The PPACA - Implementation Phase I

[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_...er-warned-w.h-was-losing-control-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_...er-warned-w.h-was-losing-control-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!

 

[dxmnkd316]

Re: The PPACA - Implementation Phase I

For the record, I work for a Dow 30 company that self-insures as well. We are offered three plans:
PPO
High deductible
Really high deductible

I've been on the PPO for as long as I've been there (and pretty much all my life with the same clinic and insurance company - I've been EXTREMELY fortunate).

This year I'm probably switching to the high deductible because of the "disincentives" they've put on the PPO.

 

[FlagDUDE08]

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.

There is legislation for JOBS JOBS JOBS. They're with the IRS, NSA, and many other government agencies.

 

[jerphisch]

Re: The PPACA - Implementation Phase I

For the record, I work for a Dow 30 company that self-insures as well. We are offered three plans:
PPO
High deductible
Really high deductible

I've been on the PPO for as long as I've been there (and pretty much all my life with the same clinic and insurance company - I've been EXTREMELY fortunate).

This year I'm probably switching to the high deductible because of the "disincentives" they've put on the PPO.

Mine is a DOW 30 as well, we have no options. Only plan offered for a family is $3K deductible, $8K out of pocket max (I think those are halved for an individual). Only thing that doesnt get paid out of pocket and count towards deductible is 1 annual checkup. Company gives $1K in an FSA provided we take health screening, and beginning next year any health issues we had this year must be improved upon in order to keep getting the FSA $.

 

[dxmnkd316]

Re: The PPACA - Implementation Phase I

Wow. That's a load of crap.

 

[SteveP]

Re: The PPACA - Implementation Phase I

For the record, I work for a Dow 30 company that self-insures as well. We are offered three plans:
PPO
High deductible
Really high deductible

I've been on the PPO for as long as I've been there (and pretty much all my life with the same clinic and insurance company - I've been EXTREMELY fortunate).

This year I'm probably switching to the high deductible because of the "disincentives" they've put on the PPO.

So does that mean you're "transitioning"?

Seriously, I turned down an out-of-state job because the employer didn't have a health plan and I couldn't find out how much I would have to pay for insurance. Fortunately, my wife's company will still be offering family coverage next year. It's a high-deductible plan, which makes it tough paying for my diabetes supplies and meds.

 

[ScoobyDoo]

Re: The PPACA - Implementation Phase I

Heh, funny. Dianne Barrette was paraded around right wing media as a victim of Obamacare. Turns out she ended up with a better deal after all. I wonder if the right wing media will update everyone?

http://www.msnbc.com/rachel-maddow-show/maybe-its-blessing-disguise

Upon further inspection, the story of this “Obamacare victim” was far different from what those initial interviews suggested. Barrette had an awful insurance plan that left her one serious ailment away from bankruptcy. The Affordable Care Act offered an upgrade at a discount – she’s eligible for a subsidy under the law. Jonathan Cohn did some additional research, discovered that Barrette could sign up for a vastly better plan than she has now, and it’d cost her between $50 to $150 more per month, depending on how much coverage she was prepared to buy. Cohn asked Barrette directly if this would appeal to her, given her personal circumstances.

Here was her response: “I would jump at it,” she said.

 

[St. Clown]

Re: The PPACA - Implementation Phase I

Heh, funny. Dianne Barrette was paraded around right wing media as a victim of Obamacare. Turns out she ended up with a better deal after all. I wonder if the right wing media will update everyone?

http://www.msnbc.com/rachel-maddow-show/maybe-its-blessing-disguise

The Affordable Care Act offered an upgrade at a discount – she’s eligible for a subsidy under the law.

It's not a discounted plan. It's a plan that receives an annual subsidy while requiring monthly payments greater than her current plan. What's happening is that the PPACA is now shifting the payment of her insurance premiums from Dianne Barrette to society at large. And that's assuming that she can handle the increased monthly premiums without going bankrupt prior to receiving her tax subsidy in April 2015.

 

[Rover]

Re: The PPACA - Implementation Phase I

It's not a discounted plan. It's a plan that receives an annual subsidy while requiring monthly payments greater than her current plan. What's happening is that the PPACA is now shifting the payment of her insurance premiums from Dianne Barrette to society at large.

Society at large will be paying her bills anyway if she's bankrupt but still needs medical care. Hospitals can't refuse her treatment, but somebody has to pay for that. That someone will be us, and I'd rather have her treated ahead of time.

 

[geezer]

Re: The PPACA - Implementation Phase I

Two of my friends work at the same small company. They just got word their insurance premium is doubling this year because of Obamacare, from an already high $1500 per month to $3000 per month. They both have kids, which might explain why they're being hit this hard. The sad thing is that the benefits are being cut (care network contraction) even while the premium is going up. It's a lose-lose situation.
There are no real changes this year at my work. Our health care plan was already gutted out over the last two years in anticipation of Obamacare taxes, so we were preemptively disenfranchised from having decent insurance because of Obamacare. By the way, how was Medicaid not always doing the job that Obamacare spent all these $billions$ failing so badly to address? It was here all along without bankrupting everyone inventing some new bureaucracy. That will probably be my last best option to get coverage for next year.

 

[unofan]

Two of my friends work at the same small company. They just got word their insurance premium is doubling this year because of Obamacare, from an already high $1500 per month to $3000 per month. They both have kids, which might explain why they're being hit this hard. The sad thing is that the benefits are being cut (care network contraction) even while the premium is going up. It's a lose-lose situation.
There are no real changes this year at my work. Our health care plan was already gutted out over the last two years in anticipation of Obamacare taxes, so we were preemptively disenfranchised from having decent insurance because of Obamacare. By the way, how was Medicaid not always doing the job that Obamacare spent all these $billions$ failing so badly to address? It was here all along without bankrupting everyone inventing some new bureaucracy. That will probably be my last best option to get coverage for next year.

This reads like a fw:fw:fw:email.

How small is the small company? Who is the insurer? What do they make? 3000/month is 36000/year. Unless they're making well into the six figures, they would be eligible to go to the exchanges since their employer provided coverage costs more than 9% of their income.

As far as your Medicaid question, it doesn't cover nearly the amount of people you are assuming it covers. The ACA was going to fix that by giving the states more money to cover more people, but many GOP governors turned it down in a case of biting off their noses to spite their faces.