The Continued Degradation of Health Insurance Under the ACA

The Continued Degradation of Health InsuranceÂ*Under the ACAÂ*|Â*John Geyman

Even if insured how much can we depend on private health insurance any more? The bottom line--less and less as it continues to degrade after almost six years under the Affordable Care Act (ACA). Its coverage continues to degrade even as its costs become increasingly unaffordable.

Supporters of the ACA tell us that things will work out if we just give it more time, but these inconvenient facts argue otherwise:

Click to expand...

I read about a quarter, but found this interesting from HuffPo none the less.

Many have pointed this fact out for many, many years. The health industry is not a field that responds to ordinary market forces. Everyone requires medical assistance (and everyone expects to receive the best possible care when they do need it) at some point in their life and very, very few can pay for the full cost of the assistance with cash readily available. And when you prevent someone from obtaining that required medical care, or provide a lower degree of care, because of their inability to pay, then the larger community usually ends up bearing the brunt of that disservice in some form or fashion.

And when you continue to try and force a a non-traditional market to abide by traditional market rules, you end up with severe issues.

Like a burning river.

MrT said:

Many have pointed this fact out for many, many years. The health industry is not a field that responds to ordinary market forces. Everyone requires medical assistance (and everyone expects to receive the best possible care when they do need it) at some point in their life and very, very few can pay for the full cost of the assistance with cash readily available. And when you prevent someone from obtaining that required medical care, or provide a lower degree of care, because of their inability to pay, then the larger community usually ends up bearing the brunt of that disservice in some form or fashion.

And when you continue to try and force a a non-traditional market to abide by traditional market rules, you end up with severe issues.

Like a burning river.

Click to expand...

The rising costs of health insurance have little to nothing to do with ObamaCare. The best you can say is that ObamaCare completely neglected to account for the rising cost of insurance.

First class healthcare, cutting edge technology and medicine etc. costs alot of money. That's the way it is.

Obama destroyed the finest healthcare system in the world and enrolled less than twelve million people in a country of 380 million. He's a shyster, who belongs in jail with Bernie Madoff.

Ray410 said:

Obama destroyed the finest healthcare system in the world and enrolled less than twelve million people in a country of 380 million. He's a shyster, who belongs in jail with Bernie Madoff.

Click to expand...

That escalated quickly. What part of ObamaCare destroyed the healthcare system? Was it the birth control? I'm guessing the birth control...

roughdraft274 said:

That escalated quickly. What part of ObamaCare destroyed the healthcare system? Was it the birth control? I'm guessing the birth control...

Click to expand...

Your post would seem to indicate that you don't know much about the subject.

Ray410 said:

Your post would seem to indicate that you don't know much about the subject.

Click to expand...

It would if one were in denial about the real causes of the cost of healthcare in this country.

roughdraft274 said:

That escalated quickly. What part of ObamaCare destroyed the healthcare system? Was it the birth control? I'm guessing the birth control...

Click to expand...

It was funny.

But, if the studies indicating it is cheaper to pay for the relatively small number of unwanted pregnancies than providing "free" BC to all are accurate, then BC would at least account for some of the premium increases we have seen.

buck said:

It was funny.

But, if the studies indicating it is cheaper to pay for the relatively small number of unwanted pregnancies than providing "free" BC to all are accurate, then BC would at least account for some of the premium increases we have seen.

Click to expand...

Do you have any studies confirming that this has caused premium increases?

roughdraft274 said:

Do you have any studies confirming that this has caused premium increases?

Click to expand...

Nope, but there are studies showing that it is more expensive to give "free" BC to all.

If accurate, it would obviously cause premium increases.

Never ceases to amaze me how completely the ACA has merged the anti-Obama right and the pro-single payer left. It's really something to see.

That said, most of those arguments are incorrect.

Plans in the individual market are unambiguously more generous now than pre-ACA, as anyone who's ever complained about costs going up for that market segment knows. Covered benefits have expanded (they're now aligned with the historically more generous group markets) and the portion of costs paid by the health plans has risen. Prior to the ACA, most (51%) of individual market enrollment was in plans that would be considered "tin"--i.e., with actuarial values below the 60% bronze minimum under the ACA. Well below the 70% actuarial value silver plans with which the author takes issue. That is, pre-ACA plans were way less generous than the most popular plans on the market today. And of course individual market plans can no longer choose to carve out benefits or individuals that they refuse to cover altogether.

Saying "American families of four with a PPO plan will pay more than 25,000 for health care in 2016" based on Milliman is misleading at best, since that number isn't what a family pays.

The valid point raised is that more needs to be done about prescription drug prices, since that's where growth is right now (price growth for everything else is still historically low). What interventions is the right prepared to endorse? The same as advocated by the single-payer folks?

roughdraft274 said:

That escalated quickly. What part of ObamaCare destroyed the healthcare system? Was it the birth control? I'm guessing the birth control...

Click to expand...

Well, that did add a lot to the cost. Unnecessarily. I figured at one point that it was going to cost my company insurer's about $20,000 a year for birth control. What's important about that is that it's the worst kind of expense: neverending and increasing. It would be $20,000 year after year, forever, and increasing.

I say "unnecessarily" because birth control for an individual isn't costly and is easily paid by working women. It runs about $30/month. Free birth control for the poor is necessary, but not for everyone. So instead of Lucy paying for her birth control, her costs go into the pot for the ins. cos. to pay, along with millions of others' birth control. It's not even medical care.

All these costs make a difference. If an ins. co. had a choice to pay for high cost treatment for, say, cancer for one year, or neverending birth control, they would choose the limited finite amount of $200,000.

buck said:

It was funny.

But, if the studies indicating it is cheaper to pay for the relatively small number of unwanted pregnancies than providing "free" BC to all are accurate, then BC would at least account for some of the premium increases we have seen.

Click to expand...

Working middle class women had no trouble paying the $30/mo. for their birth control. Making ins. cos. pay for it was unnecessary for them. It adds greatly to the cost. Consider that it's millions of women, every month, forever. And increasing. It contributes to the high cost plaguing the situation. (It's not even medical care.)

Consider this: Ins. doesn't pay for hormones, which are just birth control pills. Same thing taken for a different purpose. So it was just a freebie to get the bill passed. And we're all paying for it, as well as the system, which is in a death spiral.

That is just one of the things plaguing this system.

buck said:

Nope, but there are studies showing that it is more expensive to give "free" BC to all.

If accurate, it would obviously cause premium increases.

Click to expand...

What studies show this?

JumpinJack said:

Well, that did add a lot to the cost. Unnecessarily. I figured at one point that it was going to cost my company insurer's about $20,000 a year for birth control. What's important about that is that it's the worst kind of expense: neverending and increasing. It would be $20,000 year after year, forever, and increasing.

I say "unnecessarily" because birth control for an individual isn't costly and is easily paid by working women. It runs about $30/month. Free birth control for the poor is necessary, but not for everyone. So instead of Lucy paying for her birth control, her costs go into the pot for the ins. cos. to pay, along with millions of others' birth control. It's not even medical care.

All these costs make a difference. If an ins. co. had a choice to pay for high cost treatment for, say, cancer for one year, or neverending birth control, they would choose the limited finite amount of $200,000.

Click to expand...

30 a month times 12 months equals 360 bucks.

360 times 30 years (the time that a woman can expect to be fertile) equals 10,800.

So 11000 to provide birth control for a woman from the age of 15 to 45.

Which number is higher Jack? 200000 or 11000?

roughdraft274 said:

What studies show this?

Click to expand...

i assume your google must be broken. There are a bunch of studies on the subject showing both conclusions. There are surveys of insurance companies, where most indicate it will increase their costs, a few saying it will decrease and some saying no change. Keep in mind, most women bought BC on there own, even before Obamacare - so changing that to "free' BC, will obviously increase costs. When I first had this conversation on this website 2 to 3 years ago, I provided simple math showing the cost differences. Lastly, even common sense.. If it truly saved money, insurance companies would have done it from the beginning - yes, even they like saving money.

buck said:

i assume your google must be broken. There are a bunch of studies on the subject showing both conclusions. There are surveys of insurance companies, where most indicate it will increase their costs, a few saying it will decrease and some saying no change. Keep in mind, most women bought BC on there own, even before Obamacare - so changing that to "free' BC, will obviously increase costs. When I first had this conversation on this website 2 to 3 years ago, I provided simple math showing the cost differences. Lastly, even common sense.. If it truly saved money, insurance companies would have done it from the beginning - yes, even they like saving money.

Click to expand...

Everything I have found shows that the costs are a drop in the bucket comparitively. The added costs are largely consumed by reductions in other expenses. And most plans already covered birth control before ObamaCare.

roughdraft274 said:

30 a month times 12 months equals 360 bucks.

360 times 30 years (the time that a woman can expect to be fertile) equals 10,800.

So 11000 to provide birth control for a woman from the age of 15 to 45.

Which number is higher Jack? 200000 or 11000?

Click to expand...

What I really liked was the "BC is cheap but it's adding a lot to insurance"

One woman can afford her BC, but if the cost is shared through insurance, it becomes unaffordable :screwy

buck said:

Nope, but there are studies showing that it is more expensive to give "free" BC to all.

If accurate, it would obviously cause premium increases.

Click to expand...

If it is...cheaper to pay for pregnancy.. why is it why we have to pay more premium for my wifes coverage because she can get pregnant?

So before the ACA.. the insurance company charged us more a month for healthcare for my wife.. (way above what the birth control cost) because she "could get pregnant" because she is in her childbearing age.

And yet the insurance didn't cover birth control.

So they charge us more because she could get pregnant.. and yet didn't cover the medication that would prevent pregnancy.

Meanwhile.. when I called.. they would cover all sorts of medication for men if you had erectile dysfunction..

roughdraft274 said:

Everything I have found shows that the costs are a drop in the bucket comparitively. The added costs are largely consumed by reductions in other expenses. And most plans already covered birth control before ObamaCare.

Click to expand...

So, basically, we agree. There are studies on both sides of the issue.

Anyway, from the insurance companies:
Payers Say Birth Control Mandate Will Increase Premiums According to Reimbursement Intelligence - Yahoo Finance

About one-half of the payers surveyed thought that mandated coverage of contraception would increase per-member-per-month pharmacy costs, although about 7% said higher pharmacy costs would be offset by lower medical costs. Noted Greenapple, "It was interesting that no one thought the mandate would offset costs by preventing unintended pregnancies, especially among young women. This is in direct opposition to the rationale for mandating these services."

"Some survey respondents were quite vocal about the impact of the women's preventive service mandate in the ACA. One pharmacy director told us, 'When mandates are put in place, organizations have an opportunity and need to raise prices, change cost structures, and pass along additional costs to our customers.'"

Click to expand...

jaeger19 said:

If it is...cheaper to pay for pregnancy.. why is it why we have to pay more premium for my wifes coverage because she can get pregnant?

Click to expand...

I would assume, it would be cheaper (short term anyway) to get rid of pregnancy altogether and replace that with BC pills. However, we are not talking of it being cheaper than all pregnancies. I was only talking about it being cheaper than the cost of the relatively few number of accidental pregnancies - specifically of those that do not take BC.

Ray410 said:

Obama destroyed the finest healthcare system in the world and enrolled less than twelve million people in a country of 380 million. He's a shyster, who belongs in jail with Bernie Madoff.

Click to expand...

I wouldn't call the pre-ObamaCare US healthcare system 'the finest in the world'. It had it's problems, some of which where major and others not so much.

It seems that ObamaCare has displaced one group of people from healthcare insurance due to increased costs on them, and granted healthcare insurance to another group via subsidies. It has also forced some to carry coverage that they don't need, can't use, or don't want, and forced them to pay for it anyway.

This movement of cost is going to piss off those who have additional cost forced on them, while those that get subsidies are going to welcome it.

Would seem logical that this is setting the conditions for class warfare. That Obama would want to set the conditions for a class war would also seem to be logical, given his ideology.

eohrnberger said:

Would seem logical that this is setting the conditions for class warfare. That Obama would want to set the conditions for a class war would also seem to be logical, given his ideology.

Click to expand...

class warfare? oh eohrn, five years after Obamacare, two years after the first enrollment and you are reduced to posting chants and slogans. If anything eohrn, President Obama's policies have headed off class warfare. The group most excluded from health care was the poor. Now they have one less reason to rise up and storm your house and take your all your possessions. But just in case, you should stock up on those survival seeds..... again.