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

[Suttree]

@Rhom

You do realize any increase you saw post passage and before the ACA was implemented has nothing to do with the law correct. Its yet another myth that has been thoroughly debunked.

[Rhom]

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.

Yet if you build your house in a flood zone, most casualty carriers can and will refuse to insure you. While that may sound a bit hard hearted, it is a reality and is why most people insuring homes are not forced to subsidize those with "terminal" or "chronic" housing issues.

[Rhom]

You do realize any increase you saw post passage and before the ACA was implemented has nothing to do with the law correct. Yet another myth that has been thoroughly debunked.

We can debate about where the fault lies, but the fact is that the rate increased as a direct result of the passage of the law. Whether it was legitimately imposed as the cost of implementing new administrative requirements or whether it merely served as an excuse to raise rates; the fact is without the ACA, there would not have been a rate increase of that size.

Again, I did not post with the intent of debating the law; my intent was to clarify that the reports of 90% increases are not figments of the collective imagination of the internet.

[TerraPrime]

Again, I did not post with the intent of debating the law; my intent was to clarify that the reports of 90% increases are not figments of the collective imagination of the internet.

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.

[Ser Scot A Ellison]

TP,

So, Rhom is lieing or miscalculated his rate increase?

[TerraPrime]

TP,

So, Rhom is lieing or miscalculated his rate increase?

You think that it is impossible that he made a mistake through incomplete research?

[Andriy Czarchenko]

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.

....

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.

...

Not taking part in the debate but you´re using the numbers incorrectly. If the price is 3 times the original the increase is 200%.

[Ser Scot A Ellison]

TP,

No, I just presume Rhom knows his own finances.

Jose,

A 200% increase is still huge.

[Borsabil]

Just noticed this as well:

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

Sure and that's exactly what I've been saying....jeez. Insurance companies offset risk by charging more, or even refusing to insure, high risk customers. They also rely on having a large number of customers. If threel of their customers houses burn down then the thousands of other policy holders whose houses don't burn down offset those losses and still leave them with a profit.

So OK let's compare that to Obamacare. Here we have a system where the insurance companies must, by law, 'insure' people who've already burnt their house down (the chronically sick) and will as a matter of course be guaranteed to take out far more in benefits than they pay in premiums. This is not insurance, if you don't believe me try calling your broker and ask for household cover but telling him oh btw the place was just gutted by fire, and see what happens.

Next we have high risk customers, those who have the equivalent of an old furnace in the basement of their all wood, termite infested home. If Obamacare was an insurance scheme, these individuals would be expected to either pay vastly more for their cover or to take remedial steps to lessen the risk of fire or be refused a policy.

Lastly we have the low risk customers, the kind of people every insurance company wants to sign up. They have smoke alarms and sprinkler systems, the latest in fire retardant materials when they construct their new home. They keep up with maintenance and do not engage in high risk activities. If Obamacare was 'insurance' such people would be offered vastly lower rates than everyone else because, and here's the thing, such individuals would probably be perfectly OK if they never took out a policy in the first place. Instead under Obamacare they're charged vastly more than their actuarial risk demands as a means for the companies to still turn a profit from paying out to those who've either burnt their house down a or are likely to in the future.

So I guess we'll see. Will a group of people who would probably be OK without 'insurance' pay vastly over the odds for a product when most of them can't afford it anyway? If the answer is no then Obamacare will fail.

[Suttree]

TP,

So, Rhom is lieing or miscalculated his rate increase?

No, not necessarily but there is a chance it could be similar to these people I referenced earlier. There is a ton of misinformation out there.

http://www.salon.com/2013/10/18/inside_the_fox_news_lie_machine_i_fact_checked_sean_hannity_on_obamacare/

Regardless the real irony as Robert Reich pointed out is:

For those of us who have been arguing for years that the best way to provide comprehensive health insurance to Americans would be to graft it onto Social Security and Medicare, and pay for it through the payroll tax, Republican opposition to the Affordable Care Act has been deeply ironic. Republicans were the ones who initially demanded it be based instead on private insurance, and be paid for with a combination of subsidies for low-income purchasers and a requirement that the younger and healthier sign up.

The ACA was originally a Dem compromise and the essential Republican plan and yet now that it is being implemented on a national scale conservatives are apoplectic. Even worse places like Fox and "anecdotes" from the internet are being fabricated to make things seem worse than the reality(not referring to Rhom here). Bottom line people need to understand the history and do their research.

TP,

No, I just presume Rhom knows his own finances.

Yet we have already seen one mistake in thread with his calculations.

[TrackerNeil]

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

you were a fool.

And you're ignorant. Let me enlighten you, assuming you care to be enlightened.

In 2009 I was working for a large, century-old law office that, shockingly, went belly-up. You can read about that here. Because the firm's health care plan was ending, I could not take advantage of COBRA, so I hunted desperately for individual coverage. The problem was that I had a history of prostatitis, which rendered me un-insurable on the private market. One underwriter told me, not unkindly, "Honey, you might as well have cancer. We won't insure you, and neither will anyone else." I soon found out she was right; I could not get a policy for love or money unless I was willing to accept exclusions large enough to drive the Battlestar Galactica through.

The firm, before it breathed its last, managed to persuade its insurer, Aetna, to allow employees to continue their coverage, regardless of preexisting conditions, although the plan would be more expensive and far less comprehensive. My choices were to either pay the $400 a month for a plan that did not require me to undergo medical underwriting (which I couldn't get past) or to forgo all coverage and hope for the best. I'm an active person, playing Ultimate Frisbee and volleyball, and it would be all too easy for me to be injured at either one, so going without coverage altogether meant giving those up, and those are the very activities that help keep me healthy, which is what I thought I was supposed to be doing. So my choices were to become less healthy and have no coverage, or to stay healthy and pay through the nose.

I chose the latter, but I see now that I was a great fool. Perhaps you can advise me on what I should have done. I await your judgment.

[Borsabil]

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.

Yeah there examples being quoted of individuals seeing 1000% increases in their premiums, I assume transitioning from cat cover to some sort of Obamacare bronze plan.

There's some questions you need to start asking. Your new policy might be more 'comprehensive' in that you'll get maternity should you fall pregnant and free birth control and psychiatric care :) but you need to take a long hard look at the In network list these policies accept which are identical to Medicare coverage.

[Andriy Czarchenko]

A 200% increase is still huge.

I never saw your post if that´s what you think Scot. It´s a very common mistake and I just wanted to correct it. As I said I´m not taking part in the debate.

[Rhom]

I can assure you that I fully understand my personal insurance policy and how it works. I routinely do audits of my insurance policies for both my work and home to ensure that I am getting the best rate possible for the coverage I desire. Additionally, given the nature of my profession I have a daily and active involvement with health insurance and understand the workings of both medical coding and claims.

My use of the percentage may be off, however the raw numbers are there for you to peruse as well rounded off to the nearest whole numbers for reference.

And of course there's also the other issue of "If you like your health insurance plan; you can keep it." Unless, you have an HSA...

[Shryke]

I can assure you that I fully understand my personal insurance policy and how it works. I routinely do audits of my insurance policies for both my work and home to ensure that I am getting the best rate possible for the coverage I desire. Additionally, given the nature of my profession I have a daily and active involvement with health insurance and understand the workings of both medical coding and claims.

My use of the percentage may be off, however the raw numbers are there for you to peruse as well rounded off to the nearest whole numbers for reference.

And of course there's also the other issue of "If you like your health insurance plan; you can keep it." Unless, you have an HSA...

It doesn't seem like it increased your rates, it just eliminated your HSA.

Which are kinda dumb anyway.

[Borsabil]

And you're ignorant. Let me enlighten you, assuming you care to be enlightened.

In 2009 I was working for a large, century-old law office that, shockingly, went belly-up. You can read about that here. Because the firm's health care plan was ending, I could not take advantage of COBRA, so I hunted desperately for individual coverage. The problem was that I had a history of prostatitis, which rendered me un-insurable on the private market. One underwriter told me, not unkindly, "Honey, you might as well have cancer. We won't insure you, and neither will anyone else." I soon found out she was right; I could not get a policy for love or money unless I was willing to accept exclusions large enough to drive the Battlestar Galactica through.

The firm, before it breathed its last, managed to persuade its insurer, Aetna, to allow employees to continue their coverage, regardless of preexisting conditions, although the plan would be more expensive and far less comprehensive. My choices were to either pay the $400 a month for a plan that did not require me to undergo medical underwriting (which I couldn't get past) or to forgo all coverage and hope for the best. I'm an active person, playing Ultimate Frisbee and volleyball, and it would be all too easy for me to be injured at either one, so going without coverage altogether meant giving those up, and those are the very activities that help keep me healthy, which is what I thought I was supposed to be doing. So my choices were to become less healthy and have no coverage, or to stay healthy and pay through the nose.

I chose the latter, but I see now that I was a great fool. Perhaps you can advise me on what I should have done. I await your judgment.

The problem is referring to broad cover health care plans as 'insurance' when they're really nothing of the sort. There is nothing unexpected or unforeseen about getting old and sick. In fact we can accurately predict, through dint of familial history and lifestyle factors, who will fall sick. If something is predictable and certain then by definition it is uninsurable.

What you're really demanding is to have your health care costs paid for by other people, which is perfectly understandable btw. But can we please leave off with the complaints that companies refused to 'cover' you when you were not in fact looking to be insured?

[Deedles]

The problem is referring to broad cover health care plans as 'insurance' when they're really nothing of the sort. There is nothing unexpected or unforeseen about getting old and sick. In fact we can accurately predict, through dint of familial history and lifestyle factors, who will fall sick. If something is predictable and certain then by definition it is uninsurable.

I call BS. I am a life and illness underwriter, a very good one at that. With extensive medical records and full proposal forms, I can't predict who will die, be diagnosed with a serious illness or become unable to work. I can predict some, certainly, and I do decline, postone, exclude and rate plans, but every year I have claims on cases I underwrote and accepted at standard rates.

[Inigima]

It's difficult to speak to Rhom's situation since we aren't privy to his details (nor should we be -- but it makes commentary difficult).

Borsabil: regarding Tracker, I think it's uncharitable to interpret it as you have. The alternative is a combination of ER care for catastrophic incidents and no professional care for anything else. The former we are ALREADY paying for, which is easy to forget since you don't write a separate check to cover uninsured ER care; improving healthcare outcomes by eliminating the latter is kind of the point of the law.

People in Tracker's position haven't chosen to have chronic conditions, remember, but they happen. The question is, do we want to, as a society, a. do nothing and let them suffer, b. allow these unasked-for, unexpected, un-courted medical issues destroy their financial stability, or c. subsidize their care to prevent a and b. I am personally pleased that we've chosen option c.

This is all very difficult to put specific numbers on, unfortunately.

[Rhom]

It doesn't seem like it increased your rates, it just eliminated your HSA.

Which are kinda dumb anyway.

The original plan was the one with the increasing rates. I later switched to the HSA.

The HSA was a place to park enough money to cover the cost of the deductible in a tax advantageous location, not exactly sure what was dumb about that.

[Shryke]

The original plan was the one with the increasing rates. I later switched to the HSA.

How was the increase tied to the ACA?

The HSA was a place to park enough money to cover the cost of the deductible in a tax advantageous location, not exactly sure what was dumb about that.

HSAs are general terrible policy.