U.S. Politics - GOP is right, PPACA has failed!

[TheKitttenGuard]

ThinkerX,

There is an income exemption for the penalty. Have to check but it should be 8% of your yearly income. Consider you stating you will have to 15% of your income for health insurance, you should qualify.

[TerraPrime]

I don't know how else to put this, but...

you were a fool.

There are many reasons to pay for a health insurance plan that seems expensive.

Before PPACA, people can be denied health insurance due to pre-existing conditions. So if someone is terminated form a job or leave a job, they need to continue their coverage through COBRA or similar programs to maintain eligibility for medical insurance later down the road.

Not to mention, if you happen to develop chronic issues like diabetes or hearth conditions while out of work, you will very liukely be denied insurance when you get your next job if you don't carry insurance while out of work.

I'd hardly describe it as foolish to do purchase insurance while out of a job.

Alternatively, if you already have expensive procedures that are either due to chronic issues, like kidney dialysis, chemotherapy, you can hardly afford to not get insurance plan to cover it. That way lays bankruptsy.

So I think you're out of line to say that it's foolish to pay $400 to $500 for health insurance each month.

[ThinkerX]

There are many reasons to pay for a health insurance plan that seems expensive.

I'm sure there are.

Before PPACA, people can be denied health insurance due to pre-existing conditions. So if someone is terminated form a job or leave a job, they need to continue their coverage through COBRA or similar programs to maintain eligibility for medical insurance later down the road.

Not to mention, if you happen to develop chronic issues like diabetes or hearth conditions while out of work, you will very liukely be denied insurance when you get your next job if you don't carry insurance while out of work.

Which leaves the other option: Deal with the pain.

Again, ACA supporters seem to have this collective delusion that there is a large number of healthy young uninsured people out there who will not mind paying extortionate rates to keep the system propped up.

I agree there are many uninsured folks out there. However, my base contention, thus far unrefuted, is that most of them are not particularly healthy or wealthy. I work with such people. Like the gal who coughs her guts up, really needs to see a doctor, but can't afford too.

I'd hardly describe it as foolish to do purchase insurance while out of a job.

My impression thats what the poor peoples option is there for. Of course, for those of the white collar caste and above, going that route is probably too humiliating to consider.

Alternatively, if you already have expensive procedures that are either due to chronic issues, like kidney dialysis, chemotherapy, you can hardly afford to not get insurance plan to cover it. That way lays bankruptsy.

And death. When your number is up, its up. Then again, there is medi-whatever and disability.

So I think you're out of line to say that it's foolish to pay $400 to $500 for health insurance each month.

Depends on what your priorities are and how much pain you are willing to tolorate.

[Borsabil]

There are many reasons to pay for a health insurance plan that seems expensive.Before PPACA, people can be denied health insurance due to pre-existing conditions. So if someone is terminated form a job or leave a job, they need to continue their coverage through COBRA or similar programs to maintain eligibility for medical insurance later down the road.Not to mention, if you happen to develop chronic issues like diabetes or hearth conditions while out of work, you will very liukely be denied insurance when you get your next job if you don't carry insurance while out of work.I'd hardly describe it as foolish to do purchase insurance while out of a job.Alternatively, if you already have expensive procedures that are either due to chronic issues, like kidney dialysis, chemotherapy, you can hardly afford to not get insurance plan to cover it. That way lays bankruptsy.So I think you're out of line to say that it's foolish to pay $400 to $500 for health insurance each month.

Oh I think you're right, if you have a lot of ongoing chronic health problems Obamacare will be a great deal for you. However for otherwise fit, healthy young adults Obamacare is a terrible proposition.

There's another issue that I haven't seen brought up much, and that's out of network coverage, which is a huge issue to consider for those with complex health issues living in areas that have inadequate hospital or specialist health care. Check you're coverage very carefully, I think for most, if not all, HMO and subsidized policies out of network cover is NOT offered. Which means if you live in a rural county with only one insurance provider you're screwed. You'll have to utilize whatever is available in your locale, which will suck big time if you need really specialist care only available in larger hospitals .

[Shryke]

Oh I think you're right, if you have a lot of ongoing chronic health problems Obamacare will be a great deal for you. However for otherwise fit, healthy young adults Obamacare is a terrible proposition.

Well yes, young fit healthy people are a key component of funding most insurance pools.

It's called Collective Action.

[Borsabil]

I don't know how else to put this, but...you were a fool.I am not rich. In a few years, I expect my income to drop by about half (has to do with contracts coming to an end and no good way to move forward).$150 a month out of a take home of $2000 a month is doable.$150 a month out of a take home of $1000 a month might be a different story.Either way, I am STILL out of pocket for a lot of so called 'minor' medical expenses, even after the 'poor peoples discount', a point you failed to grasp.I would point out, AGAIN, there are a lot of people - maybe one in five? one in four? for whom $1000 - $1600 a month is their normal takehome pay. Not a hope in hell of getting insewerance through their employers, even with the ACA. Which will put them in the same situation as me. So how does the ACA stay afloat when these people collectively take the penalty (or skip insewerance and taxes both) rather than get insewerance? After all, for these people forking over a couple hundred extra at tax time AND still taking advantage of the 'poor peoples discount' is a lot more economical than paying for budget busting insurance - and even $150 a month is a budget buster.For that matter, what possible reason would all these young, healthy sorts who are due to be soaked to keep the ACA running have to buy insurance rather than take the penalty? Assuming, of course, that most of them are better off than then $1000 - $1500 a month crowd, which I highly doubt.Without auto insurance, you don't legally drive.With the ACA, without health insurance, you don't legally breathe.See the difference? One is optional, for many folks, The other...

Yep, there will not be enough young solvent young adults willing to overpay for health insurance to make these insurance pools actuarially sound. Hell even middle age folk having their insurance policies cancelled and shoveled into Obama care are likely to drop out once they are confronted with premiums that are going up by 90% , even if they are 'better' I.e. Offering maternity to men and mental health to the assuredly sane and orthopedics to the young and fit etc. Many small businesses are facing staggering increases in premiums, they face a choice of stopping employees insurance or going bust, even larger corporations have been and will continue to shunt their employees to less than thirty hours a week to avoid Obamacare. Has ANY of this been factored in when the government and insurance companies were working out their actuarial tables 4years ago? I highly doubt it.

I think we're guaranteed a delay in roll out, many Democratic congress critters are already calling for that. The Republicans MAY go along with it, though the way Obama treated them when they offered that a few weeks ago I'd think they'd be foolish to cooperate. Let the Dems live with the consequences of their own arrogance and stupidity.

[Borsabil]

Well yes, young fit healthy people are a key component of funding most insurance pools.

It's called Collective Action.

Yeah socialism. The problem is socialism only 'works' when the government uses a big stick. Under Obamacare the penalties for not signing up are both way less than the policies cost AND essentially voluntary. If you don't want to pay the fine then just don't overpay the IRS, then you won't be eligible for a refund.

[The guy from the Vale]

Yep, there will not be enough young solvent young adults willing to overpay for health insurance to make these insurance pools actuarially sound. Hell even middle age folk having their insurance policies cancelled and shoveled into Obama care are likely to drop out once they are confronted with premiums that are going up by 90% , even if they are 'better' I.e. Offering maternity to men and mental health to the assuredly sane and orthopedics to the young and fit etc. Many small businesses are facing staggering increases in premiums, they face a choice of stopping employees insurance or going bust, even larger corporations have been and will continue to shunt their employees to less than thirty hours a week to avoid Obamacare. Has ANY of this been factored in when the government and insurance companies were working out their actuarial tables 4years ago? I highly doubt it.

I think we're guaranteed a delay in roll out, many Democratic congress critters are already calling for that. The Republicans MAY go along with it, though the way Obama treated them when they offered that a few weeks ago I'd think they'd be foolish to cooperate. Let the Dems live with the consequences of their own arrogance and stupidity.

You may deride it all you like, but mental health insurance is absolutely worrth it even for those assuredly sane. Some mental health problems only manifest at a later age, and you won't know about them until they start showing up, when they can start messing up your life.

And you know, that's the entire point of health insurance. You may be healthy now, but there are many eventualities that might complicate your health. They are each not very likely, but there are quite a number of them. And if you catch any one of them while being uninsured, it's a catastrophe for the rest of your life (due to the accrued debt) instead of a major inconvenience for a few weeks or months.

[Shryke]

Yeah socialism. The problem is socialism only 'works' when the government uses a big stick.

Good thing they've got one then. Thanks for admitting it works though, I'm glad you are finally onboard.

Under Obamacare the penalties for not signing up are both way less than the policies cost AND essentially voluntary. If you don't want to pay the fine then just don't overpay the IRS, then you won't be eligible for a refund.

So you pay a fine (that increases as time goes on) and in return you get no healthcare. What a deal!

[Deedles]

Just a quick comment. Those who are arguing that "young and fit people" won't buy insurance. Sure they will. I live in a country with a weird hybrid healthcare scheme. You can go public for more or less everything. This means your costs are capped at a very low level (e.g. 700 for Emergency costs). You can buy private insurance which is community rated to top this up, it opens some hospitals, semi private and private wards, quicker access to some consultants, but the base health care doesn't really improve.

I have private healthcare. I'm 32 and fit. I've never claimed for anything in the 7 years I've had it. My partner also has it, aged 37, when he hasn't been to a doctor, let alone a hospital in 13 years. Young and fit people can will and do buy insurance, even if not needed for catastrophes

[ants]

Yep, there will not be enough young solvent young adults willing to overpay for health insurance to make these insurance pools actuarially sound. Hell even middle age folk having their insurance policies cancelled and shoveled into Obama care are likely to drop out once they are confronted with premiums that are going up by 90% , even if they are 'better' I.e. Offering maternity to men and mental health to the assuredly sane and orthopedics to the young and fit etc. Many small businesses are facing staggering increases in premiums, they face a choice of stopping employees insurance or going bust, even larger corporations have been and will continue to shunt their employees to less than thirty hours a week to avoid Obamacare. Has ANY of this been factored in when the government and insurance companies were working out their actuarial tables 4years ago? I highly doubt it.

...

You know, your statements don't really hold together logically. Lets suppose your armageddon scenario results and no youngsters join up. Then the only new insured people would be those who couldn't get insurance due to issues like pre-existing conditions. Yes, that would push prices up, but not that much. I think many would still see this as a win. So why under your worse case scenario would prices rise by 90%? If its mostly the same pool of people as before?

On the other hand, there is the strong possibility that a number of younger people will take insurance. This will push prices down. The competition element of being on exchanges will push prices down.

So what is the reasoning for you to say that all these prices will go up by 90%?

[Suttree]

So what is the reasoning for you to say that all these prices will go up by 90%?

Would love to see a source on that.

[Borsabil]

You know, your statements don't really hold together logically. Lets suppose your armageddon scenario results and no youngsters join up. Then the only new insured people would be those who couldn't get insurance due to issues like pre-existing conditions. Yes, that would push prices up, but not that much. I think many would still see this as a win. So why under your worse case scenario would prices rise by 90%? If its mostly the same pool of people as before?

On the other hand, there is the strong possibility that a number of younger people will take insurance. This will push prices down. The competition element of being on exchanges will push prices down.

So what is the reasoning for you to say that all these prices will go up by 90%?

Nope. There are a huge number of people with pre-existing conditions getting guaranteed insurance at a massively reduced rate, that after all is the point of Obamacare. The insurance companies only agreed to this as they were promised that young, fit healthy people would be forced into the system and would be made to massively over pay for their policies. This is how Obamacare will 'work', a cross generational subsidy. The fact that you don't understand this is unsurprising, the liberals I know who I've discussed this with are remarkably ignorant on the subject and assume I'm talking BS, even though its in the friggin law lol.

From your post you seem to believe that millions of new chronically sick customers for the insurance companies is a 'good thing' for their business. Unfortunately in the real world if someone takes out more in benefits than they're paying in premiums that's what's called a loss and the money must be found from somewhere else to make up the difference.

As for my 90% claim? Now apparently there's been some minor issues with the website and the federal exchange, I'm told of some mention of the matter in the media, but you might have missed it? Anyway because of this unfortunate, and totally unforeseen, turn of events gaining nation wide data is proving difficult, but there are many anecdotal accounts all over the Internet, a majority from dumbfounded Obama supporters, dumbfounded that they're being asked to pay nearly double for their new policies as their old policies are cancelled. Here's one:

"In 2013, Brown’s plan with Kaiser has a $5,000 deductible and a $6,000 out-of-pocket maximum. It costs him $272 a month.

In 2014, Kaiser offered him a plan with a $4,500 deductible and a $6,350 out-of-pocket max. But the premium is $519 a month.

It’s very similar coverage for almost double the cost.

Brown’s story was so astonishing that Glenn Melnick, a health economist at the University of Southern California, simply didn’t believe it when I called him to ask how this big of a rate increase could be happening. “A 90 percent increase just doesn’t make sense to me,” he said.

Melnick encouraged me to double-check the facts, saying that there must be something Brown was missing. But Brown provided his documents from Kaiser, I reviewed them and forwarded them to Melnick, who confirmed that Brown’s analysis — a 90.9 percent increase for similar coverage — checked out."

Now to be fair people receiving subsidies and those with pre-existing conditions will do well out of Obamacare, but many people, younger, healthier people who are self insured, are going to see eye watering increases in their premiums. Again this is how Obamacare is designed to work, the healthy paying for the sick, the young paying for the old.

[Inigima]

"In 2013, Browns plan with Kaiser has a $5,000 deductible and a $6,000 out-of-pocket maximum. It costs him $272 a month.

In 2014, Kaiser offered him a plan with a $4,500 deductible and a $6,350 out-of-pocket max. But the premium is $519 a month.

Its very similar coverage for almost double the cost.

Browns story was so astonishing that Glenn Melnick, a health economist at the University of Southern California, simply didnt believe it when I called him to ask how this big of a rate increase could be happening. A 90 percent increase just doesnt make sense to me, he said.

Melnick encouraged me to double-check the facts, saying that there must be something Brown was missing. But Brown provided his documents from Kaiser, I reviewed them and forwarded them to Melnick, who confirmed that Browns analysis a 90.9 percent increase for similar coverage checked out."

Maybe I'm not seeing it because I'm on a smartphone, but is there a source for this?

[Suttree]

Anecdotal accounts on the internet...facepalm.

Meanwhile the negative accounts that were picked to go on a show like Hannity were fact checked and thoroughly debunked. You knew from the start tossing out that 90% increase was disingenuous. Not surprised given your posting history but at least try and debate in an honest manner.

[Inigima]

Just noticed this as well:

Again this is how Obamacare is designed to work, the healthy paying for the sick, the young paying for the old.

I mean, this is basically how all insurance works: people who are not filing claims subsidize the people who are.

[sologdin]

Yeah socialism. The problem is socialism only 'works' when the government uses a big stick. Under Obamacare the penalties for not signing up are both way less than the policies cost AND essentially voluntary. If you don't want to pay the fine then just don't overpay the IRS, then you won't be eligible for a refund.

yeah, that's why single payer systems result in better health outcomes than the US.

[Borsabil]

Anecdotal accounts on the internet...facepalm.

Meanwhile the negative accounts that were picked to go on a show like Hannity were fact checked and thoroughly debunked. You knew from the start tossing out that 90% increase was disingenuous. Not surprised given your posting history but at least try and debate in an honest manner.

What you're condemning me for not providing links to good data? Why don't we have good data on the program? Too be clear many self insured people who do not qualify for subsidies will see massive premium spikes, why? Because this is the one group that are offered no protection under Obamacare and it is entirely logical for insurance companies to pass on their increased costs from offering lower premiums to the old and chronically ill to these customers

[Rhom]

So what is the reasoning for you to say that all these prices will go up by 90%?

I'd love to see that too... considering mine went up 300% since passage of the ACA, and the plan that I got to reduce that is no longer being offered due to provisions in the ACA as of January 1.

I know there are many good aspects and intentions to the bill, so I won't debate the larger issue. However, I do think its important for people to understand what actual people are experiencing.

I'll give details. Married, father, Caucasian male, mid-30's, no chronic health issues, family history of heart disease, no other red flags, self employed. My wife and kids are covered through her work, to add me to the plan would have been financially unfeasible.

So there's my actuarial information. Prior to passage of the Affordable Care Act, I was paying around $120/mo to Anthem Blue Cross/Blue Shield for a plan that featured a $250 deductible and a 20% coinsurance. In the first year of renewal after passage of ACA, my premium for that same plan jumped to just over $240/mo. I kept it even though it was obviously a better plan than my health care needs really necessitated. The next renewal was set to increase my premium to $350/mo. A 300% increase in price was not something I was willing to pay, so I switched to a Health Savings Account plan with a $5000 deductible through Anthem and reduced my premium back down to $120/mo.

About a month ago, I received a letter stating that due to provisions in the PPACA the plan will no longer be offered after January 1, 2014. (Basically, Health Savings Accounts are going away to be replaced by some other product without the same tax advantages. I really don't understand why.) However, I was able to renew my current plan early and extend my coverage until December 2014 (would have termed in February) at $128/mo.

Sadly, my story is not unique among others that I speak to in my practice or from my independent insurance agent I work with. So when asking where the numbers for these increases are coming from, I think its important to realize that they are coming from real people who are feeling a not insignificant pinch in their pocketbook as a direct result of the passage of the law.

[TerraPrime]

As for my 90% claim? Now apparently there's been some minor issues with the website and the federal exchange, I'm told of some mention of the matter in the media, but you might have missed it? Anyway because of this unfortunate, and totally unforeseen, turn of events gaining nation wide data is proving difficult, but there are many anecdotal accounts all over the Internet, a majority from dumbfounded Obama supporters, dumbfounded that they're being asked to pay nearly double for their new policies as their old policies are cancelled.

Yeah, I am sure that there are some people whose premiums are going up. One of the forum users here attested to that. But I am taking these accounts of high rate increases with a giant grain of salt, given the antics of people who are not informed and who did not do the requisite work to investigate thoroughly.

Again this is how Obamacare is designed to work, the healthy paying for the sick, the young paying for the old.

Yes, because PPACA still follows the insurance model, and that's how insurance policies work, from car insurance to health insurance to house insurance - those who do not suffer claims subsidize those who do with the insurance company acting as the risk bearer and cost distributor. This is not a unique invention by Obama's team. Also, this is not substantively different from the old system, where people with illnesses end up using emergency room services that they cannot pay, and at which point tax payers are tapped to pay for these procedures. The PPACA just makes this cost-sharing happen on the front-end, which is cheaper, because regular procedures are charged at a lower rate than emergency room treatments.