Obamacare basics

[Mulligan]

Quote:

Originally Posted by jarts98 You're right about the rebate, thus the reason I don't believe they're lying and, in fact, the mandates are behind the increase in the rate of premium growth.

Your previous observations would be reflected in my current situation. My individual plan has not been subjected to the new rules, being grandfathered and with lifetime limits in effect. The premium has only went up $3 in the almost 3 years that I have had it.

[MichaelB]

Quote:

Originally Posted by jarts98 You're right about the rebate, thus the reason I don't believe they're lying and, in fact, the mandates are behind the increase in the rate of premium growth.

This chart from the Kaiser foundation shows an accelerated rate of growth for health care premiums dating back to 1999, around 5x the rate of inflation. The accompanying presentation can be found here http://ehbs.kff.org/pdf/2012/8345-Chartpack.pdf

[ERhoosier]

Quote:

Originally Posted by Yumadons I'm one whose health insurance is "going away" under ObamaCare. For 30 years I've purchased HI from the AVMA (American Veterinary Medical Association). Received notice that as of 12/31/13, AVMA will no longer be able to sell HI to veterinarians. Under the new law, they would be required to sell their HI to anyone who wanted to buy it, and they're not equipped to do that.

So much for "If you like your health care plan, you can keep your health care plan."- Obama Aug 11, 2009 in New Hampshire

PolitiFact | Barack Obama promises you can keep your health insurance, but there's no guarantee

As I've said many times, only time will tell how the ACA will eventually play out.

[bUU]

Quote:

Originally Posted by FIRE'd@51 bUU also acknowledged that there's nothing in ACA to prevent companies (or municipalities) from ending their coverage for current employees and dumping them on the exchanges, which was essentially the question OP asked.

Indeed and hopefully all companies that would otherwise pass-along more cost to employees than they'd have to pay for comparable insurance through ACA will end their own coverage. No one benefits from a situation where both employers and employees are paying more for health insurance.

Quote:

Originally Posted by ripper1 Yes, but if it passes a lot of retired folks from Chicago will see their premiums more than double.

Presumably that would be something that the employer would have wanted to accomplish either way, either through direct premium pass-along increases, or short-changing the quality of the insurance.

In the end, employers will do what they will, sometimes in the best interest of their business, occasionally even privately-owned businesses will act out of spite. There's no accounting for that in the context of the ACA - it doesn't require spitefulness, nor effectively fosters it, nor would it either forestall or foster business decisions made in the business' best interests.

[samclem]

Quote:

Originally Posted by MichaelB I've seen this [that employers may dump employees into exchanges] written elsewhere on the forum but can't find a source. Do you have a link or info source to this?

Well, it's certainly true for small employers: The law was written specifically to allow them to use the exchanges. There is also an official new program to offer these same small employers tax credits if they continue to provide coverage that meets the ACA guidelines (so, no traditional HDHPs, etc).
Large employers (over 50 FTE): Employers just need to make an assessment as to whether it's better to pay the fine/tax or provide coverage. It's not simply a matter of which is cheaper for them, since keeping good employees is also important. In some cases (e.g. low wage employees) it may help attract employees if employers >don't< provide coverage, since the employee will do better by taking the taxpayer-offered subsidy and the employers can offer increased cash compensation (e.g. maybe matching their present health care contribution minus the fine/tax. If that was the level of compensation needed to keep quality employees before, maybe it would be tha same afterward). This may be viewed as an asset transfer from government to businesses (just as the subsidy for small employers is a "tax expenditure").
I'm not being a wiseacre-- would links about any of this be illuminating? You know the ACA, so I'm guessing this isn't news.

[FIRE'd@51]

Quote:

Originally Posted by bUU Indeed and hopefully all companies that would otherwise pass-along more cost to employees than they'd have to pay for comparable insurance through ACA will end their own coverage. No one benefits from a situation where both employers and employees are paying more for health insurance.

Yes, but as Ziggy pointed out in a post above, it seems more likely that the cost of insurance purchased in the exchanges will be higher, since they will likely have risk pools of less healthy people. Unfortunately, rather than eliminating adverse selection, Obamacare seems to perpetuate it.

IMO, until everyone is in the same risk pool, schemes like Obamacare are really not much more than "re-arranging the deck chairs".

[bUU]

Quote:

Originally Posted by samclem keeping good employees is also important

This cannot be overstated, at least in the form, either attracting and keeping excellent employees is important, or employees are going to be treated like dirt regardless. Increasingly, the latter is the de facto reality, generally unrelated to health care.

[anethum]

Quote:

Originally Posted by FIRE'd@51 Yes, but as Ziggy pointed out in a post above, it seems more likely that the cost of insurance purchased in the exchanges will be higher, since they will likely have risk pools of less healthy people. Unfortunately, rather than eliminate adverse selection, Obamacare seems to perpetuate it. IMO, until everyone is in the same risk pool, schemes like Obamacare are really not much more than "re-arranging the deck chairs".

You're forgetting that the risk pools will also now include many healthy people who either presently choose not to be insured or who cannot afford to be insured. As I have said previously on other threads, I was covered by Blue Cross of Massachusetts when "Romneycare" went into effect. The total premium dropped, as well as my share of the premium. That would indicate that enlarging the pool to include virtually everyone actually lowered the average cost.

[travelover]

Quote:

Originally Posted by ERhoosier So much for "If you like your health care plan, you can keep your health care plan."- Obama Aug 11, 2009 in New Hampshire PolitiFact | Barack Obama promises you can keep your health insurance, but there's no guarantee As I've said many times, only time will tell how the ACA will eventually play out.

Bummer. In all fairness, the statement that you'd be able to keep your current insurance was to counter claims that were being made that Obamacare would force everyone into some new government insurance plan against their will. Kind of like the "Obamacare will kill your grandmother" hysteria that was circulated for awhile.

[Texas Proud]

Quote:

Originally Posted by anethum You're forgetting that the risk pools will also now include many healthy people who either presently choose not to be insured or who cannot afford to be insured. As I have said previously on other threads, I was covered by Blue Cross of Massachusetts when "Romneycare" went into effect. The total premium dropped, as well as my share of the premium. That would indicate that enlarging the pool to include virtually everyone actually lowered the average cost.

Lowering the average cost is not the same as loweing the total cost...

Obamacare was touted as a plan to lower the total cost... so far it does not seem to be doing that...

[anethum]

Quote:

Originally Posted by jarts98 I believe (although I'm certainly biased) that my clients genuinely care for their employees and don't want to cancel coverage, but as the mandates of ACA continue to drive up the premiums (which is what the carriers are saying), they may be forced to drop coverage. It's not greed on their part (especially since they want to increase the pay rates to reallocate the "savings" from not paying health premiums) - it's economics.

One of the most important mandates of the PPACA was the lifting of the lifetime cap on benefits. That has already gone into effect. Driving sick people into bankruptcy was detrimental for the individuals, their health care providers, and society at large.

[Texas Proud]

I have a question that maybe should be moved to another thread... but will ask here and see what people think...

We continue to talk about 'health care', which is only focused on medical care but does not include dental care.. I am surprised that there is little talk about this care, which is pretty important to most folks... bad teeth and bad gums can lead to other health problems...

So, why is dental care left out of the discussion when we talk 'health care'


PS.... not talking about crowns and cosmetic stuff, but basic dental care.

[anethum]

Quote:

Originally Posted by Texas Proud Lowering the average cost is not the same as loweing the total cost... Obamacare was touted as a plan to lower the total cost... so far it does not seem to be doing that...

It is way too soon to draw any conclusions. The major elements of the law haven't even gone into effect yet.

[bUU]

ACA is a first step toward reducing overall cost of health care. Not a magic incantation that makes all problems go away instantaneously. And not something that will make each individual's own personal costs go down. When you compute the costs of health care, it is essential that you include the cost of providing indigent care in ERs. There is no question that shifting those services out of ERs and into more cost-efficient provider venues will lower costs. Also, don't forget to include the costs, including some amount associated with untimely death, associated with lack of coverage for preexisting conditions, or exceeding of lifetime caps, or the more general inability to afford health care due to lack of health insurance.

[Alan]

Quote:

Originally Posted by Texas Proud I have a question that maybe should be moved to another thread... but will ask here and see what people think... We continue to talk about 'health care', which is only focused on medical care but does not include dental care.. I am surprised that there is little talk about this care, which is pretty important to most folks... bad teeth and bad gums can lead to other health problems... So, why is dental care left out of the discussion when we talk 'health care' PS.... not talking about crowns and cosmetic stuff, but basic dental care.

My retiree HI does not cover dental check ups and cleanings, or the cosmetic stuff, but it does cover the more serious side of dental care such as gum disease and root canals which, if untreated, will lead to much more serious health problems.

[youbet]

Quote:

Originally Posted by bUU ACA is a first step toward reducing overall cost of health care.

That's not necessarily true. We'll know the answer some years down the road but we don't know now.

[travelover]

Quote:

Originally Posted by Texas Proud .......... Obamacare was touted as a plan to lower the total cost... so far it does not seem to be doing that...

It has only been in full effect since 2014.

[Mulligan]

Quote:

Originally Posted by anethum One of the most important mandates of the PPACA was the lifting of the lifetime cap on benefits. That has already gone into effect. Driving sick people into bankruptcy was detrimental for the individuals, their health care providers, and society at large.

Not to be disagreeable, with your statement or to even say your wrong, but did people really have such small lifetime caps, that this was a truly big issue for the masses? I still am hanging on to my grandfathered plan, and it has a 7 million dollar cap, which was standard issue for the policy.I haven't given it a thought as I would think you would truly have to be a one in a million plus, to bump up near that total. Maybe I am taking my health for granted, but I am more in the concern for dental costs as another person mentioned, than health costs. I am very much in support of uninsurable people having the right to acquire insurance, but I would bet for the typical person, not having disability insurance was more of a financial strain long term, than the medical debts that an insured person acquired. Maybe I am wrong. I have known several fund raising activities for families who have had medical problems, and they actually had good insurance. It was the bills piling up from not working that was causing financial hardship for the families.

[bUU]

Quote:

Originally Posted by Mulligan Not to be disagreeable, with your statement or to even say your wrong, but did people really have such small lifetime caps, that this was a truly big issue for the masses?

It was clearly a big enough issue for insurers to impose lifetime caps in the first place, and definitely a big issue for those who exceeded the caps.

Quote:

Originally Posted by Mulligan I am very much in support of uninsurable people having the right to acquire insurance, but I would bet for the typical person, not having disability insurance was more of a financial strain long term, than the medical debts that an insured person acquired.

Fixing one problem doesn't preclude also fixing another problem.

[MichaelB]

Quote:

Originally Posted by Yumadons I'm one whose health insurance is "going away" under ObamaCare. For 30 years I've purchased HI from the AVMA (American Veterinary Medical Association). Received notice that as of 12/31/13, AVMA will no longer be able to sell HI to veterinarians. Under the new law, they would be required to sell their HI to anyone who wanted to buy it, and they're not equipped to do that.

Interesting, thanks for the info. It appears the underwriter is withdrawing all of its policies because, even though they are offered in all 50 states, they are only registered in one (Illinois) and the new legislation requires them to register and comply with all 50 states. So, a loophole in the "keep your coverage" consideration.