The question is whether most Americans are starting to get accustomed to the idea that affordable health care is a right. I can remember the days when you lost your job and wanted to have health insurance you had to pay astronomical premiums under COBRA to keep your health insurance. Even before the ACA things had gotten better for the self-employed and premiums were more affordable.
But still if you lose your job or you get a serious medical condition, then the ACA puts you in a better position than you were in before. And if the Republicans were to get rid of the ACA in 2016...there is going to need an alternative that deals with those issues. The ACA may not be popular as a whole but some provisions are very popular. And you can't just take out the unpopular things and keep the popular ones--it won't work. The Republicans will use the ACA to their political advantage until 2016...but I doubt they will get rid of it.

freeman3 wrote:The question is whether most Americans are starting to get accustomed to the idea that affordable health care is a right. I can remember the days when you lost your job and wanted to have health insurance you had to pay astronomical premiums under COBRA to keep your health insurance. Even before the ACA things had gotten better for the self-employed and premiums were more affordable.
But still if you lose your job or you get a serious medical condition, then the ACA puts you in a better position than you were in before. And if the Republicans were to get rid of the ACA in 2016...there is going to need an alternative that deals with those issues. The ACA may not be popular as a whole but some provisions are very popular. And you can't just take out the unpopular things and keep the popular ones--it won't work. The Republicans will use the ACA to their political advantage until 2016...but I doubt they will get rid of it.

They will gut it and leave in place only a few popular principles.

They will start with the medical device tax, which may be veto-proof. That is a DUMB provision of the law and doesn't raise that much revenue.

It would take 60 votes in the Senate. No one thinks we're going to have 60 Republicans. And it would take a presidential signature. No one thinks we're going to get that," McConnell said during a campaign-stop interview with Fox News

McConnel is right. Nothing will happen for the rest of Obama's term.
By 2016 the law will be entrenched and people use to its provisions. At least in 26 States.
Wholesale change that doesn't recognize that most Americans are getting used to the idea that health care is a right... or should be ... won't be a winning issue.

freeman3 wrote: I can remember the days when you lost your job and wanted to have health insurance you had to pay astronomical premiums under COBRA to keep your health insurance.

The amount of a COBRA premium is no more than 3% more than the actual premium your employer pays on your behalf (and COBRA still exists, BTW), and most employers didn't mark it up that 3%. The premium of a group plan that an employer carries was, and still is, much better priced than an individual plan, at least in New York State. The only benefit of the ACA is that if you're broke, you can get a subsidy to help pay for the insurance, but the amount being paid to the insurance company is going to be more than what anyone was paying under COBRA.

When I have a little more time, I'll follow up on my personal experience with the ACA, which some may find illuminating. Hopefully others who also have actual personal experience will chime in.

rickyp wrote:

It would take 60 votes in the Senate. No one thinks we're going to have 60 Republicans. And it would take a presidential signature. No one thinks we're going to get that," McConnell said during a campaign-stop interview with Fox News

McConnel is right. Nothing will happen for the rest of Obama's term.

"Nothing?"

Wanna bet?

On the other hand, I should be saying "great." The law is very unpopular. Republicans used it like a club and took the Senate. So, let Obama protect it; let Warren fight to save it. That's a great recipe for 2016.

You really don't get it: it is UNpopular. The employer mandate will worsen the bad effects of the law.

Oh, and Obama's illegal issue of work permits? Yeah, that gives employers a solid reason NOT to hire Americans: they can save money (via the ACA) by hiring legal illegals.

By 2016 the law will be entrenched and people use to its provisions. At least in 26 States.
Wholesale change that doesn't recognize that most Americans are getting used to the idea that health care is a right... or should be ... won't be a winning issue.

Let's wager! C'mon, put your money where you mouth is! It's a no-lose proposition, according to you!

I stand corrected regarding Cobra but getting a subsidy when you're out of a job is a pretty big difference. And COBRA only lasts18 months so if you're new job did not have insurance, you were out of luck prior to the ACA.

geojanes wrote:

freeman3 wrote: I can remember the days when you lost your job and wanted to have health insurance you had to pay astronomical premiums under COBRA to keep your health insurance.

The amount of a COBRA premium is no more than 3% more than the actual premium your employer pays on your behalf (and COBRA still exists, BTW), and most employers didn't mark it up that 3%. The premium of a group plan that an employer carries was, and still is, much better priced than an individual plan, at least in New York State. The only benefit of the ACA is that if you're broke, you can get a subsidy to help pay for the insurance, but the amount being paid to the insurance company is going to be more than what anyone was paying under COBRA.

When I have a little more time, I'll follow up on my personal experience with the ACA, which some may find illuminating. Hopefully others who also have actual personal experience will chime in.

From what I understand, the major problem is the rise in co-pays and deductibles. I've seen figures as high as 326%. I'm guessing that is in large measure what is keeping the popularity so low.

fate

From what I understand, the major problem is the rise in co-pays and deductibles. I've seen figures as high as 326%. I'm guessing that is in large measure what is keeping the popularity so low

Depends which level of insurance you buy...
If you buy the basic coverage the deductibles and co-pays are higher ... BUT

Prior to Obamacare, $10,000 to $20,000 deductibles were common in the individual market, said Timothy Jost, a law professor at Washington and Lee University in Lexington, Virginia, who supports the act. Republicans now criticizing the law have long argued the health-care system would benefit from consumers having “more skin in the game,” he said.

“This is essentially Republican health policy, where you have higher cost sharing,” Jost said in an interview. “Now that it’s individuals who have actual bills they have to pay, it’s a problem.”

So what's the Republican alternative again? And how is this really different that prior to the ACA when people bought insurance with high deductibles ?
http://www.bloomberg.com/news/2013-11-1 ... -risk.html

rickyp wrote:fate

From what I understand, the major problem is the rise in co-pays and deductibles. I've seen figures as high as 326%. I'm guessing that is in large measure what is keeping the popularity so low

Depends which level of insurance you buy...
If you buy the basic coverage the deductibles and co-pays are higher ... BUT

Wrong. If co-pays and deductibles are going up across the board, then it doesn't matter what level you buy--your costs are going up.

So what's the Republican alternative again? And how is this really different that prior to the ACA when people bought insurance with high deductibles ?
http://www.bloomberg.com/news/2013-11-1 ... -risk.html

You're serious? You've never done any research on this, have you?

Support for the Affordable Care Act has plummeted since late last summer, and people with employer-based health insurance say they increasingly are paying more for out-of-pocket medical expenses, a new Bankrate.com survey released Wednesday revealed.

When Bankrate.com first polled people in September—right before the launch of Obamacare insurance exchanges, there was an even split between those who said they would repeal the Affordable Care Act if given the power to do so and those who would keep it: 46 percent each. (The rest either had no opinion or didn't know how they felt.)

But three months later, after the botched launch of those government-run exchanges, the number of people who said they would gut Obamacare had risen to 48 percent, while the number of respondents who said they would keep it as law had plunged to 38 percent.

The survey also found that people, by a 2-to-1 margin, felt Obamacare had had a more negative than positive impact on their own, individual health care. The poll questioned 1,005 adults, and had a margin of error of 3.6 percentage points.

"We have seen a softening in support of the law," said Doug Whiteman, Bankrate.com insurance analyst. "I really think that stems from all the adverse publicity in the last several months" that focused on the technologically crippled federal Obamacare exchange and the resulting low enrollment in the first two months of operation, he said.

His company's survey also found that a total of 44 percent of people with employer-provided insurance said they are shelling out more dollars in deductibles and copayments than they were a year ago. And 47 percent of that group of people reported having more money deducted from their paycheck to pay the cost of those insurance plans than in 2012.

People earning between $50,000 and $75,000 annually were the most affected group: with 64 percent of them reporting a bigger hit on their paychecks from health insurance. Just 38 percent of the people earning less than $30,000 reported paying more for insurance in payroll deductions as of 2013.

'Cadillac tax' wallop

Whiteman attributed the jump in the number of people reporting increases in their out-of-pocket expenses to companies anticipating Obamacare's so-called Cadillac tax, which beginning in 2018 will levy a 40 percent tax on company insurance benefits that exceed $10,200 for an individual and $27,500 for a family.

"Some employers are citing the Cadillac tax as the reason they are paring back some of their health insurance benefits," Whiteman said. Increasing deductibles—which forces employees to pay a bigger share of their medical care and possibly may make them more price-conscious about using their benefits—is one strategy companies are using to address the tax.

He said that trend will "most definitely" strengthen the closer it gets to 2018. (Bold added)

The ACA has lost support. Why? Because unlike other entitlements, it is costing people money!!!

If you think THAT is going to get more popular as costs get even higher as we approach 2018, you're out of your mind.

Fate

If co-pays and deductibles are going up across the board, then it doesn't matter what level you buy--your costs are going up.

The key word is IF. Prove that they are... What I've linked you to shows this

There are four levels of coverage on the exchanges -- bronze, silver, gold and platinum. Bronze plans, the cheapest and least generous, are designed to cover about 60 percent of medical costs and carry higher deductibles. Platinum plans, the most expensive, cover about 90 percent of costs, yet charge higher monthly premiums

If one has a platinum plan and 90% of costs are covered...co-pays and deductibles are not going up...

fate

The ACA has lost support. Why? Because unlike other entitlements, it is costing people money!!!

As opposed to the republican alternative which isn't going to cost people money?

As opposed to before the ACA when health care costs were plummeting? and people had a really easy time dealing with their insurance companies, who were quick to ensure reimbursement with every claim and were knocking co-pays and deductibles down monthly?

rickyp wrote:Fate

If co-pays and deductibles are going up across the board, then it doesn't matter what level you buy--your costs are going up.

The key word is IF. Prove that they are... What I've linked you to shows this

There are four levels of coverage on the exchanges -- bronze, silver, gold and platinum. Bronze plans, the cheapest and least generous, are designed to cover about 60 percent of medical costs and carry higher deductibles. Platinum plans, the most expensive, cover about 90 percent of costs, yet charge higher monthly premiums

If one has a platinum plan and 90% of costs are covered...co-pays and deductibles are not going up...

Um, that really doesn't address whether co-pays and deductibles are going up. All it says is that you have an option: higher deductibles and co-pays (relative to the OTHER plans) or lower deductibles and co-pays (relative to the OTHER plans). However, it says NOTHING about the rise (or lack thereof) in those costs.

On the other hand, my article DID address it via a survey. I'll post that part again since apparently EVEN BOLDING IT DIDN'T HELP YOU.

His company's survey also found that a total of 44 percent of people with employer-provided insurance said they are shelling out more dollars in deductibles and copayments than they were a year ago. And 47 percent of that group of people reported having more money deducted from their paycheck to pay the cost of those insurance plans than in 2012.

Oh, wait. This will help. It has pictures--should make it easier for you to understand.



The whole article is here: http://www.healthpocket.com/healthcare- ... nses-go-up

Try googling: "out of pocket expenses increasing under obamacare"

fate

The ACA has lost support. Why? Because unlike other entitlements, it is costing people money!!!

As opposed to the republican alternative which isn't going to cost people money?

No, as opposed to Social Security and Medicare, which people perceive as being "free," even though they're not. In this case, we are being forced to buy a product and finding out it's not a good deal in many cases.

As opposed to before the ACA when health care costs were plummeting? and people had a really easy time dealing with their insurance companies, who were quick to ensure reimbursement with every claim and were knocking co-pays and deductibles down monthly?

One little, two little, three little straw men,
Four little, five little, six little straw men . . . sing it with me!

So sorry, rickyp, but, as usual, the facts are on my side. Meanwhile, you have nothing but a healthy supply of kerosene.

fate

No, as opposed to Social Security and Medicare, which people perceive as being "free," even though they're not. In this case, we are being forced to buy a product and finding out it's not a good deal in many cases

.

The notion that someone must buy health insurance has been part of the republican position on health insurance since before 1993...

Many states now require passengers in automobiles to wear seat-belts for their own protection. Many others require anybody driving a car to have liability insurance. But neither the federal government nor any state requires all households to protect themselves from the potentially catastrophic costs of a serious accident or illness. Under the Heritage plan, there would be such a requirement.” The mandate made its first legislative appearance in 1993, in the Health Equity and Access Reform Today Act—the Republicans’ alternative to President Clinton’s health-reform bill—which was sponsored by John Chafee, of Rhode Island, and co-sponsored by eighteen Republicans, including Bob Dole, who was then the Senate Minority Leader.

The notion that health insurance isn't a good deal.... well that's reflective of the need to have minimum standards in insurance offerings I guess... Up till the ACA insurance companies often used deceptive packaging to hide the fact that insurance being bought had little real value. (You're going to argue that people were happy with these shells. Ad i suppose often they were, until they had to make claims...)
In reality health care costs in the US are way out of line and now people are faced with seeing the actual costs. When health care for indigents was provided through emergency wards, the costs of that care wasn't immediately apparent. (Kinda like the way you think people view the provision of social security and medicare - free).

And I guess you may end up right that the cost of deductibles and co-pays will be a point of irritation. But then those opposing have to offer an alternative. Usually republicans suggest that people should pay their own way right?

rickyp wrote:fate

No, as opposed to Social Security and Medicare, which people perceive as being "free," even though they're not. In this case, we are being forced to buy a product and finding out it's not a good deal in many cases

.

The notion that someone must buy health insurance has been part of the republican position on health insurance since before 1993...

So what? What does that have to do with costs--"it's not a good deal."

The notion that health insurance isn't a good deal.... well that's reflective of the need to have minimum standards in insurance offerings

No, it's not. It has to do with taxes. The architect of the plan called it a massive transfer of wealth.

In any event, it's not popular. Why not? Because for most people, it has either had no effect or a negative effect.

And I guess you may end up right that the cost of deductibles and co-pays will be a point of irritation. But then those opposing have to offer an alternative. Usually republicans suggest that people should pay their own way right?

I have facts. You have? Squadoosh.

Doctor Fate wrote:Oh, wait. This will help. It has pictures--should make it easier for you to understand.



The whole article is here: http://www.healthpocket.com/healthcare- ... nses-go-up

I've read it. What it does not do is compare like with like. It compares the average of all current plans with the averages of each different category of future plans. What would be a better comparison would be to compare the plans that actual people take out with what they have before. Or perhaps to show a breakdown of current plans by levels of co-pay, in similar proportions.

Also, it's not clear how cost-sharing reductions for those on low incomes affect the figures (and what the pre-2014 figures would be like for the same cohort of insured).

Co-pays may go up, or down, and so may premiums. Overall, the cost of insurance is likely to go up, just as it does over time for all other forms of insurance I've seen. Infllation does that. But one thing that I know from having recently renewed my car insurance is that my premium will depend on the level of excess that applies (which is a similar concept to co-pay). The overall cost of both is what is a better measure of the overall cost. Someone who is not likely to need prescription drugs might well go for a high co-pay plan because it's a lower premium. And vice-versa for someone who thinks that claims are more likely.

So my own experience is that I had insurance through a plan organized by the state of New York specifically for small employers. I'm not sure all the details, but the state got insurers to give special group rates to small employers that qualified, and my business qualified and that's how we got our insurance for the past few years.

Last year, due to changes required by the ACA, my business no longer qualified for the State plan because it was no longer considered a "group" plan under the ACA. Fine. Whatever. We'll get insurance on the individual exchange.

First, it must be said that options and prices not only change by state, but they also change by ZIP code. I was talking to my insurance broker who had vastly different options and prices on Long Island than we do here in the City, so I'm not sure how educating this is for anyone else. Second, I hate buying insurance. It's not a zero sum game: the house always wins in the insurance business due to profit and overhead, which actually takes a huge chunk out of the money that is paid into insurance, so when you buy insurance, most everyone loses money, and that is an investment that repulses me.

That said, my impressions: the website was pretty bad. It was very hard to compare rates and plans in part because there were so many different options: this one has mental health coverage, that one doesn't, that type of thing. It is run and operated by the State of New York, one of the most dysfunctional organizations that exist, so that's not really a surprise. We were able to see who was participating on the state website, and we actually shopped for insurance using the websites of the different companies.

But it was very hard to determine what plan to sign up for because while we're in the open enrollment period, the contracts with the doctors for next year aren't all done yet. So we don't know if our service provider will be participating in that plan next year. Really dumb: how about staggering provider signup so that it's done before people sign up so they know who they can see? Duh! There were a bunch of other little maddening things that I won't go into.

The whole process and value was pretty bad. The plan we ended up with is clearly a worse value than the plan we had previously. The premium is actually slightly lower than what we currently pay, but it essentially doesn't cover much of anything. Previously, my insurance cost $1,200 a month for my family with a $1,200 deductible and completely covered a bunch of standard things. My new plan will be about $1,150 a month with a $12,000 deductible. To get a similar deductible as my current plan, the monthly premium was in the $1,600-$1700 range.

Any system that retains a big difference between group plans and individual plans is dumb. Insurance through your employer costs one price, but if you get your insurance through the exchange, it's a higher price for the same service. Putting the insurance companies at the center of this mess was like putting the foxes in charge of the hen house. They are going to get paid, and they will be the first to be paid. The market has recognized this and has bid up the price of all the big health insurers over the past couple of years far more than the general market.

I have no doubt that ACA supporters were trying to do the right thing, but there are very powerful interests who are vested in extracting as much from us as they can and the ACA really hasn't done anything about that, at least in NYC in my zip code. The insurers are still going to get paid, but now poor people will be able to have these crappy plans for pennies on the dollar, and you and I will pay the dimes and quarters to make up the difference. I like the fact that poor people will now be able to afford health insurance, and I've had friends who are able to get insurance for the first time in many years because of the ACA, but I just wish the insurance they got was better and didn't cost so much, and that's where the ACA has failed. At least in this single datum.