Study: Obamacare Is Not Collapsing

[vash1012]

The large rate increase this year can be partially blamed on the elimination of some subsidies to insurers that were included temporarily in the ACA as well as normal market corrections in the face of rising healthcare costs. I do not think large rate increases will be the norm anymore than it is for the employer provided health insurance market. I think its important to keep in perspective how wide spread the issue of people not having access to insurance is, for instance in Nevada there are 14 counties expected to not have an insurance exchange option in 2018 with 8000 possible people left without coverage. 8000 people out of 2.9 million Nevada residents is not "collapsing". You could easily extend coverage to everyone by allowing people to buy into medicaid or medicare if there is no coverage option in their area.

But none of that will fix the second part of the problem which is that care is really expensive in America. You can DIRECTLY attribute our health care costs to the for profit element of our healthcare system and the administrative costs of maintaining such a system. The only fix to this is going to be heavy governmental regulation and oversight or/most likely and a single payer healthcare system. There is simply no other measure that can meet the goal of covering as many people as possible and providing them effective, efficient healthcare.

 

[radcen]

Under the ACA, do people with no coverage options still get the tax penalty?

 

[Moderate Right]

You are spot on!

Yep. That's what I remember about you. Editing other's posts to make them say what you want. Your dishonesty knows no bounds.

 

[Vern]

If aca works on a national level there is no reason it wont work on a state level too.

Its funded on a national level. States weren't inclined to spend that money. 19 states weren't even inclined to spend 10% of the cost of insuring 5 million people. Try to look at the situation from reality instead of a conservative narrative (this advice pretty much applies to all your posts). It will greatly improve the quality of your posts.

 

[Vern]

That all sounds very nice and rational and articulate and all, but these problems of rate increases and companies pulling out of states has been happening since long before Trump came around. Now, Trump certainly has helped speed it along to some degree, but it cannot all be laid at his feet.

Not if one wants to be fair and objective, at least.

But rate increases and insurers pulling out the market also existed before Obamacare. But the fact is republicans encouraging people to not sign up, defunding the risk corridor program (that was identical to Medicaid part D) and not expanding Medicaid also drove up prices. Defunding the risk corridor program drove insurers out of business (and hence out of the market). Trump's actions and threats only made both issues worse. Its just beyond hypocritical for republicans to decry "increasing premiums" as they purposely cause increasing premiums. And one simply needs to look at Nevada to see that they found a simple tweak to get more insurers in the market.

The surprisingly simple way Nevada recruited more Obamacare insurers

I'm sorry, its just painful to think how much better Obamacare would be for everybody if republicans weren't encouraging people to not sign up and driving up prices. Prices will eventually stabilize as the markets stabilize but when they do, the prices will be higher because of republican efforts with fewer enrolless and fewer insurers.

 

[Vern]

.....
Seems I can't explain it simply enough for you.

Already stated that I wasn't puzzed at all. That's twice now. How many times until it takes with you?

You said they were lying, I said that they were just show votes. Unless you are calling something else a lie, because it, again, makes no sense in reference to a vote.

Yes A60, you stated several times you weren't puzzled but you've explained nothing. If you want me to believe you weren't "puzzled" you need to explain your statement "That says to me that Republicans just can't let go of their new found power over us.” Flailing, whining and telling me you weren't puzzled does not explain that statement. It looks like you're trying to explain this "new found" action from republicans. Its not about me. its not about your claim you weren't "puzzled". Its about a statement you made that looks like you're making excuses for "new found" republican hypocrisy.


And fyi, "lying about repeal" and "show votes" are the same thing. If you want to pretend they are different go ahead but doesn't explain your statement about "new found power".

And what about the $2500 in savings per year? Are getting that?

just another dishonest narrative from the same people who told you that there were death panels, no one will sign up, no one will pay, it only reduces the deficit because its 6 years of benefits and 10 years of revenue, hundreds of thousands of doctors will retire, 50-100 million will lose insurance. They also told you for 7 years they could come up with a better plan. And they told you they'd repeal it first chance they got (which still seems to puzzle you). So they're not really a good source of information about Obamacare are they?

 

[Manc Skipper]

It MUST be collapsing, it's got OBAMA in the name, so it has to go, whatever. If it's not collapsing now, it will be shortly.

 

[radcen]

But rate increases and insurers pulling out the market also existed before Obamacare. But the fact is republicans encouraging people to not sign up, defunding the risk corridor program (that was identical to Medicaid part D) and not expanding Medicaid also drove up prices. Defunding the risk corridor program drove insurers out of business (and hence out of the market). Trump's actions and threats only made both issues worse. Its just beyond hypocritical for republicans to decry "increasing premiums" as they purposely cause increasing premiums. And one simply needs to look at Nevada to see that they found a simple tweak to get more insurers in the market.

The surprisingly simple way Nevada recruited more Obamacare insurers

I'm sorry, its just painful to think how much better Obamacare would be for everybody if republicans weren't encouraging people to not sign up and driving up prices. Prices will eventually stabilize as the markets stabilize but when they do, the prices will be higher because of republican efforts with fewer enrolless and fewer insurers.

There was no ACA market prior to the ACA.

 

[Vern]

There was no ACA market prior to the ACA.

there was an individual market before Obamacare (at least for the people allowed to buy insurance) and that's what the exchanges are.

 

[Greenbeard]

Is it more generous or does it just distribute the premium differently?

The plan he described makes the insurer immune to the 1st 10k and 50% of additional costs incurred.

So lets say he ran up 100k in medical bills. The 1st.10k isnt covered and the next 45k would not be covered either. Is the silver plan better?

No, and this is what I was getting at when I said: "Bronze plans are generally good for two kinds of people: those who don't expect to have medical expenses and prefer a catastrophic plan, and those who expect to have a lot of health expenses (given the way the OOP max works)."

If you're incurring more than about $18K in expenses in this situation you're better off with the bronze plan because the OOP maxes are the same.

That all sounds very nice and rational and articulate and all, but these problems of rate increases and companies pulling out of states has been happening since long before Trump came around. Now, Trump certainly has helped speed it along to some degree, but it cannot all be laid at his feet.

Not if one wants to be fair and objective, at least.

Let's be clear: there was one big jump in benchmark premiums and that was this year. And the reason was pretty clearly to make up for underpricing in previous years to achieve profitability (which appears to have been accomplished).

As for market exits before, that's more or les normal market dynamics and the sort of sorting to be expected. What's starting to happen now, with insurers leaving specifically because the administration is threatening to upend markets is a very different beast. Particularly now that it's pretty clear the markets have otherwise stabilized after a tumultuous first few years.

Under the ACA, do people with no coverage options still get the tax penalty?

Hasn't happened yet. But almost certainly not.

 

[trouble13]

Its funded on a national level. States weren't inclined to spend that money. 19 states weren't even inclined to spend 10% of the cost of insuring 5 million people. Try to look at the situation from reality instead of a conservative narrative (this advice pretty much applies to all your posts). It will greatly improve the quality of your posts.

If its finacially feasable on the federal level than it should be econimically feasable on the state level without federal assistance. Going forward if your incapable of discussing things absent of your personal digs I wont be responding. Im trying to have an open discussion of the various approaches to improve our healthcare system. If your convinced ACA is the best approach and enough people in your state agree with you, vote for it. raise state taxes if you need too. I dont begrudge you from making that choice. I dont have that right. Why do you feel you have the right to make that choice for the 49 states you do not reside in?

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[trouble13]

No, and this is what I was getting at when I said: "Bronze plans are generally good for two kinds of people: those who don't expect to have medical expenses and prefer a catastrophic plan, and those who expect to have a lot of health expenses (given the way the OOP max works)."

If you're incurring more than about $18K in expenses in this situation you're better off with the bronze plan because the OOP maxes are the same.



Let's be clear: there was one big jump in benchmark premiums and that was this year. And the reason was pretty clearly to make up for underpricing in previous years to achieve profitability (which appears to have been accomplished).

As for market exits before, that's more or les normal market dynamics and the sort of sorting to be expected. What's starting to happen now, with insurers leaving specifically because the administration is threatening to upend markets is a very different beast. Particularly now that it's pretty clear the markets have otherwise stabilized after a tumultuous first few years.



Hasn't happened yet. But almost certainly not.

I agree that people need to choose their plan based on which plan fits their needs the best. I am curious how much money the insurance company is sheilded from paying if we used that same 100k cost example and the person had the platinum plan. I think its an interesting question worth exploring. You pay a higher premium but have a lower deductable, but overall is the insurance company still only paying out 45k of that persons costs or is the number significantly lower or higher.

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[Greenbeard]

I agree that people need to choose their plan based on which plan fits their needs the best. I am curious how much money the insurance company is sheilded from paying if we used that same 100k cost example and the person had the platinum plan. I think its an interesting question worth exploring. You pay a higher premium but have a lower deductable, but overall is the insurance company still only paying out 45k of that persons costs or is the number significantly lower or higher.

That market doesn't have a platinum plan. But let's use the examples of the bronze and silver plans we've already looked at, plus the "best" (i.e., lowest OOP max) gold plan available. These examples are all for a 50-year-old in that market.

So you have a premium, plus what you have to contribute when you incur your $100K expense.

With an expense that high, you obviously hit the OOP max in every plan so your situation is:

	Annual Premium	Person Pays	Insurer Pays	Percent Covered by Insurers
Bronze	$4,040	$7,150	$92,850	92.9%
Silver	$5,020	$7,150	$92,850	92.9%
Gold	$8,382	$5,000	$95,000	95.0%

As I already pointed out, in that case where your expenses are particularly high you're best off in the bronze plan (thanks to the OOP limits). But no matter what you choose, the insurer is picking up 90%+ of your expenses.

 

[Vern]

If its finacially feasable on the federal level than it should be econimically feasable on the state level without federal assistance. Going forward if your incapable of discussing things absent of your personal digs I wont be responding. Im trying to have an open discussion of the various approaches to improve our healthcare system. If your convinced ACA is the best approach and enough people in your state agree with you, vote for it. raise state taxes if you need too. I dont begrudge you from making that choice. I dont have that right. Why do you feel you have the right to make that choice for the 49 states you do not reside in?

You want to complain about Obamacare but you are slowly realizing everything you've been told is a lie so we get the "hey, I'll make it about states rights" narrative. As I've already pointed out, its funded on a national level. And that's because it was taxed on a national level. You couldn't get 19 states to spend 10% of the cost of insuring 5 million people. Now you think you can get 50 states to pass the taxes necessary to fund it. Oh but you magically avoid that point by telling us you don't begrudge a state that does that. I'll let the 50 states know you don't begrudge them democracy. Oddly, you still begrudge democrats for democracy on a national level.

And T, what you call it a dig, I call it solid advice. Case in point, not begrudging states democracy is looking at something from a narrative because it ignores you and yours obediently begrudging the federal govt for democracy. It seemed like such a good point when you posted it didn't it? Had you followed my advice, that wouldn't have happened.

 

[Moderate Right]

But rate increases and insurers pulling out the market also existed before Obamacare. But the fact is republicans encouraging people to not sign up, defunding the risk corridor program (that was identical to Medicaid part D) and not expanding Medicaid also drove up prices. Defunding the risk corridor program drove insurers out of business (and hence out of the market). Trump's actions and threats only made both issues worse. Its just beyond hypocritical for republicans to decry "increasing premiums" as they purposely cause increasing premiums. And one simply needs to look at Nevada to see that they found a simple tweak to get more insurers in the market.

The surprisingly simple way Nevada recruited more Obamacare insurers

I'm sorry, its just painful to think how much better Obamacare would be for everybody if republicans weren't encouraging people to not sign up and driving up prices. Prices will eventually stabilize as the markets stabilize but when they do, the prices will be higher because of republican efforts with fewer enrolless and fewer insurers.

Insurers come and insurers go but before Obamacare we were never down to just one or zero insurers.

 

[Moderate Right]

It MUST be collapsing, it's got OBAMA in the name, so it has to go, whatever. If it's not collapsing now, it will be shortly.

When you're down to just one insurer or zero insurers, that's collapsing, no matter how much spin you want to put on it.

 

[Moderate Right]

If its finacially feasable on the federal level than it should be econimically feasable on the state level without federal assistance. Going forward if your incapable of discussing things absent of your personal digs I wont be responding. Im trying to have an open discussion of the various approaches to improve our healthcare system. If your convinced ACA is the best approach and enough people in your state agree with you, vote for it. raise state taxes if you need too. I dont begrudge you from making that choice. I dont have that right. Why do you feel you have the right to make that choice for the 49 states you do not reside in?

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Good luck. Vern is not capable of that.

 

[cabse5]

Study: Obamacare Is Not Collapsing

---

What is hurting some ACA exchanges is the uncertainty injected into the healthcare structure by Trump and hard conservatives in the GOP majority Congress. Health insurance companies usually make policy/pricing changes today that are based on 12 month industry analyst predictions. But this is impossible when the government purposefully injects uncertainty into the equations. Senate Majority Leader Mitch McConnell (R/KY) has far less than the number of GOP votes necessary to pass the Better Care Reconciliation Act of 2017. If a compromise cannot be reached in the near term, McConnell will be forced to consider Democrat amendments to craft a passable bill.

Additional: Individual Insurance Market Performance in Early 2017

Collapsing? No. It's acting like single-payor healthcare. Which is, IMO, the goal of dems all along.

On the good side, everyone gets healthcare. Healthcare costs are reduced.
On the bad side, with the astronomical premiums and deductibles, everyone can, maybe, afford a doctor's visit one time. If you're middle class, you're screwed. Then the only way to get ACA healthcare coverage is to lower your standard of living. This is how healthcare costs are lowered.

 

[trouble13]

That market doesn't have a platinum plan. But let's use the examples of the bronze and silver plans we've already looked at, plus the "best" (i.e., lowest OOP max) gold plan available. These examples are all for a 50-year-old in that market.

So you have a premium, plus what you have to contribute when you incur your $100K expense.

With an expense that high, you obviously hit the OOP max in every plan so your situation is:

	Annual Premium	Person Pays	Insurer Pays	Percent Covered by Insurers
Bronze	$4,040	$7,150	$92,850	92.9%
Silver	$5,020	$7,150	$92,850	92.9%
Gold	$8,382	$5,000	$95,000	95.0%

As I already pointed out, in that case where your expenses are particularly high you're best off in the bronze plan (thanks to the OOP limits). But no matter what you choose, the insurer is picking up 90%+ of your expenses.

your math is losing me on how you come to the conclusion that the insurer is picking up 90% of the costs?

When I did the math for the bronze plan I came up with the plan only covering 45k of the 100k billed based on the numbers the other poster provided. Are you saying his numbers are wrong?

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[trouble13]

You want to complain about Obamacare but you are slowly realizing everything you've been told is a lie so we get the "hey, I'll make it about states rights" narrative. As I've already pointed out, its funded on a national level. And that's because it was taxed on a national level. You couldn't get 19 states to spend 10% of the cost of insuring 5 million people. Now you think you can get 50 states to pass the taxes necessary to fund it. Oh but you magically avoid that point by telling us you don't begrudge a state that does that. I'll let the 50 states know you don't begrudge them democracy. Oddly, you still begrudge democrats for democracy on a national level.

And T, what you call it a dig, I call it solid advice. Case in point, not begrudging states democracy is looking at something from a narrative because it ignores you and yours obediently begrudging the federal govt for democracy. It seemed like such a good point when you posted it didn't it? Had you followed my advice, that wouldn't have happened.

Im not avoiding anything. People are saying that ACA is doing better than its being portrayed as and is self sustaining. Other people disagree that ACA lives up to those claims. Some dont like the lack of choice associated with ACA. Im saying each state should decide for itself. If ACA is working so well it should become a popular choice.

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[Vern]

Insurers come and insurers go but before Obamacare we were never down to just one or zero insurers.

Your obedient flailing overlooks the simple facts. Besides the fact that 4 of the 5 states down to one are red states (Alaska is the other but its problems are unique) you’re also overlooking that republican have been and continue to sabotage Obamacare. Since you follow me around to whine you cant deny you’ve seen the numerous posts in thread alone. It’s just beyond dishonest and hypocritical to sabotage something then claim “see, I told you it wouldn’t work”. But yet every conservative does it. And in spite of republican sabotage, its still working.

Number of Issuers Participating in the Individual Health Insurance Marketplaces | The Henry J. Kaiser Family Foundation

New Hampshire had one carrier control 90% of the market before Obamacare and then only had one carrier on the exchange the first year. check out the chart above, they went up to 5 before going down to 4. See, that's how Obamacare works in states that try to make it work.

 

[Vern]

Im not avoiding anything. People are saying that ACA is doing better than its being portrayed as and is self sustaining. Other people disagree that ACA lives up to those claims. Some dont like the lack of choice associated with ACA. Im saying each state should decide for itself. If ACA is working so well it should become a popular choice.

We were not discussing what people say. We were discussing your “states rights” narrative. Seems like your narrative requires you to deflect from my post. That’s what happens when you look at real world problems through the rose colored glasses of a conservative narrative Your “narrative” is still ignoring that 19 states wouldn’t spend 10% of the cost of healthcare for 5 million people. Your narrative simply cant address the fact that states don’t want to spend the money hence nothing would get done in the vast majority of them. And here’s another thing chants and slogans don’t address: the escalating cost of healthcare and the millions denied coverage and the millions more who couldn’t afford it was a national problem. The federal govt not only has the right to step in, it has a mandate (yea, I could have said obligation). Something about promoting the general welfare.

Anyhoo, once again I’m trying to have an open and honest discussion with someone who’s trying to limit the conversation to what “aligns” with a narrative. Hence the deflection at the first sign of a fact. Please don’t begrudge democrats for democracy and don’t begrudge me for posting facts.

 

[Anthony60]

Yes A60, you stated several times you weren't puzzled but you've explained nothing. If you want me to believe you weren't "puzzled" you need to explain your statement "That says to me that Republicans just can't let go of their new found power over us.” Flailing, whining and telling me you weren't puzzled does not explain that statement. It looks like you're trying to explain this "new found" action from republicans. Its not about me. its not about your claim you weren't "puzzled". Its about a statement you made that looks like you're making excuses for "new found" republican hypocrisy.

I think I see the problem. You are tying yourself in knots with all these conditions and believing that everything is mutually exclusive. If I believe that the votes they took with Obama as president are show votes, it doesn't mean other things like them liking the power that Obamacare gives to the government can't also be true.

Another problem is that you like to project things you wish I did into the post, like "Flailing, whining". LOL! So I read it and think (and most other people), I never said that. Then I think, well, you must be responding to the wrong post.

Now, I'm losing track here, but it's got to be at least three times since you decided that I said I was puzzled (of course, I never said that) that I am correcting you in telling you I never said I was, nor was I ever puzzled by the votes. Sorry to be so bold, but your lack of ability to understand that can not retroactively make me "puzzled" in the past.

I must say, although it's quite tedious to have to tell someone over and over that I know what I was thinking in my own head compared to you telling me different, it does provide a good example of the workings, albeit dysfunctional, of the liberal mind pertaining to the utter dismissal of facts in order to operate.

I'll tell you a little secret among us Conservatives... we know you guys need to dismiss facts and warp things in order to hold on to liberal ideas. We know all about it.

 

[trouble13]

We were not discussing what people say. We were discussing your “states rights” narrative. Seems like your narrative requires you to deflect from my post. That’s what happens when you look at real world problems through the rose colored glasses of a conservative narrative Your “narrative” is still ignoring that 19 states wouldn’t spend 10% of the cost of healthcare for 5 million people. Your narrative simply cant address the fact that states don’t want to spend the money hence nothing would get done in the vast majority of them. And here’s another thing chants and slogans don’t address: the escalating cost of healthcare and the millions denied coverage and the millions more who couldn’t afford it was a national problem. The federal govt not only has the right to step in, it has a mandate (yea, I could have said obligation). Something about promoting the general welfare.

Anyhoo, once again I’m trying to have an open and honest discussion with someone who’s trying to limit the conversation to what “aligns” with a narrative. Hence the deflection at the first sign of a fact. Please don’t begrudge democrats for democracy and don’t begrudge me for posting facts.

I am not going to keep continue warning about your personal digs. I will ignore them again but if you find you can not stop or you chose not I wll be ending this conversation.

If ACA is a sucess on a national level it should also be a viable endeavour to achieve on a state level, absent of federal intervention. Your counter argument seems to be that it wont work at a state level because it is something the states dont want to fund. I asked you what gives the feds the authority to decide for all the states what the best approach is. you are justifying the feds position by saying it speaks to the general welfare clause.

IMO and the SCOTUS's opinion your interuptation is overally broad. It is not the feds obligation to provide welfare to any group or individual. They can choose to do so but thats different than saying they are obligated too. Your argument is ideological not legal. There is no legal reason why the gov has to provide people with healthcare.

I personaly disagreement that the mandate aspect is legal but im satisified that it went to the court and they decided. I am willing to live with that. The question has been resolved even though I dont like the answer. Thats how we settle disputes in a civilized society. Im not invested in ACA failing but I am invested in seeing a better healthcare system. IMO, less is more in the case of gov involvment in healthcare and that is what im advocating. That is not deflecting

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[Greenbeard]

your math is losing me on how you come to the conclusion that the insurer is picking up 90% of the costs?

When I did the math for the bronze plan I came up with the plan only covering 45k of the 100k billed based on the numbers the other poster provided. Are you saying his numbers are wrong?

Under the ACA, all plans must have an out-of-pocket max on essential health benefits. Legally, this year that max for an individual can be no higher than $7,150--which indeed is where the bronze plan in this example has set its cap.

What that means in practice for a plan that has a $6,650 deductible is that after you've paid the deductible, you only pay 50% coinsurance on the first $1,000 of expenses incurred beyond the deductible. Because at that point you hit the OOP max. Once that happens, the plan pays 100% of your expenses the rest of the year.

When you choose an example of incurring huge expenses like $100K, the calculation of your total out-of-pocket liability really just becomes a question of what the OOP max for a plan is--because you're definitely going to hit it. You did the calculation fine, you just didn't apply the cap. You can't incur $55K in cost-sharing liability, at most you can incur $7,150 with that plan and your insurer has to pay the rest. Which in this case is over 90% of the expenses.