The Dismantling of ObamaCare - Ongoing Updates.
- Thread starter AllenChicago
- Start date
FE is not a (valid) substitute for major medical. Commissions are multiple times more and residual premiums from which claims are paid are ridiculously lower.
No carrier will write a contract without pre-ex unless they can underwrite, exclude or enforce participation requirements. They will happily write ASO contracts but given the fact of Medicare claims paying infrastructure and a Republican Congress, the gubmt won't go that route. Kicking back to the states won't help those who can't pass underwriting which is most everyone over 50 especially when the standard questions asked "have you ever ".
Repubs spent the last 8 yrs opposing every Democratic proposal for political reasons regardless of their value. Now, they own what happens next. Pinche Trump the narcissist.
Oh, I was just implying that since some people probably can't get health coverage, depending on the route we end up with, people might ya know...expect to kick the bucket sooner than later or be more inclined to plan now.
But I see where you're coming from.
davephx
Expert
- 57
ACA AND BEYOND - ACA and/or any replacement will doom private insurance in our country if these two problems are not addressed.
1. Private insurance cannot insure people with a preexisting condition any more than you can insure a "burning house."
2. Private insurance cannot insure an "unlimited risk."
Regarding health care, both may be admirable social causes, but they are simply not insurable. No actuary or algorithm can possibly calculate the potential cost of these risks. If we are to avoid the pit falls of socialized medicine and retain the advantages of a viable free enterprise health system, these two "social goods" must be removed from the equation. If we as a country agree that these two elements of heath care are worthy of providing to all our citizens, it falls on the government, not private industry, to fund them. The solution is simple...let the government pay for these social benefits.
SIMPLIFIED SOLUTIONS - While nuances abound, here is a good starting point to address these social problems.
1. Allow individuals to apply for private insurance, be rated (with no preexisting conditions allowed) on their health history and purchase any plan they want and/or can afford. If rejected, rated too highly or have existing conditions, let them purchase a government plan like Medicaid, Medicare or even VA. Companies could be rated based on their loss ratio and if the cost per person exceeds the cost of a government sponsored plan, the company could bonus the employees an amount equal to the cost of the government plan into a HSA and let them shop the private market or buy the government sponsored plan.
2. The government could act as reinsurer for private industry for claims that exceed a designated cap...say $1,000,000 or more.
Above is the best option I've heard of so far.
Source: Idaho Insurance Agency - Alerts | Idaho Insurance Agency
1/18/2017
1. Private insurance cannot insure people with a preexisting condition any more than you can insure a "burning house."
2. Private insurance cannot insure an "unlimited risk."
Regarding health care, both may be admirable social causes, but they are simply not insurable. No actuary or algorithm can possibly calculate the potential cost of these risks. If we are to avoid the pit falls of socialized medicine and retain the advantages of a viable free enterprise health system, these two "social goods" must be removed from the equation. If we as a country agree that these two elements of heath care are worthy of providing to all our citizens, it falls on the government, not private industry, to fund them. The solution is simple...let the government pay for these social benefits.
SIMPLIFIED SOLUTIONS - While nuances abound, here is a good starting point to address these social problems.
1. Allow individuals to apply for private insurance, be rated (with no preexisting conditions allowed) on their health history and purchase any plan they want and/or can afford. If rejected, rated too highly or have existing conditions, let them purchase a government plan like Medicaid, Medicare or even VA. Companies could be rated based on their loss ratio and if the cost per person exceeds the cost of a government sponsored plan, the company could bonus the employees an amount equal to the cost of the government plan into a HSA and let them shop the private market or buy the government sponsored plan.
2. The government could act as reinsurer for private industry for claims that exceed a designated cap...say $1,000,000 or more.
Above is the best option I've heard of so far.
Source: Idaho Insurance Agency - Alerts | Idaho Insurance Agency
1/18/2017
Uh, the government doesn't have any money.
Except what it takes from us.
There are no magic money machines in the private sector or public sector. No matter what is on your wish list, we as consumers and taxpayers are funding the cost.
Very few claims exceed $1M.
Most carriers can and do absorb all claims. Very rare, except for the smallest carriers, to purchase specific stop loss coverage on their block.
Approximately 70% of claim dollars cover chronic illness, most of which can be prevented or reversed by lifestyle.
@somarco. And, people will not stop eating their sugar and chemical filled garbage called ed food when it is still available.
And, ACA rates are double underwritten rates because of adverse selection and resulting utilization.
Carriers will not write individual contracts without pre-ex and the ability to decline. Many cannot pass underwriting and there may be a move back to small group.
As this unfolds, go look for groups with only 50% participation. Get a quote on all enrolled. Hold employer total contribution constant. Adjust plan design to make total employer cost fit. You'll likely find lots of lazy agents about to see an AOR. There will be a sweet spot in terms of size and perhaps industry.
Max out your personal HSA as Repubs kick up the limits. Let the good times roll!!!
Things need to crash just a little more.
Pinche Trump!!
And, ACA rates are double underwritten rates because of adverse selection and resulting utilization.
Carriers will not write individual contracts without pre-ex and the ability to decline. Many cannot pass underwriting and there may be a move back to small group.
As this unfolds, go look for groups with only 50% participation. Get a quote on all enrolled. Hold employer total contribution constant. Adjust plan design to make total employer cost fit. You'll likely find lots of lazy agents about to see an AOR. There will be a sweet spot in terms of size and perhaps industry.
Max out your personal HSA as Repubs kick up the limits. Let the good times roll!!!
Things need to crash just a little more.
Pinche Trump!!
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Don't believe the facts below, you really did save $2500 ! If you have $2500 in your bank account, it wouldn't have been there without ACA.
Average Individual Health Insurance Premiums Increased 99% Since 2013, the Year Before Obamacare, & Family Premiums Increased 140%, According to eHealth.com Shopping Data
eHealth reports that average premiums for people not receiving Obamacare subsidies were $393 for individual coverage and $1,021 for family coverage during the first two months of open enrollment; in 2013 individual premiums averaged $197, or $436 for families
eHealthInsurance.com Investor Relations
Average Individual Health Insurance Premiums Increased 99% Since 2013, the Year Before Obamacare, & Family Premiums Increased 140%, According to eHealth.com Shopping Data
eHealth reports that average premiums for people not receiving Obamacare subsidies were $393 for individual coverage and $1,021 for family coverage during the first two months of open enrollment; in 2013 individual premiums averaged $197, or $436 for families
eHealthInsurance.com Investor Relations
Hey Y,
Does this mean you are for or against ACA? I know you've been in the INDY health game a long time....what would you like to see happen (that would be favorable for agents and the public)...what type of plan would work for both????
Thanks man!
Of course they can. Pre-ex can be covered when there are other controls, like strictly enforced OEP/SEP rules, or requirement for continuous coverage, participation levels met, proper plan design to avoid overconsumption, etc. It has been done for many years and even decades, most notably in the group market.
Unlimited Risk (i.e. unlimited maximum benefit) is also insurable, since the huge majority of claimants have less than $1,000 worth of medical bills per year, the next large segment have less than $40,000 per year, and only a tiny fraction of claimants go over $1M in claims per lifetime.
Kids to age 26, free preventive care, birth control, etc., are also not costly at all to insure.
The elephant is high taxes & fees, excessive mandated benefits, strict benefit designs leaving few choices, 3:1 age bands, unattractive to young and healthy people, low participation and very loose constraints on who can join and when they can join. This recipe causes adverse selection which causes a death spiral.
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I'm kind of curious. Assuming that the public sector could do all of the above, would you be in favor of a single-payor plan?
And a second question... if the private sector did all of the above but did not pay agent commissions on any plan would you still be in favor of a private sector, for-profit solution over a public one?
And a third question... do you believe that a Wellpoint/Anthem mega-company is more responsive to their clients than Medicare is? (If so you've never been on hold for hours trying to get one of their people to solve a billing issue... and not have it solved... like my father has had to do with his plan... but my grandfather has never had to call Medicare for anything.)
Finally a fourth question: I wonder if comp for group and IFP went to zero but if the state or federal governments offered a single-payer solution with say a 15% FYC with a 10% /yr trail, if maybe some of you here would dance to a different tune?
As an outsider to this sector of the financial services industry it seems to me that agents favor the private sector because they hope to see it restored to the days of 15%-20% FYC.
No statement here, just questions... and not trying to stir up a beehive or flame-war. These are just issue that I've discussed with friends who work in your sector and am wondering if single-pay is just about the money, which I suspect has a lot to do with it, although no doubt many just 'hate' government-anything... some agents I speak with would happily privatize Medicare if they could.
(I have no dog in this hunt... I don't sell or buy health insurance... my company provides 100% no-cost-to-me, low/no deduct coverage in what what you would call a "Cadillac-plan" ... just curious about these issues you folks debate here day in and day out.)
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