From ACA to AHCA - ObamaCare to TrumpCare

[scagnt83]

Just like with the house plan those headlines neglect to mention that the 15 million people leaving health insurance in 2018 are doing so because they want to. No more mandate.

Not because they want to. Because they cant afford it. Big difference.

The largest percentage who would lose insurance are those in Medicaid expansion states where that expansion will be eleminated. They want it, just cant afford it.

This bill screws the poor royally, but also screws the middle class and older people who dont have access to group coverage. Many in those two catagories will go without, and not by choice but for financial reasons. I cant tell you how many people age 55-64 are delaying retirement for the sole reason of health insurance, this will only make matters worse.

 

[kgmom219]

Not because they want to. Because they cant afford it. Big difference.

The largest percentage who would lose insurance are those in Medicaid expansion states where that expansion will be eleminated. They want it, just cant afford it.

This bill screws the poor royally, but also screws the middle class and older people who dont have access to group coverage. Many in those two catagories will go without, and not by choice but for financial reasons. I cant tell you how many people age 55-64 are delaying retirement for the sole reason of health insurance, this will only make matters worse.

Typical conversation for me happened again today. Clients husband lost job in 2016, typically made $150K. They had to sell their 5000 square foot house and move into their lake house, which was struggle, since its only 3000 sq ft.

"My husband got a job, so I need to adjust our income from $50K ($2000 subsidy) to $100K (no subsidy)"

OK...the least expensive plan I can get you is $1700/month with a $6850 deductible.

<Insert 4 letter words here. Plus Obama is the devil, who can possibly afford this, Thank G-D Trump is the President and is going to get this thing repealed>

Just for the record, I hear this quite frequently and really just keep my mouth shut. But she asked what I thought and when the rates were going to go down. "Well. There isn't anything in AHCA or BRCA that will actually lower the rates. Plus, if they allow these through, you will no longer be able to get health insurance. All 4 of you would be rejected in underwriting"

Silence.

"What do you mean? We are healthy!"

And then I explained to her how with 2 kids on ADHD meds, a husband with Type 2 AND HBP and her recent ankle surgery that is still requiring PT, all 4 of them wouldn't have gotten coverage Pre-ACA when the COBRA expired.

To give her a LOT of credit, she was very gracious and thanked me for putting it in perspective, because they had never had anything except employer coverage.

Almost always, when I explain this to people, they are horrified about how bad it was. Which is why the polls are so lopsided. People may hate Obamacare, but they don't want people to be denied coverage or have lifetime max restrictions, either.

 

[AllenChicago]

Not because they want to. Because they cant afford it. Big difference.

The largest percentage who would lose insurance are those in Medicaid expansion states where that expansion will be eleminated. They want it, just cant afford it.

This bill screws the poor royally, but also screws the middle class and older people who dont have access to group coverage. Many in those two catagories will go without, and not by choice but for financial reasons. I cant tell you how many people age 55-64 are delaying retirement for the sole reason of health insurance, this will only make matters worse.

The CBO is using ObamaCare-quality plans as the standard when predicting that 15 million will drop their insurance in 2018. To show you how out-of-touch with reality the CBO is, only about 10.4 million people are on private ACA plans as of 6.1.2017. Yet 15 million will leave next year!


Medicaid isn't touched until after the 2020 Presidential elections. That's by design.


The Senate and the House bills do screw certain groups. One Senator said today after meeting with President Trump that the only way to "save everybody" is to do a 100% Repeal of ObamaCare, followed by Involuntary Medicaid Enrollment of everyone who does not have health coverage from other sources, a year later.

Sounds fine to me. My target market will be the same as it was prior to 2014.

 

[scagnt83]

The CBO is using ObamaCare-quality plans as the standard when predicting that 15 million will drop their insurance in 2018. To show you how out-of-touch with reality the CBO is, only about 10.4 million people are on private ACA plans as of 6.1.2017. Yet 15 million will leave next year!


Medicaid isn't touched until after the 2020 Presidential elections. That's by design.


The Senate and the House bills do screw certain groups. One Senator said today after meeting with President Trump that the only way to "save everybody" is to do a 100% Repeal of ObamaCare, followed by Involuntary Medicaid Enrollment of everyone who does not have health coverage from other sources, a year later.

Sounds fine to me. My target market will be the same as it was prior to 2014.

Over time, I highly doubt you will find it "fine" for your target market. Unless the high risk pool pays agents comp.

The CBO number includes Medicaid. So that is the reason for the difference in numbers.

But plenty on private insurance will lose coverage too. Take a look at Kaiser's numbers...

- 5mm+ per year aged 55-64 will eventually lose coverage

- At minimum, 1 out of 4 people will be declined coverage for pre-x. That ratio is higher for ages 50+. (I would guess its more like 60% for that age group based on my UW expereince selling life insurance

- After tax-credits, the majority of states will see Net Premiums Increase.

- Average exchange enrolee age 55-64 will see a 96% increase in Premiums if over 200% FPL.


The majority will not qualify for it or wont be able to afford it. Imo, there is a very low chance that there will be the same number of prospects you had pre OCare.

How ACA Repeal and Replace Proposals Could Affect Coverage and Premiums for Older Adults and Have Spillover Effects for Medicare | The Henry J. Kaiser Family Foundation

Premiums and Tax Credits under the Affordable Care Act vs. the Senate Better Care Reconciliation Act: Interactive Maps | The Henry J. Kaiser Family Foundation

Premiums under the Senate Better Care Reconciliation Act | The Henry J. Kaiser Family Foundation

Gaps in Coverage Among People With Pre-Existing Conditions | The Henry J. Kaiser Family Foundation

 

[TN_agent]

I am at ground zero here. Pretty much the unhealthiest state in the union. All of my focus is on Medicare and Group. Individual U65 health insurance is a 20-year-old Tennessee Walking Horse limping into the dog food factory.

Health Shares, here we come!! Take vitamins and pray, hope you don't get sick! Luckily I don't smoke and can pass their underwriting, mainly because I never go to the doctor to be diagnosed with anything.

 

[AgentOrange]

One Senator said today after meeting with President Trump that the only way to "save everybody" is to do a 100% Repeal of ObamaCare, followed by Involuntary Medicaid Enrollment of everyone who does not have health coverage from other sources, a year later.

Sounds fine to me. My target market will be the same as it was prior to 2014.

This is actually the best way to do it, only we should give every American Medicaid coverage or the equivalent subsidy to buy their own insurance. This way everyone has the least basic coverage but those who can afford better coverage can pay for better coverage.

Eliminate every other coverage with the exception of VA. No more Medicare, group (as we know it), Obamacare, state and federal worker retirement plans, etc. True individual coverage, not dependent on employers, market based and universal.

This is the way they do it in Israel.

 

[junkman]

@KD, I note that $1700×12 ~ $20,000 annually which is 20% of gross income for making $100,000 for a HDHP that likely pays no claims. Many at that income level have no assets.

@others, premiums will likely drop drastically once all are enrolled without adverse selection. This has been demonstrated many times by forcing participation on large group.

The current proposal boggles the mind when combined with awareness that Congress is made of educated people with access to the information. The only conclusion is that they are incredibly selfish and self-serving in the face of crisis.

 

[AllenChicago]

Over time, I highly doubt you will find it "fine" for your target market. Unless the high risk pool pays agents comp.

The CBO number includes Medicaid. So that is the reason for the difference in numbers.

But plenty on private insurance will lose coverage too. Take a look at Kaiser's numbers...

- 5mm+ per year aged 55-64 will eventually lose coverage

- At minimum, 1 out of 4 people will be declined coverage for pre-x. That ratio is higher for ages 50+. (I would guess its more like 60% for that age group based on my UW expereince selling life insurance

- After tax-credits, the majority of states will see Net Premiums Increase.

- Average exchange enrolee age 55-64 will see a 96% increase in Premiums if over 200% FPL.


The majority will not qualify for it or wont be able to afford it. Imo, there is a very low chance that there will be the same number of prospects you had pre OCare.

How ACA Repeal and Replace Proposals Could Affect Coverage and Premiums for Older Adults and Have Spillover Effects for Medicare | The Henry J. Kaiser Family Foundation

Premiums and Tax Credits under the Affordable Care Act vs. the Senate Better Care Reconciliation Act: Interactive Maps | The Henry J. Kaiser Family Foundation

Premiums under the Senate Better Care Reconciliation Act | The Henry J. Kaiser Family Foundation

Gaps in Coverage Among People With Pre-Existing Conditions | The Henry J. Kaiser Family Foundation

The Medicaid $$ reductions don't happen next year. But the CBO says that 15 million ObamaCare customers will "lose their coverage" in 2018. Whether they do so voluntarily, or involuntarily, there's only 11 million private insurance customers on Obamacare. IMO, the CBO is in over its head with these big health bills.

When Kaiser (or anyone else) talks about premium changes, they're referring to plans that are essentially what metal plans are now, aren't they? They have no clue as to what an underwritten $5,000 - $10,000 deductible HSA-qualified plan is. Those plans were my primary product, and I'm hoping to get them back.

Although, its not likely unless I move. Illinois is like New York and California, when it comes to controlling corporations. Illinois will not "opt-out" of ObamaCare era protections and benefits. This refusal to allow the free-market to operate, could backfire on those states, unless enough "insurer bailout" funds are guaranteed.

 

[junkman]

@allen: the main premium problem is adverse selection. All else is smoke and mirrors.

Things like birth control reduce claims. Most cannot pass underwriting and underwriting should not be a source of carrier competition. Let the competition be about effective management. That requires regulation to set the rules. Think of it as race drivers meeting a set of specs so that the distinguishing factor is skill and luck.

Congress should have to enroll in and pay full premiums for whatever they come up with - no 125 plan, no employer premium. They should suck up the whole premium like the hourly worker or sole proprieter does.

 

[AllenChicago]

@allen: the main premium problem is adverse selection. All else is smoke and mirrors.

Things like birth control reduce claims. Most cannot pass underwriting and underwriting should not be a source of carrier competition. Let the competition be about effective management. That requires regulation to set the rules. Think of it as race drivers meeting a set of specs so that the distinguishing factor is skill and luck.

Congress should have to enroll in and pay full premiums for whatever they come up with - no 125 plan, no employer premium. They should suck up the whole premium like the hourly worker or sole proprieter does.

Congress is about to give themselves a $2500 monthly stipend to partially offset the cost of owning two homes.

They print their own money.