Author Topic: Health Insurance Dilemma  (Read 1424 times)

benali72

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Health Insurance Dilemma
« on: May 03, 2017, 07:19:51 PM »
This is not a political post, just a heads-up based on information I get from years of working as an IT person in a large insurance company.

I assume that most of the folks on this board -- being consultants -- buy their own health insurance.

Health insurers in the ACA file their preliminary plans with the government for 2018 by May 23rd. They can adjust them somewhat before finalizing them by Oct 1.

Early scuttlebutt is that the number of insurers will be dropping significantly. Big premium increases are likely for those remaining.

(The reasons are technical and have to do with premium stabilization funding (risk corridors, risk adjustment, reinsurance), premium subsidies, mandated coverage, etc. You have to go way beyond the partisan political baloney you read/hear everywhere to understand how insurance companies are making decisions for 2018).

What will we do?

Overall, I think the strategy is to hunker down and keep your insurance however you can and wait till the politicians settle down their policies.

Meanwhile...

If you're one of those lucky people who buys an individual plan that is not tied to the marketplace, I'd suggest keeping it if you have the option. Be thankful if you only face a big rate increase.... at least you're insured.

Another option is employer-provided insurance. I know one contractor who is ditching her independent career specifically to seek shelter in company-provided health insurance.

The two dozen co-op insurers established by the ACA were a good option for several years. But no longer. Only 4 are left and these will die soon, as Congress has declined to pay the funds to them established in the ACA. IOW, they are being killed on purpose.

Since all health insurance markets are local, we'll all face different landscapes.  What's your plan for a safe transition through the next couple years?

The Gorn

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Re: Health Insurance Dilemma
« Reply #1 on: May 03, 2017, 07:31:29 PM »
What's your plan for a safe transition through the next couple years?

Make my wife keep her job with a health plan.  :P
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Code Refugee

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Re: Health Insurance Dilemma
« Reply #2 on: May 04, 2017, 04:34:42 AM »
Thanks for the heads up. I have employer provided, but it's close to useless and I generally end up paying cash, which is cheaper and faster than using it.

I can't imagine how bad this system needs to get before it is overthrown. I also think people defending the current system as a good system are automatically insane.

The Gorn

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Re: Health Insurance Dilemma
« Reply #3 on: May 04, 2017, 02:00:31 PM »
I can't imagine how bad this system needs to get before it is overthrown. I also think people defending the current system as a good system are automatically insane.

Do you mean defending the ACA/Obamacare system, or defending private health insurance? Or sort of both?

Libtards absolutely refuse to acknowledge Obamacare's core problem, cost containment. As one liberal asshole on CoT stated today, "The ACA can surely be improved. The AHCA will kill people who would have lived otherwise.".

Witness Benali72's correct statements starting this thread.

The Republican proposal of $8 billion over five years to fund non insurable patients at the state level is a fraction of what it will take. And if you delegate this to the states, it WILL suck and the money WILL be wasted. The God damn mother fucking thing-suckers in my state government regularly find ways to turn off my brother's measly $16/month food stamps. God damn state employees for their worthlessness.

Repubitards, stupid brain dead ideologue Republicans, view health care needs as irrelevant and as a sign of moral weakness. As a fat retired COPD guy with state sponsored retiree health insurance who I knew on Facebook stated, government supplied health care is foolish and someone with health problems and non insurability isn't the problem of the government.  The guy died of COPD in summer 2015.
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Re: Health Insurance Dilemma
« Reply #4 on: May 04, 2017, 03:24:03 PM »
I meant ACA but yeah I'll include both for sure for completeness and accuracy since what we had before was just as bad but in very slightly different ways.

Dammit: Effective, efficient and affordable Universal Health Care is a SOLVED problem in the entire rest of the world. It's not like this is either rocket science or even "really hard" like the God Emperor remarked.

The Gorn

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Re: Health Insurance Dilemma
« Reply #5 on: May 04, 2017, 05:28:23 PM »
^ Clicking nonexistent "Like" and "Anger" emoticon buttons...
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Re: Health Insurance Dilemma
« Reply #6 on: May 05, 2017, 02:10:42 PM »
Health insurers in the ACA file their preliminary plans with the government for 2018 by May 23rd. They can adjust them somewhat before finalizing them by Oct 1.

Early scuttlebutt is that the number of insurers will be dropping significantly. Big premium increases are likely for those remaining.

(The reasons are technical and have to do with premium stabilization funding (risk corridors, risk adjustment, reinsurance), premium subsidies, mandated coverage, etc. ...).

(I bolded the relevant items)

I ran across this small explanation on CoT the other day about "risk corridors":

Quote
"When they passed Obamacare, they put a bailout fund in Obamacare," Rubio said while addressing frontrunner Donald Trump on Feb. 25, 2016. "All these lobbyists you keep talking about, they put a bailout fund in the law that would allow public money to be used, taxpayer money, to bail out companies when they lost money. We led the effort and wiped out that bailout fund."

--

By "bailout fund" they mean the risk corridor, which was put in place as a form of meta insurance for health insurers.  With the risk corridors gone insurers pulled out of markets.

Republicans created the entire problem they claim to be solving.
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JoFrance

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Re: Health Insurance Dilemma
« Reply #7 on: May 05, 2017, 03:48:30 PM »
Well, now healthcare is going to transition from the ACA to the AHCA.  This is step one.  By itself, it isn't good enough, but at least they repealed a lot of the hidden taxes in the ACA.  This bill will change a lot before it is signed into law and that's a good thing.  I'm particularly interested in being able to buy insurance across state lines and becoming part of group insurance that is not connected to an employer.

There is no doubt the ACA is unsustainable.  I'm glad that I have my husband's healthcare through his employer for right now.

benali72

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Re: Health Insurance Dilemma
« Reply #8 on: May 05, 2017, 04:07:48 PM »
The health insurers goal is to make money.

For individual markets the ACA imposed big new costs on the insurers:

* must cover pre-existing conditions
* can't bump off people due to new conditions (a common scam prior to ACA, called recission)
* no lifetime or annual payout limits
* premium caps (can't charge elderly more than 3* young folks, can't charge more for the sick, can't isolate sick into separate pools, etc)

In exchange, insurers get big new money inflows from:

* everyone is required to buy insurance
* premium subsidies
* premium stabilization funding

These rules were all made by one political party. Now the other is in power and is actively dismantling them.

Yet insurers are still requried to operate under the old rules for the 5/23 and 10/1 deadlines!  Setting up plans for all of 2018 that are not allowed to change during that entire year.

The insurers feel they face huge risks filing for 2018 under the old rules while the market may be changing to something new and as yet unknown. Especially with a President criticizing their new ACA income streams and a House bill that recinds them.

That's why I'm hearing many insurance companies will bail from offering individual insurance.

Among my insurance friends, it's become gallows humor. A huge fail is possible, the only question is which party will take the biggest hit when they both blame the other for the fiasco.

My personal plan is to pray my insurer doesnt drop my plan. If they do, it'll be a huge expense for a new plan on whatever is left of the individual market. I may be forced out of PPO and into some sub-standard HMO. Sure hope not.

The Gorn

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Re: Health Insurance Dilemma
« Reply #9 on: May 05, 2017, 06:59:40 PM »
The health insurers goal is to make money.

For individual markets the ACA imposed big new costs on the insurers:

* must cover pre-existing conditions
* can't bump off people due to new conditions (a common scam prior to ACA, called recission)
* no lifetime or annual payout limits
* premium caps (can't charge elderly more than 3* young folks, can't charge more for the sick, can't isolate sick into separate pools, etc)

In exchange, insurers get big new money inflows from:

* everyone is required to buy insurance
* premium subsidies
* premium stabilization funding

These rules were all made by one political party. Now the other is in power and is actively dismantling them.

The absolute joy being expressed by Trump and his team over the House vote on this law is making me vomit. They absolutely betray no idea that ordinary people (whom they likely have no social contact with) will be bankrupted by these changes.

I'm in JoFrance's camp - I think Trump has had good *intentions*. But I differ substantially from Jo's automatic faith in Trump.

I think the Deep State has gotten its hooks into Trump and he doesn't have the depth of understanding or mental discipline to follow through on his promises.  In particular, Trump acted like he had strong convictions about health care law during the campaign - he's on record on TV interviews for supporting preexisting conditions allowances.

But then he roundly criticized his party for not passing Paul Ryan's old bill. This new bills still fucks over health care insurance recipients and he likes  that it's now going to the senate. He appears to consider a bad health care bill that leaves Americans wide open to new insurance abuses which will make all of us sacrifice, a victory.

JoFrance, why do you think this is a good thing? I don't see the bill being fixed by the Republicans. And Trump doesn't have the mental bandwidth to argue for maintaining benefit levels.

Yet he says publicly to the Australian PM that Australia has better health care than the US. And then says US health care will be "great".

I HOPE Trump will angle for a public option. But I suspect he's going to cave.

I will despise him if he caves to the retard Republican make-the-common-person-suffer tendency.
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benali72

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Re: Health Insurance Dilemma
« Reply #10 on: May 05, 2017, 07:54:15 PM »
Seems Gorn and JoFrance have the best strategy to remain insured ... be married to an FTE spouse who gets employer-based coverage.

Even then, you gotta pick the right company to be an FTE at.  Only about half (49%) of US employers still offer a health insurance benefit to their employees.

For the estimated 20 million or so people who buy health insurance on the individual market, the short term outlook is grim.  I can see this situation killing more independents' careers than the 2000 tech crisis, the 9/11 economic scare, or the 2008+ recession.

Or more even than the advent of IRS 1706, that ruined the IT careers of several of my friends years ago.

"Sad!"


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Re: Health Insurance Dilemma
« Reply #11 on: May 05, 2017, 08:19:21 PM »
"Sad!"

Quoted for irony.  >:(

I agree with everything you wrote.
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JoFrance

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Re: Health Insurance Dilemma
« Reply #12 on: May 06, 2017, 04:39:07 PM »
If you go back to the Trump plan, step one was to get rid of Obamacare and they did it through budget reconciliation so they could only do so much.  Step two was tweaking the plan through Tom Price at HHS and step three was opening up the marketplace across state lines so that insurers could offer group plans where people with similar needs could get a group rate, without an employer.  That's my understanding of what Trump wants to do, but it had to have a starting point and that is the Ryan plan that we currently have.

Ryan's plan is not good by itself, but the budget reconciliation process was the only way to get rid of all the Obamacare regulations.  It repealed almost $1T in taxes.  Step two (HHS) will allow Tom Price to decide what is mandated and what is not. 

The Senate will change Ryan's bill and we'll see where we are then, but the ultimate goal that Trump envisions is what I said above.  If we had a large marketplace there would be competition and plans that address specific needs of people.  I don't need maternity coverage, I need a plan for older people.

From everything I've read, this is the ultimate goal of the Trump administration.  He will strong-arm Republicans to get this done.  He did it with the House and now the Senate, which will be much harder because the vote margin is slim.  This is all a good thing.  These people are earning their money for the first time in years and they're going to own this bill. Just saying no is not going to be an option.

I'm most interested in opening up the market that has been stifled because of Obamacare regulations.  New types of insurance plans that fit individual needs is what we need.  Why am I paying for maternity care but can't get care for my needs as an older person under Obamacare?

We have to wait and see what will happen.  Yes, benali72, the best scenario under Obamacare is to have insurance from a spouse that is a FTE.  They get affordable plans.  I did it the other way and it cost $1700 a month for my husband and I.  Obamacare was not a good thing for us.

We have to trust Trump.  I do.  I think he is going to fix it all for us in the end but right now, Congress is having their say.  Whatever they come up with, he'll make better.  That's my opinion.

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Re: Health Insurance Dilemma
« Reply #13 on: May 06, 2017, 05:11:37 PM »
We have to trust Trump.  I do.  I think he is going to fix it all for us in the end but right now, Congress is having their say.  Whatever they come up with, he'll make better.  That's my opinion.

He said today that fake news is riling up the public about the Republican health care plan. He's in a reality distortion bubble if that's what he actually thinks.

Either he meant what he kept saying in campaign interviews, or he'll take a politically expedient course that directly hurts millions of policy holders.
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JoFrance

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Re: Health Insurance Dilemma
« Reply #14 on: May 07, 2017, 03:45:16 PM »
The fake news isn't helping, but the Trump admin does a poor job of communicating what is going on with healthcare and quelling people's fears.  Their message is disjointed, at best.  A little here, a little there, it isn't good enough.  It makes them look bad.

Trump is going to hold Congress's feet to the fire.  The House bill will change under the Senate.  Hopefully they will make it better.  The bottom line is that this is all still a work in progress.  We'll have to wait and see what changes are made by the Senate.

None of this would have to happen if Obamacare was any good.  It isn't.  One size fits all doesn't work and isn't affordable.  I think if Trump puts his name on any healthcare legislation its going to be something that includes the private sector and works better than Obamacare.  He won't go back on his word to the people.

He's not a politician, he's a businessman that solves problems.  The biggest issue for him is working with Congress.  So far he's done very well because he actually got the House to vote on a healthcare bill.  I can only imagine how much arm twisting he did for that to happen with our do nothing Congress.