The PPACA - Implementation Phase I

[LynahFan]

Re: The PPACA - Implementation Phase I

I call bull*****, and here's why. Insurers have two issues under ACA. Everybody needs to have insurance (good thing for insurers) and you can't deny people insurance for prior disabilities (bad thing for insurers).

So, insurers get a flood of healthy people paying premiums who aren't using the system all that much, and a bunch of older sickly people as an offset. The benefit for the insurers is, the older sickly people are most likely being subsidized by the feds while the younger healthy people aren't. So, why the rate increases unless its to line the insurers' pockets?

You're making a pretty big assumption that the additional premiums paid by previously uninsured people will equal the additional payments the insurers will make to cover people who were previously uninsured (including those with high costs who had been deemed uninsure-able). In fact, it would be quite shocking if those two sums did happen to exactly cancel out.

 

[Rover]

You're making a pretty big assumption that the additional premiums paid by previously uninsured people will equal the additional payments the insurers will make to cover people who were previously uninsured (including those with high costs who had been deemed uninsure-able). In fact, it would be quite shocking if those two sums did happen to exactly cancel out.

But that's the deal the insurers struck with the Obama administration over the legislation. In order for them to support coverage for the previously uninsurable, they demanded that a requirement be but in there to get the younger healthy people added to the pool. If that doesn't cancel out as you say, they shouldn't have agreed to it then, right?

 

[FlagDUDE08]

Re: The PPACA - Implementation Phase I

But that's the deal the insurers struck with the Obama administration over the legislation. In order for them to support coverage for the previously uninsurable, they demanded that a requirement be but in there to get the younger healthy people added to the pool. If that doesn't cancel out as you say, they shouldn't have agreed to it then, right?

You're still making a huge assumption that the penalty to not join will be higher than the amount it will cost to join. From what I've heard, the penalty is smaller, meaning people aren't going to join.

 

[Rover]

You're still making a huge assumption that the penalty to not join will be higher than the amount it will cost to join. From what I've heard, the penalty is smaller, meaning people aren't going to join.

Aren't you undervaluing or compeletely not valuing actually having insurance though?

This is completely random, but if it'd cost you 500 bucks a month for insurance, and currently you pay zero and have none, you might be okay with that. However, lets say the law goes into effect and now doing nothing costs you 250 bucks as opposed to paying 500. At that point one might say its better to shell out the extra 250 and have insurance than to do nothing but still end up paying. So, the question isn't the difference between insurance costs and tax penalty. Its if the tax penalty is lower than what you think having insurance is worth and the monthly premium which you're paying anyway.

 

[FreshFish]

Re: The PPACA - Implementation Phase I

Here's where one of the bigger messes is most likely to occur:

People read that they can enroll in an insurance plan at any time they want, and pre-existing conditions will not interfere with their ability to be offered coverage at standard rates. They think they'll game the system and wait until they are sick before buying insurance. then they get into an accident. Sure, they can buy insurance afterward, but none of their injuries will have occurred while they were covered, and so they will still be on the hook for all the treatement for those injuries anyway, just as if the law hadn't been passed.

If anything, the law will probably in practice exacerbate the problem of people not having coverage when it is most needed because people don't understand the details about pre-existing conditions. The press says you can buy insurance and pre-existing conditions will be covered. That's just plain wrong!

The law says you can buy insurance at any time and pre-existing conditions cannot be used as a reason to deny you coverage. The law does NOT say that coverage must be offered retroactively. Coverage is only offered on a go-forward basis.

 

[St. Clown]

Re: The PPACA - Implementation Phase I

Here's where one of the bigger messes is most likely to occur:

People read that they can enroll in an insurance plan at any time they want, and pre-existing conditions will not interfere with their ability to be offered coverage at standard rates. They think they'll game the system and wait until they are sick before buying insurance. then they get into an accident. Sure, they can buy insurance afterward, but none of their injuries will have occurred while they were covered, and so they will still be on the hook for all the treatement for those injuries anyway, just as if the law hadn't been passed.

If anything, the law will probably in practice exacerbate the problem of people not having coverage when it is most needed because people don't understand the details about pre-existing conditions. The press says you can buy insurance and pre-existing conditions will be covered. That's just plain wrong!

The law says you can buy insurance at any time and pre-existing conditions cannot be used as a reason to deny you coverage. The law does NOT say that coverage must be offered retroactively. Coverage is only offered on a go-forward basis.

Take this for what it's worth.

I was listening to a radio show a few weeks ago (months now?), and a couple guys who claimed to work for insurance companies called in and said that their companies would avoid the very scenario you're discussing by making it so insurance wouldn't be effective for something like 15 days or a month after the contract is signed. That way they could avoid the situation where guy breaks an arm, calls the insurance company to get coverage, and then goes to the hospital an hour or two later.

 

[joecct]

Re: The PPACA - Implementation Phase I

Take this for what it's worth.

I was listening to a radio show a few weeks ago (months now?), and a couple guys who claimed to work for insurance companies called in and said that their companies would avoid the very scenario you're discussing by making it so insurance wouldn't be effective for something like 15 days or a month after the contract is signed. That way they could avoid the situation where guy breaks an arm, calls the insurance company to get coverage, and then goes to the hospital an hour or two later.

But, if you come down with the Big C, the pre existing clause could be a benefit.

To be fair, I think the best bet is a quarterly (semi annual / annual?) open season, where you have 1 month to sign up for insurance then it is effective the start of the next quarter. For example, Open Season runs 2/15 - 3/15 and coverage starts 4/1.

 

[FlagDUDE08]

Re: The PPACA - Implementation Phase I

Here's where one of the bigger messes is most likely to occur:

People read that they can enroll in an insurance plan at any time they want, and pre-existing conditions will not interfere with their ability to be offered coverage at standard rates. They think they'll game the system and wait until they are sick before buying insurance. then they get into an accident. Sure, they can buy insurance afterward, but none of their injuries will have occurred while they were covered, and so they will still be on the hook for all the treatement for those injuries anyway, just as if the law hadn't been passed.

If anything, the law will probably in practice exacerbate the problem of people not having coverage when it is most needed because people don't understand the details about pre-existing conditions. The press says you can buy insurance and pre-existing conditions will be covered. That's just plain wrong!

The law says you can buy insurance at any time and pre-existing conditions cannot be used as a reason to deny you coverage. The law does NOT say that coverage must be offered retroactively. Coverage is only offered on a go-forward basis.

Did you ever watch "The Case of the Purloined Policies" from the Mathnet segment of Square One TV? Although it's not an exact case, a policy is taken out for a fake vehicle, and a couple days later the "vehicle" is conveniently reported stolen, in order to collect money.

 

[FlagDUDE08]

Re: The PPACA - Implementation Phase I

Take this for what it's worth.

I was listening to a radio show a few weeks ago (months now?), and a couple guys who claimed to work for insurance companies called in and said that their companies would avoid the very scenario you're discussing by making it so insurance wouldn't be effective for something like 15 days or a month after the contract is signed. That way they could avoid the situation where guy breaks an arm, calls the insurance company to get coverage, and then goes to the hospital an hour or two later.

If I were head of an insurance company (and unfortunately I'd pretty much need a monopoly to do this; could probably only get away with it in rural areas), I'd require a coverage minimum. i.e. If you buy a policy, you must keep it for at least two years, with a termination fee of triple the remaining premiums excepting in the cases of death or transfer of permanent residence to a state in which my company's conglomerate does not offer coverage.

 

[FreshFish]

Re: The PPACA - Implementation Phase I

To be fair, I think the best bet is a quarterly (semi annual / annual?) open season, where you have 1 month to sign up for insurance then it is effective the start of the next quarter. For example, Open Season runs 2/15 - 3/15 and coverage starts 4/1.

Yes, that is very sensible. Had there been any grownups with real world experience involved in drafting the law, that would have been a sensible way to set it up. You have to buy the insurance in advance to be covered for anything that happens, and if everyone had the same open enrollment window, then insurance companies could price their offerings with some semblance of reliability.

Under your plan, pre-existing conditions don't stop you from being eligible to buy health insurance at "standard" rates during the open enrollment window.

Another element that will be very unpopular as it becomes better understood is the lack of age banding. You'd think they could at least do a "18 - 40 / 41 - 55 / 56 - 70 / 71 and older" kind of deal or something like that to make the rates more palatable.

Best would be a linkage between premium and lifestyle choice: cigarette smokers should pay more than non-smokers, for example.

 

[Twitch Boy]

Re: The PPACA - Implementation Phase I

Did you ever watch "The Case of the Purloined Policies" from the Mathnet segment of Square One TV? Although it's not an exact case, a policy is taken out for a fake vehicle, and a couple days later the "vehicle" is conveniently reported stolen, in order to collect money.

No, because when Mr. Glitch came on during Mathman I changed the channel.

One time Mr. Glitch just went ahead and ate Mathman right at the start. "Beware the evil Mr. Glitch. He will...*nom nom nom*...eat you." GAME OVER. That was pure evil on the part of the producers.

/though he deserved it for wearing a Weasels helmet

 

[LynahFan]

Re: The PPACA - Implementation Phase I

But that's the deal the insurers struck with the Obama administration over the legislation. In order for them to support coverage for the previously uninsurable, they demanded that a requirement be but in there to get the younger healthy people added to the pool. If that doesn't cancel out as you say, they shouldn't have agreed to it then, right?

Why not? They never promised not to raise rates - it was Obama's accountants who guessed that insurers wouldn't have to raise their rates. New captive customer base + increased premiums across the board = win for insurance companies. If I were an insurance exec, I'd have taken that deal every day and twice on Sundays.

 

[FlagDUDE08]

Re: The PPACA - Implementation Phase I

No, because when Mr. Glitch came on during Mathman I changed the channel.

One time Mr. Glitch just went ahead and ate Mathman right at the start. "Beware the evil Mr. Glitch. He will...*nom nom nom*...eat you." GAME OVER. That was pure evil on the part of the producers.

/though he deserved it for wearing a Weasels helmet

I don't think there was a Mathman episode that time around.

 

[FlagDUDE08]

Re: The PPACA - Implementation Phase I

Why not? They never promised not to raise rates - it was Obama's accountants who guessed that insurers wouldn't have to raise their rates. New captive customer base + increased premiums across the board = win for insurance companies. If I were an insurance exec, I'd have taken that deal every day and twice on Sundays.

Or perhaps that was the plan all along. Price the poor out so they all die.

 

[St. Clown]

Re: The PPACA - Implementation Phase I

Or perhaps that was the plan all along. Price the poor out so they all die.

It's like the song says,

Tax the rich.
Disease the poor.
'Til there are no poor no more.

Oh, wait.

 

[Rover]

The law says you can buy insurance at any time and pre-existing conditions cannot be used as a reason to deny you coverage. The law does NOT say that coverage must be offered retroactively. Coverage is only offered on a go-forward basis.

Which is completely fair. As I think you said, you can't break your arm and then get insurance and then go in for treatment. In my career employers tended to have you sign up at least two months before the insurance actually kicked in. I think that's reasonable. A big point of this law is personal responsibility. Part of that responsibility is signing up ahead of time for insurance which shouldn't be that difficult for functioning human beings.

Lynah, insurance companies as part of taking the deal have to live within certain parameters. You can't say "thanks for the new clients" then jack up rates 500% even though the costs haven't gone up comparably. Anybody who tries that needs to be subject to an investigation.

 

[LynahFan]

Re: The PPACA - Implementation Phase I

Lynah, insurance companies as part of taking the deal have to live within certain parameters. You can't say "thanks for the new clients" then jack up rates 500% even though the costs haven't gone up comparably. Anybody who tries that needs to be subject to an investigation.

Yeah, we can't have private companies going around pricing their products willy-nilly, when we could spend additional money having government bureaucrats do it for them...

 

[brookyone]

Re: The PPACA - Implementation Phase I

Yeah, we can't have private companies going around pricing their products willy-nilly, when we could spend additional money having government bureaucrats do it for them...

Yeah, we should maintain the old status quo with private companies pricing their products willy-nilly for the sole purpose of excluding millions from their selective market.

 

[unofan]

Yeah, we can't have private companies going around pricing their products willy-nilly, when we could spend additional money having government bureaucrats do it for them...

Having private companies controlling something with nearly completely inelastic demand is asking for all sorts of market failures.

 

[FlagDUDE08]

Re: The PPACA - Implementation Phase I

Yeah, we should maintain the old status quo with private companies pricing their products willy-nilly for the sole purpose of excluding millions from their selective market.

Yeah, we should be forced to pay for the unhealthy choices of others...