I'm glad so many people will get much needed medical care but I am very worried about how this will be paid for. Many hospitals are already owed millions because the government can't afford to pay them. This bill could cause thousands to lose jobs bc the hospitals aren't getting paid and can no longer afford to pay as many employees.
I think this is a wonderful concept but have no idea how it can successfully be executed right now.
Let's hold each other, drink wine, and not think about it! K?
A. Young healthy people, who typically forgo coverage due to cost (but have a positive effect on the risk pool, lowering costs) will be mandated to purchase coverage as well;
B. People who have Pre-existing conditions with no insurance are still getting care - but typically in the form of the more expensive negative health outcomes, which we are all paying for anyway.
I still don't understand why they didn't impose a limit. why not just do it? what is the point of leaving it open like this and taking the risk that prices can get out of control?
Also, let me add that many in the healthcare/insurance/health costs industry believe this is the first step in a monumental shift in the way health care coverage is purchased.
Eventually we will see the first big employer opt out of offering coverage, and opting to pay the fine instead. As soon as that happens, companies will follow suit. What we'll be left with is a competitive market which will benefit the public, as companies need to compete to win customers.
I can see what you're saying - and it makes sense (w/r/t economy and psychology), but I still think it's a big gamble. Which had a simple solution. Why leave it up to that one brave company owner to pull a jerry mcguire? just go the one extra step to make sure it doesn't happen in the first place.
seriously - the more I think about it, the more wtf I get. We have become so freaking greedy over the years, it's just pretty much who we are now. Trusting these big companies to get it together and sort this out themselves is just insanity imo.
I have a question about pre-existing conditions as it currently stands. Right now, as long as you don't have a lapse longer than 62 days you're still covered right?
i believe so, yes.
for us, personally, it would be a hardship to pay the COBRA premiums that would allow us not to have a lapse in coverage (should my husband lose his job) in addition to what we may have to pay out of pocket to cover life-sustaining medication.
I still don't understand why they didn't impose a limit. why not just do it? what is the point of leaving it open like this and taking the risk that prices can get out of control?
It makes no sense to me.
why who didn't impose a limit? congress?
anyone who has been involved in the details of this law.
Well, the increase in premiums you are concerned about (if it were to happen - we are on track for them to keep rising without reform anyway) would be the trigger here.
Once the cost of providing coverage is more than the fines, it's over.
I'm also concerned about the ultimate outcome of this, and the effect it will have on premiums for those with pre-existing conditions. It guarantees that they CAN have coverage, but does not and cannot specify that that coverage should be at all affordable. I'm concerned that premiums will be so exorbitant for those that truly need coverage, that those people ultimately opt to pay the fine instead and keep passing the costs along, even though the rest of the country will also be paying higher premiums.
Basically I'm concerned about the lack of integrity of large insurance companies.
anyone who has been involved in the details of this law.
well, congress wrote it and they likely didn't put some things in in a horse-trading attempt to get the bill passed. further, i'm guessing that there was a perception that there were limits to the power under either a commerce clause or taxing authority to control the income of private companies. but this isn't my area, so i'm not 100% on that.
ETA: and clearly i need to reread the law, because i thought that there were some premium caps.
SCOTUS can't add anything to a law that isn't already there, just rule on the law as it stands.
I don't know how it's going to get paid for, I think a lot of people will lose jobs, the quality of health care will go down, the out of control IRS will get worse, and the consumer's cost of insurance will skyrocket. For some people I know, it already has. We are already struggling with our country's debt and I don't think this will help.
I don't think Obamacare is the way to go. We do have a very flawed health care system in this country, but I don't think this is the answer. I think the answer will involve at least 5 more years of study with a variety of experience from finances, government, consumers, and health care providers. And, it should involve all political parties working together to come up with the best answer.
This coming from someone whose life has been a pre-existing condition, who has a family member without insurance battling cancer, and who has a friend who is a doctor who has shown me their side of this issue.
marynjoe - it has been studied for years. There is an entire body of research on this stuff. Just because the average joe doesnt' know about it, it doesn't mean it doesn't exist.
And the bill was authored by Gingrich. It is truly from both sides of the aisle, despite the R posturing because Obama's in office and not McCain.
On a personal level: The pre-existing condition is a big thing and not being able to turn people down for family medical history (I have back and pelvis issues that will most likely lead to back surgery down the road, and an extensive medical history of breast and skin cancer) and the only health insurance I've been able to get is through my company.
I'm so ignorant with all of this, but isn't the deal that if the premiums are insane and you can't afford them there will be government assistance? Or is it going to be a case of a lot of people can't afford it, but also make to much to qualify for aid?
Post by krisandgrace on Jun 28, 2012 12:59:57 GMT -5
It means that my SD who is 22 will still have coverage under our insurance until she is 26, with out this bill she would be dropped in January.
This means she will be able to continue on to grad school with out having to worry about finding any job at all that offers health care coverage right way so she can get the medicine she need to take to keep her MS from flaring up. Taking this medicine that keeps her from possibly being paralyzed for the rest of her life and there for end up on disability.
She will also be able to find health care coverage with her preexisting condition when she is 26 and be able to be a productive member of society instead of an invalid.
I am, by no means, an expert on Health Care Reform so please take what I say with a grain of salt.
As far as premiums for people with pre-existing conditions, there are a couple of ways that the costs are expected to be controlled.
First, after 2014, no rate ups will be allowed based upon medical conditions. This means that an insurance company cannot charge a sick member more than a healthy one for coverage based upon their health condition.
Secondly, the insurance companies are required to send their rates to the State Dept of Insurance for review. If the basic rates that the company are offering are too high, the DOI can object and force the insurance company to change them or they can make life very difficult for the insurance companies. The second part is meant to keep the basic rates offered to all members at a 'manageable' level.
Again, I'm not an expert, but I work for a large insurance company. Over the last 2 years, we've been implementing the changes required by Health Care Reform, so I've seen a lot of the provisions firsthand.
for the record - knowing my general opinion on things, it's likely assumed that I'm just a grumpy old nay-sayer on this.
That's not really the case. I like the idea of this. I love the instant change it makes for families like Sara's... but I just can't get past some of the big questions that never seem to be answered.
Perhaps I live in a dream world b/c I'm one who was totally behind changes in the HC system. It needed to happen. I just wish there was a better way to do it.
"proposed increases of ten percent or more will be evaluated by experts to assess whether they are based on reasonable cost assumptions and solid evidence. The review and scrutiny is expected to prevent unjustified premium hikes by insurance companies and to help provide those who buy insurance with greater value for their premium dollar. "
Regarding percentage of your premium used for health care: cciio.cms.gov/resources/files/getting_value_for_your_premium_dollar_04072011.pdf "The law requires insurers to spend at least 80 percent (and for large plans that are not self insured, at least 85 per cent) of your premium dollars on direct medical care and efforts to improve the quality of care you receive."
Regarding Health Care Exchanges: "Prior to PPACA, individual and family paid premiums, alone or in combination with other qualified health expenses, can be applied toward claiming a medical expense deduction under federal income tax provisions. PPACA raises the excess medical deduction limit from 7.5% of AGI to 10% of AGI. Individuals who are eligible for premium credits (beginning in 2014) will also be eligible for subsidies to help them pay for cost-sharing (e.g., deductibles and copayments). In terms of the premiums, PPACA implicitly sets a pre-tax “affordability cap” of 9.5% of income on base coverage plans in the exchange (i.e., plans with a beginning actuarial value of 70%, not including the impact of cost-sharing subsidies), for individuals and families with income up to 400% of poverty."
The law says that the companies can't turn you away for a pre-existing conditions, but no where does it specify a cap on premiums.
Won't they just raise the prices to cover this? ultimately having a negative effect b/c most people can't afford it?
I thought premium ceilings would be part of the deal.
Am I missing something?
The company that I used to work for had a decent health insurance plan. Our insurance rep actually told the owners to drop their insurance because the rates were going to go sky high, and if they had insurance and dropped it after all was settled with the bill, they would be fined for letting it go. So, our insurance hit the road.
Now I work someplace that already has crap insurance, and we already pay a lot out of check for it. I fear what is going to happen to our premiums and coverage.
If I can't afford it, would I qualify for free health care? Or am I screwed because I can't afford it and will then get fined for not having it?
Could someone who has more knowledge than I regarding this please explain where the general person with a family to insure falls into play?
And please note, I am not being a pot-stirrer, or snarky about it. I really just don't get it, and am wondering how it will play out.
How long until some people say that's it cheaper for them not to get insurance and just wait for the IRS to come after them, since they're not getting a refund anyway? IRS wants to take things away? They have nothing to take. IRS wants to take money from their paycheck? Quit work. So, they can quit work, and get government financial aid as well as health insurance. You KNOW people are going to do this, whether it really works or not.
There are going to be health insurance exchanges in each state, where consumers can go to purchase individual plans at a much lower rate than is currently available, and shop competitively.
The law says that the companies can't turn you away for a pre-existing conditions, but no where does it specify a cap on premiums.
Won't they just raise the prices to cover this? ultimately having a negative effect b/c most people can't afford it?
I thought premium ceilings would be part of the deal.
Am I missing something?
The company that I used to work for had a decent health insurance plan. Our insurance rep actually told the owners to drop their insurance because the rates were going to go sky high, and if they had insurance and dropped it after all was settled with the bill, they would be fined for letting it go. So, our insurance hit the road.
Now I work someplace that already has crap insurance, and we already pay a lot out of check for it. I fear what is going to happen to our premiums and coverage.
If I can't afford it, would I qualify for free health care? Or am I screwed because I can't afford it and will then get fined for not having it?
Could someone who has more knowledge than I regarding this please explain where the general person with a family to insure falls into play?
And please note, I am not being a pot-stirrer, or snarky about it. I really just don't get it, and am wondering how it will play out.
I guess Crocs was typing at the same time as me. I'll read her links....
I'm hoping that my mom will qualify for insurance assistance b/c she can't afford it right now, but doesn't quite qualify for Medicare or state assistance. If she gets fined b/c she can't afford it and can't get assistance, I'm going to be pissed.
I don't know how it's going to get paid for, I think a lot of people will lose jobs, the quality of health care will go down, the out of control IRS will get worse, and the consumer's cost of insurance will skyrocket. For some people I know, it already has. We are already struggling with our country's debt and I don't think this will help.
I don't think Obamacare is the way to go. We do have a very flawed health care system in this country, but I don't think this is the answer. I think the answer will involve at least 5 more years of study with a variety of experience from finances, government, consumers, and health care providers. And, it should involve all political parties working together to come up with the best answer.
This coming from someone whose life has been a pre-existing condition, who has a family member without insurance battling cancer, and who has a friend who is a doctor who has shown me their side of this issue.
Even though i am happy about pre existing, i do agree with you. I am not pro obamacare.
apalettepassion.wordpress.com/ WHO IS BONQUIQUI!?!?!?!??!
"I was thinking about getting off on demand, but it sounds like I should be glad that I didn't"
There are going to be health insurance exchanges in each state, where consumers can go to purchase individual plans at a much lower rate than is currently available, and shop competitively.
We don't need to force everyone to buy insurance if this were already available. Why not offer this first, then see where we stand?
There are going to be health insurance exchanges in each state, where consumers can go to purchase individual plans at a much lower rate than is currently available, and shop competitively.
We don't need to force everyone to buy insurance if this were already available. Why not offer this first, then see where we stand?
A. Because people are demanding an overhaul of the health system. B. Because medical costs are rising too fast to sit around and wait to see how it pans out anymore. C. Because B. is due, in very large part, to people not buying insurance and saddling the rest of us with the cost of their care.