The Sad Case of the Patient Protection and Affordable Care Act

[ScoobyDoo]

Re: The Sad Case of the Patient Protection and Affordable Care Act

http://vitals.nbcnews.com/_news/2012...ly-study-finds

Look at that, subsidized birth control cuts down on abortions. That should be a win-win for everyone, right? Right?
...(crickets chirping)...

Nope. Pro Life groups are anti-sex.

[unofan]

Re: The Sad Case of the Patient Protection and Affordable Care Act

http://vitals.nbcnews.com/_news/2012...ly-study-finds

Look at that, subsidized birth control cuts down on abortions. That should be a win-win for everyone, right? Right?
...(crickets chirping)...

[joecct]

Re: The Sad Case of the Patient Protection and Affordable Care Act

HFS

That's incredible.

You didn't know? The Feds (and retired Feds like me) have a nice assortment. IF they had opened the pool up to the "uncovered", then my premiums may have gone up a bit, but we would have been spared the rigamarole of ACA.

[FlagDUDE08]

Re: The Sad Case of the Patient Protection and Affordable Care Act

I learned something new about the law, that I didn't know before. Another serious drafting error (assuming the author of this article is accurate, at least....)

I had read in several places that the way the law is worded, the tax credits are only available for participation in a state-run exchange, but not for participation in an exchange set up in their state by the federal government; however, this is the first time I've seen it asserted that if there is no state-run exchange, there are no penalties taxes on employers or people for not providing health insurance, either.

What a mess. Given how intricate and complicated insurance can be, and given that states have had exclusive province over insurance regulation, the idea that the Federal government could rewrite everthing in one single law, and also somehow get it 100% right the first time without giving thought to a potential need for subsequent revision...I kept asking myself, "what are these people thinking?"

Now I'm tempted to re-phrase, by replacing "what are" with "were." Market innovation has done quite well for us here in the US compared to the rest of the world for decades, and to think that overnight we'll entirely replace market forces with central planning diktats.....

This is just too funny.

"We have to pass the bill to know what's in it." That's otherwise known as signing a contract without reading it. We learned the consequences in the South Park episode "HUMANCENTiPAD". Why is the government setting a bad example for its people by not reading what they agree to do?

[FreshFish]

Re: The Sad Case of the Patient Protection and Affordable Care Act

I learned something new about the law, that I didn't know before. Another serious drafting error (assuming the author of this article is accurate, at least....)

The debate over President Obama’s health-care law has taken another twist. Now conservatives and libertarians are defending it, while the administration tries to toss part of the legislation out.

....

Obama’s plan makes tax credits available to people who get health insurance from exchanges set up by state governments. If states don’t establish those exchanges, the federal government will do so for them. But federal exchanges don’t come with tax credits: The law OKs credits only for people who get insurance from state-established exchanges.

And that creates some problems the administration didn’t foresee, and now hopes to wish away.

....

If [the states] don’t [set up exchanges], the tax credits don’t go into effect and the federally established exchanges won’t work: People won’t be able to afford the insurance available on them without the subsidy.

States have another incentive to refrain from setting up exchanges: It protects companies and individuals in the state from tax increases.

The law introduces penalties up to $3,000 per employee for firms that don’t provide insurance — but only if an employee is getting coverage with the help of a tax credit. No state exchanges means no tax credits and thus no employer penalties.

The law also penalizes people for not buying insurance. In some cases, being eligible for a tax credit and still not buying insurance subjects you to the penalty. So, again, no state exchange means no tax credit and thus fewer people hit by the penalty.

I had read in several places that the way the law is worded, the tax credits are only available for participation in a state-run exchange, but not for participation in an exchange set up in their state by the federal government; however, this is the first time I've seen it asserted that if there is no state-run exchange, there are no penalties taxes on employers or people for not providing health insurance, either.

What a mess. Given how intricate and complicated insurance can be, and given that states have had exclusive province over insurance regulation, the idea that the Federal government could rewrite everthing in one single law, and also somehow get it 100% right the first time without giving thought to a potential need for subsequent revision...I kept asking myself, "what are these people thinking?"

Now I'm tempted to re-phrase, by replacing "what are" with "were." Market innovation has done quite well for us here in the US compared to the rest of the world for decades, and to think that overnight we'll entirely replace market forces with central planning diktats.....

[dxmnkd316]

Re: The Sad Case of the Patient Protection and Affordable Care Act

If you want to see what the Feds have for health benefits, go here: http://www.opm.gov/insure/health/search/plansearch.aspx

This is what should be out there for everyone, but why re-invent the wheel?

HFS

That's incredible.

[joecct]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Yeah, I'm lucky. Our company self-insures so we get a bunch of choices. A high deduct or two "regular" plans (one administered through Blue Cross Blue Shield the other through HealthPartners).

If you want to see what the Feds have for health benefits, go here: http://www.opm.gov/insure/health/search/plansearch.aspx

This is what should be out there for everyone, but why re-invent the wheel?

[dxmnkd316]

Re: The Sad Case of the Patient Protection and Affordable Care Act

That makes more sense. The problem is still that many people who receive healthcare through their employer do not have the option to choose a higher deductible plan.

Yeah, I'm lucky. Our company self-insures so we get a bunch of choices. A high deduct or two "regular" plans (one administered through Blue Cross Blue Shield the other through HealthPartners).

[FreshFish]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Was your plan one of those who had a high administrative cost? It could be that instead of refunding premiums, they lowered the following year's rates. Or, the size of the pool got a lot bigger so the risk is more spread out. Just guesses.

It is not uncommon for there to be a one-year lag between rates and experience. Much depends upon how wide the experience pool is. The smaller the pool, the greater the potential for year-over-year volatility.

It's also possible that a large employer with a higher risk profile switched companies, removing a disproportionate drag on the experience pool. There are easily half a dozen diferent hypothetical explanations that might fit.

[joecct]

Re: The Sad Case of the Patient Protection and Affordable Care Act

The exact same plan costs ~6.5% less than this year. Nothing about it changed.

Was your plan one of those who had a high administrative cost? It could be that instead of refunding premiums, they lowered the following year's rates. Or, the size of the pool got a lot bigger so the risk is more spread out. Just guesses.

[jerphisch]

Re: The Sad Case of the Patient Protection and Affordable Care Act

I think you two COMPLETELY missed my point. The point was that premiums are meaningless if you don't know your deductible. In the situation I mentioned, you should have seen the word "car" in the sentence and realized I was using car insurance as an example.

(Edit: In retrospect, my original sentence was clumsy. I meant taking your car insurance deductible to $1,000 to reduce your premiums. Since I know a lot of people with $500 deductibles. Same thing with health insurance. A high deductible plan will necessarily carry low premiums.)

That makes more sense. The problem is still that many people who receive healthcare through their employer do not have the option to choose a higher deductible plan.

[dxmnkd316]

Re: The Sad Case of the Patient Protection and Affordable Care Act

The exact same plan costs ~6.5% less than this year. Nothing about it changed.

Nothing at all? No change in coverage? No change in deductible? No change in how prescriptions are handled?

I guess I'd be curious to see what insurance premiums do in the private world before I make my final judgment.

[unofan]

Re: The Sad Case of the Patient Protection and Affordable Care Act

The point was that premiums are meaningless if you don't know your deductible.

The exact same plan costs ~6.5% less than this year. Nothing about it changed.

[dxmnkd316]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Did you call The General? My employer's plan has a $3,000 deductible, and I pay the same for 1 month of health insurance for my family that we pay for 6 months of car insurance on 2 cars.

This. Most people don't have a 1K deductible. Wouldn't that be nice?

I think you two COMPLETELY missed my point. The point was that premiums are meaningless if you don't know your deductible. In the situation I mentioned, you should have seen the word "car" in the sentence and realized I was using car insurance as an example.

(Edit: In retrospect, my original sentence was clumsy. I meant taking your car insurance deductible to $1,000 to reduce your premiums. Since I know a lot of people with $500 deductibles. Same thing with health insurance. A high deductible plan will necessarily carry low premiums.)

[leswp1]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Did you call The General? My employer's plan has a $3,000 deductible, and I pay the same for 1 month of health insurance for my family that we pay for 6 months of car insurance on 2 cars.

This. Most people don't have a 1K deductible. Wouldn't that be nice?