If this Actually Works, then What?

[RayNY]

I looked around and haven't seen this discussed yet (anywhere to be honest).

What if this actually works?

Not like how the PCIP "worked", I mean, what if they actually enroll all the people they want to in time? What if the nation gets on board and people grab their subsidized or non-subsidized healthcare during the enrollment period because it's the "right thing to do"?

Can the infrastructure handle all the apps? Payments? Billing? Can the provider networks handle the influx of new patients? (We all know, new insureds are the heaviest users of medical services.)

Will this be stable if there is no money coming in from penalties? What if no one chose a "caddilac" plan, and everyone went out of their way to get coverage and avoid the mandate penalty? What if these incentives and penalties actually work?

Has there been any data released on a "best case scenario"? How many people could end up in this system before the enrollment period ends? Is there data on room for expansion in provider networks, unused capacity, average beds full, etc. on a national scale?

TL;DR Anyone have any data or reports on whether the players in this game can handle all the participation this project could generate? Can this survive if everyone gets on board and avoids all penalties?

 

[xrac]

The only data is wild eyed guesses.

 

[RayNY]

No one reviewed how many doctors we have and their excess capacity? Current hospital utilization and room for expansion? There's no alternative projections from a budget office of what happens if people actually participate instead of resisting and generating hundreds of billions in penalty income?

 

[houcoogster]

Physician Assistant colleges will have to expand enrollments. Look for temp trailers in Dr. office parking lots. Insurance companies will experience a high rate of lapses for NSF ect. I also look to see more waivers granted for certain employers.

Funny thing about it is all this will be taking place during AEP. It will be frantic, insurance execs will be loading up on the Xanax

Those are my predictions, share yours.

 

[Crabcake Johnny]

Define "works." Nothing "works." Universal health care doesn't work, our current system doesn't work and Obamacare will not work.

You may want to talk about what "will be."

 

[taterpeeler]

It gets crasy on the morning of Oct 1 at 8AM when you talk to that first client that believed all the talk... that client that makes 401% of FPL when that client is now paying 500 bucks for a family of 4 7K HSA and you pop them with about 1100 buck premium and the oop climbs to 12700 a year.... that's when the chaos begins.....

me: rate will be 1100 a month....
them: 1100 a year?
me: no, a month
them: B.S.... it was going to be cheaper... I just bought a new car figuring the premium was going way down
me: oh, and your oop is going to 12700 a year

fun times

 

[Yagents]

On an individual case by case, success will be defined all over the board.

But in the press, it will be just rosy

Gov't number releases will show things are hunky dory.

What you read will butt up against reality
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[timsip]

If you don't believe that the administration will be spinning this to make it look like daisies when in reality it is going to be an economy suck, just read all of the crap being put out that the economy is doing great today. If you buy that, I have a piece of land overlooking the islands out by Phoenix just for you!

 

[Ann H]

I see us going through a roller-coaster of problems and "fixes" to those problems. None of these programs actually work. They just exist, and you keep modifying them in reaction to the most pressing problem. Sticker shock, claims shock, and network shock will be some of the first ones.

The Democrats have been doing a much better job at communication than the Republicans. So far, they've convinced people that California's rates went down. That's like saying I have a 2500 square foot home in a quality neighborhood for $250,000 but now I can buy a 1700 square foot home in a lower class neighborhood for $200,000. See the prices went down.

The problem is that the "rate buyers" will take this, hook line and sinker. They will reduce their premium gladly. Then the claims will hit, and they'll find that those $45/$65 Dr. visit copays really add up. They'll say, "why is my out-of-pocket so much higher?". They'll say, "The government said these are richer benefit plans, though".

 

[somarco]

So far, they've convinced people that California's rates went down.

A local college professor said something similar for GA rates.

"On average, these plans are coming in slightly less than premiums of employer plans,'' said Custer.
He said he based that assessment on premiums for a single person in employer plans in the 2012 Kaiser Family Foundation/HRET benefits survey, where an HMO plan for an individual in the South averaged $456 per month.
"A lot of the fears about premium shock are unfounded, at least in these preliminary filings,'' Custer said.
InsureBlog: Obamacare | GSU Prof. Bill Custer Whiffs It

What he fails to mention is that small group rates are about 2x individual rates.

Also doesn't count on smaller doc networks and minuscule Rx formularies.