Sounds like something from the Medicare Advantage play book.
From ACA to AHCA - ObamaCare to TrumpCare
- Thread starter AllenChicago
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Sounds like something from the Medicare Advantage play book.
So other than the mandates and possible getting rid of some of the taxes what is different from the current law? I think it's a huge mistake not charging people with a pre-x who don't have continuous coverage higher rate.
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We'll have to wait until the bill is finalized by the Senate to see how Pre-X will be handled. The HOUSE version is a major headache in this regard. Opt-In states would have one system, and Opt-Out states would have another.
But you're right. The Senate plan sounds like a properly-funded ObamaCare.
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Here's a high-level overview that compares ObamaCare against the House and the Senate versions of the American Health Care Act.
9 Things To Know About The Senate Health Care Bill : Shots - Health News : NPR
Two Items I don't like about the Senate bill:
1. Subsidies cut-off at 350% of FPL, instead of 400%.
2. More complication. Not only are subsides based on income, but age as well. For instance, a 59-64 year old is expected to pay up to 16.2% of income.
Both the House and Senate versions allow states to opt-out of ObamaCare mandates for the 10 Essential Health Benefits and mandatory Pre-Existing Condition coverage. This by itself can create chaos for insurers. Why would ANY of them stay in a state that keeps all the expensive ObamaCare mandates?
9 Things To Know About The Senate Health Care Bill : Shots - Health News : NPR
Two Items I don't like about the Senate bill:
1. Subsidies cut-off at 350% of FPL, instead of 400%.
2. More complication. Not only are subsides based on income, but age as well. For instance, a 59-64 year old is expected to pay up to 16.2% of income.
Both the House and Senate versions allow states to opt-out of ObamaCare mandates for the 10 Essential Health Benefits and mandatory Pre-Existing Condition coverage. This by itself can create chaos for insurers. Why would ANY of them stay in a state that keeps all the expensive ObamaCare mandates?
They are all going to be situs'ed out of Oklahoma
This is the disaster part of the bill. I can handle that poor people are getting hammered, they always do with a GOP controlled Congress, then the pendulum swings back and they get too much money. What I cannot deal with is that they are going to ***** sick people. It won't matter how much money you have, if you are single, widow, divorced, have no access to group coverage AND have any type of illness, there is nothing available. (And don't throw the high risk POS plans at me).
And BTW...they still haven't fixed the premium/deductible issue.
We need pre-ex based on the old HIPAA group guidelines and some type of premium reimbursement mechanism in place for the 10% that are responsible for 90% of the claims.
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This is the playbook for the road to Medicare for All. The GOP is just too dense to realize it.
This will piss off old people, young people, poor people, upper middle income families, and especially sick people. The GOP will regret this "bigly" if it passes. Its a bigger clusterf*ck than Obamacare was.
This will piss off old people, young people, poor people, upper middle income families, and especially sick people. The GOP will regret this "bigly" if it passes. Its a bigger clusterf*ck than Obamacare was.
The root cause of this mess, which is the total $ of claims made by people with serious health issues, is not solvable with legislation that completely ignores it.
If 10% of the population is responsible for 90% of total claims, as has been stated somewhere in this forum, there needs to be a plan that eliminates (or minimizes) the impact of these claims on overall insurance rates. If those claims were completely taken out of the population and paid separately, rates conceivably could be lowered by at least 50% and probably closer to 75%.
The problem, though, is that no one on either side of aisle is even mentioning this so they will continue to try to figure out ways to move an overinflated ball of claims around, it can't possibly succeed.
Going to finally learn how to say y'all????
Here is an article from 2012 about this subject: https://www.theatlantic.com/busines...made-up-50-of-us-health-care-spending/251402/
The article states that 1% of the population has 20% of the cost, just removing those people from the risk pool and giving them a government grant for healthcare would lower rates by at least 24% (assuming 80% MLR).
And 5% make up 50% of the costs, remove these people and insurance rates can come down 58%.
It seems hard to believe that this data has been around for so long and has been ignored by everyone involved in crafting legislation
