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Old 11-14-2013, 02:33 PM   #21
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My main concern is this: Most of the people hardest hit by the cancellations were probably "preferred risk" individuals who were facing large rate increases under ACA. But at the same time, the ACA plans were priced in a way that assumed these people would be in that risk pool.

So if many of the folks who were about to lose their old plans suddenly no longer have to get an ACA policy, doesn't that mean that the ACA policies have been significantly underpriced (with many of those healthier folks not in the pool for 2014) as the overall pool of insureds in the ACA plans is "sicker" than the actuaries originally assumed?
I don't think so ziggy. Meaning, I don't think the ACA policies were underpriced (without the subsidy that is).

At least that is my experience here in Va. Some states could vary. Anthem BC/BS in Virginia was/is offering the same policies on and off the exchange at the same prices going forward. The only incentive to go to the exchanges is only if you qualify for a subsidy. No other reason. They are the major carrier here.

Their private Off exchange policies sold to individuals even have the same names and the same levels of Bronze, Silver...etc.
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Old 11-14-2013, 02:38 PM   #22
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My main concern is this: Most of the people hardest hit by the cancellations were probably "preferred risk" individuals who were facing large rate increases under ACA. But at the same time, the ACA plans were priced in a way that assumed these people would be in that risk pool.

So if many of the folks who were about to lose their old plans suddenly no longer have to get an ACA policy, doesn't that mean that the ACA policies have been significantly underpriced (with many of those healthier folks not in the pool for 2014) as the overall pool of insureds in the ACA plans is "sicker" than the actuaries originally assumed?
Yes, I think you are right. It seems likely that there will be adverse selection issues as a result of this last second change, but it remains to be seen whether the state insurance commissioners and insurers will play along.
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Old 11-14-2013, 02:42 PM   #23
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Hope this isn't too political but it might address some people's concern about whether the insurers are mandated to offer the policies that were canceled. Certainly not a done deal by any means...but...it is a possibility.

Landrieu's Obamacare 'Keep Your Plan' Bill Gains Merkley As Co-Sponsor - Business Insider
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Old 11-14-2013, 02:53 PM   #24
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I don't think so ziggy. Meaning, I don't think the ACA policies were underpriced (without the subsidy that is).

At least that is my experience here in Va. Some states could vary. Anthem BC/BS in Virginia was/is offering the same policies on and off the exchange at the same prices going forward. The only incentive to go to the exchanges is only if you qualify for a subsidy. No other reason. They are the major carrier here.

Their private Off exchange policies sold to individuals even have the same names and the same levels of Bronze, Silver...etc.
We may have our signals crossed here. The insurers don't care about the subsidies. They get paid the full premium regardless of the allocation of the payments from individuals and Uncle Sam.

I'm saying that people in these individual plans who want to keep them are probably healthy enough that they can get covered for less than the current ACA plans (which assumed a wider pool of insureds). But if they can stay in their current (cheaper) plans for another year, then some of the healthier folks who were being counted on as part of the risk profile of the ACA plans are not there, at least not in 2014.

But again, that requires that the insurers play along. And I hope this announcement wouldn't have been made unless many (if not most) of them were ready to play along.
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Old 11-14-2013, 02:57 PM   #25
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Hope this isn't too political but it might address some people's concern about whether the insurers are mandated to offer the policies that were canceled. Certainly not a done deal by any means...but...it is a possibility. Landrieu's Obamacare 'Keep Your Plan' Bill Gains Merkley As Co-Sponsor - Business Insider
I personally would stand to save thousands of dollars a year from this proposal, so it wouldn't offend me, until I got dropped.. . But seriously I don't understand why the initiators of this proposal were original supporters of the ACA. I do not see how Obamacare can survive with all the healthy people staying on their current plans. This has to be political pandering. I understand a one year extension, but how can supporters of this be supporters of Obamacare, too? Unless they are more worried about keeping their job, or they are counting on Mr. Reid blocking it and thus being able to save face, and yet still implement the ACA. Not trying to be political, just trying to figure out the logic, as I know they surely understand the consequences of this proposal.
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Old 11-14-2013, 03:04 PM   #26
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I'm saying that people in these individual plans who want to keep them are probably healthy enough that they can get covered for less than the current ACA plans (which assumed a wider pool of insureds). But if they can stay in their current (cheaper) plans for another year, then some of the healthier folks who were being counted on as part of the risk profile of the ACA plans are not there, at least not in 2014.

.
Yes...I must have misunderstood you. I see what you are saying now. Yes...the older policies are cheaper even though they still had hefty increases. I have a direct compare. Mine was extended for a year and is cheaper than my husband's policy that was canceled immediately at 100% increase for an ACA compliant policy.
Your point is well taken. Don't know what they will do about those lost dollars.
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Old 11-14-2013, 03:10 PM   #27
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I personally would stand to save thousands of dollars a year from this proposal, so it wouldn't offend me, until I got dropped.. . But seriously I don't understand why the initiators of this proposal were original supporters of the ACA. I do not see how Obamacare can survive with all the healthy people staying on their current plans. This has to be political pandering. I understand a one year extension, but how can supporters of this be supporters of Obamacare, too? Unless they are more worried about keeping their job, or they are counting on Mr. Reid blocking it and thus being able to save face, and yet still implement the ACA. Not trying to be political, just trying to figure out the logic, as I know they surely understand the consequences of this proposal.
I can't figure that one out either Mulligan.
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Old 11-14-2013, 05:26 PM   #28
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This has to be political pandering. I understand a one year extension, but how can supporters of this be supporters of Obamacare, too? Unless they are more worried about keeping their job, or they are counting on Mr. Reid blocking it and thus being able to save face, and yet still implement the ACA. Not trying to be political, just trying to figure out the logic, as I know they surely understand the consequences of this proposal.
Yes, given the advanced state of disarray that the individual market is now in, I can't see how this is a serious attempt to address the problem people are having with insurance and the disconnect between reality and what was promised.

Instead, it is a very earnest attempt to fix an urgent problem of another kind. If the present public anger can be turned toward state insurance commissioners or to insurance companies (because "the President told them they could extend the policies, but now they won't"--because they can't turn on a dime with 45 days left, and re-establish all their previous policies, set the appropriate premiums, assure continuity of provider networks by plan type, etc), then I think this announcement will be counted as a big success.

After the way the trade group for the health insurers (AHIP) and the companies themselves behaved in their support for the ACA (for a government-guaranteed increase in market share and to the detriment of their customers), I doubt that health insurance companies have any friends left on either side of the ideological spectrum. To be double-crossed by their present allies would be a fine turn of events. I certainly don't give a d*mn what happens to these worthless rent-seekers at this point.
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Old 11-14-2013, 07:01 PM   #29
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As a holder of an individual policy that went down under the new ACA policies, I am just curious what these individual policies were that are reported to have gone up so much.

In hearing about these really high % increases, it always (from what I have come across thus far) turns out they were catastrophic health plans which were very reasonable in cost. So when you then add to a cheaper policy the added preventative health care screenings, mental health, no pre-existing conditons, recisions, max lifetime and yearly caps etc., then proportionately you get a much higher % jump.

I am not saying other more generous plans didn't go up. I don't know.
I'm just interested in learning the truth about this so I posted a link asking people if they wouldn't mind posting the type of policy they have now and the cost for 2013 vs what kind of policy they get at what cost under ACA for 2014.

Some people provided enough detail to make a comparison and some didn't so it's really hard to compare without much detail. Would really like to have the skinny on these numbers and know what % went up (and from what kind of plan), what stayed the same and what went down.

My son's went down for a comparable ACA plan, but he had a plan with 0 deductible and very little in the co-pay costs (but a higher mo. premium plan)
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Old 11-14-2013, 07:10 PM   #30
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Yes, I think you are right. It seems likely that there will be adverse selection issues as a result of this last second change, but it remains to be seen whether the state insurance commissioners and insurers will play along.
Well it looks like at least one state insurance commissioner isn't interested in playing along.... I suspect there will be many others. The insurers' aren't interested either.

State insurance commissioner rejects Obama’s proposal to extend canceled policies | HealthCare Checkup | Seattle Times
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Old 11-14-2013, 07:17 PM   #31
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....But again, that requires that the insurers play along. And I hope this announcement wouldn't have been made unless many (if not most) of them were ready to play along.
You give the administration more credit than they are due. Unfortunately, they're not that smart.

Given the industry's public remarks and the NAIC's remarks on the announcement, I think they were not consulted at all. They seemed to be blindsided to me.
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Old 11-14-2013, 07:21 PM   #32
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Good observations I think Mod... I aligns with my plan anyways.. I bought my $5500 deductible, no co-pays, $7 million deductible for $72 a month in 2010. It is now $88. The biggest jump in premium was $10 last year when they had to implement the "free yearly visit". The $10 a month increase covered that yearly doctor visit. I also declined mental health, drug rehab, and as a 40 something male took a big gamble and didn't ask for maternity care either. I earlier in the year had read an insurance projection on costs associated with all the add ons. Surprisingly to me only about 25% of the projected increase was for allowing the unhealthy people to join. All the other mandates and such was projected to make up the rest of the increased cost.
Yes, I will continue to complain, but I understand why I have to be dumped into all the other new coverages. With guaranteed issue, you could have people pick and choose when they wanted each coverage then drop it when done with it...My favorite was a letter released by an insurance company from a lady who wrote to thank them for their great coverage of her pregnancy/birth costs. She said she then dropped them because she doesn't plan on having children again for awhile, but if she does again, she will certainly sign up with them again if she does. Ya, I bet they were just thrilled with that promise!
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Old 11-14-2013, 08:28 PM   #33
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As a holder of an individual policy that went down under the new ACA policies, I am just curious what these individual policies were that are reported to have gone up so much.

In hearing about these really high % increases, it always (from what I have come across thus far) turns out they were catastrophic health plans which were very reasonable in cost. So when you then add to a cheaper policy the added preventative health care screenings, mental health, no pre-existing conditons, recisions, max lifetime and yearly caps etc., then proportionately you get a much higher % jump.

I am not saying other more generous plans didn't go up. I don't know.
I'm just interested in learning the truth about this so I posted a link asking people if they wouldn't mind posting the type of policy they have now and the cost for 2013 vs what kind of policy they get at what cost under ACA for 2014.

Some people provided enough detail to make a comparison and some didn't so it's really hard to compare without much detail. Would really like to have the skinny on these numbers and know what % went up (and from what kind of plan), what stayed the same and what went down.

My son's went down for a comparable ACA plan, but he had a plan with 0 deductible and very little in the co-pay costs (but a higher mo. premium plan)

Well here is a data point. I've had my Kaiser mid level plan for 11 years. Over the 11 year the premium has a bit more than doubled so an average increase of 7%. The plan is grandfathered in, and this week I received notice the premiums will increase 12% (assuming state insurance commission approval.) There is an ACA gold plan which has premiums $1/month cheaper. The ACA plan offers, maternity, birth control, and proscription drugs.
current plan has no deductible the ACA has a $1500 deductible.
Max out of pocket current is $3,000 ACA gold $6350.
Hospital current $250/day ACA $500/day
current Labs/X-rays 50% copay ACA $30 each (so ACA is cheaper).

Overall the current plan is a better deal than the ACA gold.
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Old 11-15-2013, 07:46 AM   #34
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One last request to keep the snarky comments and political speculation at bay. Many of us are affected by this and can benefit from a helpful and fact based discussion.

Here's a helpful FAQ from KFF What Consumers Need To Know About The Obama Plan For Canceled Health Policies - Kaiser Health News

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What Consumers Need To Know About The Obama Plan For Cancelled Health Policies

Q: What did Obama propose?

A: He’s allowing insurers to extend plans that existed on Oct. 1 to existing customers through the end of 2014. In many cases the existing plans have been less expensive than policies with more benefits scheduled to take effect next year.

If carriers do renew, they must disclose the shortfall between the benefits of the existing plan and benefits required by the Affordable Care Act. It’s possible the insurers will charge more for these renewed policies.

Q: Who is affected?

A: The proposed change affects individuals and families who buy plans directly from insurers and received cancellation notices in recent weeks. The administration is also allowing extension of small-employer plans that didn’t meet ACA requirements.

If you aren’t already covered by a noncompliant plan you can’t buy in now. Consumers covered by Medicaid, Medicare or large employers are unaffected.

Q: How are consumers reacting? What should they do if they got a cancellation notice?

A: At least some canceled insurance customers applauded Obama’s announcement.

“That’s amazing. I look forward to hearing from Blue Cross about that,” said Paige Smith, 63, of Florence, Ala., who got a cancellation notice from BlueCross BlueShield of Alabama in October.

Advocates say consumers should check with their insurer to see if it will be renewing canceled policies. Even if it is, consumers, especially those with chronic illness, should review alternatives offered in the health law’s online marketplaces to see if they offer better coverage.

Insurance sold through the marketplaces also comes with substantial government subsidies for those who qualify. By contrast, the noncompliant plans Obama is allowing to be stretched into next year are not eligible for subsidies.

Q. Who decides whether I can renew a policy slated for cancellation?

A. Insurers and state regulators. Neither Obama nor the federal Department of Health and Human Services can force extension of the plans.

But the administration did set rules: If insurers renew policies – and their state allows it – they must notify consumers and point out that they may find other options and subsidies through the online marketplaces.

Q: How have insurers reacted?

A: Many wanted to learn more details about Obama’s offer. BlueCross BlueShield of North Carolina, which was canceling about 200,000 individual policies at end of the year, said it was interested in the option but not ready to commit.

Florida Blue says it will allow customers to renew 2013 policies, a decision that could affect as many as 300,000 people over the next year and immediately affects 40,000 people who were losing their existing plan at end of this year.

Some insurers are urging state regulators to disallow the extensions. In California, the state should “stay the course and transition people into more comprehensive policies,” said Patrick Johnston, CEO of the California Association of Health Plans.

The major insurance trade group warned that consumers renewing noncompliant plans will be predominantly younger and healthier, while older and sicker people will migrate to the subsidized marketplaces. That could drive up costs.

“Changing the rules after health plans have already met the requirements of the law could destabilize the market and result in higher premiums for consumers,” said Karen Ignagni, CEO of America’s Health Insurance Plans.

Q: The year is almost over. Insurers have already told consumers to buy plans by Dec. 15 if they want coverage for Jan. 1. Can the companies reverse course so quickly?

A: That’s unclear. Besides setting 2014 prices for the plans and dispatching hundreds of thousands of letters, insurers must gain approval from state regulators.

Q: Will state regulators allow this?

A: Some may not. Many objected to Obama’s suggestion. Extending subpar plans could “undermine the new market and may lead to higher premiums,” said Jim Donelon, president of the National Association of Insurance Commissioners.

Washington state Insurance Commissioner Mike Kreidler said he would not allow insurers to extend the policies “in the interest of keeping the consumer protections we have enacted.”

Regulators note that existing plans might not include health-law features such as caps on out-of-pocket costs and coverage of essential benefits such as prescription drugs, maternity care and hospitalization.

But in California, Insurance Commissioner Dave Jones said he supports Obama’s suggestion and will urge insurers to extend policies. Regulators in Florida and Kentucky also said they would allow the move.
Note: Kaiser foundation allows full reproduction of their content as long as they are identified as the source.
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Old 11-15-2013, 09:18 AM   #35
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..........
Given the industry's public remarks and the NAIC's remarks on the announcement, I think they were not consulted at all. They seemed to be blindsided to me.
I am surprised that the industry did not anticipate this. Surely they knew that some people would not be able to keep the coverage they had. If anyone from the industry spoke up, I missed it.
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Old 11-15-2013, 09:39 AM   #36
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Lets please leave political analysis and speculation out of this and focus on how this affects getting health insurance.
IMHO- No significant effect. Too little lead time (& carrier financial incentive?) to affect those policies already cancelled, and carriers who have already exited certain states are certainly not going to spend resources re-entering HI market in those states for only 1 yr's worth of business.
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