Are we allowed to talk about it yet?

[simple girl]

HR 1628 is on the Schedule for 8:30 p.m. tonight.

Legislative Schedule · House.gov

If so, any bets on how many responses before the thread goes haywire and is closed?

I have to make a joke because otherwise this bill makes me .

I am pretty sure it will pass the house. Not so sure what will happen in the Senate. The fight continues.

 

[MichaelB]

It is on the house calendar. There's a FAQ here with the bills and amendments under consideration. http://www.early-retirement.org/forums/f47/useful-links-to-2017-health-care-reform-85783.html Our discussion needs to stick to the specifics on the bills and amendments. Really, there's no need to get into how the House and Senate will vote.

 

[Ronstar]

HR 1628 is on the Schedule for 8:30 p.m. tonight.

Legislative Schedule · House.gov

If so, any bets on how many responses before the thread goes haywire and is closed? ....

I think we'll be fine if we stay away from speculation and mudslinging comparisons between this bill and ACA.

 

[easysurfer]

Simple Girl, the title of your thread made me as I thought about posting the very same question.

I do have a burning question about What or How of the latest proposal but guess What or How is too speculative so will refrain but how someone else asks that before this thread starts sizzling like bacon on a skillet. So, I will self-moderate, bite my tongue and not say anything .

 

[simple girl]

Simple Girl, the title of your thread made me as I thought about posting the very same question.

I do have a burning question about What or How of the latest proposal but guess What or How is too speculative so will refrain but how someone else asks that before this thread starts sizzling like bacon on a skillet. So, I will self-moderate, bite my tongue and not say anything .

Now my burning question is, what is your burning question?




Seriously, moderators, I respect the need to cull arguing and think you do an excellent job!!!

I am in limbo with no idea how to prepare to FIRE as I can't make a realistic budget for 2018. I have no idea how to estimate costs. Very frustrating. Oh well. It is what it is!

 

[easysurfer]

Now my burning question is, what is your burning question?




Seriously, moderators, I respect the need to cull arguing and think you do an excellent job!!!

I am in limbo with no idea how to prepare to FIRE as I can't make a realistic budget for 2018. I have no idea how to estimate costs. Very frustrating. Oh well. It is what it is!

I meant to say "but hope someone else asks". Not "but how someone else asks". I hate my typos that change the meaning to what I intended to say. Just thought I'd clarify.

As for the burning question, that would go something like "With the new proposal, HOW can ..." but that's too close to speculative territory for me and I don't want to get tasered . That said, the moderators do a really good job and I'm really trying to be a good guest on the forum.

 

[simple girl]

Ok here is one of my questions:

I heard an interview in which one specialist said the following: with this new bill, if one state allows lifetime caps to be brought back, employer-based plans across the United States are then legally allowed to reinstitute lifetime caps in their plans.

True or False? Or somewhere in between?

 

[MichaelB]

I have seen no mention of lifetime caps in the proposed legislation.

 

[bingybear]

Now my burning question is, what is your burning question?




Seriously, moderators, I respect the need to cull arguing and think you do an excellent job!!!

I am in limbo with no idea how to prepare to FIRE as I can't make a realistic budget for 2018. I have no idea how to estimate costs. Very frustrating. Oh well. It is what it is!

Some of us have ER, but the plans were based on previous laws, etc.

Some of the issues with planning based on this law are the choices. Are you considered high-risk, does your state choose to implement high risk pools (stability), if the state chooses high-risk pools... then when. I would expect if you get a sick later, I would expect you would fall into high-risk pools the next year provided your state took that option.

There is not enough information on how this will effect me or others to really make solid decisions or comments. This is kind of wait and see how it flushes out.

 

[Fedup]

There is an article about this on WSJ. Before Obamacare passed, some employers plan didn't have a cap either.

 

[MichaelB]

I am in limbo with no idea how to prepare to FIRE as I can't make a realistic budget for 2018. I have no idea how to estimate costs. Very frustrating. Oh well. It is what it is!

I think this means you are normal. Clarity would be a warning sign.

As for the burning question, that would go something like "With the new proposal, HOW can ..." but that's too close to speculative territory for me and I don't want to get tasered . That said, the moderators do a really good job and I'm really trying to be a good guest on the forum.

If it is about any of the items in the bill or any of the amendments, it is a legitimate topic - as long as the discussion is "what does this actually mean" or "how does this affect us ER types, and what options doe we have?".

 

[simple girl]

I have seen no mention of lifetime caps in the proposed legislation.

Agreed - but what do you think of what they say about how lifetime caps could be affected in this article? Complicated and confusing...was curious as to your take on it.

https://www.brookings.edu/2017/05/0...for-people-with-employer-coverage-nationwide/

 

[easysurfer]

I think this means you are normal. Clarity would be a warning sign.


If it is about any of the items in the bill or any of the amendments, it is a legitimate topic - as long as the discussion is "what does this actually mean" or "how does this affect us ER types, and what options doe we have?".

Okay. I'll take a stab then. My burning questions are for states that choose to use high risk pools, how the heck are they going to monitor who is high risk who is not? Back to the days of underwriting? Also, where would they draw the line as to what is high risk or pre-existing conditions? I don't expect answers now as so much is up in the air. Thanks for letting me vent .

 

[winger]

I'm 1.5 years from Medicare. When the dust clears, I hope there is some safety there.

 

[MichaelB]

Okay. I'll take a stab then. My burning questions are for states that choose to use high risk pools, how the heck are they going to monitor who is high risk who is not? Back to the days of underwriting? Also, where would they draw the line as to what is high risk or pre-existing conditions? I don't expect answers now as so much is up in the air. Thanks for letting me vent .

This white paper by Milliman provides the rational and analysis for risk pools and the Federal Invisible Risk Pool. It spells out pretty clearly how they might be structured. https://thefga.org/wp-content/uploads/2017/04/The-Federal-Invisible-High-Risk-Pool.pdf

In it, they identify 8 conditions that automatically classify as "high risk".

 

[Fedup]

This is from wsj
How Republican Health-Care Bill Would Affect You https://www.wsj.com/articles/how-health-care-bill-would-affect-you-1493863810

 

[MichaelB]

Really, I think links to general media reports are unhelpful in this discussion. Let's keep the discussion on our specific thoughts and not general media reporting.

 

[GTFan]

This white paper by Milliman provides the rational and analysis for risk pools and the Federal Invisible Risk Pool. It spells out pretty clearly how they might be structured. https://thefga.org/wp-content/uploads/2017/04/The-Federal-Invisible-High-Risk-Pool.pdf

In it, they identify 8 conditions that automatically classify as "high risk".

From the background section of that paper:

The introduction of the FIHRP requires that persons who are eligible to be ceded to the FIHRP complete
a health questionnaire to be used by the carrier to determine if the person will be ceded. The definition of
who is eligible to be ceded is one of the variables in our analysis. One possibility is that a carrier can
cede anyone they insure, whether the person is newly insured with the carrier, changing plans, or staying
with a current plan. The other possibility is that persons staying with the same plans with their current
carriers are not eligible to be ceded to the FIHRP

The House amendment for the FIHRP is http://amendments-rules.house.gov/amendments/Palmer322170833193319.pdf, and it says that the insurer can decide to put anyone in the FIHRP based on the health survey.

Here there be dragons. BIG dragons if you get ceded and the high-risk funding is not adequate, which was the case for most states before the ACA.

And the 'keep plan with current carriers' sounds good until your insurer leaves the exchange and you have to pick a new one, then you get to meet the dragon.

 

[easysurfer]

This white paper by Milliman provides the rational and analysis for risk pools and the Federal Invisible Risk Pool. It spells out pretty clearly how they might be structured. https://thefga.org/wp-content/uploads/2017/04/The-Federal-Invisible-High-Risk-Pool.pdf

In it, they identify 8 conditions that automatically classify as "high risk".

Thanks. That's a lot of info. Looks like I'll sit back and wait for the dust to settle more, but info is helpful nonetheless.

 

[joeea]

There's nothing to talk about quite yet.

Even if it actually comes to vote, even if it actually passes the house, it still has to go to the Senate.

The Senate almost certainly will make changes. The changes will need to be reviewed and voted upon by both the House and Senate.

Whatever is on the agenda for tonight will not be whatever does or doesn't make its way into law.

Once there is an actual change to current healthcare law, then we should have a lot of discussion about the impact. Until then, your guess is as good as mine.

 

[MichaelB]

Agreed - but what do you think of what they say about how lifetime caps could be affected in this article? Complicated and confusing...was curious as to your take on it.

https://www.brookings.edu/2017/05/0...for-people-with-employer-coverage-nationwide/

Well, in theory, the MacArthur Amendment is limited to individual and small group plans. In those, there is nothing preventing a state from removing some EHBs, which in effect would lead to lower lifetime spending projections. By taking some high risk people out of the general pool, the long term total cost for the remaining, healthier people, is also contained. So, the lifetime cap doesn't need to be eliminated, actuarially it will adjust, and that will affect premiums.

In other words, there is no need to change the regulation regarding the lifetime cap. What matters is what is included in the mandatory coverage, and for conditions not included in that list, what options are available.

I don't see that in the bill. There may be a separate risk pool, but there is no mention of how people get coverage for items eliminated from the essential health benefits list but not eligible for the risk pool.

 

[MichaelB]

Thanks. That's a lot of info.

Yeah, it is, but after reading it 4 times, there are some real nuggets.

Edit to add - the language in the amendments pretty closely follows the methodology described by Milliman, so it is worthwhile reading for anyone who wants to know how the risk pools are intended to function.

 

[Chuckanut]

Maybe the British ex-pats on this site can help us keep things in perspective.

IIRC, when the British National Health System was created it was very controversial. And, it has taken a long time with lots of changes, fixes, etc. to get it to where it is today. So, why should we Americans expect to hit it out of the park on the first at-bat?

IMHO, this thing is going to be a work-in-progress for at least a decade. So we might as well all work together for the best overall compromise.

 

[easysurfer]

Yeah, it is, but after reading it 4 times, there are some real nuggets.

Edit to add - the language in the amendments pretty closely follows the methodology described by Milliman, so it is worthwhile reading for anyone who wants to know how the risk pools are intended to function.

I read only 3 times, then decided I'll wait for the Cliff Notes .

At least now, I'm more comfortable that I won't be placed in a high risk pool if my state chooses to use them.

 

[GTFan]

I don't see why you would say that, given that anyone can be put in the pools. You must have a clean medical history.