The PPACA - Implementation Phase I

[Rover]

Re: The PPACA - Implementation Phase I

In 08 he didn't run on jobs?

In 2008 he ran on a liberal agenda and won big. In 2012 he ran on a "don't compare me to the Almighty, compare me to the opposition" platform...and won comfortably. Expect that same thing in 2016 with Clinton vs whoever.

[BassAle]

Re: The PPACA - Implementation Phase I

My premium is increasing by 5% (less than previous years) and no change in coverage for me(for lower income workers they actually reduced the annual out of pocket maximum.) So it isn't all doom and gloom.

my premium hasn't gone up in 4 years I think, largely thanks to the fact that we are self-insured and the company started a wellness program that seems to be helping a lot of people (on site fitness trainer, lots of fitness classes during the work day, lifestyle coaching). No changes as a result of the ACA.

[DrDemento]

Re: The PPACA - Implementation Phase I

My premium is increasing by 5% (less than previous years) and no change in coverage for me(for lower income workers they actually reduced the annual out of pocket maximum.) So it isn't all doom and gloom.

Just for reference-do you purchase your own policy? Or are you part of a group policy from an employer? And is this policy now ACA compatable or will it be cancelled after this next renewal? Also-if you don't mind-age group? My wife over the past 12 years with Horizon BC of NJ has never had any increase less than 7% and some years as high as 19%(this year) and she has already received the letter telling us that this is the last time it will be renewed ever.

I ask much of this to see if we here in the lovely state of NJ are receiving a similar experience to what others are seeing in different areas of the country.

[DrDemento]

Re: The PPACA - Implementation Phase I

my premium hasn't gone up in 4 years I think, largely thanks to the fact that we are self-insured and the company started a wellness program that seems to be helping a lot of people (on site fitness trainer, lots of fitness classes during the work day, lifestyle coaching). No changes as a result of the ACA.

Again-is this a group policy or an individual policy? As far as i can tell the cancellations and major increases are limited so far to those who purchase individual policies only.

[FreshFish]

Re: The PPACA - Implementation Phase I

my premium hasn't gone up in 4 years I think, largely thanks to the fact that we are self-insured and the company started a wellness program that seems to be helping a lot of people (on site fitness trainer, lots of fitness classes during the work day, lifestyle coaching). No changes as a result of the ACA.

It sounds like you have an employer-sponsored small group plan. I hope that you have a similar experience at the end of next year....don't overlook the fact that the employer mandate was delayed for a year, so that whatever problems lurked in PPACA for employer-sponsored plans have merely been pushed out of sight, and not at all eliminated.

Also, the language of PPACA gives HHS wide latitude to write enabling regulations, and so far HHS has used this latitude in a very political manner. They do not like self-insured plans, they do not like them at all. There is ticking time-bomb language that would make many self-insured plans obsolete (most self-insured plans use a high-level stop-loss policy which makes fantastic economic sense but leaves too many entities outside of government control to satisfy their dictatorial nature). I hope you get to keep it 15 months from now.

[Rover]

Re: The PPACA - Implementation Phase I

I'm in a group policy at work and we went up more last year. This year no change in premiums.

Any insurer worth his salt has already changed their policies to comply with the new law since several provisions (such as no lifetime limits on care) are already in effect. As far as individual policies, what we're now hearing is that the people TV complaining about their coverage getting cancelled had terrible coverage and were basically paying money for no services. Small wonder you can't get a policy like that anymore.

[FreshFish]

Re: The PPACA - Implementation Phase I

Washington Post publishes an internal White House memo dated May 11, 2010 that presages all of the problems we have seen since:

I am writing to relay my concern about the way the Administration is implementing the new health reform legislation. I am concerned that the personnel and processes you have in place are not up to the task, and that health reform will be unsuccessful as a result.

....

My general view is that the early implementation efforts are far short of what it will take to implement reform successfully. For health reform to be successful, the relevant people need a vision about health system transformation and the managerial ability to carry out that vision. The President has sketched out such a vision. However, I do not believe the relevant members of the Administration understand the President’s vision or have the capability to carry it out. [emphasis in original]

The rest of the memo is extraordinary. I am very impressed: it was written by someone who passionately believed in the promise and ideals behind PPACA and wanted to see them work. Anyone who supports the law should read it: the author lays out the essential minimal steps for the law to work. If the administration had followed through on those suggestions, I might very well be sitting on the fence, still mulling over my reaction. However, contrast those excellent proposals to what actually has been done.

There was no commitment to making the law work; all they cared about was passing it. Once it was passed, that was it, their job was done. Now the rest of us are stuck with Max Baucus' "train wreck" of epic proportions.

[ScoobyDoo]

Re: The PPACA - Implementation Phase I

In 08 he didn't run on jobs?

Yeah, in '08. Not in '12. And he NEVER ran on JOBS JOBS JOBS. Still waiting for Boner's JOBS JOBS JOBS legislation. The only thing I know for sure is there will be an abortion rider somewhere in the bill.

[jerphisch]

Re: The PPACA - Implementation Phase I

Just for reference-do you purchase your own policy? Or are you part of a group policy from an employer? And is this policy now ACA compatable or will it be cancelled after this next renewal? Also-if you don't mind-age group? My wife over the past 12 years with Horizon BC of NJ has never had any increase less than 7% and some years as high as 19%(this year) and she has already received the letter telling us that this is the last time it will be renewed ever.

I ask much of this to see if we here in the lovely state of NJ are receiving a similar experience to what others are seeing in different areas of the country.

Group policy through a self insured employer. Have been here a little over 5 years and we have had 10%+ increases most years, except the one where they switched from a standard plan to a high deductible one. They were kind enough to leave cost the same as the previous year while killing the coverage. Not sure how to quatify the increase in cost of switching plans but I would guess the % increase there was astronomical. I believe the policy is now ACA compliant as the list of changes from last year to this has a blurb about including all ACA costs.

[DrDemento]

Re: The PPACA - Implementation Phase I

Group policy through a self insured employer. Have been here a little over 5 years and we have had 10%+ increases most years, except the one where they switched from a standard plan to a high deductible one. They were kind enough to leave cost the same as the previous year while killing the coverage. Not sure how to quatify the increase in cost of switching plans but I would guess the % increase there was astronomical. I believe the policy is now ACA compliant as the list of changes from last year to this has a blurb about including all ACA costs.

Then not quite comparable to what was done here to us in NJ. Since we closed the office and just do consulting work-we lost the opportunity to keep our group policy. Unbelievable difference for us. The deductible and out of pocket maximum is a 10 fold increase. The drug copayment changed from 10 generic/30 brand name to a 50% copay(but that 50% is based solely on wht the insurer feel the drug should cost and not the real world price.

No one has a crystal ball-and i don't dare speculate on what will happen to group policies in the next few years. But what many of the self insured are seeing right now may portend a bit about what will happen in the future for the group coverages. I am not smart enough and certainly not a large business owner to know what effects that could have in the workplace.

[walrus]

Re: The PPACA - Implementation Phase I

So as late as today Obama has been saying you can sign up for Insurance on the phone or in person, guess what, no you can't according to NBC evening news. They're claiming no matter how you sign up your info has to go thru a portal that doesn't work. Does Obama have any idea whats going on with his signature legislation?

[SteveP]

Re: The PPACA - Implementation Phase I

So... now we learn the White House was told three years ago that Obamacare would be a ginormous screwup.
http://www.cbsnews.com/8301-505263_1...l-3-years-ago/

Three years ago, a trusted Obama health care adviser warned the White House it was losing control of Obamacare. A memo obtained by CBS News said strong leadership was missing and the law's successful implementation was in jeopardy. The warnings were specific and dire -- and ignored.

(David) Cutler wrote no one was in charge who had any experience in complex business start-ups. He also worried basic regulations, technology and policy coordination would fail.

[DrDemento]

Re: The PPACA - Implementation Phase I

So... now we learn the White House was told three years ago that Obamacare would be a ginormous screwup.
http://www.cbsnews.com/8301-505263_1...l-3-years-ago/

Steve: I am sure they got a ton of input from insurance people-but i wonder how much was asked for from the medical providers of care that would be ruled by the legislation?

[Old Pio]

Re: The PPACA - Implementation Phase I

So as late as today Obama has been saying you can sign up for Insurance on the phone or in person, guess what, no you can't according to NBC evening news. They're claiming no matter how you sign up your info has to go thru a portal that doesn't work. Does Obama have any idea whats going on with his signature legislation?

And if not, why not? What was Howard Baker's famous Watergate question? "What did the president know and when did he know it?"

[Old Pio]

Re: The PPACA - Implementation Phase I

Yeah, in '08. Not in '12. And he NEVER ran on JOBS JOBS JOBS. Still waiting for Boner's JOBS JOBS JOBS legislation. The only thing I know for sure is there will be an abortion rider somewhere in the bill.

Cha ching!