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Old 09-04-2016, 10:46 PM   #41
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OK. From hope, back to despair.

I looked at United Healthcare, but they are really out of individual insurance market, on or off exchange.

Then, I looked at Aetna next. Their Web site asks "If you have existing conditions, mark off as many of the following afflictions as applicable". What the heck? I thought they cannot ask about preexisting conditions anymore, after ACA. Still, I proceeded up to the point they said "Fill in your address and phone number, so that we can contact you". I clicked off their Web page at that point.

Have not tried other insurers.
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Old 09-05-2016, 06:24 AM   #42
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With insurers dropping out of individual health insurance market, and my corner of the wood not being exempted, some of us will not have much of a choice next year, if any!

I just saw this following map showing that 6 entire states are down to one or fewer insurers for 2017. Fewer? Like in zero?

Holy moly, this can't be right! What are we going to do?

The map below comes from this Web site: See this map of Obamacare's insurance-competition problem - Business Insider.

Somebody, please tell me that they have a mistake, and this is not true.




They need a public option in a hurry if there are no other options. Otherwise we all would be breaking the law and it wouldn't be our fault.


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Old 09-05-2016, 06:30 AM   #43
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Breaking the law or not, all I want is to get healthcare if and when I need it (do not need any now). And the way the healthcare providers are gouging their patients, the only way to avoid ridiculous prices is to get protection from an insurance company.

It feels like paying the Mafia for protection, but that is the only option one has. Sad!
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Old 09-05-2016, 06:31 AM   #44
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OK. From hope, back to despair.

I looked at United Healthcare, but they are really out of individual insurance market, on or off exchange.

Then, I looked at Aetna next. Their Web site asks "If you have existing conditions, mark off as many of the following afflictions as applicable". What the heck? I thought they cannot ask about preexisting conditions anymore, after ACA. Still, I proceeded up to the point they said "Fill in your address and phone number, so that we can contact you". I clicked off their Web page at that point.

Have not tried other insurers.
They cannot deny you insurance because of pre-existing conditions, or charge you more. You still will have to wail 'til Nov 1, when open enrollment begins, to know who will be selling policies for 2017.
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Old 09-05-2016, 06:44 AM   #45
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I am more mad than worried at this whole mess.
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Old 09-05-2016, 06:58 AM   #46
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They need a public option in a hurry if there are no other options. Otherwise we all would be breaking the law and it wouldn't be our fault.
Having seen enough ineptness and indifference of bureaucrats and politicians, I prefer a solution involving private enterprises, but somehow it's elusive.
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Old 09-05-2016, 07:04 AM   #47
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..........Yes, the insurer could theoretically use their power to negotiate lower rates from providers, but providers will still have the (vast) majority of patients who get their care from employer-sponsored, group, and Medicare plans, so the lone exchange insurance company still might have little ability to get lower rates. And, why should they even try? They will get 20%, the health care providers get 80%--their interests are best served if the while bill gets larger over time (even if driven by increasing payments to providers) because their 20% will get larger.
.........
Really good points. I guess the key is to have some competition in a region, but not so much that it dilutes the insurance companies' ability to bargain.
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Old 09-05-2016, 08:06 AM   #48
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Having seen enough ineptness and indifference of bureaucrats and politicians, I prefer a solution involving private enterprises, but somehow it's elusive.
The solution is only elusive in the US. Other countries have come to a range of solutions involving single payer to regulated private insurance, but they have an advantage over the US because their costs are usually at least half for equal or better outcomes.

Healthcare is simply too expensive in the US.
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Old 09-17-2016, 06:01 AM   #49
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That sounds like Maricopa County, AZ. Phoenix Health Plans announced Thursday they are dropping out of the 2017 AZ exchange leaving Cigna as the only on-exchange option in that county.
Update: It appears Centene (Ambetter) will be the sole exchange carrier for Maricopa County, AZ (Phoenix) instead of Cigna.
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Centene Corp. is seeking regulatory approval to sell ACA marketplace health insurance in Maricopa and Pima counties next year. Centene said it wants to sell health-maintenance organization plans under the "Ambetter" brand.

Cigna now says that it doesn't expect to offer its own marketplace insurance in Maricopa County.

With Centene's decision to offer marketplace insurance in Arizona next year, Cigna officials said the insurer no longer plans to sell individual plans next year. Instead, Cigna Medical Group will be a medical provider for consumers who purchase Centene's plans in Maricopa County, Cigna officials said.

Reference: New 'Obamacare' insurer comes to Maricopa County as another exits
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Old 09-17-2016, 08:42 AM   #50
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When will the Mexican public healthcare provider, the Secretariate de Salud, apply to offer exchange plans to Arizona residents in underserved counties? The Mexican government would make money (based on prevailing US health insurance prices, copays, etc) and Arizonans would finally have a "public option." Yes, some creative methods would need to be employed to get patients to the existing providers (until Mexican clinics could be set up in Arizona), but that seems to be a minor problem when considering the long-term win-win aspect of this proposal. Logistics aside, the metric is "getting people covered," the actual provision of quality medical care is generally considered a separate issue.
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Old 09-17-2016, 08:51 AM   #51
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I wonder when the Mexican public healthcare provider, the Secretariate de Salud, will apply to offer exchange plans to Arizona residents in underserved counties. The Mexican government would make money (based on prevailing US insurance prices) and Arizonans would finally have a "public option." Yes, some creative methods would need to be employed to get patients to the existing providers (until Mexican clinics could be set up in Arizona), but that seems to be a minor problem when considering the long-term win-win aspect of this proposal.
Actually, most Arizona residents already have good health care insurance options. Those on Medicare, TriCare, Medicaid, or covered by group health plans now total 90% of the population, and they're fine. Telling the remaining 10% to go to Mexico is one option. Another is to stop treating them as a separate group, or stop letting the insurers pick and choose their customers and apply the same rules to them that they want from us.
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Old 09-17-2016, 09:04 AM   #52
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Another is to stop treating them as a separate group, or stop letting the insurers pick and choose their customers and apply the same rules to them that they want from us.
So, in broad strokes: Additional regulation that requires any company offering health care insurance to the private market (group plans, employer plans, etc) to offer similar ("complying") insurance via the exchanges? Would the rates have to be the same as those employer plans (and, since these are negotiated individually with each group/employer based on risk profiles, which rates would they be required to offer?). In any case, this would have the impact of driving up the prices of these private plans (otherwise, the insurance companies would already be offering those rates on the exchanges,and making money). Maybe this transfer of risk and costs to private customers with resultant instability in that system, in the grand scheme, is a "feature," not a "bug."

The exchanges were supposed to offer a pool of applicants with a risk profile fairly representative of the general public. Apparently, there's something happening that the central planners did not anticipate.
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Old 09-17-2016, 09:17 AM   #53
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So, in broad strokes: Additional regulation that requires any company offering health care insurance to the private market (group plans, employer plans, etc) to offer similar ("complying") insurance via the exchanges? Would the rates have to be the same as those employer plans (and, since these are negotiated individually with each group/employer based on risk profiles, which rates would they be required to offer?). In any case, this would have the impact of driving up the prices of these private plans (otherwise, the insurance companies would already be offering those rates on the exchanges,and making money). Maybe that, in the grand scheme, is a "feature," not a "bug."

The exchanges were supposed to offer a pool of applicants offering a risk profile fairly representative of the general public. Apparently, there's something happening that the central planners did not anticipate.
Central planners? Really?

The weakness in the current scheme is unavoidable. In any region, if an insurer is free to offer policies to some groups but not others some will be underserved. Segmenting them into smaller groups will never lead to a more positive outcome. Allowing the insurance companies to exclude groups, for whatever reason, will always benefit the insured population and create the appearance of cost saving, as the cost of the exclusion is never included.

Large groups deal with this easily and without complaint. Everyone is included, premiums are the same for all members regardless of gender, age, or health condition.
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Old 09-17-2016, 10:00 AM   #54
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....Large groups deal with this easily and without complaint. Everyone is included, premiums are the same for all members regardless of gender, age, or health condition.
Individual health insurance in Vermont has been this way for a long time... no underwriting was allowed even before ACA and the same price for all plans irrespective of gender, age, tobacco use, etc. While I concede that it sounds wacky it seems to work well... our prices are a bit higher than national averages for individual health insurance but our increases over recent years have been much more moderate.

I guess that I don't understand how individual health insurers currently choose customers as you are talking about.
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Old 09-17-2016, 10:24 AM   #55
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I guess that I don't understand how individual health insurers currently choose customers as you are talking about.
Well, in the case of Maricopa County, Arizona, major insurers offer coverage for Medicare, Medicaid, and large groups. In effect, they are choosing to serve 90% of the population and choosing not to serve the remaining 10%.
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Old 09-17-2016, 11:10 AM   #56
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Do off-exchange plans give you a Form 1095 for your tax returns?


Yeah it seems like insurers are cherry-picking counties or "redlining" ones they don't want to bother with. Not necessarily because of the money the residents have but maybe more what kind of providers they have to deal with in certain places.
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Old 09-17-2016, 11:13 AM   #57
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Well, in the case of Maricopa County, Arizona, major insurers offer coverage for Medicare, Medicaid, and large groups. In effect, they are choosing to serve 90% of the population and choosing not to serve the remaining 10%.
Ah, I see... they are just deciding to not offer individual health insurance. I understand what you are saying for large group and Medicare (I assume that you mean Medicare supplemental coverage) but I don't get Medicaid.... isn't Medicaid a government program? What is a private insurer's role with respect to Medicaid?
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Old 09-17-2016, 11:21 AM   #58
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.......

The exchanges were supposed to offer a pool of applicants with a risk profile fairly representative of the general public. Apparently, there's something happening that the central planners did not anticipate.
People are allowed to not participate by paying a tiny fine. I wish the IRS had the same choice available either pay my income taxes or pay a fine of $250 or 2% of my income.
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Old 09-17-2016, 11:29 AM   #59
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This whole thing in Az is becoming quite a joke. My GF was with Cigna when we were in Colorado. Bad experience all in all. Now that we are here in Az she went with BCBS instead of Cigna and loves it. Now BCBS has exited and our options in Maricopa County are quite limited. Cigna network through Centene/Ambetter looks like our only exchange choice as of now. (At least that's my understanding).

Looks like we will have to go off exchange and get some sort of plan for her directly from an insurer. Only four more years to medicare!
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Old 09-17-2016, 11:33 AM   #60
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People are allowed to not participate by paying a tiny fine.
And, on top of that, the law still requires that ERs must provide treatment for people regardless of ability to pay. They had the ability to pay--to buy insurance, often with government assistance, that would have covered the ER treatment. That's what the "affordability" provisions of the ACA are designed to do, and we all pay for that. So, for many people there just are not many financial or even medical consequences for "going bare," especially when an individual can simply sign up at any time and get a newly discovered chronic condition covered.
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