Another Rivet Pops in Maine

[Winter_123]

State legislature has just passed a bill banning caps on health insurance claims. I imagine that is both annual and lifetime but I am doing other things and have the radio on and just heard a snippet.

Keep in mind that this is on top of GI and on top of the fact that Anthem is already paying out over 85-90 in claims (according to their filings, otherwise I have no idea what is true), and on top of the fact that the state has denied a rate increase for two years in a row and Anthem is now in court over it. Lifting caps will hold costs down, right?

As discussed, there is a view here and among many that getting heatlh reform more under the control of the states would be progress. Unfortunateley, that is primarily a Southern view. Many of the northern states are very pink and in cahoots with Obama. If they see something in MaoCare that they like but it is not scheduled to be implemented for a while they are likely to want to implement it at the state level to be the firstest to be the pinkest.

Yes, we know it is all on a meltdown course but Obama, Hillary, and the dems said in the campaign that costs do not matter- that they will simply tell the insurance companies what the premiums will be. And by jove they are well on their way. What they do for an encore, I know not.

Change you can believe in.

 

[Norwayguy]

Winter what I don't understand about this legislation is that policies are already GI so if you reach a lifetime cap you should be able to get a new policy and the issue would come down to Pre-X, My understanding of pre-x is as long as you have not had a break in coverage pre-x can not be used....However since we have almost no carriers in Maine If you hit a lifetime cap with Anthem its not like you can turn to the failing Dirigo program because enrollment is closed...Could this be another case of the Legislature coming up with a fix to health insurance in Maine made necessary by the rules they themselves have put in place chasing competition out of Maine....Part of me has been rooting for Anthem to tell Maine to shove it and pull out of the state.

 

[Winter_123]

Winter what I don't understand about this legislation is that policies are already GI so if you reach a lifetime cap you should be able to get a new policy and the issue would come down to Pre-X, My understanding of pre-x is as long as you have not had a break in coverage pre-x can not be used....However since we have almost no carriers in Maine If you hit a lifetime cap with Anthem its not like you can turn to the failing Dirigo program because enrollment is closed...Could this be another case of the Legislature coming up with a fix to health insurance in Maine made necessary by the rules they themselves have put in place chasing competition out of Maine....Part of me has been rooting for Anthem to tell Maine to shove it and pull out of the state.

Yup, as discussed, since most of us here in Maine are not really in the health business (for obvious reasons) all I can do is sort of comment from the sidelines and observe and dont have expertise. To your issue about caps and pre-X, that is a good point and I suspect it comes into play as a client may go forward with future expenses. In other words, they may be able to just get another policy. However, I suspect that a client can get hammered if they have a big event that pushes them over while still under the old policy. In other words, how the heck do you manage that. You are nearing your cap under your policy so you drop it to come in under a new one to pick up some breathing space or what? It is not as though they/we have other carriers to switch over to. (maybe a little anthem). I don't know. What a mess.

Short answer, I/we don't know. No one at the state or fed level has thought some of this through and how the pieces fit together so it is easy to plead ignorance but at the same time no one else has even given it any thought.

I hear ya on the piece about secretly wanting Anthem to pull out to just let all the craziness hang out. Problem is that as we go forward the feds will nix that type of thing. In other words, if a state does business in any state it will have to offer it in all as part of some interstate thing. Don't know the details but it will some type of commie thing like that. We are on a public utility model now, not only in the state but nationwide so if you pull out it will have to be part of some grandiose plan that is approved by grandiose people.

Change you can believe in.

 

[Mr. Bill]

Well, here you go, y'all, why not go and ask The Anointed One your questions directly.

(anyone else find it a bit funny that the Narcissist-in-Chief has an answer for everything?)

Tickets still available. Let us know how it goes. You know you want to....

Tickets available for Obama's Maine visit | SeacoastOnline.com

 

[HealthGuy]

With all these companies pulling out of markets there will be no need for maternity coverage.

 

[scagnt83]

No one at the state or fed level has thought some of this through and how the pieces fit together so it is easy to plead ignorance but at the same time no one else has even given it any thought.

Thats the problem, we dont have experts drafting our healthcare legislation, we have press hungry politicians who dont know the first thing about how insurance or healthcare works.

Just look at the bailout, we let the same people who got us into this mess make the plan to get us out of it.... and we ignore the people who actually warned of the credit crisis!

 

[somarco]

Oh wise one, the answers to all your questions (at least for those who do not reside in Maine) can be found here.

The doctor has spoken.

 

[Winter_123]

Thats the problem, we dont have experts drafting our healthcare legislation, !

Any good lawyer or politician knows that when a contract or legislation is drafted the unclear portions benefit one side or the other. In the instance of MaoCare it benefits the government as we have already seen with the pre-x for children issue.

 

[Norwayguy]

Well, here you go, y'all, why not go and ask The Anointed One your questions directly.

(anyone else find it a bit funny that the Narcissist-in-Chief has an answer for everything?)

Tickets still available. Let us know how it goes. You know you want to....

Tickets available for Obama's Maine visit | SeacoastOnline.com

I actually thought about trying to get tickets for about 2 seconds....I know if I was there listening to him it would just make my blood boil and I might say something I disagreed with...also the standing in line in pouring rain didn't sound so great either.

 

[TXINSURANCE]

Winter in ME if you apply for Anthem and have not had health insurance in a long time (over 63 days) do you have a 12 month wait on pre ex?