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Old 03-04-2015, 10:32 AM   #41
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$239/mo w $4K deductible is a great deal relative to the cost of health care - well below average cost.

Then how come all the young healthy kids in this country haven't flocked to sign up?

Mike
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Old 03-04-2015, 10:39 AM   #42
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Then how come all the young healthy kids in this country haven't flocked to sign up?
I don't have enrollment figures for young adults, do you?

And when you're young an invincible, you'd rather spend your money on iPhones and fun stuff, not health insurance. No one likes to pay for home or auto insurance either, but most do.

By your logic your son shouldn't pay for Soc Sec or Medicare since he doesn't need it now.
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Old 03-04-2015, 10:41 AM   #43
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Let's just hope the SCOTUS doesn't gut the whole thing.
SCOTUS had a chance to gut the whole thing and passed. This case is very specific. Are people eligible for subsidies in states that do not have an exchange that the state created. Only eligibility of subsidies is an issue. This case (unless SCOTUS goes off on a tangent which occasionally happens ) doesn't address the requirement to have coverage, how coverage is defined or penalties if one does not have coverage.

As we've beaten to death earlier, a state could create a portal to the existing federal exchange for little cost. The original intent of the law was clearly to force the individual states to create the exchanges so the federal government wouldn't have to do it. When the law was passed, those voting for the bill couldn't imagine a state not jumping on the expansion of Medicare or the need to create an exchange to get the subsidies. When so many states didn't, the feds had to rush their half baked exchange into operation that belatedly seems to be working. The costs and problems associated with creating individual state exchanges (IMHO) seems to vindicate the states that didn't try to take on the task.

The obvious, cheapest solution in the event of SCOTUS deciding that a law should be as written and not wished a couple of years later is to change the ACA to allow the federal exchange to get subsidies. It won't be that easy or pretty. I expect the portal websites to be done.
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Old 03-04-2015, 10:43 AM   #44
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Originally Posted by Midpack View Post
I don't have enrollment figures for young adults, do you?

And when you're young an invincible, you'd rather spend your money on iPhones and fun stuff, not health insurance. No one likes to pay for home or auto insurance either, but we do.
I totally agree with you. But the point is.......this is EXACTLY the intention of the ACA from the beginning. Make the young and healthy pay for the old and sick. (and if the young and healthy refuse to pay the UNAFFORDABLE rates, we'll penalize them!) Our President sold this as "healthcare for all" not taking into consideration that that the young and healthy bulletproof were not going to take part.

Mike
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Old 03-04-2015, 10:44 AM   #45
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I don't have enrollment figures for young adults, do you?

And when you're young an invincible, you'd rather spend your money on iPhones and fun stuff, not health insurance. No one likes to pay for home or auto insurance either, but most do.
The young and healthy are subsidizing the sick and old. That's baked into the bill. If a young, healthy person does not qualify for a subsidy, there is no reason for them not to feel like they are getting the short end of the stick in this bill. Before the ACA act, they were the only people that could get reasonably priced heath insurance. The ACA greatly increased their costs.
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Old 03-04-2015, 10:56 AM   #46
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The thread topic is not about the merits of the ACA. That discussion has led to a multitude of health care threads being closed, and if it continues, is likely to happen once again.

It is about the Supreme Court case, which deals with the legality of providing subsidies to policies acquired on Federal health exchanges. All other provisions of the ACA have been implemented and are in force, such as essential health benefits, coverage for family members under age 26, and guaranteed coverage.

Why not stick to the thread topic? If the Supreme Courts decides against the subsidies, how will that affect us, and what options will we have?
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Old 03-04-2015, 11:16 AM   #47
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The thread topic is not about the merits of the ACA. That discussion has led to a multitude of health care threads being closed, and if it continues, is likely to happen once again.

Two thread topics in particular, the ACA and pensions, always make me think, "Hoo boy, here we go again...".

Information posted that is informative has been a great help, especially back in the confusing period during the ACA rollout. I even pointed the nice Japanese lady who does my hair (seeing her again this afternoon) to E-R.org to help her understand what was happening.
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Old 03-04-2015, 11:29 AM   #48
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An update from the deliberations. From the WSJ:

Quote:
The Supreme Court sparred Wednesday over a centerpiece of the Affordable Care Act, with swing Justice Anthony Kennedy voicing concerns about potential constitutional consequences of a ruling that strikes down tax credits in the law.
Justice Kennedy said he saw "a serious constitutional" question with the challenger's argument that states were supposed to choose between setting up their own exchanges and forfeiting the tax credits. His concern has a direct link with the 2012 health-care ruling, in which the justices voted 7-2 that Congress couldn't put excessive financial pressure on the states to implement a portion of the law that expanded Medicaid.
Maybe the collateral effects of that earlier ruling are still being felt.

We won't know the results until June, the questions being asked by the Justices are all we have as far as a crystal ball right now.
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Old 03-04-2015, 11:33 AM   #49
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......Why not stick to the thread topic? If the Supreme Courts decides against the subsidies, how will that affect us, and what options will we have?
+1

Will be interesting to read coverage of today's oral arguments before the Court, even though formal decision not expected for many weeks. (possibly June).

FWIW- I would NOT expect overturn of subsidies to open the door to "cheap" catastrophic HI plans. Catastrophic plans, even for those under 30, are not much cheaper than Bronze plans. US health care costs are HIGH, and HI companies only have a net operating profit margin is in 3-5% range. So regardless of what SCOTUS decides in this case, large HI premium cuts just ain't happenin'
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Old 03-04-2015, 11:37 AM   #50
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update on arguments

3 huge surprises at Obamacare?s oral*arguments - Vox
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Old 03-04-2015, 11:43 AM   #51
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Originally Posted by wrigley View Post
My perfectly healthy 23 old year son ventured onto the Healthcare.gov website to take a look around at health insurance. $239.00 a month with a $4000 deductible was the best he could do. Needless to say he elected to pay the penalty. Prior to the ACA he had a catastrophic plan that primarily covered major medical issues but he was also able to routinely see a doctor if he wished with affordable/manageable co-pays. $92.00 a month was his premium. If you are young and healthy the ACA shafts you because that is the only way they can afford to pay for the not young and healthy!

Mike

I thought that under a certain age you still could buy catastrophic plan under ACA.... am I wrong



Edit to add: Just checked.... a catastrophic plan for a 27 YO actually cost more than the lowest bronze plan where I live... cheapest plan was $155.... catastrophic was $170....
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Old 03-04-2015, 11:58 AM   #52
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Wow... interesting read...

I had read about the standing issue awhile back, but most people said that the SC would probably not look at it since all it would do it cause a delay.... eventually they would get a case like this and it would come up again...

The theory about forcing the states to set up an exchange is interesting...

I also think it is interesting that Alito thew out waiting until the end of the year.... he was probably a vote to stop subsidies and this can give some cover to another justice...

I bet there will be a split decision... IOW, the side that wins will have justices with different reasons for why they decide that way....
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Old 03-04-2015, 12:16 PM   #53
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Wow... interesting read...

I had read about the standing issue awhile back, but most people said that the SC would probably not look at it since all it would do it cause a delay.... eventually they would get a case like this and it would come up again...

The theory about forcing the states to set up an exchange is interesting...

I also think it is interesting that Alito thew out waiting until the end of the year.... he was probably a vote to stop subsidies and this can give some cover to another justice...

I bet there will be a split decision... IOW, the side that wins will have justices with different reasons for why they decide that way....
I was surprised that the government solictor general blew off the "standing" issue raised by Ginsberg. He knows that it will just come back again so he's going for a decision now before a potential Repub president could appoint a replacement justice. Of course, a Repub president could make the whole case a mute point with the current Congressional makeup.

We can count on it being a split decision. This is primarily a partisan political issue that SCOTUS is not immune to as much as we may wish it to simply interpret the "law." The law is frequently seen through politically colored glasses. This decision will not be the end no matter how it goes.
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Old 03-04-2015, 12:19 PM   #54
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The thread topic is not about the merits of the ACA. That discussion has led to a multitude of health care threads being closed, and if it continues, is likely to happen once again.

It is about the Supreme Court case, which deals with the legality of providing subsidies to policies acquired on Federal health exchanges. All other provisions of the ACA have been implemented and are in force, such as essential health benefits, coverage for family members under age 26, and guaranteed coverage.

Why not stick to the thread topic? If the Supreme Courts decides against the subsidies, how will that affect us, and what options will we have?
But some are predicting that if subsidies are invalidated, millions of people would be affected directly and if they drop insurance because of the lack of subsidies,
the remaining insureds could see their premiums go up, the so-called "death spiral" that kills the whole system.

The plaintiffs were cultivated and the real forces behind this case, which include conservative think tanks looking for any way to challenge and invalidate the law, have the ultimate aim of killing the law entirely.

So it is a proxy battle for the law in its entirety.
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Old 03-04-2015, 12:32 PM   #55
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The plaintiffs were cultivated and the real forces behind this case, which include conservative think tanks looking for any way to challenge and invalidate the law, have the ultimate aim of killing the law entirely.

So it is a proxy battle for the law in its entirety.
Can we please rein this in? The justices will rule on the information that is presented to them. There are PLENTY of vested interests on both sides (and some surprising "bedfellows") so let's just look at the case and its ramifications.
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Old 03-04-2015, 12:36 PM   #56
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Well it's also another question about this case.

Are the justices going to consider this case only in "textualist" terms, literally the few words in a couple of sentences?

Or are they going to consider the context of this case, which is that it could unravel the whole law, leading to chaos in the ACA exchanges.

Alito apparently raised the idea of invalidating the subsidies but staying that decision through the end of this year, so that people who enrolled for this year would get coverage and subsidies to the end of the year but in 2016 and thereafter, there would be uncertainty about what form of ACA remains after the subsidies are gone for a huge portion of the ACA insured.
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Old 03-04-2015, 12:51 PM   #57
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Alito apparently raised the idea of invalidating the subsidies but staying that decision through the end of this year, so that people who enrolled for this year would get coverage and subsidies to the end of the year but in 2016 and thereafter, there would be uncertainty about what form of ACA remains after the subsidies are gone for a huge portion of the ACA insured.
Great! If the concern is really about assuring people can get health insurance, then people should be happy that a way might be found to do that (and to ease the transition) if a major part of the law is upheld (well, "overturned" in some people's view).
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Old 03-04-2015, 12:54 PM   #58
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Decision will not bother me, I live in NY (state exchange).
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Old 03-04-2015, 01:01 PM   #59
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Catastrophic plans, even for those under 30, are not much cheaper than Bronze plans
Not in my experience.

For an Ohio family of 3 (53/62/20) we currently pay $480/month for a non-ACA catastrophic/HSA plan. The cheapest bronze exchange plan I could find was $1200/month.

And this horrible, non-compliant, just shy of illegal plan pays for preventative care such as annual physicals, breast exams, flu shots, and colonoscopy (all items we've used this year).
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Old 03-04-2015, 01:51 PM   #60
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According to a recent study by the Rand Study in conjunction with Kaiser, eliminating the subsidy would leave only the sickest people clinging on to policies, with a loss of the healthy middle and lower income folks, and have a very significant effect on the cost of insurance across the board for everyone.
The only way to avoid that is to re-instate underwriting and have insurance companies be able to impose pre-existing conditions again. Google the study.
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