Author Topic: What comes after the ACA?  (Read 105844 times)

Lagom

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Re: What comes after the ACA?
« Reply #700 on: January 25, 2017, 02:03:44 PM »
Back in 2005, I paid $125/month for insurance for my family.  2007, I paid $153/month. Before that, premiums had been fairly steady.

2017, I'll pay $598/month and have higher deductibles and larger co-pays and I also pay $100/month to have my husband on my insurance because he also has access through his work; so total monthly cost is $698/month. 

At the rate of 19% increase every 2 years (2005-2007) -- I should only be paying around $365/month for excellent insurance. I no longer have excellent insurance (nobody does).

Indeed. Thank you for your anecdotal and emotionally driven contribution to this topic.

obstinate

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Re: What comes after the ACA?
« Reply #701 on: January 25, 2017, 02:48:12 PM »
I no longer have excellent insurance (nobody does).
Are you trolling?

protostache

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Re: What comes after the ACA?
« Reply #702 on: January 25, 2017, 03:15:00 PM »
Back in 2005, I paid $125/month for insurance for my family.  2007, I paid $153/month. Before that, premiums had been fairly steady.

2017, I'll pay $598/month and have higher deductibles and larger co-pays and I also pay $100/month to have my husband on my insurance because he also has access through his work; so total monthly cost is $698/month. 

At the rate of 19% increase every 2 years (2005-2007) -- I should only be paying around $365/month for excellent insurance. I no longer have excellent insurance (nobody does).

Are these individual rates or employer rates? If employer, what did they pay on your behalf?

maizeman

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Re: What comes after the ACA?
« Reply #703 on: January 25, 2017, 04:46:04 PM »
Back in 2005, I paid $125/month for insurance for my family.  2007, I paid $153/month. Before that, premiums had been fairly steady.

2017, I'll pay $598/month and have higher deductibles and larger co-pays and I also pay $100/month to have my husband on my insurance because he also has access through his work; so total monthly cost is $698/month. 

At the rate of 19% increase every 2 years (2005-2007) -- I should only be paying around $365/month for excellent insurance. I no longer have excellent insurance (nobody does).

Did you have a cap on lifetime benefits on your old plan? And if you ever have to use it to cover something major (five+ figures)?

For a short while right before the ACA kicked in I was paying $80/month for private health insurance. And right after I was paying $250-some for an HSA eligible plan off of an exchange. (I think? I remember it was a 3x increase). But for me increase in peace of mind from the removal of lifetime caps and not having to worry about my insurer going back through my medical history trying to find a way to kick me off if I ever actually needed it was worth the increase.

But I'll be the first to acknowledge that not everyone puts the same relative value on peace of mind vs lower monthly expenses.
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sol

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Re: What comes after the ACA?
« Reply #704 on: January 25, 2017, 05:15:41 PM »
Today's Republican proposal to replace the ACA is to repeal the ACA outright and then offer every American a $5k tax break to buy private insurance on the individual market, with no market restrictions.  So no guaranteed issue to people with pre existing conditions, a return of lifetime caps, no guaranteed access to birth control or preventative care, and insurers can go back to exclusionary policies that cover everything except what you already have wrong with you.

Technically this might make insurance affordable to everyone, if they choose to buy really crappy insurance with a $20k deductible that can just drop you if you get sick or injured.  That's about the nicest thing I can say about this plan.

waltworks

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Re: What comes after the ACA?
« Reply #705 on: January 25, 2017, 05:41:39 PM »
If it's a straight refundable credit, that's not a horrible deal (assuming children are included). If it's only applicable to taxes owed - not so great for most folks.

If we're going to try letting the market work, that might be a way to do it, I suppose. Hand out money (sort of), have people spend it as they choose.

Obviously all the insurance-denied horror stories will come back/continue, and people with chronic illnesses will be f'd. That's not so good.

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protostache

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Re: What comes after the ACA?
« Reply #706 on: January 25, 2017, 06:00:56 PM »
If it's a straight refundable credit, that's not a horrible deal (assuming children are included). If it's only applicable to taxes owed - not so great for most folks.

If we're going to try letting the market work, that might be a way to do it, I suppose. Hand out money (sort of), have people spend it as they choose.

Obviously all the insurance-denied horror stories will come back/continue, and people with chronic illnesses will be f'd. That's not so good.

-W

Everyone has or will have a disqualifying preexisting condition in their lifetime. Everyone. So no, it's not so good.

CDP45

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Re: What comes after the ACA?
« Reply #707 on: January 25, 2017, 10:32:24 PM »
https://kaiserfamilyfoundation.files.wordpress.com/2015/03/7235-09-figure-9.png

Top 5% of enrollee users account for 53% of spending. This is the root of the problem where the spending is unlimited and causing healthcare costs to rise for everyone. I suspect similar figures for Medicare.

Why don't you think there is a market for life insurance for those over 100 years old? You can fight the laws of economics, but you can't repeal them. It's not insurance if there near certainty of a claim, and that's why it works for those under the age of 65, because catastrophic health claims are rare and uncertain.

Here's a simple example: If the estimated healthcare costs per year are $50,000 on average for people that are 60 years old, but the government says insurers can only charge $10,000/yr in premium, where do you think that other $40,000/yr is coming from?

sol

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Re: What comes after the ACA?
« Reply #708 on: January 25, 2017, 10:50:21 PM »
If it's a straight refundable credit, that's not a horrible deal (assuming children are included). If it's only applicable to taxes owed - not so great for most folks.

If we're going to try letting the market work, that might be a way to do it, I suppose. Hand out money (sort of), have people spend it as they choose.

Obviously all the insurance-denied horror stories will come back/continue, and people with chronic illnesses will be f'd. That's not so good.

-W

The proposal is from Rand Paul, so while it doesn't specify I would assume it is non refundable.  It's also not clear how that would apply to families, like 5k each for a family of five should cover their family premiums, but 5k for a widowed 80 year old probably leaves her high and dry.

I also like how blatantly regressive it is.  Hey, if that 19 year old disabled janitor with no tax burden gets a 5k tax break, so should Jamie Dimon.  Conservatives are always looking out for YOU.

waltworks

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Re: What comes after the ACA?
« Reply #709 on: January 25, 2017, 11:25:01 PM »
Given that I'm not sure even 50% of Americans have $5k in income tax due in a given year, seems like it would have to be a real refundable credit to make any sense at all.

The devil's in the details, as usual. If it's straight refundable, it's not regressive. If it's NOT refundable, then it's an enormous shaft to the middle class, who don't generally have enough tax liability that it would help them.

The sad thing is that the details should have been worked out and made public for a proposal like this in, oh, say 2008 or 2009. Or at the very least, today. The throwing-shit-at-the-wall-and-seeing-what-sticks process is important, but it's a little late to be doing that when you're already canceling the funding for the existing system.

-W

Metric Mouse

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Re: What comes after the ACA?
« Reply #710 on: January 26, 2017, 07:20:28 AM »
ACA has some serious damn problems. I have gone from paying 6700 in premiums a year to over 21000 with worst coverage since ACA became law. This is a HUGE problem for many many American families.

I don't mean to ignore your thoughtful contributions with the rest of your post, but it bears repeating that this sort of view is part of the problem from a politicization standpoint. Premiums were going up and coverage going down for almost everyone before the ACA and there is evidence that for many if not most, that slowed after the ACA was enacted. It's very easy to say "my rates went up thus the ACA was a failure!" But that is an entirely emotional argument.
Actually, that only held true until 2017.  The premium increase for this year alone wiped out all  "slowing of premium growth". And i see this as a legitimate criticism of the ACA; it was promised to save money and reduce costs of health care.  (Maybe this iwas never the intention of the ACA; which case it would be a criticism of Barack Obama for flat lying, and then yet another aspect of the ACA that needs improvement. )
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NoStacheOhio

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Re: What comes after the ACA?
« Reply #711 on: January 26, 2017, 07:30:55 AM »
ACA has some serious damn problems. I have gone from paying 6700 in premiums a year to over 21000 with worst coverage since ACA became law. This is a HUGE problem for many many American families.

I don't mean to ignore your thoughtful contributions with the rest of your post, but it bears repeating that this sort of view is part of the problem from a politicization standpoint. Premiums were going up and coverage going down for almost everyone before the ACA and there is evidence that for many if not most, that slowed after the ACA was enacted. It's very easy to say "my rates went up thus the ACA was a failure!" But that is an entirely emotional argument.
Actually, that only held true until 2017.  The premium increase for this year alone wiped out all  "slowing of premium growth". And i see this as a legitimate criticism of the ACA; it was promised to save money and reduce costs of health care.  (Maybe this iwas never the intention of the ACA; which case it would be a criticism of Barack Obama for flat lying, and then yet another aspect of the ACA that needs improvement. )

Last I saw, overall health care expenditures improved versus the projection if ACA never existed. I don't know if that's changed for 2017, but it's sort of a different animal. Obviously, premiums are what people see, and what affect people, but I think the intent with ACA was a more systemic approach.
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brooklynguy

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Re: What comes after the ACA?
« Reply #712 on: January 26, 2017, 07:57:10 AM »
The fact sheet for Rand Paul's proposal describes the $5k tax credit as follows:

Quote from: Rand Paul Proposal Fact Sheet
Provides individuals the option of a tax credit of up to $5,000 per taxpayer for contributions to an HSA. If an individual chooses not to accept the tax credit or contributes in excess of $5,000, those contributions are still tax-preferred.

Since it's "per taxpayer," it seems there's no additional credit for dependents.  And since it's "up to" $5k (and an "option" that individuals are contemplated to potentially "choose[] not to accept"), it seems that it's not intended to be refundable (because, if it were, why would anyone under any circumstance choose not to receive the maximum credit)?

I expect this proposal's moniker of "The Obamacare Replacement Act" will, more than any other factor, enhance its chances of being well received by Congressional Republicans.

AdrianC

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Re: What comes after the ACA?
« Reply #713 on: January 26, 2017, 08:19:25 AM »
Indeed. Thank you for your anecdotal and emotionally driven contribution to this topic.

In aggregate the ACA might have slowed down the increase of insurance premiums, but there are certainly financial winners and losers. If a pool gets sicker overall, costs will rise for everyone in that pool. Sure, most participants in the ACA get subsidies and don't see the increase. For those of us without subsidies it has been a rough time.

Everyone sees the increases in deductibles. A $10K deductible isn't a real problem for us rich FIRE'd folks, but many people on Obamacare have never had $10K to their name. They can't do it.

That said, I still support the ACA because up we do have vastly better coverage than the old "drop you when you get sick" plan. Unfortunately, insurance companies have been pulling out for financial and political reasons and my family is now in a plan with a shockingly narrow network. The ACA obviously can't continue as-is.

Anxious to see the Republican replacement. I read Rand Paul's proposal discussed above.

https://www.paul.senate.gov/imo/media/doc/ObamacareReplacementActSections.pdf

Meh. I really don't want to go back to filling out those forms with 10 years of medical history, knowing that if you forget one little thing they could drop you later.

Schaefer Light

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Re: What comes after the ACA?
« Reply #714 on: January 26, 2017, 09:36:01 AM »
I like Rand Paul's plan.  It opens up HSAs to everyone, removes the contribution limit, and allows the use of HSA money to pay for insurance premiums.

OurTown

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Re: What comes after the ACA?
« Reply #715 on: January 26, 2017, 09:57:34 AM »
I read it as a dollar for dollar credit, is this correct?  I contribute 5 grand to the HSA and I get a $5,000 tax credit?

OurTown

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Re: What comes after the ACA?
« Reply #716 on: January 26, 2017, 10:04:17 AM »
If I'm reading this right, we could exclude our premiums paid on an employer provided plan, AND we get a $5,000 credit for putting $5,000 in an HSA.  Per taxpayer means 5 for me and 5 for the spouse, right?  If that's right, this is great for those of us that can afford to plow ten grand into an HSA.

MishMash

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Re: What comes after the ACA?
« Reply #717 on: January 26, 2017, 10:06:43 AM »
I read it as a dollar for dollar credit, is this correct?  I contribute 5 grand to the HSA and I get a $5,000 tax credit?

I hope not, how many lower income folks do you know that have 5k laying around to put in an HSA each year?

brooklynguy

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Re: What comes after the ACA?
« Reply #718 on: January 26, 2017, 10:18:54 AM »
I read it as a dollar for dollar credit, is this correct?  I contribute 5 grand to the HSA and I get a $5,000 tax credit?

Yes, to the extent you have at least $5k of tax liability to be offset against (assuming the credit is nonrefundable, which is how I am reading the proposal).

If I'm reading this right, we could exclude our premiums paid on an employer provided plan

Premiums paid on an employer-provided plan are already nontaxable today, so there's no change there (the proposal does propose extending that favorable tax treatment to non-employer-provided coverage by making premiums for coverage purchased on the individual market tax-deductible as well, but that too only benefits people with otherwise-positive tax liability in the first place).

Quote
If that's right, this is great for those of us that can afford to plow ten grand into an HSA.

But, again, it's useless to those of us without sufficient positive tax liability, which would include the prototypical frugal early retiree, not to mention the average American (as walt noted above).

waltworks

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Re: What comes after the ACA?
« Reply #719 on: January 26, 2017, 10:38:57 AM »
Median household income in the US is about $51k. Assume that's a 3-person household (1 dependent) and no special circumstances (no disabilities, military members, IRA/401k contributions, etc) and you have a rough federal tax liability of $1600. For the whole household.

That theoretical $10-15k (not sure what the deal is with dependents in this "plan") in health care just turned into $1600, assuming you're a median household.

I mean, that's nice and all. But it will instantly remove the vast majority of the people currently covered by the ACA from the world of health insurance.

At somewhere around $110k income you would get the full benefit. $110k income and up is about 5% of US households, for what it's worth.

-W

OurTown

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Re: What comes after the ACA?
« Reply #720 on: January 26, 2017, 10:43:06 AM »
Yeah, I don't think it's good policy either.  For me, personally, it sounds great.

NESailor

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Re: What comes after the ACA?
« Reply #721 on: January 26, 2017, 10:59:03 AM »
Median household income in the US is about $51k. Assume that's a 3-person household (1 dependent) and no special circumstances (no disabilities, military members, IRA/401k contributions, etc) and you have a rough federal tax liability of $1600. For the whole household.

That theoretical $10-15k (not sure what the deal is with dependents in this "plan") in health care just turned into $1600, assuming you're a median household.

I mean, that's nice and all. But it will instantly remove the vast majority of the people currently covered by the ACA from the world of health insurance.

At somewhere around $110k income you would get the full benefit. $110k income and up is about 5% of US households, for what it's worth.

-W

And that's still without dependents I think.  My family gross income for 2016 was somewhere around 130K but with 2 dependents and just barely squeaking under the tIRA deductibility phaseout our fed tax liability is looking more like 4K and change.  I already consider ourselves to be fairly well off so if what you guys have figured out holds true - this would be a tragically comical kick in the face to the non-wealthy population.

waltworks

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Re: What comes after the ACA?
« Reply #722 on: January 26, 2017, 11:46:26 AM »
Yeah, it would leave frugal-minded ER folks in a bit of a bind, as well as just normal working-class people.

I suppose for our family the logical thing to do would be to pay off our house (interesting how the calculus on that changes here too) and lower our MAGI (through a combo of working less and maxing tIRA/401k stuff) to under the threshold for Medicaid. That wouldn't be that hard to do, I suppose. But I expect Medicaid will get a LOT worse going forward too...

Maybe this: Pay off house (can't be seized in bankruptcy) and "self insure" by just declaring bankruptcy if very big medical expenses come up?

Hilarious stuff, sort of.

-W


Gin1984

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Re: What comes after the ACA?
« Reply #723 on: January 26, 2017, 12:08:58 PM »
Yeah, it would leave frugal-minded ER folks in a bit of a bind, as well as just normal working-class people.

I suppose for our family the logical thing to do would be to pay off our house (interesting how the calculus on that changes here too) and lower our MAGI (through a combo of working less and maxing tIRA/401k stuff) to under the threshold for Medicaid. That wouldn't be that hard to do, I suppose. But I expect Medicaid will get a LOT worse going forward too...

Maybe this: Pay off house (can't be seized in bankruptcy) and "self insure" by just declaring bankruptcy if very big medical expenses come up?

Hilarious stuff, sort of.

-W
Not all states allow for a house to be waived from the $2000 asset cap.

waltworks

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Re: What comes after the ACA?
« Reply #724 on: January 26, 2017, 12:21:44 PM »
Good point. That strategy would only work in some places. Still, there are lots of other ways to hide/transfer assets that you could use.

My point more generally is that this would create a totally bizarre set of incentives for people with assets to get around actually paying for health care, and it would totally screw over the 95% of the population without those assets/income.

A UBI looks better every day. This stuff is just a mess. Cancel it all and just hand out the cash.

-W

scantee

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Re: What comes after the ACA?
« Reply #725 on: January 26, 2017, 12:31:13 PM »
ACA status update. January 26, 2017.

Trump told GOP congressional leaders today that he is toying with the idea of leaving Obamacare as is, until the 2018 election, so that it is politically bad for Democrats during the mid-terms.

I think that about sums up the reality of the matter. There is no good alternative to ACA, Republicans know that and know they have no viable alternative to replace it, so they plan to punt the issue down the road for as long as possible, attempting to lay ACA's problems at the feet of the Democrats for as long as possible. 

NoStacheOhio

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Re: What comes after the ACA?
« Reply #726 on: January 26, 2017, 12:49:52 PM »
ACA status update. January 26, 2017.

Trump told GOP congressional leaders today that he is toying with the idea of leaving Obamacare as is, until the 2018 election, so that it is politically bad for Democrats during the mid-terms.

I think that about sums up the reality of the matter. There is no good alternative to ACA, Republicans know that and know they have no viable alternative to replace it, so they plan to punt the issue down the road for as long as possible, attempting to lay ACA's problems at the feet of the Democrats for as long as possible.

So they're choosing not to even try to fix known and agreed-upon flaws? What if Democrats introduce changes to ACA? Insta-no?
The first step is acknowledging you have a problem, right?

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sol

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Re: What comes after the ACA?
« Reply #727 on: January 26, 2017, 12:51:22 PM »
ACA status update. January 26, 2017.

Trump told GOP congressional leaders today that he is toying with the idea of leaving Obamacare as is, until the 2018 election, so that it is politically bad for Democrats during the mid-terms.

I think that about sums up the reality of the matter. There is no good alternative to ACA, Republicans know that and know they have no viable alternative to replace it, so they plan to punt the issue down the road for as long as possible, attempting to lay ACA's problems at the feet of the Democrats for as long as possible.

I'm okay with this plan.  Let the ACA continue to function as designed (though they appear to be refusing to consider making any changes that might help people), and let Democrats take the blame and the credit.  Fine.  If Republicans want to be the party of no, this is one avenue.  Just say no to all changes.

Meanwhile, needed improvements to the ACA may have to wait until Democrats eventually regain control.  I'm not sure what Republican leadership sees as the positive outcome of this situation.

NESailor

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Re: What comes after the ACA?
« Reply #728 on: January 26, 2017, 01:04:55 PM »

I'm okay with this plan.  Let the ACA continue to function as designed (though they appear to be refusing to consider making any changes that might help people), and let Democrats take the blame and the credit.  Fine.  If Republicans want to be the party of no, this is one avenue.  Just say no to all changes.

Meanwhile, needed improvements to the ACA may have to wait until Democrats eventually regain control.  I'm not sure what Republican leadership sees as the positive outcome of this situation.

Well, refusing to enforce the penalties supporting the individual mandate will have a rather negative effect on the whole thing.  They'll introduce (or speed up if you believe we're there already) the death spiral and blame the failure on the other side.  This could work very well short term - politically, that is.  Problem is - to actually fix it would require a system even more robust than the ACA, which is ideologically unpalatable to folks who understand ideology but not economics.

NoStacheOhio

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Re: What comes after the ACA?
« Reply #729 on: January 26, 2017, 01:36:27 PM »
ACA status update. January 26, 2017.

Trump told GOP congressional leaders today that he is toying with the idea of leaving Obamacare as is, until the 2018 election, so that it is politically bad for Democrats during the mid-terms.

I think that about sums up the reality of the matter. There is no good alternative to ACA, Republicans know that and know they have no viable alternative to replace it, so they plan to punt the issue down the road for as long as possible, attempting to lay ACA's problems at the feet of the Democrats for as long as possible.

I'm okay with this plan.  Let the ACA continue to function as designed (though they appear to be refusing to consider making any changes that might help people), and let Democrats take the blame and the credit.  Fine.  If Republicans want to be the party of no, this is one avenue.  Just say no to all changes.

Meanwhile, needed improvements to the ACA may have to wait until Democrats eventually regain control.  I'm not sure what Republican leadership sees as the positive outcome of this situation.

My problem with the plan is that they've already started to undermine the law at the executive level. They can't light the fuse and then blame someone else. I mean, they will, but you get my point.
The first step is acknowledging you have a problem, right?

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obstinate

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Re: What comes after the ACA?
« Reply #730 on: January 26, 2017, 04:10:39 PM »
My problem with the plan is that they've already started to undermine the law at the executive level. They can't light the fuse and then blame someone else. I mean, they will, but you get my point.
Whether they get away with this depends on how stupid the American public is, and how skillful the Democratic spin machine is. Nobody ever lost money betting on the stupidity of the public. However, I think that the wrecking ball that is cheeto-President may make somewhat of a dent in the Republican spin machine. His ineptitude combined with the disastrousness of his economic policies may end up lending credence to the Democrats' narrative. All depends on the economy over the next four years, which is, I suppose, inevitable.

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Re: What comes after the ACA?
« Reply #731 on: January 26, 2017, 04:16:27 PM »
My problem with the plan is that they've already started to undermine the law at the executive level. They can't light the fuse and then blame someone else. I mean, they will, but you get my point.
Whether they get away with this depends on how stupid the American public is, and how skillful the Democratic spin machine is. Nobody ever lost money betting on the stupidity of the public. However, I think that the wrecking ball that is cheeto-President may make somewhat of a dent in the Republican spin machine. His ineptitude combined with the disastrousness of his economic policies may end up lending credence to the Democrats' narrative. All depends on the economy over the next four years, which is, I suppose, inevitable.

Oh good, do we bring back the phrase: "It's the economy, stupid!"?
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jim555

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Re: What comes after the ACA?
« Reply #732 on: January 26, 2017, 05:15:06 PM »
Ironically if they remove the Individual Mandate it will hurt those who make too much to get subsidies, which tend to be more Republican.  The 200% FPL level and lower is the sweet spot in the scheme.  As the premiums rise the subsidies rise as well.  Those who don't get subsidies are the ones who will get screwed.

AdrianC

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Re: What comes after the ACA?
« Reply #733 on: January 26, 2017, 06:00:23 PM »
Ironically if they remove the Individual Mandate it will hurt those who make too much to get subsidies, which tend to be more Republican.  The 200% FPL level and lower is the sweet spot in the scheme.  As the premiums rise the subsidies rise as well.  Those who don't get subsidies are the ones who will get screwed.

Unless all the insurance companies an area pull out of the exchange. Then everyone there is screwed.

Some areas currently have only one insurer on the exchange.

obstinate

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Re: What comes after the ACA?
« Reply #734 on: January 26, 2017, 06:29:46 PM »
That is definitely a problem, and it should be fixed. But it affects a fraction of people. Most people have a lot of plan choices, with a national average of thirty options per enrollee. 

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Re: What comes after the ACA?
« Reply #735 on: January 27, 2017, 07:42:53 AM »
ACA has some serious damn problems. I have gone from paying 6700 in premiums a year to over 21000 with worst coverage since ACA became law. This is a HUGE problem for many many American families.

I don't mean to ignore your thoughtful contributions with the rest of your post, but it bears repeating that this sort of view is part of the problem from a politicization standpoint. Premiums were going up and coverage going down for almost everyone before the ACA and there is evidence that for many if not most, that slowed after the ACA was enacted. It's very easy to say "my rates went up thus the ACA was a failure!" But that is an entirely emotional argument.

Where did I say it was a failure? I didn't. What I did say is that my premiums have nearly tripled since it went into effect. That is 100% not emotional but fact. Please do continue though.

rtrnow

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Re: What comes after the ACA?
« Reply #736 on: January 27, 2017, 07:56:43 AM »
ACA has some serious damn problems. I have gone from paying 6700 in premiums a year to over 21000 with worst coverage since ACA became law. This is a HUGE problem for many many American families.

I don't mean to ignore your thoughtful contributions with the rest of your post, but it bears repeating that this sort of view is part of the problem from a politicization standpoint. Premiums were going up and coverage going down for almost everyone before the ACA and there is evidence that for many if not most, that slowed after the ACA was enacted. It's very easy to say "my rates went up thus the ACA was a failure!" But that is an entirely emotional argument.


Where did I say it was a failure? I didn't. What I did say is that my premiums have nearly tripled since it went into effect. That is 100% not emotional but fact. Please do continue though.

Your statement certainly implies that the aca is to blame for those increases. That is not fact.

titan2k10

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Re: What comes after the ACA?
« Reply #737 on: January 27, 2017, 08:15:01 AM »
ACA has some serious damn problems. I have gone from paying 6700 in premiums a year to over 21000 with worst coverage since ACA became law. This is a HUGE problem for many many American families.

I don't mean to ignore your thoughtful contributions with the rest of your post, but it bears repeating that this sort of view is part of the problem from a politicization standpoint. Premiums were going up and coverage going down for almost everyone before the ACA and there is evidence that for many if not most, that slowed after the ACA was enacted. It's very easy to say "my rates went up thus the ACA was a failure!" But that is an entirely emotional argument.


Where did I say it was a failure? I didn't. What I did say is that my premiums have nearly tripled since it went into effect. That is 100% not emotional but fact. Please do continue though.

Your statement certainly implies that the aca is to blame for those increases. That is not fact.

You're joking right? If not please point out the source of my premiums increasing nearly 300% since ACA went into effect? I will be waiting....

rtrnow

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Re: What comes after the ACA?
« Reply #738 on: January 27, 2017, 08:32:37 AM »
ACA has some serious damn problems. I have gone from paying 6700 in premiums a year to over 21000 with worst coverage since ACA became law. This is a HUGE problem for many many American families.

I don't mean to ignore your thoughtful contributions with the rest of your post, but it bears repeating that this sort of view is part of the problem from a politicization standpoint. Premiums were going up and coverage going down for almost everyone before the ACA and there is evidence that for many if not most, that slowed after the ACA was enacted. It's very easy to say "my rates went up thus the ACA was a failure!" But that is an entirely emotional argument.


Where did I say it was a failure? I didn't. What I did say is that my premiums have nearly tripled since it went into effect. That is 100% not emotional but fact. Please do continue though.

Your statement certainly implies that the aca is to blame for those increases. That is not fact.

You're joking right? If not please point out the source of my premiums increasing nearly 300% since ACA went into effect? I will be waiting....

sigh... It's already been pointed out in this thread. Many insurance premiums rose at a lower percentage after the ACA than before. There maybe be many reasons for that, aca or not. I'll repeat, your anecdotal "my premiums went up so that proves it" is not fact.

nereo

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Re: What comes after the ACA?
« Reply #739 on: January 27, 2017, 08:32:52 AM »
ACA has some serious damn problems. I have gone from paying 6700 in premiums a year to over 21000 with worst coverage since ACA became law. This is a HUGE problem for many many American families.

I don't mean to ignore your thoughtful contributions with the rest of your post, but it bears repeating that this sort of view is part of the problem from a politicization standpoint. Premiums were going up and coverage going down for almost everyone before the ACA and there is evidence that for many if not most, that slowed after the ACA was enacted. It's very easy to say "my rates went up thus the ACA was a failure!" But that is an entirely emotional argument.


Where did I say it was a failure? I didn't. What I did say is that my premiums have nearly tripled since it went into effect. That is 100% not emotional but fact. Please do continue though.

Your statement certainly implies that the aca is to blame for those increases. That is not fact.

You're joking right? If not please point out the source of my premiums increasing nearly 300% since ACA went into effect? I will be waiting....

I believe the point being made here is that you cannot, in isolation, blame the ACA for premium increases.  In other words, what would your premiums have been had the ACA not been enacted and had no other major changes been made to our health care system?

Unfortunately what we have here is an unreplicated experiment with tons of interacting factors.  One can make educated guesses how things would have been different, but that's about it.
For many it's enough to look at premium increases during the ACA and conclude that it didn't do enough to stop these increases.  Others will look at the rate of overall premium increases and not that premiums were not rising as fast after the ACA started going into effect.
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waltworks

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Re: What comes after the ACA?
« Reply #740 on: January 27, 2017, 08:34:32 AM »
Who wants to put any money on premiums going down (on comparable insurance) if the ACA is repealed in part or whole?

Yeah, that's what I thought...

-W

titan2k10

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Re: What comes after the ACA?
« Reply #741 on: January 27, 2017, 08:46:52 AM »
ACA has some serious damn problems. I have gone from paying 6700 in premiums a year to over 21000 with worst coverage since ACA became law. This is a HUGE problem for many many American families.

I don't mean to ignore your thoughtful contributions with the rest of your post, but it bears repeating that this sort of view is part of the problem from a politicization standpoint. Premiums were going up and coverage going down for almost everyone before the ACA and there is evidence that for many if not most, that slowed after the ACA was enacted. It's very easy to say "my rates went up thus the ACA was a failure!" But that is an entirely emotional argument.


Where did I say it was a failure? I didn't. What I did say is that my premiums have nearly tripled since it went into effect. That is 100% not emotional but fact. Please do continue though.

Your statement certainly implies that the aca is to blame for those increases. That is not fact.

You're joking right? If not please point out the source of my premiums increasing nearly 300% since ACA went into effect? I will be waiting....

sigh... It's already been pointed out in this thread. Many insurance premiums rose at a lower percentage after the ACA than before. There maybe be many reasons for that, aca or not. I'll repeat, your anecdotal "my premiums went up so that proves it" is not fact.

Once again you must be joking. My anecdotal example doesn't weigh as much as the anecdotal example that supports your argument? Got it. What a joke. Keep on trucking bud.

nereo

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Re: What comes after the ACA?
« Reply #742 on: January 27, 2017, 08:50:55 AM »

Once again you must be joking. My anecdotal example doesn't weigh as much as the anecdotal example that supports your argument? Got it. What a joke. Keep on trucking bud.
again, no.  Neither holds a great deal of weight.  One can look at the rate of change, or whether the total premiums charged were affordable, or whether access to care (either individually or as a population) changed.  All are valid view points but none can definitively say that the ACA was a "success" or "failure"
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rtrnow

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Re: What comes after the ACA?
« Reply #743 on: January 27, 2017, 08:51:21 AM »
ACA has some serious damn problems. I have gone from paying 6700 in premiums a year to over 21000 with worst coverage since ACA became law. This is a HUGE problem for many many American families.

I don't mean to ignore your thoughtful contributions with the rest of your post, but it bears repeating that this sort of view is part of the problem from a politicization standpoint. Premiums were going up and coverage going down for almost everyone before the ACA and there is evidence that for many if not most, that slowed after the ACA was enacted. It's very easy to say "my rates went up thus the ACA was a failure!" But that is an entirely emotional argument.


Where did I say it was a failure? I didn't. What I did say is that my premiums have nearly tripled since it went into effect. That is 100% not emotional but fact. Please do continue though.

Your statement certainly implies that the aca is to blame for those increases. That is not fact.

You're joking right? If not please point out the source of my premiums increasing nearly 300% since ACA went into effect? I will be waiting....

sigh... It's already been pointed out in this thread. Many insurance premiums rose at a lower percentage after the ACA than before. There maybe be many reasons for that, aca or not. I'll repeat, your anecdotal "my premiums went up so that proves it" is not fact.

Once again you must be joking. My anecdotal example doesn't weigh as much as the anecdotal example that supports your argument? Got it. What a joke. Keep on trucking bud.

My premiums went down. I payed $275 per month before, and now I pay $185 per month. There you go the ACA is a complete success. /sarcasm

waltworks

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Re: What comes after the ACA?
« Reply #744 on: January 27, 2017, 08:57:45 AM »
I think the larger point is that super-high deductible catastrophic plans are... probably worth having for many people. Doing away with those was IMO a mistake.

But again, that doesn't mean just throwing the whole healthcare system into chaos is the best way to handle it.

-W

nereo

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Re: What comes after the ACA?
« Reply #745 on: January 27, 2017, 09:00:50 AM »
I think the larger point is that super-high deductible catastrophic plans are... probably worth having for many people. Doing away with those was IMO a mistake.

This is exactly the kind of health care plan I have, and the kind of plan that I (and many mustachians) want.
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sol

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Re: What comes after the ACA?
« Reply #746 on: January 27, 2017, 09:18:33 AM »
This is exactly the kind of health care plan I have, and the kind of plan that I (and many mustachians) want.

Wait, didn't walt just say plans like the one you're on (and I'm on) aren't available anymore and that's the reason why the ACA is broken?

Also, the ACA is clearly a failure because it turned all green stoplights red.  I saw like five red stoplights yesterday.  Clearly a failure.

Bucksandreds

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Re: What comes after the ACA?
« Reply #747 on: January 27, 2017, 09:23:01 AM »
I think the larger point is that super-high deductible catastrophic plans are... probably worth having for many people. Doing away with those was IMO a mistake.

But again, that doesn't mean just throwing the whole healthcare system into chaos is the best way to handle it.

-W

The reason that the ACA couldn't allow those was that since lower to middle income people couldn't afford the high deductibles they needed higher income people to sign up for the lower deductible plans to shift some of the cost away from lower-middle income people. The ACA has been a total success if you look at it in terms of access to care at prices that are affordable (10% or less of income.) It's a complete failure if you look at it in terms of cost for higher income healthy people. Liberals judge it through the lens of the former and conservatives the latter. Since 17.7% of U.S. GDP is spent on healthcare the ACA has not placed a ridiculous burden on anyone. The true solution is lowering the percentage of GDP spent in this country on healthcare to typical 1st world levels. That would require single payer, prescription price controls and rationed care. These are completely unpalatable to conservatives so we are left with the ACA (originally a conservative idea) and no real long term options from conservatives. Once this iteration of conservatism collapses in this country (as early as 2020 in my opinion) we can get real solutions.

Gin1984

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Re: What comes after the ACA?
« Reply #748 on: January 27, 2017, 09:41:24 AM »
I think the larger point is that super-high deductible catastrophic plans are... probably worth having for many people. Doing away with those was IMO a mistake.

But again, that doesn't mean just throwing the whole healthcare system into chaos is the best way to handle it.

-W
They did look at who used them, and it was not a large percentage of the population over 30.  But it is not done away with, it is available to those who are more likely to use them, young people.

AdrianC

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Re: What comes after the ACA?
« Reply #749 on: January 27, 2017, 10:39:20 AM »
This is exactly the kind of health care plan I have, and the kind of plan that I (and many mustachians) want.

Wait, didn't walt just say plans like the one you're on (and I'm on) aren't available anymore and that's the reason why the ACA is broken?

Sol, what plan are you on, if you don't mind me asking? Is it a "super-high deductible catastrophic plan"?