Universal Health Insurance Coverage, new proposal

[landover]

Here is link to new proposals, any chance of passing this year? I didn't see any thing to control costs, I may have missed it. But without substantial cost control how will this get paid. This can be the first step, once costs go out of control then cost control will come. Anyway first let's see if it get enacted.

 

[M Paquette]

Thanks for the link. I suspect this thread probably belongs over here, though.

It's a nice proposal compared to the recent 'product', but due to the usual external circumstances it is effectively dead on arrival.

I'm continuing to budget the usual high amount for medical insurance, with the usual 7.5%/year medical inflation rate, and would advise others to do the same rather than hope for Federal relief.

 

[travelover]

Thanks for the link. I suspect this thread probably belongs over here, though............

Yup.

 

[Gone4Good]

but due to the usual external circumstances it is effectively dead on arrival.

Not necessarily.

It looks like this proposal is a compromise between the already passed Senate and House bills. The plan seems to be for the House to pass the Senate bill and then have new legislation that "reconciles" the Senate bill to the compromise bill. Conceivably that could be done through the reconciliation process in the Senate thereby avoiding the need for 60 votes.

Health reform is very much alive if the Democrats want it bad enough. They only need to muster a simple majority in both houses to make it happen.

 

[dgoldenz]

What good is health reform if you don't have a job to pay for it? Most of my clients (I am a health agent) struggle to pay premiums of $300-400/month. If those premiums were suddenly $1000/month, they wouldn't be clients much longer. If you can't write the check, then you can't write the check, period!

 

[landover]

What good is health reform if you don't have a job to pay for it? Most of my clients (I am a health agent) struggle to pay premiums of $300-400/month. If those premiums were suddenly $1000/month, they wouldn't be clients much longer. If you can't write the check, then you can't write the check, period!

Why will premiums be $1000/month, source? And there is subsidy for low income group.

 

[dgoldenz]

Why will premiums be $1000/month, source? And there is subsidy for low income group.

Source? Try the Massachusetts Health Connector and run some family rates for yourself: https://www.mahealthconnector.org

Let me know where you can find the family rates for $300-400/month.

Just because you aren't "low income" by the government's standards doesn't mean you can afford $1000/month for health insurance. The income levels proposed also are not based on geographic regions - someone making $100k in Manhattan has just a slightly higher cost of living than someone making $100k in Middle of Nowhere, Idaho.

 

[Gone4Good]

Let me know where you can find the family rates for $300-400/month.

$575 / month for me and my wife according to the connector.

Similar plan in TX runs $511. But if I'm sick in TX, I can't get that plan, or maybe any plan whereas in MA I can.

And the subsidy is designed to keep health premiums below 10% of income.

 

[REWahoo]

But if I'm sick in TX, I can't get that plan, or maybe any plan ...

You should be able to get in the high risk pool even with an illness. Rates are double the cost for a healthy individual.

 

[Texas Proud]

Why will premiums be $1000/month, source? And there is subsidy for low income group.

Heck, our company insurancs is already over $1,000 per month for a family...

But maybe he was quoting for an individual...

 

[dgoldenz]

$575 / month for me and my wife according to the connector.

Similar plan in TX runs $511. But if I'm sick in TX, I can't get that plan, or maybe any plan whereas in MA I can.

And the subsidy is designed to keep health premiums below 10% of income.

How old are you and your wife? If it's $575/month in Mass, it's probably $200/month in Virginia. That's also for you and your wife, add two more people and your cost is $1000/month like I said. Good thing you and your wife aren't 60 years old, because the premiums for 2 60-year-olds in Mass. is about $940/month for the absolute cheapest, crappiest plan available.

 

[Gone4Good]

How old are you and your wife? If it's $575/month in Mass, it's probably $200/month in Virginia. That's also for you and your wife, add two more people and your cost is $1000/month like I said. Good thing you and your wife aren't 60 years old, because the premiums for 2 60-year-olds in Mass. is about $940/month for the absolute cheapest, crappiest plan available.

And how many 60yr olds get through the underwriting process with no exclusions?

 

[dgoldenz]

And how many 60yr olds get through the underwriting process with no exclusions?

Some companies don't do exclusions, like Anthem and Aetna, so for those companies, all of them that aren't declined. You didn't answer my question though.

 

[Gone4Good]

Some companies don't do exclusions, like Anthem and Aetna, so for those companies, all of them that aren't declined. You didn't answer my question though.

But then how many 60 year olds get through the underwriting process without getting declined. (And I am actually curious about your answer. I assume it would be a lot, but you do this for a living so you'd know for sure. But on second thought, they can just charge a really high price.)

I don't know what question I was supposed to answer. Our age? We're 38.

I think we're discussing two sides of the same coin. Sick people can't get affordable insurance without regulatory fiat. Regulatory fiat will cause rates to go up for people with insurance (in part because insuring sick people is expensive). If those rate increases make insurance unaffordable, it doesn't really matter why you can't get insurance (the insurance company excludes you or you can't afford it). Not having insurance is not having insurance.

But that is why the proposed legislation cost so much. The subsidies look to be pretty large.

 

[dgoldenz]

But then how many 60 year olds get through the underwriting process without getting declined. (And I am actually curious about your answer. I assume it would be a lot, but you do this for a living so you'd know for sure.)

I don't know what question I was supposed to answer. Our age? We're 38.

I think we're coming at the same problem from two different directions. Sick people can't get insurance without regulatory fiat. Regulatory fiat will cause rates to go up for people with insurance. Those rate increases could make insurance unafordable. Bottom line, it doesn't matter why you can't get insurance (the insurance company excludes you or you can't afford it). Not having insurance is not having insurance.

But that is why the plan cost so much. The subsidies look to be pretty large.

I don't get as many apps for 60-year-olds as younger people with families, but of the ones that apply, usually about 80% get approved when going with Anthem. Then again, I do a lot of pre-screen underwriting to make sure they can get approved before sending in an application. I hardly write any Aetna because their rates suck and I don't like the way they handle their rate-ups and practice of splitting family members on to separate policies.

38-year-old couple in Virginia:

Anthem $6k deductible HSA - $199/month
United Healthcare $2500 deductible co-pay plan - $298/month

So, the Mass. plan is 2-3x the price and has a much more limited network, usually the lowest priced ones are local HMO's only. If you want a nationwide network like BCBS is probably more than the $575 mentioned. Add in a few kids and you will see quite a difference.


Subsidies are great....if you're poor. If you make $100k and have to spend $12-18k/year on health insurance (before any out-of-pocket costs, mind you), that's not very attractive when you could be spending 1/3 of that now. Ironically, the people making the most money are the ones that can afford the lowest-cost, highest-cost-sharing option like a $10k deductible HSA plan, but the .gov doesn't want to offer high-deductible HSA plans. Don't forget that the more people spend on health insurance, the less they have to spend on everything else. That'll get the economy going.

 

[Gone4Good]

Subsidies are great....if you're poor. If you make $100k and have to spend $12-18k/year on health insurance (before any out-of-pocket costs, mind you), that's not very attractive when you could be spending 1/3 of that now. Ironically, the people making the most money are the ones that can afford the lowest-cost, highest-cost-sharing option like a $10k deductible HSA plan, but the .gov doesn't want to offer high-deductible HSA plans. Don't forget that the more people spend on health insurance, the less they have to spend on everything else. That'll get the economy going.

As a nation we spend 16% of GDP on health care. That works out to $7,600 per person annually ($30,400 for a family of 4). It is simply not possible that everyone can get insured with a real insurance plan for a couple hundred bucks per month. If your health care costs are less than $7,600 per year ($633/month) per person it is only because someone else is paying more or someone else if footing the bill.

So maybe its worth thinking about how it can possibly make economic sense for insurance companies to offer all of those really inexpensive policies you sell when the per-capita cost of US health care is so much higher than the premiums charged. The answer explains a big part of the difference between the cost of insurance in Massachusetts and Virginia.

 

[gerrym51]

I live in Ma. and although I have insurance from my company I have investigated isurance through the mass connector.

You are right. it is not cheap. however they have to take you no matter what. thats why ma insuance is so high. the other is that most of us who have insurance from our companies don't realize how much the companies pay into the plans . they subsidize about 80 %.

gerry

 

[mark500]

As costs soar, Mass. foresees change in health insurance rules - The Boston Globe

 

[dgoldenz]

As costs soar, Mass. foresees change in health insurance rules - The Boston Globe

Surprise.

 

[Gone4Good]

As costs soar, Mass. foresees change in health insurance rules - The Boston Globe

Turnbull and others said it would be fairer to link the formula to the percentage of income a resident is paying toward health insurance. That is similar to the approach proposed by President Obama and the US Senate.

So the fix is to make it more like what is being proposed at the Federal level?

Somehow I don't think that was the point mark500 really wanted to make, but sometimes it helps to read the article and not just the headline.

Anyhow, cost pressures aren't confined to MA.

Anthem Blue Cross raising individual health insurance rates as much as 39% in CA (and a bunch of other states too). And CA is one of those "low cost" states with lighter regulation . . .

"I've never seen anything like this," said Mark Weiss, 63, a Century City podiatrist whose Anthem policy for himself and his wife will rise 35%. The couple's annual insurance bill will jump to $27,336 from $20,184.

"Low cost"

 

[travelover]

I don't think we are at a state of equilibrium yet. When we get there the yowls of the injured will drown out the scare tactics of the vested interests.

 

[ERD50]

So the fix is to make it more like what is being proposed at the Federal level?

Somehow I don't think that was the point mark500 really wanted to make, but sometimes it helps to read the article and not just the headline.

I think mark500 (and the article) made the point just fine. Regardless of what fixes are being proposed, MA got further involved in health care, and cost went up for a lot of people.

We keep hearing, "costs keep going up, we have to do something", but if that "something" also comes with increased costs, well, that is a hollow argument.

-ERD50

 

[Gone4Good]

We keep hearing, "costs keep going up, we have to do something", but if that "something" also comes with increased costs, well, that is a hollow argument.

-ERD50

Cost is just one argument. Another argument is that people who are sick may not be able to get health insurance under the current system. Another argument is that 10% of the U.S. population doesn't have health insurance. Another argument is that the ranks of the uninsured grows every year. Another argument is that uninsured people have worse health outcomes than people with insurance.

So there are lots of arguments to change the current system. But even with respect to cost, it isn't enough to say "costs are rising in MA" and ignore that costs are also rising pretty dramatically everywhere else too. Do we have evidence that costs are rising more quickly in MA than elsewhere . . . that would be useful data.**

But even then, the MA comparison ignores the things in pending legislation that at least have the potential to control costs. This from the WSJ opinion section (no friend to "Obamacare") Health Reform Passes the Cost Test - $600B in Savings Over the Next Decade. We can argue as to whether those savings will be realized, and people certainly do. But how much savings are the opponents projecting to realize from the status quo?

** Looking for data on relative health care inflation among states I found this from the Boston Globe based on a study commissioned by Blue Cross Blue Shield . . . State mandates not driving health coverage costs

On the third anniversary of Massachusetts' landmark health insurance overhaul, a new report shows that employers, consumers, and state government paid the same, proportionately, for health coverage after 2006 as they did the year before the initiative started.

 

[Gone4Good]

BTW, wasn't the MA reform signed into law by Republican presidential hopeful Mitt Romney and voted for by recent star Senator Scott Brown?

Those evil socialists. (disclaimer for the sarcasm impaired, this is obviously sarcasm)

Here's the Socialist-in-Chief, Romney, explaining in a 2006 WSJ oped why mandates and subsidies are Grrreat! Health Care for Everyone? We found a way.

And who said this legislation isn't bi-partisan.

 

[ERD50]

Gone4Good - while those may all be valid points, it does not invalidate the point that mark500 made. HC costs in MA are going up.

My point in posting that was that you seem to want to distract from that with other points. But ..., HC costs in MA are going up.

Or, for the Monty Python fans - "Fine Plumage that Norwegian Blue!" does not change the fact that the "The Parrot is Dead!" If only I could say the same about the current HC proposals. But they seem only to be on life support.

Not to worry, Speaker Pelosi says we should pass the bill, and then we can find out what is in it.

Speaker Nancy Pelosi | News Room | Press Releases

“You’ve heard about the controversies within the bill, the process about the bill, one or the other. ....

“But we have to pass the bill so that you can find out what is in it, away from the fog of the controversy.

Plenty of blame to go around, but I'm trying to stick to some facts rather than call anyone an 'evil socialist', and the fact is ..., HC costs in MA are going up.

And, CONGRATS on the status change!

-ERD50