The ACA for 2018- What To Expect

flghtr65's Avatar
The enrollment period to obtain health insurance from the government marketplace exchange started on Nov 1,2017 for the year 2018. The subsidy to help policyholders pay for the premium is available. This subsidy was voted on by congress and cannot be removed by executive order. A family of 4 that makes less than $94,000 or a family of 2 that makes less than $64,000 is eligible to receive the subsidy. The subsidy to help lower the cost of the deductible and copays was eliminated by Trump with an EO.

http://www.msn.com/en-us/money/healt...N&OCID=DELLDHP
the_real_Barleycorn's Avatar
The enrollment period to obtain health insurance from the government marketplace exchange started on Nov 1,2017 for the year 2018. The subsidy to help policyholders pay for the premium is available. This subsidy was voted on by congress and cannot be removed by executive order. A family of 4 that makes less than $94,000 or a family of 2 that makes less than $64,000 is eligible to receive the subsidy. The subsidy to help lower the cost of the deductible and copays was eliminated by Trump with an EO.

http://www.msn.com/en-us/money/healt...N&OCID=DELLDHP Originally Posted by flghtr65
You mean that Trump neutralized a previous EO with his own EO. An illegal EO since the president can't change what was passed by the House. Isn't that what you just said?
I could give a shit less. All I know is my Business's Health Insurance, (we furnish health insurance as part of our employment package), has gone from $110,000 dollars in 2010 to $195,000 as of Jan 2018.

That is money right out of my pocket.

Health insurance is now our 2d largest expense after labor.

The good thing is our deductibles are still quite low, unlike all of the leeches who get their health insurance for free but can't even use it because of the extremely high deductibles.
flghtr65's Avatar
You mean that Trump neutralized a previous EO with his own EO. An illegal EO since the president can't change what was passed by the House. Isn't that what you just said? Originally Posted by the_real_Barleycorn
I did explain why the subsidy to help pay the premium was still available. I left it for the reader to conclude that Trump's EO undid or neutralized a previous EO for the other subsidy. If I am in the individual health insurance market, I would rather have the subsidy to help pay the premium (If I had to make a choice). You are correct in what you wrote about what Trump did. In upholding the law the president gets some leeway on interpretation with Executive Orders.
flghtr65's Avatar
All I know is my Business's Health Insurance, (we furnish health insurance as part of our employment package), has gone from $110,000 dollars in 2010 to $195,000 as of Jan 2018.

That is money right out of my pocket.

Health insurance is now our 2d largest expense after labor.
Originally Posted by Jackie S
The cost of your health insurance went up because there are more high risk people in the risk pool that were not there in 2010 and prior to that. If everyone were in compliance with the mandate( individual) the cost of your business health insurance would not have gone up that much.
The cost of your health insurance went up because there are more high risk people in the risk pool that were not there in 2010 and prior to that. If everyone were in compliance with the mandate( individual) the cost of your business health insurance would not have gone up that much. Originally Posted by flghtr65
And the reason for that is all of the young people in the age group between 21 and 35 don't want to pay for health insurance they don't need.

It was doomed to fail.

But that was the whole plan to begin with. When people finally through their hands up in the air and gave up trying to fix it, here comes the Federal Government with single payer. Which means, people with jobs pay, and leeches get theirs for free.
WTF's Avatar
  • WTF
  • 11-04-2017, 04:21 PM

The good thing is our deductibles are still quite low, unlike all of the leeches who get their health insurance for free but can't even use it because of the extremely high deductibles. Originally Posted by Jackie S
LOL...that was unfortunately pretty funny Jackie!
WTF's Avatar
  • WTF
  • 11-04-2017, 04:23 PM
And the reason for that is all of the young people in the age group between 21 and 35 don't want to pay for health insurance they don't need.

It was doomed to fail.

But that was the whole plan to begin with. When people finally through their hands up in the air and gave up trying to fix it, here comes the Federal Government with single payer. Which means, people with jobs pay, and leeches get theirs for free. Originally Posted by Jackie S
Actually the leeches are the age group of 21-35 who do not need health insurance....because some of them actually do and we wind up paying for them at the local level when they go to the ER.
LexusLover's Avatar
The cost of your health insurance went up because there are more high risk people in the risk pool that were not there in 2010 and prior to that. If everyone were in compliance with the mandate( individual) the cost of your business health insurance would not have gone up that much. Originally Posted by flghtr65
What? The cost of health care went up because carriers were REQUIRED by agency demands and regulations to cover shit that was not "required" before and those people who didn't get the "excessive" coverage paid the "tax" for not having health insurance, which cost less that paying the premiums for the coverage they didn't want! So EVERYONE was withing the "mandate"!

You want the Feds to ORDER ALL PEOPLE TO HAVE MEDICAL COVERAGE!

Is that BEFORE the Feds ORDER ALL PEOPLE TO HAVE AN ID?
flghtr65's Avatar
[QUOTE=LexusLover;1060150718]What? The cost of health care went up because carriers were REQUIRED by agency demands and regulations to cover shit that was not "required" before

You want the Feds to ORDER ALL PEOPLE TO HAVE MEDICAL COVERAGE!

Is that BEFORE the Feds ORDER ALL PEOPLE TO HAVE AN ID?[/QUOTE

Have you ever heard of a "Risk Pool"? When the ACA became the law high risk people (people with pre-existing conditions or people who were already sick) can't be denied the opportunity to purchase health insurance. High risk people submit more claims than a relatively healthy person. The underwriter for a health insurance company looks at claim history of the past year to determine premium price for the current year. With more sick people in the risk pool more claims were submitted after the ACA became law and the government exchanges were set up. That is why Jackie noticed the increase in cost starting after year 2010.

The added risk to the risk pool had more to do with increasing costs than the fact that all policies sold must have the ten minimum benefits. There are some exceptions for young people but generally speaking all policies must have the ten minimum benefits (bronze,gold silver etc)
this applies whether you get the insurance from your employer like IBM, ATT, GM or from the government exchange.

Everyone should have health insurance, a young person can get sick ( the risk is not as high as older person). The fact is before the ACA became law 82% of the population had insurance now it's 92%. That is an increase of 10%. I don't think the USA needs a single payer system. However, group health insurance from the employer needs to be supplemented with something for the individual market. Before the ACA was passed there were to many uninsured people who wanted health insurance.
flghtr65's Avatar
And the reason for that is all of the young people in the age group between 21 and 35 don't want to pay for health insurance they don't need.
Originally Posted by Jackie S
In 2018 young people should get the bonze plan. The premium is very cheap and a good plan to have if you don't expect a lot of doctor visits. From the link in post #1.

Because consumers can use their premium subsidy to buy any level of coverage, that money can be enough to cover the full price of a lower-cost bronze plan.
This year consumers in some areas had access to zero-premium bronze plans, but Claxton said for 2018 it will be many more people.
Bronze plans are not for everybody, since they typically have annual deductibles of $6,000 or more. But they may appeal to younger people or those who expect to have just a few doctor visits over a year.
Rising premium subsidies also can make "gold" plans more affordable. Those offer a higher level of coverage, comparable to what employers provide.
Unique_Carpenter's Avatar
The cost of your health insurance went up because there are more high risk people in the risk pool that were not there in 2010 and prior to that. If everyone were in compliance with the mandate( individual) the cost of your business health insurance would not have gone up that much. Originally Posted by flghtr65
Umm, wrong.
Individually purchased health insurance is in a totally and legally separated risk pool than employer group health plans.
But thank you for causing me to get my first laugh of the day.
Group policy cost is up due to health care costs.
Individual policy costs are up even more, due to that, plus the inclusion of high risk folks in the pool.

And for your post just above, why should taxpayer dollars pay for someones health insurance?
That's a huge issue that you're ignoring.

Actually the leeches are the age group of 21-35 who do not need health insurance....because some of them actually do and we wind up paying for them at the local level when they go to the ER. Originally Posted by WTF
Umm, also wrong.
The issue is not 21 to 35yr olds. The issue is high risk folks over age 26 that do not have jobs with group plans. Let's get facts correct. Frankly, ignoring an accident, anyone under 30 is low risk unless there's a family history of something.

Don't any of you guys know insurance folks that actually deal with the experience numbers? Those folks see the crap coming a couple years out.

A fundamental error back when Obamacare was passed was the amount of folks in their 20s that would be added to the individual pools. I know truckloads of that age kids and they all ride on their parent's employer group plans till the last possible point. And by then, they are usually in a job that has it's own group plan. There's other demographic assumption errors in the original deal, but that's the largest one that friends the insurance business talk about.

Here's the rest of my bit,

My two closest hospitals do not deal with the Obamacrap insurance. Why: The insurance reimbursement offers do not cover actual costs. I have a bunch of clients at one and a few friends at the other. Similar to myself they are all thankful that their employer has group insurance and can pretty much drive to any hospital, or doctor, they wish.

As Jackie mentions at post 3, employer's that have group plans have had premium issues also. Luckily, a decent employer realizes the value of long term employees.

Yes, the added high risk individual mandate has sent the experience rating through the roof. Yes, some insurance cos think that they can mandate reimbursement rates. But when a large professionally run operation (hospital) says no more bullshit and tells insurance cos to get stiffed on the individual plans, and when one of the largest primary insurance company for individual policies pulls out of most everywhere for individual policies (Anthem/Blue Cross/Blue Shield) the failure verdict is in.

Of course denial is fine for the Oshitcare supporters on capital hill. After all, they are all on a group plan.
But when and the Democratic targeted electorate finally realizes that their Oshitcare policy is crap, and I'm thinking 2018 after zillions get huge medical bill cause their policy coverage is shit and their geographically handy hospital is not covered, then perhaps the democxxx(I'll leave out a good joke) will finally realize that they do have to do something.

There's only one (ssshhh it's a secret but there's a second option) thing to do. As the Republicans are trying to do, removal of the mandate and tax penalty will have to be passed. That would get the high risk folks out of the rate base. Ugly concept but true.

And behind the curtain is the triple level secret thing of nationalizing health care. The question is, which of the few remaining insurance co's will be asked to handle the payment paper shuffle? Are not the insurance co's kissing up to the politicos already and merging?

Time for more coffee. Carry-on.
WTF's Avatar
  • WTF
  • 11-05-2017, 08:23 AM

You want the Feds to ORDER ALL PEOPLE TO HAVE MEDICAL COVERAGE!

Is that BEFORE the Feds ORDER ALL PEOPLE TO HAVE AN ID? Originally Posted by LexusLover


Do you want FEMA to continually subsidize the Flood Insurance industry in this region?

https://www.christianpost.com/news/s...surance-54735/

The National Flood Insurance Program (NFIP) provides insurance to homeowners in flood prone areas. Unintentionally, however, the program has encouraged home building in flood-prone, environmentally sensitive areas, at great cost to American taxpayers.
The NFIP, now under the direction of the Federal Emergency Management Agency (FEMA), was created in 1968 to provide flood insurance for homeowners. Private insurers would not provide flood insurance because they would not be able to diversify the losses, according to Jim Hilliard, assistant professor of Risk Management and Insurance at the Terry College of Business at the University of Georgia, in an interview with The Christian Post.
Insurers can provide coverage for something like a fire because it is unlikely that many homes would be affected by fire damage in a given year. Floods, however, affect entire neighborhoods, so insurance companies would be unable to cover the costs of natural disasters as catastrophic as floods.
The federal government, on the other hand, has the resources to compensate losses due to floods. Homeowners who take part in the NFIP buy flood insurance from a private insurer, but the federal government, if flood damage occurs, covers the loss.
The premiums are low, “as low as $129 per year,” the NFIP website advertises. The revenue generated by the premiums do not cover all the costs of flood damage for those in the program, so the federal government has to pay the difference.
An unintended consequence of the NFIP, according to Hilliard, is that the program encourages development in flood prone areas. So, when a flood does occur, there is more damage, and American taxpayers end up paying much of the cost.
The additional costs are not limited, however, to covering the costs of housing damage covered by flood insurance. There are also the additional costs associated with evacuation and rescue efforts that come with having more housing communities built in flood-prone areas.



.
LexusLover's Avatar

Have you ever heard of a "Risk Pool"? Originally Posted by flghtr65
In all your infinite wisdom over these many years you have studied the health insurance "risk" and "coverage" business ....

have you EVER HEARD of the Feds supporting insurance companies to cover their losses .... with "grants"???????

When Government starts "subsidizing" businesses and people, the incentive to make a profit and/or earn a living evaporates.

I'm quite familiar with health care billing (coding of services) and the EOB's that are generated by that process ... both from myself and others who have asked me to look at them.

You keep beating your head against a scheme that the original "architects" never expected to work .... without government subsidies .... because every friggin' one of them wanted a "one-payer" system so they wanted to get companies and people dependent upon taxpayer money to get coverage and keep it .... KNOWING that the system would collapse in time on its own weight!

Why the fuck do you think Obaminable et al kept kicking the can down the road on the deadlines kicking in before the next election? And why do you think Gruber was laughing at YOU AND EVERY OTHER DUMBFUCK WHO BELIEVED IT WAS "THE ANSWER"?

Gruber is still laughing his ass off at YOU!

And Bernie is now calling for just that as a "solution" to the failed ObaminableCare!!!!!!

BTW: I've said it before: Pelosi was looking for a California bailout for their retiree health care program for state employees! She got it!
bambino's Avatar
I expect the ACA to be gone as we know it by the end of 2018.