Health Insurance That Doesn’t Cover the Bills Has Flooded the Market Under Trump

[Khayembii Communique]

The plan detailed in the story that was purchased by the couple was purchased during the Obama administration. How could it have been non-ACA compliant, or Trump's fault? :roll:

The plan was a short-term stopgap plan. Trump is allowing normal insurance plans to skirt these rules. Pretty obvious why it would be Trump's fault that these plans are now being allowed. It's explained right in the article:

The Diazes’ plan was nothing like the ones consumers have come to expect under the 2010 Affordable Care Act, which bars insurers from capping coverage, canceling it retroactively, or turning away people with preexisting conditions. But the law includes an exemption for short-term plans that serve as a stopgap for people between jobs. The Trump administration, thwarted in its attempts to overturn the ACA, has widened that loophole by stretching the definition of “short-term” from three months to a year, with the option of renewing for as long as three years.

 

[JasperL]

The plan detailed in the story that was purchased by the couple was purchased during the Obama administration. How could it have been non-ACA compliant, or Trump's fault? :roll:

So you're trying to save a failed argument by moving the goal posts?

This was your claim: "These are the same garbage plans that the Democrats were mandating that people buy under Obamacare." There was never any mandate to buy plans that were not ACA compliant and were therefore disregarded for purposes of the penalty for being uninsured. If you had this "insurance," and were required to get insurance under ACA, the ACA considered you to be UNINSURED and you would owe penalties for being uninsured.

And it is Trump's fault that he extended the time period permissible for these 'short term' plans from 3 months to a year, allowed people to renew them to extend the term to 36 months, (both not allowed under ACA or Obama regulations) and gutted the disclosure requirements by not making the plain language summaries required for ACA plans mandatory for these plans.

 

[Moderate Right]

It should come as no surprise that the Trump administration has made enabling predatory actions by bad actors and promoting junk insurance the centerpiece of its health care agenda, such as it is. Junk plans--"short term" health plans, despite the fact that they're now available for the entire year--are on the verge of becoming a bonanza for hucksters no longer bound by consumer protection rules.

Think of these plans as the Trump University of health insurance. Beyond failing to offer the basic protections and coverage people have come to expect in the age of the ACA (pre-existing condition protections, no caps or limits, etc), short term plans on average spend an absurdly low 39 cents of every premium dollar they collect on actual medical care. By contrast, ACA-compliant plans are legally required to dedicate at least 80-85% of premiums on actual care.

Health Insurance That Doesn’t Cover the Bills Has Flooded the Market Under Trump




"Grifters gonna grift" remains the guiding philosophy of policy coming out of this administration.

LOL. Obamcare left people with $16,000 deductibles and out of pocket costs.

 

[Deuce]

I support laws that require an insurance seller to honestly present all the details of a plan they want to sell. I support the notion of "caveat emptor".

If the details of a plan were honestly presented and the buyer agreed to buy the plan, they have nobody to blame but themselves if they didn't understand what they were buying.

God, the fairy tale universe you people live in. Health insurance companies are already prohibited from lying to you. Look how that works.

 

[Deuce]

LOL. Obamcare left people with $16,000 deductibles and out of pocket costs.

People had huge out of pocket costs before Obamacare. That's why healthcare was a top-three topic in the 2008 election. Remember?

 

[TU Curmudgeon]

It should come as no surprise that the Trump administration has made enabling predatory actions by bad actors and promoting junk insurance the centerpiece of its health care agenda, such as it is. Junk plans--"short term" health plans, despite the fact that they're now available for the entire year--are on the verge of becoming a bonanza for hucksters no longer bound by consumer protection rules.

Think of these plans as the Trump University of health insurance. Beyond failing to offer the basic protections and coverage people have come to expect in the age of the ACA (pre-existing condition protections, no caps or limits, etc), short term plans on average spend an absurdly low 39 cents of every premium dollar they collect on actual medical care. By contrast, ACA-compliant plans are legally required to dedicate at least 80-85% of premiums on actual care.

<SARC>Exactly what is your problem with the minimal 156.4% markup that the supporters of free enterprise democratic capitalism are using to ensure that they receive a modest return on their investment of billions of dollars of their own money? Why do you prefer the unAmerican **S*O*C*I*A*L*I*S*T** police state model that the left-wing, loony, liberal, leftist, pinko, commie hordes want to cram down America's throat in their quest for dictatorial power?</SARC>

 

[TU Curmudgeon]

Trump said in late June the WH would release its healthcare plan in a few weeks. This is September. Where is it?

One week in the middle of 2020, one week in 2022, and one week sometime in 2024. That's three and three qualifies as "a few" so that is when the White House is going to release its healthcare plan.

Is everything perfectly clear now?

 

[Mycroft]

God, the fairy tale universe you people live in. Health insurance companies are already prohibited from lying to you. Look how that works.

So, people need nanny government to protect them from their own stupidity. Yeah...no doubt that's true, but I say screw those idiots if they buy something without knowing what it is. Taxpayers shouldn't be on the hook to fix their mistakes.

 

[TU Curmudgeon]

I support laws that require an insurance seller to honestly present all the details of a plan they want to sell. I support the notion of "caveat emptor".

If the details of a plan were honestly presented and the buyer agreed to buy the plan, they have nobody to blame but themselves if they didn't understand what they were buying.

Have you ever actually read the whole of a mortgage document? Do you know that one of the reasons why the lender can demand payment in full immediately is (I paraphrase) "because we feel like it"?

 

[Mycroft]

Have you ever actually read the whole of a mortgage document? Do you know that one of the reasons why the lender can demand payment in full immediately is (I paraphrase) "because we feel like it"?

Yes, I have. And I didn't sign it until I did.

Seems that's a major difference between me and those idiots in the OP's article.

 

[jimbo]

Detractors claim that Obamacare pushed prices up. That was due to junk insurance being forced off the market. What's the point of paying less for insurance that doesn't cover you? Trump thinks you deserve the "option" of paying to not be covered.

I've always purchased insurance that doesn't cover everything. I typically was a very low user of health care, so I purchased high deductible catastrophic insurance only precisely because it cost less, I knew a billionaire who felt he was capable of funding his own risks. He had no insurance of any kind. Why should either of us be forced into a one size fits all plan?

Trump is correct.

 

[TU Curmudgeon]

No. We don't need 2000+ pages of legislation to tell sellers to be honest.

Did you know that the entire Canada Health Act consists of three pages?

Did you know that the entire Medical Service Act [RSBC 1979] CHAPTER 255 is even shorter?

Did you know that those (less than) six pages provide me with a level of healthcare insurance that exceeds the "Platimum +" level in almost all American private healthcare insurance policies?

Did you know that the highest monthly premium I would have to pay for that level of healthcare insurance is $75.00 per month (which would cover two adults [and their children if they had any])?

How much would you pay to provide healthcare insurance FOR YOUR WHOLE FAMILY that had

1. NO "annual" cap;
2. NO "per incident" cap;
3. NO "lifetime" cap;
4. NO "per condition" cap;
5. NO EXCEPTION for "preexisting conditions";
6. NO RESTRICTION on medical care provider;
7. NO RESTRICTION on which hospital could be used;
8. 100% REIMBURSEMENT for all medications in excess of $1,200 annually; and
9. which COULD NOT BE CANCELLED for any reason?

I'd pay, at most, $75.00 (roughly US$56.25) per month.

 

[tres borrachos]

As amusing as trying to find a page count on a blog is, you could just, you know, look at the law. Presumably for the first time in your life!

But...Rob Schwab!

 

[JasperL]

I've always purchased insurance that doesn't cover everything. I typically was a very low user of health care, so I purchased high deductible catastrophic insurance only precisely because it cost less, I knew a billionaire who felt he was capable of funding his own risks. He had no insurance of any kind. Why should either of us be forced into a one size fits all plan?

Trump is correct.

But a "catastrophic" health care plan is most definitely NOT what the plans in the OP provide. It's fine to effectively self-insure the stuff up to a big deductible. In general, we pick the highest possible deductible for all our insurance. But the plans in question would absolutely fail you as a catastrophic plan, because of the per-incident limits, such as $5,000 per surgery, etc. So if you had a heart problem and needed valve replacement, it might cost $100k, and the plan pays....$5,000, leaving you on the hook for $95,000. A decent catastrophic plan would leave you on the hook for maybe the first $15,000 or whatever, then pay $85,000. If you have the $15,000, that's a (IMO) wise decision.

You just can't make a case for a plan with relatively high deductibles and low per-incident limits as the plans in the OP have. They're junk.

And as to the $billionaire, who cares? If he has to pay a penalty, that's fine, and he or she could easily afford a basic high deductible ACA plan and never even see the amount on his personal balance sheet - it would be below buried in the rounding errors, but regardless making any policy on what makes sense for the top 1/10th of a percent, or 1/1,000th percent isn't wise.

 

[JasperL]

LOL. Obamcare left people with $16,000 deductibles and out of pocket costs.

Not really. The private insurance companies did that. If you want lower deductibles, you have to pay higher premiums. The other alternative is plans that exclude things like cancer, hospitalization, or other care that's expensive to provide, what's called "death panels" in other contexts.

It's true the ACA didn't create a system where the private, mostly for profit healthcare insurance industry handed out free lunches to those shopping on the exchanges, but that's not something the ACA can solve. The only way around high deductibles for a plan that has the lowest monthly premiums is far more in taxpayer subsidies. I support those, but if that's what you want you need to be honest about it as well.

 

[Crossfire]

Did you know that the entire Canada Health Act consists of three pages?

Did you know that the entire Medical Service Act [RSBC 1979] CHAPTER 255 is even shorter?

Did you know that those (less than) six pages provide me with a level of healthcare insurance that exceeds the "Platimum +" level in almost all American private healthcare insurance policies?

Did you know that the highest monthly premium I would have to pay for that level of healthcare insurance is $75.00 per month (which would cover two adults [and their children if they had any])?

How much would you pay to provide healthcare insurance FOR YOUR WHOLE FAMILY that had

1. NO "annual" cap;
2. NO "per incident" cap;
3. NO "lifetime" cap;
4. NO "per condition" cap;
5. NO EXCEPTION for "preexisting conditions";
6. NO RESTRICTION on medical care provider;
7. NO RESTRICTION on which hospital could be used;
8. 100% REIMBURSEMENT for all medications in excess of $1,200 annually; and
9. which COULD NOT BE CANCELLED for any reason?

I'd pay, at most, $75.00 (roughly US$56.25) per month.

Did you know that one country's situation cannot be magically applied to another country?

 

[JasperL]

People had huge out of pocket costs before Obamacare. That's why healthcare was a top-three topic in the 2008 election. Remember?

Right. The argument at its core is Obama didn't change rewrite the rules of math...

Care costs $X per year per insured. Insurers get that from 1) premiums, plus 2) copays and deductibles. I picked the lowest premium plan, and my deductibles are high! OBAMA WHY DID YOU FAIL US!?!! If I pay less to the insurance company, why do they demand I cover more of the costs on my own?!!!

 

[mrjurrs]

Detractors claim that Obamacare pushed prices up. That was due to junk insurance being forced off the market. What's the point of paying less for insurance that doesn't cover you? Trump thinks you deserve the "option" of paying to not be covered.

Those junk policies are the primary reason why medical expenses for those with medical insurance is still a leading cause of personal bankruptcies in America.

 

[Crossfire]

People need to get a little better educated about the healthcare industry and why it is so expensive before they give their solutions to make it worse. Government is the problem. The "socialist" entities of Medicare and medicaid are the problem. Where I live, we just had two hospitals shut down because they could not afford to stay open because, you got it, Medicare and medicaid reimbursements are so low. To try to offset some of those losses, they charge the rest of us insane amounts for treatment. But, hey, I am sure the government will get it right this time.

 

[jimbo]

But a "catastrophic" health care plan is most definitely NOT what the plans in the OP provide. It's fine to effectively self-insure the stuff up to a big deductible. In general, we pick the highest possible deductible for all our insurance. But the plans in question would absolutely fail you as a catastrophic plan, because of the per-incident limits, such as $5,000 per surgery, etc. So if you had a heart problem and needed valve replacement, it might cost $100k, and the plan pays....$5,000, leaving you on the hook for $95,000. A decent catastrophic plan would leave you on the hook for maybe the first $15,000 or whatever, then pay $85,000. If you have the $15,000, that's a (IMO) wise decision.

You just can't make a case for a plan with relatively high deductibles and low per-incident limits as the plans in the OP have. They're junk.

And as to the $billionaire, who cares? If he has to pay a penalty, that's fine, and he or she could easily afford a basic high deductible ACA plan and never even see the amount on his personal balance sheet - it would be below buried in the rounding errors, but regardless making any policy on what makes sense for the top 1/10th of a percent, or 1/1,000th percent isn't wise.

Then, if the plan you want for me doesn't meet my expectations, I'd go elsewhere.

With thousands of insurance plans available, do you think I cannot find a plan that fits my wants?

I have no interest in a plan that fits you or the government thinks fits my needs.

 

[mrjurrs]

As I said, I support laws that require an insurance seller to honestly present all the details of a plan they want to sell.

What I don't support...and what Obamacare did...is telling insurance sellers what they were allowed and not allowed to put in their plans and telling buyers what they HAD to buy...or else.

Let the buyer choose and let the buyer live with what they choose...good or bad.

My problem with your position is that when someone gets sick under one of these policies, the people get stuck paying for what isn't covered. If someone can't afford health insurance that is one thing. If a person thinks they are saving a few bucks and are still covered, that is an insurance company ripoff.

 

[Mycroft]

My problem with your position is that when someone gets sick under one of these policies, the people get stuck paying for what isn't covered. If someone can't afford health insurance that is one thing. If a person thinks they are saving a few bucks and are still covered, that is an insurance company ripoff.

Or...it's a stupid person buying insurance.

Tell me...why do you want to blame the insurance company when a customer buys something from them that they turn out not to like?

 

[mrjurrs]

I'm not sure the optics on this are as great as you seem to think they are. These are the same garbage plans that the Democrats were mandating that people buy under Obamacare.

So now it's bad that people have them? Huh....

I mean, this outrage just feeds the old joke: Democrats don't care what you do, so long as it is mandatory.

Factually incorrect.

 

[mrjurrs]

LOL. Obamcare left people with $16,000 deductibles and out of pocket costs.

Assuming you are correct, how is that worse than paying 100% of the costs?

 

[jmotivator]

So you're trying to save a failed argument by moving the goal posts?

This was your claim: "These are the same garbage plans that the Democrats were mandating that people buy under Obamacare." There was never any mandate to buy plans that were not ACA compliant and were therefore disregarded for purposes of the penalty for being uninsured. If you had this "insurance," and were required to get insurance under ACA, the ACA considered you to be UNINSURED and you would owe penalties for being uninsured.

And it is Trump's fault that he extended the time period permissible for these 'short term' plans from 3 months to a year, allowed people to renew them to extend the term to 36 months, (both not allowed under ACA or Obama regulations) and gutted the disclosure requirements by not making the plain language summaries required for ACA plans mandatory for these plans.

What moving the goal posts? You are trying desparately to play both sides of the story as it suits your narrative. These garbage plans are not new, and they are well within the guidelines of the ACA.

In fact, the couple featured in that article purchased that particular plan during the Obama administration. The insurers are required to meet all of the ACA regulations on insurance whether or not they are purchased through the exchanges, or they have a waiver. Either way, that couple could not have purchased that plan in 2016 unless it met ACA minimum requirements.

The article is amazingly dishonest in what it doesn't tell you. We have heard story after story about how Trump made 2 million people lose health care coverage... but what actually happened was that a lot of people, free from the mandate, drop precisely this type of garbage coverage that they had otherwise been required to. Now you want to blame Trump for these garbage plans that the Democrats allowed through ACA regulation.

The cheap plans that were touted under Obama as evidence that Obamacare was working were precisely these garbage plans that charges many times more than cheap plans pre-ACA, and had such high OOP requirements that people couldn't afford to use them.