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Old 08-01-2013, 09:41 AM   #141
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So the strategy would be to sign up at places marketing to these "young invincibles" and not the ones advertising in AARP Magazine?
I guess we need to wish them luck in snagging the young ones. If they don't buy into the concept of paying more to subsidize us older ones, we may be in for some additional "rate shock" a year from now.
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Old 08-01-2013, 10:42 AM   #142
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Education loans are not dischargeable in bankruptcy, why not the same approach for health care expenses for those who do not buy health insurance? That should inspire the young invincibles!
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Old 08-01-2013, 01:27 PM   #143
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Education loans are not dischargeable in bankruptcy, why not the same approach for health care expenses for those who do not buy health insurance? That should inspire the young invincibles!
I think that's because people found a loophole, just after graduating they would file for bankruptcy (obviously they didn't have any $ and maybe no job yet).
A better way is to refuse treatment unless you have HI or $ up front ...but I'm pretty sure that wouldn't fly.
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Old 08-01-2013, 01:36 PM   #144
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I think that's because people found a loophole, just after graduating they would file for bankruptcy (obviously they didn't have any $ and maybe no job yet).
A better way is to refuse treatment unless you have HI or $ up front ...but I'm pretty sure that wouldn't fly.
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Teejay, you are such a heartless person! You cant just not give a person treatment....Me being of kinder heart would treat them, then extoll some physical punishment on them and warn them to expect the intensity to be greater the next time you come in without insurance. During my formative years, pain seemed to be the best motivator for me to conform to the rules.
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Old 08-01-2013, 02:07 PM   #145
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During my formative years, pain seemed to be the best motivator for me to conform to the rules.
Or, loss of freedom would hit pretty hard. We've got this sequester going on, surely the federal government has some work that needs to be done. All the person would owe would be the payback hours for the cost of their treatment. Compute it at the hourly wage rate of the median taxpayer (since that would be roughly the number of hours his fellow taxpayers had to work to pay for his treatment. Fair. ). That MRI after the fight in the bar? Could be a lot of hours in the sun picking up trash in a national park.
On a more serious note--I do think there are appropriate carrots and sticks available to encourage people to have insurance, even without direct government fines. Having no medical insurance should definitely be a factor in computing a credit rating (that should get the attention of some "invincibles", since credit scores affect everything from loan rates to the cost of other types of insurance). And potential employers should have access to this information (is a person reliable and responsible if they won't even get subsidized health insurance? Will they be as healthy on the job if they aren't able to get affordable treatment?).
The taxpayers of this nation are paying a lot of money to assist people with getting insurance. The folks who already were covered and liked their coverage are in many cases sacrificing, too--losing that coverage for coverage that they may find to be an inferior value. Given all this, it's not unreasonable to ask the uninsured to take responsibility for themselves, and for the failure to do so to have real consequences.
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Old 08-01-2013, 02:43 PM   #146
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So the strategy would be to sign up at places marketing to these "young invincibles" and not the ones advertising in AARP Magazine?
That's my theory, anyway.

If the insurance companies have a say, look for the tables at the mall to be set up in front of REI or the Gap, not Lane Bryant or the Rockport store.
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Old 08-01-2013, 03:09 PM   #147
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Or near a NIKE Factory Store.
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Old 08-01-2013, 03:18 PM   #148
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Lots of members are finding these health care threads useful, so lets keep this thread focused on PPACA updates and news.
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Old 08-01-2013, 06:13 PM   #149
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The office of the Assistant Secretary for Planning and Evaluation (ASPE) at Health and Human Services prepared the projections that the Congressional Budget Office has used in scoring the benefits and costs for the ACA.

They have recently published a report that evaluated the state exchange premiums that have been published so far. (We've had individual threads or sub-threads that have discussed each as they were released.)

It's the first account I've seen that puts all of the published-to-date metal plan premiums side-by-side.

As one might expect, HHS sees a sunny forecast ahead for the remaining states and the federal exchanges. We'll see.

report:
http://aspe.hhs.gov/health/reports/2...b_premiums.pdf
web page:
ASPE
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A goal of the Affordable Care Act is to increase competition and transparency in the markets for individual and small group insurance, leading to higher quality, more affordable products. Information on proposed premiums in the individual and small group markets has recently been made available by selected states, and it is now possible to move from theoretical arguments to data-driven analysis. This research brief analyzes proposed rates in the individual market for 2014 in the eleven states that have made information available, and compares these rates to those estimated by the Congressional Budget Office. Further, for six states, we compare the rates that will be charged to small employers with the average amount that small employers would have been expected to pay in 2014 for comparable coverage and a comparable population. Overall, silver premiums in the 2014 individual and small group markets are nearly 20% lower than expected....

...Although there are many hypotheses that might account for the finding that actual premiums appear to be substantially below ASPE-derived CBO estimates, a likely explanation is that greater competition and greater transparency are driving down prices in the Marketplace.
Figure 2: Comparison of ASPE-Derived CBO 2014 Premium Estimate to Individual Market Second Lowest Cost Issuer’s Silver Premium, Weighted by Expected 2014 Individual Market Age Distribution

Note: Ohio and Virginia have not yet posted premiums for all issuers; the numbers presented here may be higher than the lowest cost 2014 silver premiums when all filings are posted.
Sources: Congressional Budget Office estimate derived as described in footnote 19. State data from publicly available sources, weighted by RAND COMPARE estimate of enrollment by age in the individual market in 2014. US average constructed by weighting each state according to its proportion of individual market enrollees per the 2011 Medical Loss Ratio filings.
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Old 08-02-2013, 05:45 PM   #150
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Looks like e-Health will have some competition. Kaiser health news reports Univision Obamacare Deal Could Put WellPoint, Blues Ahead Of Competitors - Kaiser Health News

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WellPoint and other Blues insurers in six states including Florida have signed deals with Univision for undisclosed sums to be the exclusive health insurance sponsor of the network’s Peabody-award winning health initiative, "Salud Es Vida," which means Health Is Life.

The deals include a special plan-sponsored Univision website that will be able to connect Latinos with coverage on the online markets, or exchanges, that will serve individuals beginning in October.
This is sure to increase the reach of the program, especially younger people.

Wonkier types and insomniacs will find the rules in this Federal Register http://www.gpo.gov/fdsys/pkg/FR-2013...2013-14540.pdf
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Old 08-02-2013, 08:57 PM   #151
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Looks like e-Health will have some competition. Kaiser health news reports ...
Nice reporting by Kaiser. I always enjoy reading "before we started asking questions, the web site said..."

This quote nicely captures my point on the business side of this being fascinating. Risks and rewards are reallocated in all kinds of interesting ways when markets are disrupted.

Quote:
[Consumers Union rep]: "Someone got into the insurance market and yelled, 'Free money! New demand!' They're all trying to figure out how to be the place where people spend their tax credit dollars," she says.
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Old 08-03-2013, 06:12 AM   #152
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Looks like e-Health will have some competition. Kaiser health news reports
I checked out the ehealth site and played around with it. I realize that it's still early but was disappointed to see that here in Mass, there is only one provider quoting.

I also read somewhere that one state offers HI for $300 a month but Mass' minimum seems to be just under $1000 a month, at least through ehealth.
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Old 08-03-2013, 07:05 AM   #153
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I checked out the ehealth site and played around with it. I realize that it's still early but was disappointed to see that here in Mass, there is only one provider quoting.
Now or in 2014? I thought Massachusetts already was operating their own "exchange", so perhaps most insurers compete through there and not through this site?

https://www.mahealthconnector.org/portal/site/connector
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Old 08-03-2013, 07:57 AM   #154
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Now or in 2014? I thought Massachusetts already was operating their own "exchange", so perhaps most insurers compete through there and not through this site?

https://www.mahealthconnector.org/portal/site/connector
That could be. The site only went out to the end of the year, not 2014 so I had to use current dates. I got an error msg if I went out past Oct.

When the day does arrive, (DW's job currently provides HC) we'll relocate our permanent/formal residence to FL and save $700/mo on HC (not to mention about $10K in state income taxes)
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Old 08-03-2013, 09:39 AM   #155
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That could be. The site only went out to the end of the year, not 2014 so I had to use current dates. I got an error msg if I went out past Oct.

When the day does arrive, (DW's job currently provides HC) we'll relocate our permanent/formal residence to FL and save $700/mo on HC (not to mention about $10K in state income taxes)
Marko, I imagine you are only seeing premium costs that are under the current health insurance system. They won't have any bearing on next years cost.
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Old 08-03-2013, 11:32 AM   #156
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Marko, I imagine you are only seeing premium costs that are under the current health insurance system. They won't have any bearing on next years cost.
You're probably right, but I don't expect prices to go dramatically down...

I'd love to get the premiums others states are quoting but we've already established that "$1000 a month is what the market will bear" here.

Still find it hard to believe that with only 4 months to go, nobody can tell me what I'd be paying.
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Old 08-03-2013, 11:58 AM   #157
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Still find it hard to believe that with only 4 months to go, nobody can tell me what I'd be paying.
In the 7 or so years I've been dealing with policies for the group we are in we have had about 6 weeks notice before prices are available for the following year. Never two months. For state exchanges, upcoming prices will be published 3 months prior to effective date. This is not an exchange issue, it is how the health care insurance business currently works.
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Developments in Michigan
Old 08-04-2013, 11:02 PM   #158
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Developments in Michigan

The legislature in Michigan is exploring some avenues, within the constraints of the ACA, that may reduce medical costs, administrative costs, and provide more options for patients.

Michigan Senate Bill 460 , sponsored by Senator Pat Colbeck, would be the first step toward setting up an infrastructure that would allow individuals to contract directly with primary caregivers (no insurance company forms/paperwork/etc) for Direct Primary Care Services (DPCS). These arrangements are increasingly popular in the private sector--pay a doctor/practice a fixed fee monthy/annually, go in as often as you need to. For specialized/more expensive issues, the patient uses a high-deductible insurance plan (HDIP) (purchased within an HSA--with all the tax advantages). The federal subsidies etc would still be in place, but the subsidy checks are used by participants to buy their DPCS contracts and their HDIP, and to pay co-pays, etc. All of this is independent of the "exchanges," I suppose Michiganders could still buy from the exchanges if they want. Michigan also hopes to use the same mechanism to cover their Medicaid patients, with the money coming from the same sources (federal/state) that now pay for the program.

A rather obscure portion of the ACA (Section 10104 (3) ) authorizes what they call "Qualified Direct Primary Care Home Plans", so waivers might not be required for implementing some portions of the Michigan proposal.

The bill has been voted out of committee and will now be considered on the floor of the Michigan Senate.

The states are supposed to be the laboratories. If Michigan implements this and it works, I suppose it might spread to other states.
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Old 08-04-2013, 11:14 PM   #159
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I checked out the ehealth site and played around with it. I realize that it's still early but was disappointed to see that here in Mass, there is only one provider quoting..
I'll trade you, 'I get your area is not covered'. ( Not really both issues stink, and as consumers I don't think we should have to deal with it.)

My current status no state exchange, feds not ready.

I love the guys that are still fighting over ACA. Its the law guys, make it work.

Oh, did one if you want my vote?

MRG
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Old 08-05-2013, 10:38 AM   #160
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Just called Anthem here in Virginia. My current plan (Premier) is going up 11% as of September ($42.75 extra a month). My plan is not grandfathered nor does it have some of the ACA requirements (like maternity). I suppose this is just their regular yearly increase (?). The increase, even though their regular increase, was not as bad as I thought it might be.

They could not tell me anything else. We did not get "the letter" in July we were suppose to get concerning ACA. Now they saying September stating that things are changing too much and they don't want to give out inconsistent information.

It's possible there will be another rate change come Jan 1st. As I understand it, I may be able to keep this plan and this premium for one more year until going to an ACA compliant plan but I'm not certain of that.

So...no real news for Virginia. At least not from Anthem.
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