OBAMA/TRUMPCARE MEGATHREAD

[StrangeSox]

They're using a lot of statistical twisting to come to these favorable conclusions in a LOT of cases. Such as devoting a study to "individual" plans, and undoubtedly targeting a specific age range within that limited group.

 

Individual market, but the ACA set up what are literally defined as benchmark plans. That's what the KFF study looked at. It wasn't some attempt by a partisan group to cherry pick certain categories.

 

Anecdotal, I know, but I don't know a single person, be they single, married, with kids, without kids, young, middle aged or old that has seen their premiums decrease from what they were paying before the ACA. And I'm betting most people here haven't, either.

 

So far, we're only in the second year of ACA plans, and these studies are looking specifically at the individual market plans (as in, buying one-off plans for you or your family versus an employer group plan) available through the exchanges. They're comparing the premiums for the first round of plans offered for 2014 to the premiums offered in 2015. Overall, there's an increase in premium prices, but that increase is far below the pre-ACA trendlines. I don't think the ACA was actually expected to give a net decrease in health insurance costs pre-subsidies but to "bend the curve" and slow the rate of growth of health insurance premiums. Health insurance premiums were growing at rates around and above 10% prior to the ACA, and there's decent evidence so far that those growth rates are being brought down.

Edited April 14, 2015 by StrangeSox

[StrangeSox]

well some googling found a report from Kaiser from January on health insurance premium changes year-over-year. A bunch of states/counties actually have negative premium growth rates, so that's a moot point anyway.

 

http://kff.org/health-reform/issue-brief/a...e-marketplaces/

 

Here's that Kaiser Family Foundation study

[cabiness42]

Individual market, but the ACA set up what are literally defined as benchmark plans. That's what the KFF study looked at. It wasn't some attempt by a partisan group to cherry pick certain categories.

 

 

 

So far, we're only in the second year of ACA plans, and these studies are looking specifically at the individual market plans (as in, buying one-off plans for you or your family versus an employer group plan) available through the exchanges. They're comparing the premiums for the first round of plans offered for 2014 to the premiums offered in 2015. Overall, there's an increase in premium prices, but that increase is far below the pre-ACA trendlines. I don't think the ACA was actually expected to give a net decrease in health insurance costs pre-subsidies but to "bend the curve" and slow the rate of growth of health insurance premiums. Health insurance premiums were growing at rates around and above 10% prior to the ACA, and there's decent evidence so far that those growth rates are being brought down.

 

OK, but what about the increase in premiums from 2013 to 2014, when many people were forced to change plans because they couldn't "keep their insurance" (despite what they were promised)? If the increase due to the forced change in plans was astronomical for an individual or family, then the fact that the increase from 2014 to 2015 was low really doesn't matter.

 

[StrangeSox]

There are tons of studies out there looking at premium increases over the last couple of decades.

[southsider2k5]

There are tons of studies out there looking at premium increases over the last couple of decades.

 

Is that premium + subsidies, or just premiums?

[Rex Kickass]

OK, but what about the increase in premiums from 2013 to 2014, when many people were forced to change plans because they couldn't "keep their insurance" (despite what they were promised)? If the increase due to the forced change in plans was astronomical for an individual or family, then the fact that the increase from 2014 to 2015 was low really doesn't matter.

 

My job at the time had one of those noncompliant policies. We renewed a month early so we could keep our plan one more year. Premiums went up 25%, our deductible increased signficantly. I had the honor of paying approximately $300 a month out of my salary to pay the first $3,000 of my health costs without any aid whatsoever. I looked at the options that were available to me through the NJ exchange (one of the worst exchanges at the time because of a lack of competition) and I actually asked my boss to just take the share that they paid for the group plan and offer it as a supplement to use the exchanges, because it would have been more affordable than the plan that we had. Our bad insurance plan, just got worse.

 

I have a new job now, with better insurance, but to be honest, I still shop for insurance when the exchange opens. I've seen better plans at reasonable costs in my state this past year. If my job's benefits weren't so good, I'd be on the exchange no question.

[StrangeSox]

Is that premium + subsidies, or just premiums?

Both, at least for the kff study. They give the breakdowns either way.

[StrangeSox]

Hh that's still a good point about the exchange transition year, definitely harder to compare across that boundary. You'd need to find the equivalent of a plan that would meet the benchmark plan from 2013 and compare it to the first true benchmark plans from 2014.

[cabiness42]

Hh that's still a good point about the exchange transition year, definitely harder to compare across that boundary. You'd need to find the equivalent of a plan that would meet the benchmark plan from 2013 and compare it to the first true benchmark plans from 2014.

 

No you don't really need to find the equivalent of a benchmark plan in 2013, because that's exactly my point. I'm talking about all the people who were forced out of their existing plans after 2013 because they didn't meet the requirements imposed in 2014. That group saw huge premium increases, and those are the people who bore the brunt of the impact of Obamacare. Those are the people who are paying the bill for all the people getting free or reduced cost insurance.

 

Again, not saying that people don't deserve to have that insurance, but this bill was crafted in a way that completely screwed over a handful of people rather than spreading out the cost in a more equitable way. This is what needs to be fixed.

[farmteam]

I'm curious as to the difference in those entering the insurance market now vs. a decade ago. Starting with lower rates/better plans? Smaller year-over-year increases general? Too early to tell those things yet, but I'd like to see how that plays out.

[StrangeSox]

No you don't really need to find the equivalent of a benchmark plan in 2013, because that's exactly my point. I'm talking about all the people who were forced out of their existing plans after 2013 because they didn't meet the requirements imposed in 2014. That group saw huge premium increases, and those are the people who bore the brunt of the impact of Obamacare. Those are the people who are paying the bill for all the people getting free or reduced cost insurance.

 

Again, not saying that people don't deserve to have that insurance, but this bill was crafted in a way that completely screwed over a handful of people rather than spreading out the cost in a more equitable way. This is what needs to be fixed.

It's simply not true that everyone who had to change plans."got screwed " or even had substantial premium increases.

 

edit: the majority of increased coverage comes from two sources: people who can now afford insurance thanks to federal subsidies and Medicaid. Neither are funded by premiums paid to insurance companies.

Edited April 15, 2015 by StrangeSox

[southsider2k5]

It's simply not true that everyone who had to change plans."got screwed " or even had substantial premium increases.

 

edit: the majority of increased coverage comes from two sources: people who can now afford insurance thanks to federal subsidies and Medicaid. Neither are funded by premiums paid to insurance companies.

 

Which probably means they aren't showing up in the final numbers.

[StrangeSox]

Huh?

[StrangeSox]

http://thehill.com/business-a-lobbying/239...panded-medicaid

The number of people lacking health insurance dropped by half in the 29 states that expanded Medicaid under ObamaCare, far more than states that did not agree to the expansion, according to new data.

 

While all states saw major increases in coverage under ObamaCare, the biggest differences were seen in states that accepted federal dollars to expand eligibility for Medicaid, according to new figures from the Urban Institute’s Health Reform Monitoring Survey.

The drop in the uninsured rate was about 30 percent in the 31 states that did not expand Medicaid eligibility.

 

Nearly 93 percent of people have insurance in the 29 states that have expanded Medicaid eligibility, the figures show. That compares to about 86 percent of people with insurance in states that have refused the expansion.

[cabiness42]

It's simply not true that everyone who had to change plans."got screwed " or even had substantial premium increases.

 

edit: the majority of increased coverage comes from two sources: people who can now afford insurance thanks to federal subsidies and Medicaid. Neither are funded by premiums paid to insurance companies.

 

No, probably not all. I'm sure you can find one or two that didn't.

 

Why did people have to change plans anyway. What about the Obamacare bill required certain kinds of existing private plans to go away???

[Balta1701]

No, probably not all. I'm sure you can find one or two that didn't.

 

Why did people have to change plans anyway. What about the Obamacare bill required certain kinds of existing private plans to go away???

The PPACA got rid of many of the "faux" insurance plans or whatever you want to call them. There were plenty - people got extremely crappy coverage and didn't realize how bad their coverage was until they actually needed it for something. That meant some people were going to lose plans that they liked and were happy with - but they were commonly happy with it because they didn't need to use it for anything that wasn't covered.

[cabiness42]

The PPACA got rid of many of the "faux" insurance plans or whatever you want to call them. There were plenty - people got extremely crappy coverage and didn't realize how bad their coverage was until they actually needed it for something. That meant some people were going to lose plans that they liked and were happy with - but they were commonly happy with it because they didn't need to use it for anything that wasn't covered.

 

That doesn't explain why it was necessary to force people off those plans.

[StrangeSox]

It's also worth pointing out that insurance companies could have continued the old plans unchanged if they wanted, but many opted to scrap the plans. Plans were changed and cancelled before the ACA regulatory changes, but 2014 brought a huge wave of cancellations and changes.

 

How about some data, HH? Is there anything out there looking at a) how many people lost their old plans b) how much their premiums increased and c) whether their more-expensive new plans provided substantially more benefits than their old plans?

[StrangeSox]

That doesn't explain why it was necessary to force people off those plans.

 

The ACA included regulatory changes as to what a plan must cover. Many of the cancelled old plans didn't meet those minimum requirements. Insurance companies could have continued these plans unchanged under grandfather clauses in the ACA, but they elected not to.

[Balta1701]

That doesn't explain why it was necessary to force people off those plans.

If you add requirements to the plan that it actually covers things, the previous, cheaper plan will no longer exist.

 

The "ok we'll let you keep your plan another year" thing that they added in 2014 when people were complaining about that was a political CYA to deal with that but honestly it was a bad thing for health care in general. These plans genuinely shouldn't exist.

 

I don't know 99% of what my health care plan covers but I don't want to suddenly find out that I got the illness it doesn't cover and that's something the market won't correct - without regulation saying "things need to be covered" virtually no consumer is going to know where the holes are in their plan until they need them and find out there's a hole there

[cabiness42]

If you add requirements to the plan that it actually covers things, the previous, cheaper plan will no longer exist.

 

The "ok we'll let you keep your plan another year" thing that they added in 2014 when people were complaining about that was a political CYA to deal with that but honestly it was a bad thing for health care in general. These plans genuinely shouldn't exist.

 

I don't know 99% of what my health care plan covers but I don't want to suddenly find out that I got the illness it doesn't cover and that's something the market won't correct - without regulation saying "things need to be covered" virtually no consumer is going to know where the holes are in their plan until they need them and find out there's a hole there

 

I'm having a difficult time buying that the government has any business telling me what my health care plan has to cover. If I choose to risk not having something covered, what business is that of anybody else?

[StrangeSox]

Every time somebody has treatment for an illness that isn't covered by insurance and doesn't pay their bill/ends up in medical bankruptcy, it affects everyone else.

[cabiness42]

Every time somebody has treatment for an illness that isn't covered by insurance and doesn't pay their bill/ends up in medical bankruptcy, it affects everyone else.

 

Yeah, there are better ways to deal with that than forcing a whole bunch of people to pay for coverage they don't need.

[Balta1701]

Yeah, there are better ways to deal with that than forcing a whole bunch of people to pay for coverage they don't need.

Actually, health insurance is pretty much by definition forcing a whole bunch of people to pay for coverage they don't need. Otherwise there's basically no such thing as health insurance.

[cabiness42]

Actually, health insurance is pretty much by definition forcing a whole bunch of people to pay for coverage they don't need. Otherwise there's basically no such thing as health insurance.

 

No, plenty of people have been voluntarily paying for varying levels of coverage for a long time. In fact, the vast majority were already paying for as much as or more coverage than the new law required. So there really was such a thing as health insurance before.