The Dismantling of ObamaCare - Ongoing Updates.

[AllenChicago]

So pre ex goes to gov't GI and healthy go pre obamacare, sounds great but what is the pricetag. Subsidies and GI wil be astronomical. We knew once subsidized, always subsidized.Bet that GI network is pretty, sorta like Medicaid, can't find many good docs that accept.

Pre-2010 Illinois high-risk pool was simply a standard BCBS-IL plan, with available deductibles between $1500 and $5000.

But, the premium was very high, even though the state of Illinois paid half. Male age 60 was $700 a month. (That was astronomical back then.) Only a certain number could sign up, then the enrollment was closed. The shut-off of enrollees varied each year from June to Sept.

Today, Illinois is broker than broke. Lottery Winners are getting IOU's. The FEDS would need to fund the pool.

I'm hoping that either a national high-risk pool is formed, or, the unhealthy can buy into Medicare, using the age-based APTC that all Americans will receive.

BTW.. Enrolling people in the old IL high-risk pool involved a 16 page application and the commission was a flat $50.. paid after the newly insured paid his/her 3rd premium.

 

[junkman]

All of this black, bla about underwriting is avoiding the real issue. Carriers know what is needed to eliminate pre-ex. Simply enroll everyone and the average cost drops.

The huge problems are trend and how to pay for it. Healthcare itself is expensive. It will continue to be while we allow drug manufacturers to charge the US for the entire cost of development while charging other countries based on manufacturing costs.

We also extend patents for minor changes causing no price competition for what are old meds with fully amortized research costs.

I note that Mr tiny hands has implemented actions that only expand government. Large government that he and control friends control is the objective.

 

[somarco]

Carriers know what is needed to eliminate pre-ex. Simply enroll everyone

How do you propose to accomplish that?

 

[kgmom219]

How do you propose to accomplish that?

I heard that a penalty might work

And I know we keep going back and forth on this, but I remember sitting in a meeting in 2013 and being told that group rates were only going to go up in TX 1% due to ACA for 2014. TX group already had dep age at 25, $5 million lifetime max req't and the only add was free wellness. Then they said if it was still $2 million, as it was before 2010(ish), we would be looking at 15%.

The $2 million cap IS a big deal. HCSC paid for more transplants in Jan 2014 then the previous 24 months COMBINED. And it all had to do with the cap and high risk pools. Even if you had an organ, if you didn't have $2 million left on your max prior to ACA, you didn't get a transplant. And in TX, our high risk pool had a $1 million cap.

Everyone knew the transplants were coming for 1/2014. HHS, the carriers, the hospitals, the damn drug manufacturers even ramped up production of the anti-rejection drugs.

Then 6 months later, Senator Rubio got some of the reinsurance money stripped and HCSC got $.12 for every dollar. THEN the rates/plans/networks collapsed. (Or skyrocketed)

We need real pre-ex, based on real coverage. US Health, STM and Medishare don't count. Keep MEC, allow for a higher deductible and higher HSA limits to match the deductible.

You decided not to have coverage for 12 months? Then you don't get pre-ex covered for 12 months. Have a nice day

(The problem with introducing pre-ex is that its a long term solution to the rate issue. We won't see any relief until 2 or 3 years after its introduced and that takes us past the midterms. It would be actual governing and I don't think Speaker Ryan has any interest in governing)

 

[tonyisme]

I have access to some health insurance rates for Brasil. Brasil passed a law years ago that all private Insurance has to cover pre -X. Their private insurance rates are in the stratosphere. I have these rates for one of my international insurance plans. They are crazy ridiculous.
Age 18-24 $5402 dlls year
Age 50 ..... $10465 dlls year
Age 65..... $29870 dlls year
And this is a $2000 deductible...no office visit co-pay
Haven't sold any of this but it's a great commission if we did!

https://www2.deloitte.com/content/d...e/gx-lshc-2015-health-care-outlook-brazil.pdf

No question covering pre-x will cause premiums to go up and up. And there are examples of this out there already
There are already countries who have done this.

 

[somarco]

No question covering pre-x will cause premiums to go up and up. And there are examples of this out there already
There are already countries who have done this.

Yup. And the USA is one of those countries.

KG, how many transplants occur per 100,000 covered participants? How many of them live more than a year after the transplant?

Let me help you out on that.

In 2015 318M people had health insurance and of that group, 30k had transplants.

The percentage of folks that get transplants comes in at 0.009%.

So how many of those 30,000 transplants have HSCS coverage?

 

[bluemarlin08]

Go back to pre 2010 plans, period end of discussion, no subsidies, total UW and high risk pools. State high risk pools with subsidies will absolutely break the bank, it happened here in Tennessee with Tenncare.
Folks will need to do what many of us had to do, get a job with health coverage or wife if married get a job with benefits. There is no right we must supply health coverage. Otherwise, we will just have the same mess colored in different colors.

 

[tonyisme]

Go back to underwriting... allow uninsurable people to buy into Medicare at rates based upon their economic situation and region. Visitors and immigrants not sure how to insure them without government $$. Some kind of affordable low Benefit Plan.

 

[somarco]

allow uninsurable people to buy into Medicare

Doubt that will happen.

Medicaid possibly, but not Medicare.

 

[somarco]

isn't the fatal flaw with healthcare reform in general that its based on the ridiculous assumption that the ever dwindling supply of PCP's will go along with it?

PCP's have been dropping for years. Many of their duties are replaced by PA's, NP's, etc.

The bigger issue is the number of providers that are being squeezed out by carriers that are forced to replace PPO's with HMO's in order to compete under Obamacare rules.

If you like your doctor, tough toenails. Get over it snowflake.