsured seems less of a reach.
Of course (for Saints) the census bureau alone was responsible for about 6 million fewer uninsured between 2012 and 2013,
*For those interested an example of the concerns with mixing and matching numbers is that the RAND number finds a growth in ESI of about 8 million that doesn't seem repeated in other surveys (except Snogger's employer) and is about 8 million off from the CBO projection.
matttyl
Footballguy
Tim, remember those "short term plans" that I talked about a few months ago? These are the "non-compliant" plans carriers are offering where the individual would still be subject to the individual penalty. You also have to answer medical questions, and may be declined due to a "pre-exisiting condition". You said that they wouldn't catch on because they aren't compliant and the plans don't offer the "benefits" of the ACA.
Their sales were up over 100% last year, and seem to be up again this year.
Since these plans are still "underwritten", they are "cherry picking" the typically young and healthy folks out of the ACA market and leaving it older and sicker on average. 57% of their enrollees are between 18 and 34 (exactly what the ACA needs for their pools to remain stable). One website alone (eHealth) sold 140k of them last year and say their sales are up again this year - and I fully believe this trend will continue. Do you think these plans should be outlawed?
Their sales were up over 100% last year, and seem to be up again this year.
Since these plans are still "underwritten", they are "cherry picking" the typically young and healthy folks out of the ACA market and leaving it older and sicker on average. 57% of their enrollees are between 18 and 34 (exactly what the ACA needs for their pools to remain stable). One website alone (eHealth) sold 140k of them last year and say their sales are up again this year - and I fully believe this trend will continue. Do you think these plans should be outlawed?
timschochet
Footballguy
I don't know. I think what I wrote earlier is that if they hurt ACA I hoped they wouldn't succeed. As to whether or not they should be legal I'm not sure.
The Commish
Footballguy
Quick question in all this...it's hard to tell, but is the overestimation of uninsured that was initially used "way back when" factored in here? This is one of the problems I have with comparing projections of year X vs projections several years away...especially when one finds a significant error after projection X has been made.Bottomfeeder Sports said:Well the CBO projected that 58 million (non seniors) would be uninsured in 2015 absent the ACA and the ACA would reduce the number by 20 million for 38 million uninsured. Using RAND's February numbers for those 18 to 64 the number uninsured was 25.8 and then adding the Urban Institute's (older Jun 2014) 7 million children and the 32,8 million uninsured is certainly better than the 38 million projected. Of course there are issues with mixing and matching these numbers but the CDC number of 36,8 for the first 9 months of 2014 seems ballpark.*matttyl said:
So if the number of uninsured is really fewer than the Feb 2013 CBO projection then I'm not so sure it is a negative that the mix is off - assuming its not all Medicaid. Assuming that 33 million is ballpark for the number uninsured for 2015 then while an additional 12 million on the market place in 2016 is unlikely, 3 million gaining insurance for 2 million less uninsured seems less of a reach.
Of course (for Saints) the census bureau alone was responsible for about 6 million fewer uninsured between 2012 and 2013,
*For those interested an example of the concerns with mixing and matching numbers is that the RAND number finds a growth in ESI of about 8 million that doesn't seem repeated in other surveys (except Snogger's employer) and is about 8 million off from the CBO projection.
matttyl
Footballguy
You can hope for whatever. I hope people don't shoot one another or drink and drive, but that's not going to do anything and certainly alone won't stop either.
I've sold some of these types of plans to people (obviously all fairly healthy, and all were under age 40). To many, they are a great deal. I'll use myself as an example - I just looked up a 34 year old male on eHealth (which doesn't even have the carrier that I use for short term plans) and I found 11 plans under $100 a month, and 8 of those 11 have a deductible of 2,500 or less. One even had a $500 deductible. The cheapest "compliant" health plan on eHealth for me was $209 a month, and it has a $6,000 deductible. If I want a deductible in the same $2,500 or less range as the short term plans, my premium is now at 283 a month, over 3x higher than the short term option.
There is obviously a huge market for this, and is not a very well known product anyway. I feel the growth in these products is only going to increase, especially if the ACA plans do in fact end up with 10-20% (or higher) premium increases next year. These are really siphoning off the young and healthy that would help the ACA pools, but are we going to ban them from being sold?
BassNBrew
Footballguy
Loan Sharks
Not a Wolf
As an insurance professional you would be stunned at the percentage of people that can't mentally grasp the concept of a deductible. I had to have a guy removed from the premises one time because I was "stealing from him" and he went nuts.
$5000 repair gave him a check for $4500 and told give the shop his $500 deductible. No amount of explaining could convince this guy that I hadn't taken 500 bucks from him and that he would have to pay that 500 bucks again to get his car fixed.
This happens ALL the time. People buy insurance and have NO idea what they are buying. That is why people get so upset with insurance companies a lot of the times, unrealistic mis matched expectations.
People freak when they didn't buy rental car coverage, it has to be 1000 times worse when you can't get the medical procedure you thought you had even though it was your ignorance that caused the problem.
I think a lot of the problems with understanding a complex contract at least in property casualty is caused by the reduction of Agents. I don't know how prevalent brokers are in health insurance but companies that are cheap like Geico and Progressive without agents and a lot of the internet purchasing has really reduced the ability to get answers. If you have an agent they are there to explain what is covered and it is binding. Sometimes it is a long process before making a major purchase which pretty much flies in the face of our culture. Americans will agonize over what features on car to purchase for weeks and shop around but gleefully walk into a insurance office and asked for the cheapest full coverage you have and then be stunned when they bought a crappy policy.
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timschochet
Footballguy
It's not quite as simple as that and I think you know it.
I was opposed to ACA because I didn't think there was any way to pay for ultimately. With ACA we as a society essentially decided to do two things: 1. Allow people who were too poor to gain healthcare insurance access to the system. 2. Allow those with pre-existing conditions to get health care insurance at the same cost as everyone else. These two things, ESPECIALLY the second one, cost a lot of money. How to get that money? By mandating that everyone has to buy insurance, particularly young and healthy people.
You remove the young and healthys from the equation, and the whole system falls apart. We can't afford to pay for pre-existing conditions. Insurance costs have to either skyrocket or the government has to support the system with more subsidies. That's the system we've chosen and we're not getting rid of it. We're stuck. So yeah, given that, I don't want to see young and healthys bail out.
BassNBrew
Footballguy
You mean the young/healthy individual policy purchasers who make 3x+ the poverty line. The majority in the corporate world aren't footing this bill.
matttyl
Footballguy
Interesting read on the state exchange of Vermont, perhaps one of the most left leaning states in the country. They had hopes for running their own small universal health care system (haven't yet, they were going to give the ACA a try on the way to universal care)...
"Under the single-payer law that the Vermont Legislature passed in 2011, the state was to seek a waiver in 2017 to trade its insurance exchange for the government-run system. Most of its 625,000 residents would be eligible for a uniform package of benefits under that system, which would be financed with a mix of state and federal funds. But Mr. Shumlin and his advisers concluded the plan would require “enormous” new taxes, including an 11.5 percent payroll tax on all Vermont businesses and a sliding-scale income tax of up to 9.5 percent. In all, he said when he announced that he was shelving it, the plan would require about $2.5 billion in additional revenue in its first year, in a state that raises only about $2.7 billion in taxes annually."
"They don’t like the way this is working and want to go back to the old way.” "“I think it’s time to pull the plug, because it may just be an unending money pit.”"(coming from Vermonters, that's interesting to hear)
Lawrence Miller, the state’s chief of health care reform - Pointing out that Vermont’s was not the only state-based exchange to still be struggling, he added, “I talk to my colleagues elsewhere and, good God, this just wasn’t set up for success.”
"Under the single-payer law that the Vermont Legislature passed in 2011, the state was to seek a waiver in 2017 to trade its insurance exchange for the government-run system. Most of its 625,000 residents would be eligible for a uniform package of benefits under that system, which would be financed with a mix of state and federal funds. But Mr. Shumlin and his advisers concluded the plan would require “enormous” new taxes, including an 11.5 percent payroll tax on all Vermont businesses and a sliding-scale income tax of up to 9.5 percent. In all, he said when he announced that he was shelving it, the plan would require about $2.5 billion in additional revenue in its first year, in a state that raises only about $2.7 billion in taxes annually."
"They don’t like the way this is working and want to go back to the old way.” "“I think it’s time to pull the plug, because it may just be an unending money pit.”"(coming from Vermonters, that's interesting to hear)
Lawrence Miller, the state’s chief of health care reform - Pointing out that Vermont’s was not the only state-based exchange to still be struggling, he added, “I talk to my colleagues elsewhere and, good God, this just wasn’t set up for success.”
timschochet
Footballguy
Good morning everybody. Sad to relate that my brother passed away last night. He had been in hospice for a couple of weeks, so this was not unexpected. At least he's out of pain.
Many of you in this thread over the last couple years not only offered me kind words but also some very useful advice. Thank you for that and I'm very grateful.
Many of you in this thread over the last couple years not only offered me kind words but also some very useful advice. Thank you for that and I'm very grateful.
Statcruncher
Footballguy
Terribly sorry to hear that Tim, thropawishes your way.
matttyl
Footballguy
Rich Conway
Footballguy
Sorry to hear that. Best wishes for you and the rest of the family.
BassNBrew
Footballguy
Tim - Terribly sorry to hear this news. I wish you and your family the best in getting through this horrible event.
The Commish
Footballguy
So sorry to hear Tim. Thoughts and prayers are with you and your family. I fear I'll be in the same boat shortly as my uncle's in pretty bad shape also.
DocHolliday
Footballguy
Sorry for your loss Tim. Take care of the family.
timschochet
Footballguy
Thanks everyone
MaxThreshold
Footballguy
Really sorry to hear about your brother. My T & P are with you and your family.
Loan Sharks
Not a Wolf
Condolences.
Bottomfeeder Sports
Footballguy
So sorry!timschochet said:
Parrothead
Footballguy
:( :( condolences to you and yourstimschochet said:
SaintsInDome2006
Footballguy
Tim, I just read this. I am so sorry. You and your family have my prayers, thoughts and best wishes today. Take care and I hope the very best for you all recovering from this in the near future.
cr8f
Footballguy
Tomboy never disappoints.
What we need to do is look at what works for other countries and adopt them here. France has a combination public private system, but profit is not a good system for healthcare, it works for some things and public systems work for others.
We spend double the rest of the world and triple what Japan spends.
I would have passed medicare for all when Obama first took office, letting those under 65 buy in at cost, making it harder to demonize because people know what it is for the most part.
It's a god but not great system but a lot better than insurance companies.
What we need to do is look at what works for other countries and adopt them here. France has a combination public private system, but profit is not a good system for healthcare, it works for some things and public systems work for others.
We spend double the rest of the world and triple what Japan spends.
I would have passed medicare for all when Obama first took office, letting those under 65 buy in at cost, making it harder to demonize because people know what it is for the most part.
It's a god but not great system but a lot better than insurance companies.
MaxThreshold
Footballguy
How about you move to France instead of us adopting the failed Socialism of Europe? Aren't you supposed to be in Canada anyways?
Tau837
Footballguy
Point: Feds consider expanding Pioneer ACO program after $384M in savings
Counterpoint: Accountable Care Organizations: Did they Reduce Medical Costs in One Year?
Apologize if this subject has already been addressed. I scanned through the last few pages and didn't see it.
Sand
Footballguy
RBM
Footballguy
matttyl
Footballguy
Over $200m invested, and the project is being scrapped and they will revert back to the federal exchange. Enrolled less than 8,600 the first year of operation.
Can you tell me how great Medicare would be if people didn't buy supplements from insurance companies?
I don't get it. Didn't TGunz point to this as a shining example of how well the ACA was working?
matttyl
Footballguy
The law's intent or not, I don't think Obama as President should be discussing what cases the Supreme Court should and shouldn't be taking on. That isn't his place.
SaintsInDome2006
Footballguy
So is this correct, that the following state exchanges have been shut down?
Hawaii, Oregon, Massachusetts, Maryland, Vermont, New Mexico and Nevada.
If this is correct, why? What does it mean, and then what do the people having coverage through those exchanges do next?
matttyl
Footballguy
I think that list of states is correct. I know Hawaii, Oregon, Maryland and Mass for sure. I think Vermont will be next to go, if they haven't already. The states realize that it's expensive to keep the state run exchange up and running, so they "revert back" to the federal exchange, healthcare.gov. The people having coverage via that exchange really don't need to do anything.
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