Trump Won, Vows Day 1 Full Repeal. Lets Discuss.

[LGilmore]

"Assuming this selling over state lines idea means "comply with your situs state, sell in any state, even if you don't comply with their laws", looks like Oklahoma might be the new home of health insurance."

Again try to understand premium pricing..... Cheap insurance sold in OK will not translate to cheap insurance sold in CA. Pricing doesn't work that way. Ask a P&C agent on why home owners rates aren't the same no matter where you live.....

It would be a short lived insurance carrier that under charges premium to areas where costs of care are greater than what their premium can withstand.

Please guys, let that sink in. We're going to see Obamacare replaced and nothing will happen to pricing that doesn't already happen. It will continue to rise.

The only way to lower costs is to shift more risk onto the insured. The premium cost for a $500 deductible is still going to be the same with an ACA label on it or not, if the plan design doesn't change.

Why? because the insurance carriers still have to pay the docs and hospitals what they charge. The ACA didn't create a discounted cost for services. so when it goes, services will still cost the same.

What we will see is millions of people going uninsured when the premium help goes away. And we will be back to an unsolvable problem again.

The GOP really doesn't want to deal with this, an H SA isn't the golden egg to solve everything for everybody. Great idea if you're young and healthy because you won't use it. Start popping out kids and hit middle age, different needs and use.

This is one of those Yea! we rejected Obamacare... now what do we do?

Anyway, please understand premium pricing. It's something every agent should know about something they sell. Please don't push the state line concept, if people believe you, they will be pissed off at you later. Don't care if you liked the ACA or not, to me it was a plan change to deal with that's all. Every year in my near 30 years of doing this, I've had to deal with plan changes.

 

[sam816]

"The only way to lower costs is to shift more risk onto the insured. "

How about cut the profits of big pharmaceuticals and medical groups? in a country no longer cares about political correctness, why are agents not telling their clients what the real problem is?

 

[marindependent]

Taking it apart will be a slow moving disaster.

 

[RayNY]

I've never understood the thought process of more = cheaper. This goes against the law of supply and demand for physical type of products.

It's negotiating power (and, primarily, a service rather than a product). If I guarantee you 100,000 members/year and my competitor promises 8,000/year, don't you think I might have some more leverage in negotiating favorable rates? Think I might be able to coerce them into stiffing the competition completely by threatening to not send them any members?

If I have 20 years of experience with a local population, don't you think I can price my product with less margin of error than a competitor with 0 experience?

They have always talked about repeal and REPLACE.

Buying over borders, allowing individuals to use HSA's, and allowing individuals to deduct premium is the replacement.

Basically the same, minus the mandate / tax penalties

It's clear they are repealing subsidies/APTC's. It's clear they are repealing all the taxes under ACA. It's clear they are cutting all programs (ACO, co-ops, PCORI, Medicaid Expansion, etc) established under ACA. They've explicitly said this and their financial estimates clearly indicate these changes.

It's implied that GI/pre-ex prohibitions are going as well. It's implied the metal tiers/AV is going away. It's implied the deductible/moop limits are going away. It's implied network adequacy requirements are going away. It's implied that the small group expansion to 100 is going away. It's implied the sole prop/husband&wife being considered individuals instead of businesses is going away. It's implied MLR is going away. It's implied prior approval is going away.

I could go on, but you get the idea.

 

[TxOnline]

Rates will go down due to:
- No more 3R's
- No more bailing out companies who can't make it
- No more govt premium taxes
- No more billion-dollar IT systems that don't function well
- No more govt overhead (high salaries for the idiots running the show)
- No more hundreds-of-thousands paid out in govt grants for each navigator every year
- And more
Sure, some of this is paid-for by the taxpayer at tax time (those 50% who actually pay FIT)
But, a ton of it is well-hidden from the public in premiums..so that the govt can lay the blame on those greedy insurance companies.
Not sayin' they aren't greedy. They wanted this complicated mess as much as the govt did (for the votes).
Grueber knew how stupid everyone was. Very few are smart enough to see all of the layers & have the time to understand the monster.

Selling across state lines won't work; & Trump will be smart enough to see that when he gets an Insurance 101 briefing.

But, the middle class can't keep paying for all of this "less than the cost of a cell phone" crap for 50% of their fellow (bought-off) citizens. They're maxed out (unless they're rich).

 

[DeadSlash]

Isn't it set up in such a way that it cannot be repealed in one pen stroke? I remember reading that, but it is always her to tell what is 100% true and what has slant. My understanding was that it was done in such a way that it could only be repealed in stages, much like the way it was implemented.

I know the rules very well, but not the legalities of repealing it.

 

[kgmom219]

It's clear they are repealing subsidies/APTC's. It's clear they are repealing all the taxes under ACA. It's clear they are cutting all programs (ACO, co-ops, PCORI, Medicaid Expansion, etc) established under ACA. They've explicitly said this and their financial estimates clearly indicate these changes.

It's implied that GI/pre-ex prohibitions are going as well. It's implied the metal tiers/AV is going away. It's implied the deductible/moop limits are going away. It's implied network adequacy requirements are going away. It's implied that the small group expansion to 100 is going away. It's implied the sole prop/husband&wife being considered individuals instead of businesses is going away. It's implied MLR is going away. It's implied prior approval is going away.

I could go on, but you get the idea.

For the most part, TX doesn't have ACO's and co-ops. We didn't expand Medicaid. Still took a 60% hit this year.

Pre-Ex is not going away. And they aren't even implying its going away. The benefit requirements? I doubt it.

The rates are not going to decrease in 2018. Not a chance. And if they remove the mandate (which they will) its going to leave a very, very sick pool for individual. Who the heck is going to offer coverage next year? Carrier compression is going to get worse, not better in 2018.

This isn't just about the subsidy people. Its also about the self-employed people who don't qualify for a subsidy and hate the options/rates. Those are the people that voted Trump. And they are the ones that will be most disappointed with the 2018 options. The ones getting a subsidy didn't vote for him anyway.

Then there will be ANOTHER revolt at the mid-terms because this thing still isn't fixed and we go through it all over again.

 

[RayNY]

TxOnline,

-The 3R's are a safety net that has encouraged carriers to under-price risk with the assumption that losses will be indemnified. Without it, they'll price higher.
-Bailing out companies means you can afford to take a risk that might require bailing out. No bail outs means more conservative, aka higher, pricing.
-Gov't premium taxes are relatively small, but you're right, rates are lower without them.
-The billion dollar IT systems were taxpayer funded, not part of premiums.
-Gov't overhead was also taxpayer funded.
-Navigators and staff were all taxpayer funded.

I agree on your other points. I'm sure you agree that what was promised is likely not what gets delivered.

Deadslash,

With a bill approved by congress, yea, sure, you can just repeal it and all regulations made to support it, as well as all executive orders issued pertaining to it in one fell swoop. That's precisely what the repeal bills pushed by the GOP would do. Read H.R. 132 for an example of how they word it.

Realistically, doing that causes a boatload of issues, both obvious and unforeseen. But, I wouldn't be surprised to see them repeal it and then fix the problems after the fact in a series of bills, rather than take the time to draft a single bill that would repeal, replace, and resolve the issues.

 

[goillini52]

For the most part, TX doesn't have ACO's and co-ops. We didn't expand Medicaid. Still took a 60% hit this year.

Pre-Ex is not going away. And they aren't even implying its going away. The benefit requirements? I doubt it.

The rates are not going to decrease in 2018. Not a chance. And if they remove the mandate (which they will) its going to leave a very, very sick pool for individual. Who the heck is going to offer coverage next year? Carrier compression is going to get worse, not better in 2018.

This isn't just about the subsidy people. Its also about the self-employed people who don't qualify for a subsidy and hate the options/rates. Those are the people that voted Trump. And they are the ones that will be most disappointed with the 2018 options. The ones getting a subsidy didn't vote for him anyway.

Then there will be ANOTHER revolt at the mid-terms because this thing still isn't fixed and we go through it all over again.

Just saw on the news that Trump's keeping the pre-existing coverage and the adult children coverage on their parents policy.

 

[djs]

It's negotiating power (and, primarily, a service rather than a product). If I guarantee you 100,000 members/year and my competitor promises 8,000/year, don't you think I might have some more leverage in negotiating favorable rates? Think I might be able to coerce them into stiffing the competition completely by threatening to not send them any members?

This is the problem. You can send me 100,000 members, but if I only have doctors to deal with 50,000 members, then I have to go out and attract more doctors, which probably means I have to pay more. If a Doctor knows I need them, they will demand a higher rate.

Drugs have the same problem. It isn't aspirins that are the problem, its the ones that cost $15000 a month. Adding more members doesn't change the overall demand for that drug, it just means I'm paying for it rather then a different insurance company, meaning it still costs $15000 a month. If you double the number of people that need the drugs, then maybe it drops to $10K a month, but I'm paying more in total.

Dan