The Dismantling of ObamaCare - Ongoing Updates.

[goillini52]

"Today I learned before 1973 it was illegal in the US to profit off of health care. The Health Maintenance Organization Act of 1973 passed by Nixon changed everything

And to be clear, it wasn't illegal for the insurance companies to make money, it was illegal for them to make unlimited money - they were non-profit organizations which meant they were limited to (I believe) 12% profits. Which meant they were obliged to reinvest any money they made above 12% profit margins into things like patient care."

I wonder if this is 100% true..

That's the year I started in the business. I don't remember it and it doesn't sound right to me.

 

[kgmom219]

I know you said in another thread that you have a tough time making sales I believe but most people on this board don't like the idea of paying 50% or more in taxes just because the poor and the sick want better or cheaper coverage.

.

Those damn sick people. They make everything suck for those around them.

(And while I agree with the obesity stuff, get over yourselves. Kids don't choose cancer.)

Implement pre ex on Indy in 2019 with the pre ACA HIPAA guidelines. No MEC in 2018, you go 6/6/12/12 pre-ex beginning 1/1/19. Get all the damn (healthy) people on STM, medi share and US Health in the pool or suffer the consequences later.

Allow MEC to go to a 10K Ded/OOP with corresponding HSA limits. Allow HSA dollars to be used for premiums.

Allow states lines sales. (So everyone will shut up about it being the solution.)

Keep the subsidies based on previous 1040. (We do it for Medicare). Fix the family glitch.

Rates will start to fall. It just won't be in time for mid terms or the next Presidental election.

NY..I rarely agree with you. But I don't need to watch the you tube video. Decisions ARE made by those who show up. #whatsnext

 

[Chazm]

Those damn sick people. They make everything suck for those around them.

(And while I agree with the obesity stuff, get over yourselves. Kids don't choose cancer.)

Implement pre ex on Indy in 2019 with the pre ACA HIPAA guidelines. No MEC in 2018, you go 6/6/12/12 pre-ex beginning 1/1/19. Get all the damn (healthy) people on STM, medi share and US Health in the pool or suffer the consequences later.

Allow MEC to go to a 10K Ded/OOP with corresponding HSA limits. Allow HSA dollars to be used for premiums.

Allow states lines sales. (So everyone will shut up about it being the solution.)

Keep the subsidies based on previous 1040. (We do it for Medicare). Fix the family glitch.

Rates will start to fall. It just won't be in time for mid terms or the next Presidental election.

NY..I rarely agree with you. But I don't need to watch the you tube video. Decisions ARE made by those who show up. #whatsnext

Let me be clear, I've agreed with you for a while on a possible solution. Don't get confused that I don't think that sick people shouldn't be able to get coverage.
But I (myselves) will not get over that single payer should be the norm in the US and that I should be penalized and have to pay 50% in taxes or more because of other people.

As a libertarian I wouldn't even mind it going back to the way it was but I know that's not happening. I just think the govt needs to get out of it.

 

[kgmom219]

Let me be clear, I've agreed with you for a while on a possible solution. Don't get confused that I don't think that sick people shouldn't be able to get coverage.
But I (myselves) will not get over that single payer should be the norm in the US and that I should be penalized and have to pay 50% in taxes or more because of other people.

As a libertarian I wouldn't even mind it going back to the way it was but I know that's not happening. I just think the govt needs to get out of it.

Oh yeah, I'm in total agreement that a VAT to pay for health insurance is NOT the solution.

If they had removed underwriting and lifetime maximums, pre-Obama, we wouldn't be in this mess. OH...and not let Merck write the Part D legislation. That would have kept the rates from skyrocketing, too.

 

[Ann H]

I'll probably get CCs of that mail.

We have family members, around age 70, who are on Medicare. They pay $130 for Part B. Each pays about $180 for a Plan F supplement and they pay about $40 for their drug plan.

They never see a medical bill...

Why can't everyone have that deal? Because of their age they use medical services way more than the millions of under 30 year olds do (or will.)

NYLife11023, Medicare and Medicaid reduces the doctor & hospital bills down to a bare bones allowance, and requires all participating medical providers in the United States to honor that allowance, and all non-participating providers in the US to charge no more than 20% higher than that allowance.

The only way doctors and hospitals could survive with that small allowance is to shift costs onto people with private insurance.

If 100% of the population joined that plan, nobody would be left to pay the costs. So, your Grandpa's premium would quadruple (or more). That's the answer to your question about why we all can't have a plan like his.

This is why many doctors limit the number of Medicare or Medicaid patients they can take. Mayo Clinic (who does not participate in Medicare, but is required to charge no more than 20% higher than Medicare allowable amounts) just announced that they will give preference in care to private-pay patients over public-pay. So, if 2 patients with the same condition arrive, they will give preference to the one with private insurance. Why? Medicare pays little of the actual cost, even at 20% higher than the "participating" providers receive.

There are folks on employer-sponsored plans that could say, "I pay NOTHING! No premium! My copay is $10, my deductible is $250, and I get a huge network of doctors. Why can't all people have this insurance? It's so inexpensive!" Answer - because your employer is paying big bucks for it, dope. Duh. The cost didn't go away, it was just cost-shifted.

Medicare is a major cost-shifter. It charges low premiums, low deductibles, and pays low reimbursement rates to providers. Then the rest of us make up for it in cost-shifting and higher taxes. Cost-shifting is not an answer. It hides the problem.

BTW, you acknowledged that we are the experts on why it won't work. In prior posts you've insinuated that we have these opinions due to greed. But folks who sell Medicare supplements make good money, and they would make good money on supplements to Medicare-for-all, too. So, greed is not the factor. The reasons we are against it is because IT WON'T WORK. That's why we were against the ACA. Most agents gave it 3-5 years, and it crumbled in year 3. The new GOP plan (the AHCA) has about 2 years of life, mostly because it's starting on a foundation of the ACA, yet if it was passed in 2010 instead of the ACA it would still have had only 4-5 years of life. These plans do not address root drivers of spiraling costs. The AHCP (the new GOP bill) actually gives agents a HUGE bump up by allowing subsidized plans to be purchased OFF the exchange, if sold through an agent. That's a gigantic bonus to our careers. But most of us are still unhappy with the AHCP in its current stage. Why? It won't work. Medicare-for-all doesn't work either. These programs put our nation through hell, then we take on a new plan in 2-5 years. Some point to other nations, and say, "Hey it works here!", but they pay attention to one issue (like no premium) without acknowledging the taxes. They point to quality measures, without acknowledging that lifestyle is the cause, not the form of healthcare payment. So, it doesn't work and that's why the "experts" don't want the nation to go through this. There are things that do work, and it has to do with root drivers of health care and control in the hands of the patient & doctor in a free-market type of decision. But the ACA, the AHCA, and Medicare-for-all programs circumvent that, making gigantic bureaucratic nightmares instead.

 

[bluemarlin08]

I recently tried to get my wife an appointment at Mayo for a rare gastro problem and was told not taking Medicare patients. This will become ore the norm I am afraid.

 

[tonyisme]

When I talk to Mayo only some departments and some illnesses will they take new Medicare patients. So has to be something Else some other diagnosis...

 

[Yagents]

Deal making in progress.......chill

https://www.wsj.com/articles/republ...kHXEqlbRcjkIjZz2ToMVFVw0OPks7w&_hsmi=46025241

In conversations with House leaders and administration officials, lawmakers focused on proposed changes to Medicaid, with conservative House Republicans pressing for work requirements and an earlier phaseout of the expansion started under the Affordable Care Act, known as Obamacare.

Some Senate Republicans also sought to boost the value of tax credits to give more aid to low-income and older people who buy insurance. Others wanted to strike a provision that calls for insurers to charge higher premiums to consumers who let their coverage lapse, a measure intended to encourage people to buy insurance.

“I’m as hopeful as I’ve been in the entire process,” said Mark Walker (R., N.C.), chairman of the group. Changes that the group would like include allowing people to use health-savings accounts to pay for insurance premiums and instituting a work requirement for some people on Medicaid.

The Republican Study Committee also pushed to accelerate a timeline for phasing out the Medicaid expansion. The House GOP proposal would start ending funding for new expansion enrollees on Jan. 1, 2020; the study committee sought to move that date to Jan. 1, 2018. One lawmaker said a compromise might be found with a Jan. 1, 2019, halt.

Some House conservatives also pushed to derail a 30% premium penalty on people who let their coverage lapse because the CBO analysis showed it would do little to induce people to obtain coverage.

Sen. John Thune (R., S.D.) said House Speaker Paul Ryan (R., Wis.) and Rep. Kevin Brady (R., Texas), chairman of the House Ways and Means Committee, seemed open to tweaking the credits.

“There’s a recognition from both a policy and a politics standpoint that this is a change that has merit and makes sense,” Mr. Thune said. “It’s going to make passage in the Senate a lot easier.”

House Majority Leader Kevin McCarthy (R., Calif.) said Wednesday evening that the House would consider next week two stand-alone bills that chip away at some of the broader changes Republicans want to make to the health-care system. Each would require 60 votes to clear procedural hurdles in the Senate.

 

[somarco]

Today I learned before 1973 it was illegal in the US to profit off of health care. The Health Maintenance Organization Act of 1973 passed by Nixon changed everything

Fake news.

First employer health insurance plan started in 1879. That same link summarizes the HMO Act of 1973 which was sponsored by driving instructor Teddy Kennedy.

More information on that act here

Blue Cross started in 1929


Kaiser (the first HMO) started in 1933

Time Insurance sold major medical in 1956

There is a great deal of confusion about health insurance profits. Most people, including many agents, cannot distinguish between profit and profit margin. Further, they cite the millions of dollars earned by insurance carriers and never bother to look at health insurance alone which was, until Obamacare, marginally profitable.

Now it is mostly red ink, especially in the IFP market.

But the carriers are still making money on ancillary lines.

Ned, are you saying Mayo does not take ANY medicare or they don't take assignment? Mayo JAX and Medicare

There are a few other clinics that are following the same rules.

 

[Chazm]

Fake news.

First employer health insurance plan started in 1879. That same link summarizes the HMO Act of 1973 which was sponsored by driving instructor Teddy Kennedy.

More information on that act here

Blue Cross started in 1929


Kaiser (the first HMO) started in 1933

Time Insurance sold major medical in 1956

There is a great deal of confusion about health insurance profits. Most people, including many agents, cannot distinguish between profit and profit margin. Further, they cite the millions of dollars earned by insurance carriers and never bother to look at health insurance alone which was, until Obamacare, marginally profitable.

Now it is mostly red ink, especially in the IFP market.

But the carriers are still making money on ancillary lines.

Ned, are you saying Mayo does not take ANY medicare or they don't take assignment? Mayo JAX and Medicare

There are a few other clinics that are following the same rules.

I just personally called Mayo Clinic here in Jax yesterday. A client wanted silver sneakers and was refusing to spend money on a Supp plan until I mentioned that she would have to drop her doctors at Mayo Clinic and she can't go there for surgeries, cancer or anything as well.
So we called them and they confirmed that they will take Medicare and PPO's out of network. Of course they do not accept assignment to Medicare so there would be an excess charge.

Walked out with a plan F in my hand