Well, when I googled it before my last post, I wound up on an AHIP document where they were talking about it. One of the things it stated is that both subsidies (premium and cost-sharing subsidies) would not be paid to the insurance company in months 2 and 3. So, by deductive reasoning, I guess that means the insurance company gets those subsidies for month one...????...
The Physician's Risk in HCR
- Thread starter Yagents
- Start date
Well, when I googled it before my last post, I wound up on an AHIP document where they were talking about it. One of the things it stated is that both subsidies (premium and cost-sharing subsidies) would not be paid to the insurance company in months 2 and 3. So, by deductive reasoning, I guess that means the insurance company gets those subsidies for month one...????...
I suppose that the insurance company will have to accept beneficiaries in subsequent years even if they default? I can get three months of coverage each year for free, pay the small penalty and live happily ever after. The insurance companies and doctors have to eat it. (Read: the rest of us have to eat it in higher premiums and medical costs)
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Woah. I suppose the commission trend from Exchange sales will not be a smooth upward curving slope, but a jagged one.
ac
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I've been saying it since this entire thing passed, but many of the people who are middle class and up are going to move towards a concierge medicine system, along with many of the better doctors. Then use their health insurance to repay for anything above and beyond a visit and medication.
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This will create a huge problem for Doctors and Hospitals.
From a producer standpoint, if you are writing exchange policies, there may be a big lapse factor.
If you are prospect broke people that lapse rate will be high. If you are prospecting people that have jobs and careers, that lapse factor should be lower.
From a producer standpoint, if you are writing exchange policies, there may be a big lapse factor.
If you are prospect broke people that lapse rate will be high. If you are prospecting people that have jobs and careers, that lapse factor should be lower.
- Thread starter
- #16
Actually, I believe it will be the opposite.
Low income - premiums are so low at 2-3% of income (with subsidies and cost sharing), and their usage and value from the plan will be so high, they won't lapse
High income - premiums are 9.5% of their income, with higher OOP at $6400 for a bronze plan, they will be the first to lapse especially if they are healthy.
Low income folks, especially if they were not paying for insurance before, will indeed drop coverage once they are "cured".
Historical loss ratio's on low income tiers are horrible and group plans with primarily low income earners have the worst participation.
Historical loss ratio's on low income tiers are horrible and group plans with primarily low income earners have the worst participation.
It's true. Low-income often go without coverage, even when they are eligible for Medicaid.
They have more disruption with bill-paying, like closed bank accounts, no forwarding address, divorce/break-ups when one partner previously paid bills for the other partner, lost jobs, squeezed budgets...
To make them an added risk for the insurers, low-income folks usually have higher health issues, due to smoking, poor nutrition, substance abuse, etc. And when the uninsured gain insurance, claims are higher due to pent-up demand.
Young people often see little value in insurance (unless they are pregnant), and they see no need to pay up to 9.5% of their income for it. When these customers receive subsidies that are so rich that the customer has no skin in the game, they often over-utilize it, then see no value in it.
Who wants this demographic?
They have more disruption with bill-paying, like closed bank accounts, no forwarding address, divorce/break-ups when one partner previously paid bills for the other partner, lost jobs, squeezed budgets...
To make them an added risk for the insurers, low-income folks usually have higher health issues, due to smoking, poor nutrition, substance abuse, etc. And when the uninsured gain insurance, claims are higher due to pent-up demand.
Young people often see little value in insurance (unless they are pregnant), and they see no need to pay up to 9.5% of their income for it. When these customers receive subsidies that are so rich that the customer has no skin in the game, they often over-utilize it, then see no value in it.
Who wants this demographic?
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- 8,448
Saturday, December 6, 2014
I didn't know this. The profession with the highest suicide rate in America is the Medical Doctor. The next study-report is expected to show that ObamaCare is increasing the number of physicians who are taking their own lives. So sad...
Story: Expert: Obamacare will push doctors toward suicide
ac
I didn't know this. The profession with the highest suicide rate in America is the Medical Doctor. The next study-report is expected to show that ObamaCare is increasing the number of physicians who are taking their own lives. So sad...
Story: Expert: Obamacare will push doctors toward suicide
ac
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February 17, 2015
In rural parts of Illinois, the doctors are increasingly turning against what they call "ObamaCare". I didn't hear this from clients last year, but all of a sudden, a few who live out in the countryside are saying that their doctors are not accepting new ObamaCare patients.
Since all major medical is ObamaCare, perhaps these doctors are just referring to ACA subsidized patients. Maybe they got burned last year by the risks described in this thread?
ac
In rural parts of Illinois, the doctors are increasingly turning against what they call "ObamaCare". I didn't hear this from clients last year, but all of a sudden, a few who live out in the countryside are saying that their doctors are not accepting new ObamaCare patients.
Since all major medical is ObamaCare, perhaps these doctors are just referring to ACA subsidized patients. Maybe they got burned last year by the risks described in this thread?
ac
