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PDad

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Reply with quote  #151 
Quote:
Originally Posted by uwApoligist
Cutting payments to insurers is a great idea.  Trump is saying he may do exactly that.  You do that, though, you have realize they will exit the market.   They are not making any money.  They are exiting the markets with the payments.
Discontinuing CSR payments seems like a no-brainer cost saving, however the savings are eventually offset by increased spending on raised premiums. The uncertainty over them has insurers in a bind.
...   
You have a situation where irresponsible porch sitters and drug addicts are showing up in emergency rooms at alarming rates.   That is costing massively.  Yes hospitals are over billing, drug companies are over billing, and there is fault there as well.
Manchin has talked often about the need to educate people getting coverage because they're still going to ERs for primary care. He's pointed at IN as having a successful program.

Removing the individual mandate is in many plans.  That will crash the market.  People just cannot afford 13k on a 50k salary.  They will not care and will exit.  You have to hold a gun to their heads to keep them in the market.  Without them, it collapses.

CBO scores for first year of various bills show removing mandates is responsible for most of the drop in insured because it's the only thing that changes - CBO even predicted 4M less in Medicaid!

Removing mandates also results in short-term premium increases, which has triggered harsh criticism from HFC members that seemingly don't realize the connection. I'd like to see someone press them on it.
mikec

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Reply with quote  #152 
Under the provisions of the Obama health law, any state compacts to allow for the interstate sale of health insurance would have to include the ten Essential Health Benefits (EHB’s) that govern the minimum coverage standards set out by the Affordable Care Act for insurance sales.

It is important to note that those EHB’s are not set in stone in the Obama health law, as section 1302(b) gives the HHS Secretary the power to “define the essential health benefits,” in ten different categories.

In other words, Secretary Price could first set the ground rules for the interstate sale of health insurance, and then tweak the minimum standards for what needs to be covered in such a plan, all without any action by lawmakers in the Congress.

In fact, in a Friday meeting with GOP lawmakers, Price indicated that he may be ready to issue a new rule on Essential Health Benefits – but there was no mention of a change on selling insurance across state lines

woody

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Reply with quote  #153 
I believe we are headed to a true 3 tiered HC system. It will actually be close to what I promoted. Instead of subsidized premiums, there will be a low quality Medicaid system for wards of the state. IE people that cannot take care of themselves, or their families. Welfare recipients, and low income families will be lumped into this low cost/no cost system that provides limited HC. The 2nd tier will be Medicare recipients, who will continue getting a low cost managed system they currently have. The upper tier care will be for those individuals that can afford the current or slightly lower insurance premiums they now pay, or receive from their employer, or that which is subsidized by their employer. Just like in European countries, and the UK, HC will be provided to all. The quality of that HC will be determined by the ability, or willingness of an individual to participate, and pay for a higher level of HC. In the UK, those with the financial ability often fly to the US to get medical procedures performed, instead of waiting for an extended period of time for treatment in their own nation. They can see a GP for a cold after a wait of up to 2 weeks. But if they want a hip replacement, the state doesn't schedule their procedure in a 2 week period or less like in the US. There are other "factors" involved. Age, cost of treatment, "quality of life" post procedure, availability of implants, the availability of surgical and hospital facilities also come into play. That's socialized medicine. It is rationed based on government funding, and bureaucrats deciding who gets what procedure based on factors other than the need of the patient, or the justification of a procedure. Rationing of HC is a given in this type of system.
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bluedog

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Reply with quote  #154 
I think if you want health-care insurance, then, go buy some.........I mean, that worked for a very long time.......Did it not?


uwApoligist

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Reply with quote  #155 
Quote:
Originally Posted by PDad

CBO scores for first year of various bills show removing mandates is responsible for most of the drop in insured because it's the only thing that changes - CBO even predicted 4M less in Medicaid!

Removing mandates also results in short-term premium increases, which has triggered harsh criticism from HFC members that seemingly don't realize the connection. I'd like to see someone press them on it.

I think the argument is the CSR payments are being used by insurance companies to premiums low on low income folks.  I am not aware of what mechanism insurance companies are implementing these graduated premiums, but that is the indication.  

If the above is true and CSRs are removed, low income folks will see their premiums immediately jump to what normal Ocare costs.   Which is about 13k for an average family of 4, assuming 1 doctor visit a year.   Low income folks are lucky if they are making 30k a year.  They will have no choice but to drop ocare.   That exodus is likely enough to continue to drive prices up on that pool.



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PDad

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Reply with quote  #156 
Quote:
Originally Posted by uwApoligist
I think the argument is the CSR payments are being used by insurance companies to premiums low on low income folks.  I am not aware of what mechanism insurance companies are implementing these graduated premiums, but that is the indication.  

If the above is true and CSRs are removed, low income folks will see their premiums immediately jump to what normal Ocare costs.   Which is about 13k for an average family of 4, assuming 1 doctor visit a year.   Low income folks are lucky if they are making 30k a year.  They will have no choice but to drop ocare.   That exodus is likely enough to continue to drive prices up on that pool.

You're off and we've covered this before. http://www.latimes.com/politics/la-na-pol-obamacare-101-cost-sharing-reductions-20170425-story.html

- CSR payments are additional subsidy for people in the 100-250% range to get at least a Silver policy which has lower out-of-pocket costs (e.g. lower deductible and copays). 

Less well-known are the so-called cost-sharing reductions. Consumers who make between 100% and 250% of the poverty line can get this additional assistance to cover co-pays and deductibles if they select certain health plans on the Obamacare marketplaces.

- Stopping CSR payments to insurers would lead to higher premiums to cover losses, however "low-income folks" wouldn't be impacted since they'd get higher subsidies.

If the payments are stopped, insurers would still be barred from charging low-income consumers for deductibles. But insurers would no longer be able to get financial aid for the costs they are bearing.

It could also cost the federal government more as higher premiums would mean higher subsidies for those who qualify (because the value of subsidies is tied to the cost of insurance premiums).

The additional cost of the subsidies might even outstrip the savings that would be generated by stopping the CSR payments, according to a new analysis from the nonprofit Kaiser Family Foundation, which estimates that stopping the CSR payments would save $10 billion in 2018 but lead to $12 billion in additional subsidy payments, assuming insurers did not abandon the Obamacare markets next year.

uwApoligist

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Reply with quote  #157 
Quote:
Originally Posted by PDad

You're off and we've covered this before. http://www.latimes.com/politics/la-na-pol-obamacare-101-cost-sharing-reductions-20170425-story.html

- CSR payments are additional subsidy for people in the 100-250% range to get at least a Silver policy which has lower out-of-pocket costs (e.g. lower deductible and copays). 

Less well-known are the so-called cost-sharing reductions. Consumers who make between 100% and 250% of the poverty line can get this additional assistance to cover co-pays and deductibles if they select certain health plans on the Obamacare marketplaces.

- Stopping CSR payments to insurers would lead to higher premiums to cover losses, however "low-income folks" wouldn't be impacted since they'd get higher subsidies.

If the payments are stopped, insurers would still be barred from charging low-income consumers for deductibles. But insurers would no longer be able to get financial aid for the costs they are bearing.

It could also cost the federal government more as higher premiums would mean higher subsidies for those who qualify (because the value of subsidies is tied to the cost of insurance premiums).

The additional cost of the subsidies might even outstrip the savings that would be generated by stopping the CSR payments, according to a new analysis from the nonprofit Kaiser Family Foundation, which estimates that stopping the CSR payments would save $10 billion in 2018 but lead to $12 billion in additional subsidy payments, assuming insurers did not abandon the Obamacare markets next year.


They will abandon many markets.   Unlike DC thinks, much of this business is not that lucrative.

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woody

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Reply with quote  #158 
So put all the ward of the state on Medicaid, and cut out the middleman, insurers. Why should we hand out money through insurance companies? It like throwing tax money through a double sieve. First we give the government bureaucracy a 40% cut to give the remaining 60% to the insurance agencies. WTF? Just put the indigent, and low income on Medicaid, and let them figure it out. Meanwhile, the rest of our productive society can enjoy awesome HC. I rarely see doctors, but had 2 surgeries to correct my F'd up shoulders within 3 months, so that I could hit my deductible in the same year. Meanwhile, the ignorant, the illegal aliens, and the stupid stumble into emergency rooms for the common cold. Nobody should be asked to subsidize the stupid, the ignorant, and illegal aliens with their insurance premiums. Take the cost of Medicaid out of section 8 housing. It's the same pot of money handed out to the same group of people. Just cut out the bureaucracies, they are just a cost factor involved with handing out OPM.
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EarlyGrayce

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Reply with quote  #159 
Just watching the So Cal local news. Anthem Blue Cross/Shield is pulling out of the ACA market. Premiums overall are increasing 12.5% for 2018. Cali insurance commissioner says if the fed subsidies get cut by trump, he will sue the fed government, because without the massive fed subsidy, the whole thing collapses. What a surprise.
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bluedog

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Reply with quote  #160 


[image] 
PDad

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Reply with quote  #161 
I'm pissed Senate Health Cmte announced they're going to start holding hearings on fixing Ocare in Sept. F'ers.

GOP should force Dems to submit a bill YESTERDAY with their fixes. Dems have been spouting off about fixes for a couple years, make them put up. Their fixes might reinvigorate some GOP members to repeal/replace Ocare.
keepinitreal

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Reply with quote  #162 
Quote:
Originally Posted by EarlyGrayce
Just watching the So Cal local news. Anthem Blue Cross/Shield is pulling out of the ACA market. Premiums overall are increasing 12.5% for 2018. Cali insurance commissioner says if the fed subsidies get cut by trump, he will sue the fed government, because without the massive fed subsidy, the whole thing collapses. What a surprise.


Was the news taken well in La Mirada?

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EarlyGrayce

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Reply with quote  #163 
Quote:
Originally Posted by keepinitreal


Was the news taken well in La Mirada?



The blue hairs in La Mirada don't give a F, they all have CPA's and loopholes. They aren't supporting the porch-sitters, I am.

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uwApoligist

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Reply with quote  #164 
I think it is too late.  It is going to collapse.

Single payer is likely only way forward now.   Unfortunate.  Rest of the world lived off the innovations that our health systems created.   You will see a true stagnation in anything new coming out for years to come.

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woody

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Reply with quote  #165 
Good, let it collapse. Then all the indigents, and low income can pile onto medicaid. The Seniors will have their Medicare handout, and the rest of us can buy a competitive priced policy with good benefits at a decent price since we wont be directly supporting the subsidy of two other people. Next up, Medicaid block grants to states with a cap on annual increases. The states that are the most Liberal, and have the most porch sitters will have a choice. Either continue raising taxes on working people to fund porch sitters, or stop giving handouts. Eventually, the income producers will leave for states with lower taxes, and the states that continue Liberal policies will fall into insolvency.
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woody

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Reply with quote  #166 
The poison pill in Obamacare was the one time up front lump sum offered to states that took the Federal money to patch up their state's Medicaid deficit. However, the poison pill required that those states provide a larger portion of state funding down the road.
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EarlyGrayce

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Reply with quote  #167 
Quote:
Originally Posted by woody
Good, let it collapse. Then all the indigents, and low income can pile onto medicaid. The Seniors will have their Medicare handout, and the rest of us can buy a competitive priced policy with good benefits at a decent price since we wont be directly supporting the subsidy of two other people. Next up, Medicaid block grants to states with a cap on annual increases. The states that are the most Liberal, and have the most porch sitters will have a choice. Either continue raising taxes on working people to fund porch sitters, or stop giving handouts. Eventually, the income producers will leave for states with lower taxes, and the states that continue Liberal policies will fall into insolvency.


Roger that. From this morning Fox News...


"Top health insurance companies in numerous states are looking to hike premiums by double-digits – some by roughly 30 percent or more – for ObamaCare plans in 2018, according to newly released figures that could light a fire under stalled efforts on Capitol Hill to fix the program.

“A lot of us have lost focus on the fact that the system we have doesn’t work,” White House Budget Director Mick Mulvaney told “Fox & Friends” on Wednesday, referring to the proposed premium hikes.

The Wall Street Journal reported that major insurers in Idaho, West Virginia, South Carolina, Iowa and Wyoming are pitching premium hikes averaging 30 percent or higher. 

Other states also could see double-digit hikes, including New Mexico, Tennessee and Texas."


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uwApoligist

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Reply with quote  #168 
6.5 Million pay fine, to avoid odummercare. 

We are 8-12 weeks from everyone getting a good sense of just how much the odummercare driven policy is going to go up.  40%, 50%?   How many just decide they can no longer afford it and exit the market?

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