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Obamacare - cost is not Affordable

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  • edited October 2015
    body
  • beebee
    edited October 2015
    @LewisBraham,
    I'm sure this is true for the very poor, but my point is if you take two co-workers being paid similar living wages over 30 years, the one who was frugal (a saver) eventually has these assets unfairly redistributed to the co-worker who did not save those same earned dollars.

    Personal story:
    A co-worker and I earn equivalent income over our 30 year careers. He chose to leased a new car every three years (ten cars and thirty years of lease payments). I owned two used cars over the same 30 years. I saved the difference between these two costs.

    Now, in retirement, my income is higher than his because I took my savings and bought an income annuity...he still has car lease payments. My extra annuity income increased my AGI compared to his. I don't get an ACA subsidy...he does.

  • edited October 2015
    @bee. Agreed the ACA is a far from optimal solution to America's healthcare problems. That would have been a single payer option or extending Medicare to every citizen. Medicare has proven far more efficient and less costly per capita than private health insurance ever has. It also avoids the fundamental conflict of interest private for-profit insurers have: Insurers make the most profits by collecting premiums from healthy people while denying sick people coverage when they need it most. The more healthy people a private insurer collects premiums from and the more sick people it denies claims for, the more profitable it will be. That is a major conflict of interest. Yet I believe the ACA was the best solution to our healthcare problem, given the political climate in which it was passed. There was no way to get Medicare or single-payer extended to all citizens with the healthcare industry lobby as powerful as it is. And besides single payer and Medicare are the socialist anti-Christ to many Americans. So it could never happen.
  • @Bee, That the poor have less savings to cover their healthcare costs has less to do with they're not being "frugal" and more to do with the fact that wages for the average American have not increased on an inflation adjusted basis for over 30 years.

    The poor and others are getting screwed by the high deductibles. 100% of it must be paid before insurance kicks in. That clause must have been written by the insurance industry.

    And that is true about the American worker but I think it is since the late '70s wages have been flat.
  • edited October 2015
    @Dex, The thing I find interesting is you blame the ACA and not the insurers themselves for gouging people. I think the ACA was the best legislation that could be passed to insure millions of Americans without insurance given the current political climate. Is that insurance less than adequate? Yes. But it's better than no insurance at all. Also, let's say the ACA is inadequate. What are you prepared to do to improve things? I don't think repeal will solve the problem, only make things much worse. So suppose the ACA is phase 1 of the solution. What's phase 2? Why not focus on the insurers gouging people instead of just cursing the entire act, which has helped many people?
  • Yet I believe the ACA was the best solution to our healthcare problem, given the political climate in which it was passed.

    Obamacare and global warming are two thing we really can not change or do anything about. I'm estimating paying $7,500 in 2017 for Oc and 20% increases until I hit 65 in 5 years. I'm guessing Medicare and the supplemental insurance will equal Oc at that time.

    If I were working, I would be pissed because I could never get ahead financially, pay raises could not keep up OC cost increases (my employee part payment) and tax increase. The American Dream is dead for the mass of people.
  • @Dex, The thing I find interesting is you blame the ACA and not the insurers themselves for gouging people. I think the ACA was the best legislation that could be passed to insure millions of Americans without insurance given the current political climate. Is that insurance less than adequate? Yes. But it's better than no insurance at all. Also, let's say the ACA is inadequate. What are you prepared to do to improve things? I don't think repeal will solve the problem, only make things much worse. So suppose the ACA is phase 1 of the solution. What's phase 2? Why not focus on the insurers gouging people instead of just cursing the entire act, which has helped many people?

    The cost structure of the insurance is dictated by OC. BCBS of Ga sent me a financial analysis showing how, due to OC mandates, rose from its current level to the new higher level. If you can find it, it is an eye opener. Costs are shifted from the old to the young.

    If there was gouging, I think it would be shown in the profit of the health ins co and something everyone in the news would be talking about.

    As to the millions, research that. How many lost their ins due to OC and how many like me had to go to it because OC eliminated my traditional ins. How many of the people had no ins before OC and now have OC is the question. Did that number mandate what we are experiencing? Would it have been better to address those people directly instead of the whole nation? Healthcare.gov site development alone might have paid for those people.

    Cost of Healthcare.gov site
    "However, that $800 million price tag is roughly 40 percent of the actual cost of the defective website. According to a new report produced by Bloomberg Government (BGOV), the cost of HealthCare.gov is closer to $2,142 million than $834 million"
  • BobC said:

    Those of us who are healthy and older (I mean mature) are really getting reamed.

    AMEN!! The only question they ask is whether or not you smoke. Very frustrating when
    I spend hours working out and keeping my sweet tooth under control.

    I hate the title of this article but still worth noting:
    emarotta.com/how-to-bilk-obamacare/

    None of that will work for me, but I appreciate your efforts! And I don't mind the title at all!;)

  • @Dex, What you're saying isn't accurate. Health insurers have been seeing record profits because of the ACA and they have been gouging customers, particularly small businesses. Yet many more people are insured under the law:

    publicintegrity.org/2015/01/26/16658/health-insurers-watch-profits-soar-they-dump-small-business-customers

    reuters.com/article/2015/01/28/usa-healthcare-insurers-idUSL1N0V71TQ20150128

    money.cnn.com/2015/01/21/investing/unitedhealth-earnings-obamacare/

    So again why just blame the ACA and not focus on the insurers?
  • Dex
    edited October 2015

    @Dex, What you're saying isn't accurate. Health insurers have been seeing record profits because of the ACA and they have been gouging customers, particularly small businesses. Yet many more people are insured under the law:

    publicintegrity.org/2015/01/26/16658/health-insurers-watch-profits-soar-they-dump-small-business-customers

    reuters.com/article/2015/01/28/usa-healthcare-insurers-idUSL1N0V71TQ20150128

    money.cnn.com/2015/01/21/investing/unitedhealth-earnings-obamacare/

    So again why just blame the ACA and not focus on the insurers?

    Before yo say I am wrong you should understand the numbers and do your homework.

    Lesson 1 - stock price is not profit

    Lesson 2 - From the article 10.3 profit on 130.5 revenues is 7.8% profit margin FOR ONE COMPANY. The Reuters says it it 5% for the industry. Research past profit margins before OC and compare with the above - that would tell you if gouging is going on. Also, research other industries profit margins.

    Lesson 3 - As to the millions, research that. How many lost their ins due to OC and how many like me had to go to it because OC eliminated my traditional ins. How many of the people had no ins before OC and now have OC is the question. Did that number mandate what we are experiencing? Would it have been better to address those people directly instead of the whole nation? Healthcare.gov site development alone might have paid for those people.

    Before you tell me I am not accurate - do your home work.

    If you have an open mind on the subject you will.


  • edited October 2015
    @Dex I am well aware stock prices are not profit margins, but there is a correlation between the two, no? Consider this: Many of the people who were uninsured prior to the law that are now insured were sickly people insurers want to deny coverage to but the new law requires them to insure. So how do you think the insurers managed to increase their profits while doing that? They're gouging certain people to help cover the losses they experience on the sick. Regardless what the margins are, their stocks wouldn't be hitting record highs if the profits weren't improving and they have been. And that has happened in an environment where many new unprofitable patients have been added to the insurance rolls.
  • Dex
    edited October 2015

    @Dex I am well aware stock prices are not profit margins, but there is a correlation between the two, no?

    Before you ask any question ... do your homework.

    Your not understanding stock price, gouging and profit margin tells me you are not aware.
  • edited October 2015
    @Dex: As far as there being more people uninsured today than before the ACA, I don't know where you're getting your facts. All the evidence I've seen indicates more people are insured today because of the law:

    cnn.com/2015/03/16/politics/obamacare-numbers-16-million-insured-rate/

    rand.org/news/press/2015/05/06.html

    bloomberg.com/news/articles/2015-05-06/health-how-17-million-people-got-insurance-under-obamacare
  • @Dex: As far as there being more people uninsured today than before the ACA, I don't know where you're getting your facts. All the evidence I've seen indicates more people are insured today because of the law:

    Add to your homework.
    Quote me where I wrote: "there being more people uninsured today than before the ACA"
  • edited October 2015
    @Dex, OK Dex, you didn't say that, but do you honestly believe: "Healthcare.gov site development alone might have paid for those people." That's almost 17 million new people added to the insurance rolls, many of whom are sickly and previously uncoverable. And you think the cost of developing a single web site would cover their insurance costs? Come on!
  • @Dex, OK Dex, you didn't say that, but do you honestly believe: "Healthcare.gov site development alone might have paid for those people." That's almost 17 million new people added to the insurance rolls, many of whom are sickly and previously uncoverable. And you think the cost of developing a single web site would cover their insurance costs? Come on!

    Before you ask any question ... do your homework.
  • @Dex, I'm sorry but I don't think you've done yours. By your own numbers for the development of the health care web site it costs $2.142 billion. That amounts to $126 per person of the 17 million new people insured by the law. That just will not cover their insurance costs.
  • I would be a lot happier if the political elite had to enroll as well...so tired of a two tier system. Any candidate who had this as part of his/her platform would have my vote...maybe even Bernie!

    See below; not that simple.
    From
    http://obamacarefacts.com/obamacare-myths/
    (an extremely handy site)

    ObamaCare Myth: Congress is Exempt from ObamaCare
    The idea that Congress is exempt form the Affordable Care Act is a myth. Congress and their staff have work based insurance, thus they should be able to stay on their current plan. However an amendment to bill before it became law said they must use health insurance marketplace. They will use the marketplace, but since their staffers, making as little as $30,000 can’t get subsidies through the marketplace (they have access to employer based coverage) their employer (the Government) is allowed to cover part of the cost of their premiums. Since all members of Congress have been well aware of this since 2010, any other claim is a willful misrepresentation of the truth.
  • Thanks David. I've got my own list of factcheck links, but the National Review quote you found may say it best:
    Congressmen and their staff, then, are getting a questionable workaround from the law — but it's from a provision of the law that treated them particularly badly rather than neutrally. The net result of the law and the workaround isn't a "special handout" for congressional employees.
    In case that isn't clear, I'll rephrase. There is indeed an exception in the ACA law for Congress - unlike employees of every other large employer in the country, Congress and staff members are excluded from getting coverage directly through their employer. Congress does indeed get special (worse) treatment under ACA.

    To mitigate this, an exception to the exception was created. Employers that provide health insurance for their employees subsidize that insurance, whether directly or through SHOP (ACA exchange for small businesses). The exception to the exception allows Congress' employer to do the same, i.e. subsidize the employees' coverage.

    So those who say that Congress is getting an exception are right. In fact, Congress is getting two exceptions, the combination of which leaves them no better than had the ACA not mentioned Congress at all (and treated them the same as any other employees under ACA).

    From CNN:
    Fact: When Obamacare was passed into law, Sen. Charles Grassley, the Iowa Republican, attached language – later revised by Majority Leader Harry Reid - to the bill mandating that members of Congress and their staffers would have to buy health insurance on the newly created health insurance exchanges. ...

    Even Grassley, the provision’s author, had tried to amend to law in order to allow the government to continue to contribute to lawmakers’ and staffers’ premiums.
    Exception 1 and Exception 2.
  • One of life's little ironies ...

    Each state creates its own list of Essential Health Benefits (EHBs) that must be included in all ACA plans. The states have a choice of benchmark plans they can use to define their EHBs.

    One of their choices is the Federal Employee Health Benefits Program (FEHBP). So Congress was forced from FEHBP into plans that could use the very same FEHBP plans for their (minimum coverage) benchmarks.

    That's not to say the states used FEHBP as their benchmark plan. (AFAIK, they're all using one of the other three options for benchmarks).

    Here's a Cigna page describing the benchmarking, and another Cigna page showing how the (required) essential health benefits vary from state to state:

    http://www.cigna.com/assets/docs/about-cigna/informed-on-reform/essential_health_benefits_fact_sheet.pdf

    http://www.cigna.com/assets/docs/about-cigna/informed-on-reform/top-10-ehb-by-state.pdf
    (Note that this list of EHBs isn't inclusive; it just lists the 11 most common benefits)

    Are those cries of "why am I paying for wigs" that I hear?
    Here's BC/BS's page on wig coverage for RI:
    https://www.bcbsri.com/sites/default/files/polices/Wig_Mandate.pdf
  • edited October 2015
    I was so hoping you would be the next digger. TYVM!

    I suspected the ricochet article was certain to be wrong.
  • Don't really have time to dig up more articles...buying a new house! But just wanted y'all to know my premiums went up 25%. Going to shop around when I have time. If anyone finds a GREAT deal, please let us all know! Thanks!
  • Just browsed healthcare.gov...those plans are $50 more/month than my Aetna plan. Premiums will be less in the county I'm moving to....just hope I can wrap this house deal up before the open enrollment period ends. Ideally, I would like a smooth transition. Back to cleaning closets:(
  • l5b - congrats on house
  • Why, thank you @davidrmoran! Not final yet, fingers crossed!
  • msf
    edited October 2015

    Don't really have time to dig up more articles...buying a new house! But just wanted y'all to know my premiums went up 25%. Going to shop around when I have time. If anyone finds a GREAT deal, please let us all know! Thanks!

    I've tried to give a more complete description of what happened than most articles on any (of the multiple) sides. Yes there were exceptions made (to those who say Congress is not getting different treatment), and no, those exceptions don't treat Congress better (to those who say Congress is getting a better deal).

    Whatever you find, try to read it against a backdrop of reality. It is likely that the article will be based on facts, but only some of them, and that's what makes the difference.

    Regarding your premiums and premiums in general. Each area and each person's situation is different. I don't know the county/state you're looking in, so I couldn't suggest alternatives, though there isn't going to be any magic plan that beats the others by 50%.

    Health also matters. In my case, this year I came out way ahead with ACA plan instead of my old plan that was cancelled at the end of 2014. Premiums were about 30% higher, but instead of a HDHP with a several thousand dollar deductible, I got a zero-deductible plan. It has a $1K out of pocket max that I blew through (so I would have been spending thousands more on the old plan). Only the second year I can remember making extensive use of health services (the other was many years ago). I chose my plan accordingly.

    Best of luck with the new house. Enjoy it in good health (gotta keep those premiums down:-))

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