Author Topic: What comes after the ACA?  (Read 1427312 times)

maizefolk

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Re: What comes after the ACA?
« Reply #6300 on: October 06, 2020, 08:35:05 PM »
Monkey Uncle, I just saw this poll showing a Biden down by only 18 points in WV. (For context, Clinton lost by 42%). So WV seems to be swinging toward Biden by more than 2x the national average.

But do you think that's a result of people in West Virginia voting to protect their access to the ACA (given our discussion a few days ago about how popular the bill has been out there now) or is it unrelated?

Monkey Uncle

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Re: What comes after the ACA?
« Reply #6301 on: October 07, 2020, 04:43:56 AM »
Monkey Uncle, I just saw this poll showing a Biden down by only 18 points in WV. (For context, Clinton lost by 42%). So WV seems to be swinging toward Biden by more than 2x the national average.

But do you think that's a result of people in West Virginia voting to protect their access to the ACA (given our discussion a few days ago about how popular the bill has been out there now) or is it unrelated?

I hadn't seen those numbers.  Interesting, but not too surprising.  I'm just guessing here, but I'd say the main reason is that Hillary Clinton was so widely reviled in WV that the 2016 numbers are the ones that were unnaturally skewed.  Registered Democrats still slightly outnumber Republicans, so I think Biden is centrist enough (and personally likeable enough) to allow more people to revert back toward their normal voting tendencies.  Historically, West Virginians have liked blue dog Democrats like Manchin.  Biden isn't exactly a blue dog, but he is perceived as being a lot closer to that than Hillary was.  Also there's the fact that Donald Trump has had four years to prove just how batshit insane he really is.

toocold

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Re: What comes after the ACA?
« Reply #6302 on: October 07, 2020, 07:07:28 AM »
Monkey Uncle, I just saw this poll showing a Biden down by only 18 points in WV. (For context, Clinton lost by 42%). So WV seems to be swinging toward Biden by more than 2x the national average.

But do you think that's a result of people in West Virginia voting to protect their access to the ACA (given our discussion a few days ago about how popular the bill has been out there now) or is it unrelated?

I think WV has the highest % of those covered by Medicaid, and by repealing ACA, many will lose this subsidy.  I'm not sure if this is impacting polls.  I think there has been a shift to Biden for awhile, especially after the first debate, so they could follow the general trend. 

rantk81

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Re: What comes after the ACA?
« Reply #6303 on: October 07, 2020, 07:14:42 AM »
I'm hesitant to trust any of the polling numbers.  I still look at https://www.realclearpolitics.com/epolls/latest_polls/

Most of the polls have a sample size of less than 1000.  I also think a lot of Trump supporters intentionally lie when responding to polls.

sherr

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Re: What comes after the ACA?
« Reply #6304 on: October 07, 2020, 07:26:51 AM »
I also think a lot of Trump supporters intentionally lie when responding to polls.

This is measurable, and all available evidence points to it not really existing.

The problem with the polls in 2016 was that they under-weighted "white non-college educated" vote in their "likely voter" models for that election, because they turned out to vote for Trump in larger numbers than they usually do. Not that there were significant numbers of "shy Trumpers".

Most people just answer the questions truthfully, but even the ones trying to be "strategic" realize that their candidate needs accurate numbers so they can make ad spending decisions correctly. Lying to pollsters doesn't help Trump.
« Last Edit: October 07, 2020, 07:30:41 AM by sherr »

Shane

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Re: What comes after the ACA?
« Reply #6305 on: October 07, 2020, 09:18:25 AM »
I'm pretty skeptical of polls. In 2016, HRC led in nearly every pre-election nationwide poll and most swing state polls, yet Trump won a decisive EC victory. A friend who has been cold calling voters for the Progressive Turnout Project says, of the people who bother to answer their phones, a majority either hang up as soon as they realize who is calling, say they don't want/have time to "talk politics," or scream crude epithets at him, "nigger lover" being an, apparent, favorite. The small percentage of people who actually take the time to answer their phones and talk with pollsters are not, imho, representative of the electorate, as a whole.

rantk81

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Re: What comes after the ACA?
« Reply #6306 on: October 07, 2020, 09:46:46 AM »
I'm pretty skeptical of polls. In 2016, HRC led in nearly every pre-election nationwide poll and most swing state polls, yet Trump won a decisive EC victory. A friend who has been cold calling voters for the Progressive Turnout Project says, of the people who bother to answer their phones, a majority either hang up as soon as they realize who is calling, say they don't want/have time to "talk politics," or scream crude epithets at him, "nigger lover" being an, apparent, favorite. The small percentage of people who actually take the time to answer their phones and talk with pollsters are not, imho, representative of the electorate, as a whole.

Yeah -- that's kind of how I feel.... Who the hell these days actually answers their phone (or takes the call seriously) when it is from an unrecognized or blocked-caller-id-number?  I certainly don't.  I'd like to see a statistic for these polls -- where, if they claim they polled 700 "likely voters" -- how many phone calls did they have to make, in order to get the input from those 700 voters?  3000 calls?  And what data is used to determine if someone is a "registered voter" vs a "likely voter" ?


Edit: LOL, Looks like the positive response rate was around 6% a couple years ago. I can only imagine it got worse.  By my estimates, a poll would need to make almost 12,000 calls to get 700 people to respond.

https://www.pewresearch.org/fact-tank/2019/02/27/response-rates-in-telephone-surveys-have-resumed-their-decline/
« Last Edit: October 07, 2020, 09:53:42 AM by rantk81 »

sherr

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Re: What comes after the ACA?
« Reply #6307 on: October 07, 2020, 09:57:33 AM »
And what data is used to determine if someone is a "registered voter" vs a "likely voter" ?

It's all self-reported, ie whether the person says they're registered or says they're very likely to vote. And then on top of that the pollster weights responses based on how representative their sample is compared to the expected "average voter" for the state. So there is certainly room for error and some amount of judgement calls involved. However you're talking about all polls being systemically wrong in the same direction. For which you'd need a good reason to believe that that's the case, not just generic hand-waviness. I can easily make the argument for example that the polls are likely to over-represent Republicans, because the majority of young people don't respond to polls (as you point out) and the majority of young people vote D.

There are some well-reasoned arguments from experts about "what went wrong" in 2016. Disagree with them if you want, but you should probably actually have a reason to disagree.

rantk81

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Re: What comes after the ACA?
« Reply #6308 on: October 07, 2020, 10:29:00 AM »
Well, I sincerely *hope* that all the polls are accurate this time...

I'm a red panda

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Re: What comes after the ACA?
« Reply #6309 on: October 07, 2020, 10:40:44 AM »
Well, I sincerely *hope* that all the polls are accurate this time...

They were accurate last time. A Trump win was within the margin of error of pretty much every poll I saw handing it to Hilary. 

sherr

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Re: What comes after the ACA?
« Reply #6310 on: October 07, 2020, 10:53:55 AM »
Well, I sincerely *hope* that all the polls are accurate this time...

They were accurate last time. A Trump win was within the margin of error of pretty much every poll I saw handing it to Hilary.

Or more differently phrased: they were only as wrong as they are in an average year. It was just an exceptionally close election and Trump manage to squeak in an improbable victory.

wenchsenior

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Re: What comes after the ACA?
« Reply #6311 on: October 07, 2020, 11:36:37 AM »
Well, I sincerely *hope* that all the polls are accurate this time...

They were accurate last time. A Trump win was within the margin of error of pretty much every poll I saw handing it to Hilary.


+1

For a financial-oriented forum, there appears to be a real lack of understanding of either how election votes are assigned, or else a serious lack of understanding of very basic statistical concepts that I find very surprising.

Kris

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Re: What comes after the ACA?
« Reply #6312 on: October 07, 2020, 11:39:10 AM »
Well, I sincerely *hope* that all the polls are accurate this time...

They were accurate last time. A Trump win was within the margin of error of pretty much every poll I saw handing it to Hilary.

Exactly this. My head metaphorically explodes every time I see someone say, "Yeah, right, trust the polls -- look how wrong they were in 2016!" In my brain I'm screaming THEY WERE ACCURATE FFS!!! THEY PREDICTED IT AS VERY CLOSE AND HILLARY'S EDGE WAS IN THE MARGIN OF ERROR BY ELECTION DAY!"

maizefolk

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Re: What comes after the ACA?
« Reply #6313 on: October 07, 2020, 04:09:43 PM »
I agree that last time (2016) the polls were just about as accurate as they usually are.

After Nate Silver got so much attention for putting out such accurate predictions of the outcome of the 2008 and 2012 elections a lot of me too websites giving percentage based forecasts popped up in 2016. Some of them painted a much rosier picture of how likely Clinton was to win with the same polling data. For example, the day before the election the New York Times published a list of the predictions from a bunch of different poll aggregators. Huffington post had their own version of 538, and put the odds of a Clinton victory at 98%. The Princeton Election Consortium was putting the odds of a Clinton victory at >99% Going into the election, FiveThirtyEight put the odds of a Trump victory at about one in three. Things with a one in three chance of happening happen all the time (about 1/3 of the time in fact).

I think that this proliferation of people making predictions based on polling data was what lead to the false sense of confidence going into 2016, and why people distrust the accuracy of polls today when really the problem was the accuracy of predictions some people made using those polls.

pecunia

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Re: What comes after the ACA?
« Reply #6314 on: October 07, 2020, 04:31:41 PM »
Dewey defeats Truman!

It ain't over 'til it's over' - Yogi Berra

Psychstache

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Re: What comes after the ACA?
« Reply #6315 on: October 07, 2020, 05:14:58 PM »
Well, I sincerely *hope* that all the polls are accurate this time...

They were accurate last time. A Trump win was within the margin of error of pretty much every poll I saw handing it to Hilary.

Exactly this. My head metaphorically explodes every time I see someone say, "Yeah, right, trust the polls -- look how wrong they were in 2016!" In my brain I'm screaming THEY WERE ACCURATE FFS!!! THEY PREDICTED IT AS VERY CLOSE AND HILLARY'S EDGE WAS IN THE MARGIN OF ERROR BY ELECTION DAY!"

Thank you for this.

Shane

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Re: What comes after the ACA?
« Reply #6316 on: October 07, 2020, 07:16:44 PM »
I agree that last time (2016) the polls were just about as accurate as they usually are.

After Nate Silver got so much attention for putting out such accurate predictions of the outcome of the 2008 and 2012 elections a lot of me too websites giving percentage based forecasts popped up in 2016. Some of them painted a much rosier picture of how likely Clinton was to win with the same polling data. For example, the day before the election the New York Times published a list of the predictions from a bunch of different poll aggregators. Huffington post had their own version of 538, and put the odds of a Clinton victory at 98%. The Princeton Election Consortium was putting the odds of a Clinton victory at >99% Going into the election, FiveThirtyEight put the odds of a Trump victory at about one in three. Things with a one in three chance of happening happen all the time (about 1/3 of the time in fact).

I think that this proliferation of people making predictions based on polling data was what lead to the false sense of confidence going into 2016, and why people distrust the accuracy of polls today when really the problem was the accuracy of predictions some people made using those polls.

^^ This makes a lot of sense to me. Probably, much of what I was thinking of as "polls" in 2016 was actually somebody's interpretation of polling data. Based on things I read in the mainstream media before going to bed on election night in 2016, I felt pretty certain that I would wake up to the news the HRC had handily beaten Trump. Unfortunately, that's not what's happened. I guess I've been unfairly blaming "polls" for my over confidence, when, in fact, it was actually various pundits' interpretation of said polls that was overly optimistic. Sorry for causing your head to explode, Kris. :)

wenchsenior

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Re: What comes after the ACA?
« Reply #6317 on: October 07, 2020, 07:48:23 PM »
I agree that last time (2016) the polls were just about as accurate as they usually are.

After Nate Silver got so much attention for putting out such accurate predictions of the outcome of the 2008 and 2012 elections a lot of me too websites giving percentage based forecasts popped up in 2016. Some of them painted a much rosier picture of how likely Clinton was to win with the same polling data. For example, the day before the election the New York Times published a list of the predictions from a bunch of different poll aggregators. Huffington post had their own version of 538, and put the odds of a Clinton victory at 98%. The Princeton Election Consortium was putting the odds of a Clinton victory at >99% Going into the election, FiveThirtyEight put the odds of a Trump victory at about one in three. Things with a one in three chance of happening happen all the time (about 1/3 of the time in fact).

I think that this proliferation of people making predictions based on polling data was what lead to the false sense of confidence going into 2016, and why people distrust the accuracy of polls today when really the problem was the accuracy of predictions some people made using those polls.

^^ This makes a lot of sense to me. Probably, much of what I was thinking of as "polls" in 2016 was actually somebody's interpretation of polling data. Based on things I read in the mainstream media before going to bed on election night in 2016, I felt pretty certain that I would wake up to the news the HRC had handily beaten Trump. Unfortunately, that's not what's happened. I guess I've been unfairly blaming "polls" for my over confidence, when, in fact, it was actually various pundits' interpretation of said polls that was overly optimistic. Sorry for causing your head to explode, Kris. :)

For a financial-oriented forum, there appears to be a real lack of understanding [by the mainstream media] of either how election votes are assigned, or else a serious lack of understanding of very basic statistical concepts that I find very surprising predictable but sad.

seattlecyclone

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Re: What comes after the ACA?
« Reply #6318 on: October 07, 2020, 08:39:31 PM »
I agree that last time (2016) the polls were just about as accurate as they usually are.

After Nate Silver got so much attention for putting out such accurate predictions of the outcome of the 2008 and 2012 elections a lot of me too websites giving percentage based forecasts popped up in 2016. Some of them painted a much rosier picture of how likely Clinton was to win with the same polling data. For example, the day before the election the New York Times published a list of the predictions from a bunch of different poll aggregators. Huffington post had their own version of 538, and put the odds of a Clinton victory at 98%. The Princeton Election Consortium was putting the odds of a Clinton victory at >99% Going into the election, FiveThirtyEight put the odds of a Trump victory at about one in three. Things with a one in three chance of happening happen all the time (about 1/3 of the time in fact).

I think that this proliferation of people making predictions based on polling data was what lead to the false sense of confidence going into 2016, and why people distrust the accuracy of polls today when really the problem was the accuracy of predictions some people made using those polls.

^^ This makes a lot of sense to me. Probably, much of what I was thinking of as "polls" in 2016 was actually somebody's interpretation of polling data. Based on things I read in the mainstream media before going to bed on election night in 2016, I felt pretty certain that I would wake up to the news the HRC had handily beaten Trump. Unfortunately, that's not what's happened. I guess I've been unfairly blaming "polls" for my over confidence, when, in fact, it was actually various pundits' interpretation of said polls that was overly optimistic. Sorry for causing your head to explode, Kris. :)

For a financial-oriented forum, there appears to be a real lack of understanding [by the mainstream media] of either how election votes are assigned, or else a serious lack of understanding of very basic statistical concepts that I find very surprising predictable but sad.

I did notice after the 2016 election that Nate Silver's FiveThirtyEight website made a point about stating probabilities as, for example, "1 in 5" rather than "20%." The thinking is that people will see a low probability number like 20% and think "that won't happen," but if it's expressed as "1 in 5" they might realize that the event in question is actually reasonably likely to occur even if we might bet against it happening.

AdrianC

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Re: What comes after the ACA?
« Reply #6319 on: October 08, 2020, 07:32:34 AM »
Last night's VP debate:

“President Trump and I have a plan to improve health care and protect preexisting conditions for every American.” - Pence.

So that's alright, then. They have a plan.

The plan is to lie about it constantly and hope enough voters buy it.

Vote! Vote in person if possible. We already did.

https://www.vox.com/2020/10/8/21507188/trump-pence-obamacare-affordable-care-act-aca-biden-harris-debate

American GenX

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Re: What comes after the ACA?
« Reply #6320 on: October 08, 2020, 07:51:18 PM »
Last night's VP debate:

“President Trump and I have a plan to improve health care and protect preexisting conditions for every American.” - Pence.

They are always talking about pre-existing conditions, but that's still not enough without the other protections and the subsidies and the Medicaid expansion, all parts of the ACA.   Many millions will not be able to afford whatever crappy insurance is available if the ACA goes away, even if they have to cover pre-existing conditions.

Monkey Uncle

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Re: What comes after the ACA?
« Reply #6321 on: October 09, 2020, 05:13:47 AM »
Last night's VP debate:

“President Trump and I have a plan to improve health care and protect preexisting conditions for every American.” - Pence.

They are always talking about pre-existing conditions, but that's still not enough without the other protections and the subsidies and the Medicaid expansion, all parts of the ACA.   Many millions will not be able to afford whatever crappy insurance is available if the ACA goes away, even if they have to cover pre-existing conditions.

Yeah, the point that always seems to get lost amid the sound bites is that a mandate to cover pre-existing conditions is worthless without a community rating requirement.  Our tea party AG has been pushing a bill at the state level to do just that: require coverage of pre-existing conditions without any regulation of what insurance companies can charge to cover them.

katsiki

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Re: What comes after the ACA?
« Reply #6322 on: October 09, 2020, 09:50:02 AM »
Does anyone know at what point ACA is affordable / viable for the average joe or family?  I have heard from a number of friends and family that it is not affordable OR not useful at the price paid.  I assume most of these folks make too much money for it to be useful / subsidized.

Wondering if there is a "cliff" at which points it tips one way or the other.

I have personally come around to the idea that something should be available nationally to all.  However, when I hear these types of stories, I wonder if ACA works for the average person who may actually need it.

WhiteTrashCash

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Re: What comes after the ACA?
« Reply #6323 on: October 09, 2020, 10:00:01 AM »
Does anyone know at what point ACA is affordable / viable for the average joe or family?  I have heard from a number of friends and family that it is not affordable OR not useful at the price paid.  I assume most of these folks make too much money for it to be useful / subsidized.

Wondering if there is a "cliff" at which points it tips one way or the other.

I have personally come around to the idea that something should be available nationally to all.  However, when I hear these types of stories, I wonder if ACA works for the average person who may actually need it.

Well, it would be expensive for me when I get a Platinum plan from work with heavy employer subsidies. If you don't get any subsidies at all, then any health insurance is expensive. If you don't have a HSA, then high deductible plans are worthless. Most people lack the education to be able to make good health insurance choices for themselves in general, but if they lose their employer-provided health insurance, they may be in for sticker shock when it comes to any plan with decent coverage.

bacchi

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Re: What comes after the ACA?
« Reply #6324 on: October 09, 2020, 10:05:23 AM »
Does anyone know at what point ACA is affordable / viable for the average joe or family?  I have heard from a number of friends and family that it is not affordable OR not useful at the price paid.  I assume most of these folks make too much money for it to be useful / subsidized.

Wondering if there is a "cliff" at which points it tips one way or the other.

I have personally come around to the idea that something should be available nationally to all.  However, when I hear these types of stories, I wonder if ACA works for the average person who may actually need it.

The median household income is $61k and the ACA subsidies stop at ~$67k for a married couple. So, for a median couple, and median families, it works fine.

Unfortunately, the subsidies are a severe cliff instead of a more gradual decline. Make $70k and you'll probably have a lower post-insurance income than a couple making $65k.

An example for Wyoming from https://www.verywellhealth.com/aca-subsidy-cliff-4770899:

Quote
25-year-old earning $48,000: Cheapest plan is $186/month (after a $231/month premium subsidy is applied)
25-year-old earning $49,000: Cheapest plan is $417/month (the person is not eligible for a subsidy)


jim555

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Re: What comes after the ACA?
« Reply #6325 on: October 09, 2020, 10:13:44 AM »
Does anyone know at what point ACA is affordable / viable for the average joe or family?  I have heard from a number of friends and family that it is not affordable OR not useful at the price paid.  I assume most of these folks make too much money for it to be useful / subsidized.

Wondering if there is a "cliff" at which points it tips one way or the other.

I have personally come around to the idea that something should be available nationally to all.  However, when I hear these types of stories, I wonder if ACA works for the average person who may actually need it.
You can check the subsidy calculator to get an idea of costs:
https://www.kff.org/interactive/subsidy-calculator/

katsiki

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Re: What comes after the ACA?
« Reply #6326 on: October 09, 2020, 11:54:02 AM »
Thanks everyone!  Good info as always from the mmm forum.

Calculator is interesting.  Playing around with some hypothetical numbers, it does not seem unreasonable. 

Paul der Krake

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Re: What comes after the ACA?
« Reply #6327 on: October 09, 2020, 12:07:37 PM »
You will always find people who find costs to be unreasonable, for literally any price point. I worked with some bottom of the barrel employees a few years back who were uninsured. The company that employed them hired a professional to come explain using real numbers how they could get coverage for as low as $20/month uunder the ACA. Someone literally stood up in front of everyone and declared they didn't have $20 to spare for some insurance. Many nodded their heads.

Exflyboy

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Re: What comes after the ACA?
« Reply #6328 on: October 09, 2020, 12:34:16 PM »
You will always find people who find costs to be unreasonable, for literally any price point. I worked with some bottom of the barrel employees a few years back who were uninsured. The company that employed them hired a professional to come explain using real numbers how they could get coverage for as low as $20/month uunder the ACA. Someone literally stood up in front of everyone and declared they didn't have $20 to spare for some insurance. Many nodded their heads.

Lets hope the $20/m option is still available after SCOTUS gets done with it..

katsiki

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Re: What comes after the ACA?
« Reply #6329 on: October 09, 2020, 12:50:51 PM »
You will always find people who find costs to be unreasonable, for literally any price point. I worked with some bottom of the barrel employees a few years back who were uninsured. The company that employed them hired a professional to come explain using real numbers how they could get coverage for as low as $20/month uunder the ACA. Someone literally stood up in front of everyone and declared they didn't have $20 to spare for some insurance. Many nodded their heads.

Very true and sad..

Coming from my perspective of employer provided insurance, the quote I just ran seems reasonable.  However, I could see someone balking at it.

Glad to know this does in fact work :)

pmac

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Re: What comes after the ACA?
« Reply #6330 on: October 09, 2020, 05:40:24 PM »
How is this even insurance when it covers pre-existing conditions? My ACA premium is $1,500/month, with a $7k individual and $13K family deductible. Highway robbery.

It seems like so many healthy people are opting out of health insurance because of the costs, and only those truly sick are staying in.

Monkey Uncle

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Re: What comes after the ACA?
« Reply #6331 on: October 09, 2020, 06:06:12 PM »
How is this even insurance when it covers pre-existing conditions? My ACA premium is $1,500/month, with a $7k individual and $13K family deductible. Highway robbery.

It seems like so many healthy people are opting out of health insurance because of the costs, and only those truly sick are staying in.

Unsubsidized or lightly subsidized insurance is horrendously expensive because health care is horrendously expensive.  Many people don't realize just how expensive their employer-provided insurance is because their employer is paying the bulk of the cost before paying the employees.  What they also don't realize is that their salary could be higher if their employer wasn't paying so much for their insurance.  ACA insurance isn't really any worse; it just seems that way because more of the cost is coming out of your take-home pay instead of your employer's revenue.

Exflyboy

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Re: What comes after the ACA?
« Reply #6332 on: October 09, 2020, 07:17:39 PM »
How is this even insurance when it covers pre-existing conditions? My ACA premium is $1,500/month, with a $7k individual and $13K family deductible. Highway robbery.

It seems like so many healthy people are opting out of health insurance because of the costs, and only those truly sick are staying in.

Unsubsidized or lightly subsidized insurance is horrendously expensive because health care is horrendously expensive.  Many people don't realize just how expensive their employer-provided insurance is because their employer is paying the bulk of the cost before paying the employees.  What they also don't realize is that their salary could be higher if their employer wasn't paying so much for their insurance.  ACA insurance isn't really any worse; it just seems that way because more of the cost is coming out of your take-home pay instead of your employer's revenue.

We really should be taxing the dollar value of employer provided HC direct to the employee. That way the pain gets shared and people would start to wake up to what it really costs.

geekette

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Re: What comes after the ACA?
« Reply #6333 on: October 09, 2020, 07:26:34 PM »
It’s been on pay stubs for years. People just don’t look.

pecunia

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Re: What comes after the ACA?
« Reply #6334 on: October 09, 2020, 07:27:51 PM »
How is this even insurance when it covers pre-existing conditions? My ACA premium is $1,500/month, with a $7k individual and $13K family deductible. Highway robbery.

It seems like so many healthy people are opting out of health insurance because of the costs, and only those truly sick are staying in.

Unsubsidized or lightly subsidized insurance is horrendously expensive because health care is horrendously expensive.  Many people don't realize just how expensive their employer-provided insurance is because their employer is paying the bulk of the cost before paying the employees.  What they also don't realize is that their salary could be higher if their employer wasn't paying so much for their insurance.  ACA insurance isn't really any worse; it just seems that way because more of the cost is coming out of your take-home pay instead of your employer's revenue.

Several years ago, my former employer did not give insurance.  I obtained it from the ACA marketplace.  There was no subsidy.  I had a bronze plan with a high deductible.  In early 2019, my employer obtained insurance for us.  He paid 100 percent.  He obtained gold coverage.  I quit last Spring and obtained COBRA.  My payments under COBRA are about 2/3 of what I was paying for the bronze plan.  It's the same insurance company but he insured us through a different state.

Medical stuff never seems priced the same as anything else you buy.  I notice that different prices are given whether you have insurance or not.  I was told that this is because the insurer's negotiate a better price.

The entire system seems to be BS.  Wipe it out and just have the government take it over.  Despite what Ronald Reagan said many years ago, my experience has been that people who work for the government really are trying to help you and often do it in a more cost effective manner than private enterprise.  It's a matter of life and death not fiscal games.

the_fixer

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Re: What comes after the ACA?
« Reply #6335 on: October 09, 2020, 11:10:47 PM »
It’s been on pay stubs for years. People just don’t look.
I see the portion I pay but the part that the employer pays is not shown on the paystub at this job or my prior employer.


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rantk81

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Re: What comes after the ACA?
« Reply #6336 on: October 09, 2020, 11:22:06 PM »
It’s been on pay stubs for years. People just don’t look.
I see the portion I pay but the part that the employer pays is not shown on the paystub at this job or my prior employer.


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It’s on the W-2 box 12DD

maizefolk

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Re: What comes after the ACA?
« Reply #6337 on: October 10, 2020, 09:17:34 AM »
The W-2 and pay stubs are different. FWIW, I checked my pay stubs and at least my employer is also listing it there when I get paid each month in a set of four values listing the employer contributions for "Social Security and Medicare" "Retirement" "Health Insurance" "Life Insurance"

Between my employer and myself my insurance costs about $480/month. But I'm not sure if their contribution is lower because I'm younger or if they pay the same for every employee. I know we as employees pay the same amount regardless of age.

This means for people who are older they will compare what an ACA plan would cost them (increases for older people who will tend to need more healthcare) to what their employers pay and conclude Obamacare is a horrible expensive mess, and for people who are younger they will compare what an ACA plan would cost them (lower for younger people who might only see a doctor for a checkup every 2-3 years) to what their employers pay and conclude Obamacare is much more efficient and cost effective than having their employers pay them less but including the cost of healthcare in their benefits.

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Re: What comes after the ACA?
« Reply #6338 on: October 11, 2020, 04:55:51 PM »
How is this even insurance when it covers pre-existing conditions? My ACA premium is $1,500/month, with a $7k individual and $13K family deductible. Highway robbery.

It seems like so many healthy people are opting out of health insurance because of the costs, and only those truly sick are staying in.

Unsubsidized or lightly subsidized insurance is horrendously expensive because health care is horrendously expensive.  Many people don't realize just how expensive their employer-provided insurance is because their employer is paying the bulk of the cost before paying the employees.  What they also don't realize is that their salary could be higher if their employer wasn't paying so much for their insurance.  ACA insurance isn't really any worse; it just seems that way because more of the cost is coming out of your take-home pay instead of your employer's revenue.

Not to mention, many pre-ACA plans were cheap because they were fake insurance. They would take your money and then, the first time you needed medical care, find an excuse to label it a preexisting condition, deny the claim and cancel the plan.

The ACA put an end to this, which means that many people are paying the true cost of health care in the U.S. when they weren't before. They're also truly covered when they weren't before, but that's less obvious if you had one of the fake plans but never had to make a claim.

American GenX

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Re: What comes after the ACA?
« Reply #6339 on: October 11, 2020, 07:17:28 PM »
How is this even insurance when it covers pre-existing conditions? My ACA premium is $1,500/month, with a $7k individual and $13K family deductible. Highway robbery.

It seems like so many healthy people are opting out of health insurance because of the costs, and only those truly sick are staying in.

Unsubsidized or lightly subsidized insurance is horrendously expensive because health care is horrendously expensive.  Many people don't realize just how expensive their employer-provided insurance is because their employer is paying the bulk of the cost before paying the employees.  What they also don't realize is that their salary could be higher if their employer wasn't paying so much for their insurance.  ACA insurance isn't really any worse; it just seems that way because more of the cost is coming out of your take-home pay instead of your employer's revenue.

Not to mention, many pre-ACA plans were cheap because they were fake insurance. They would take your money and then, the first time you needed medical care, find an excuse to label it a preexisting condition, deny the claim and cancel the plan.

The ACA put an end to this, which means that many people are paying the true cost of health care in the U.S. when they weren't before. They're also truly covered when they weren't before, but that's less obvious if you had one of the fake plans but never had to make a claim.

Unfortunately, it didn't.

https://www.healthcaredive.com/news/aca-plans-denied-nearly-1-in-5-in-network-claims-in-2017/549312/

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Re: What comes after the ACA?
« Reply #6340 on: October 11, 2020, 07:55:09 PM »
My impression is that at least one of the reasons the employer-sponsored health insurance, at least for large employers, was a better deal is that a large employer has a substantial negotiation advantage because they're negotiating for thousands or tens of thousands of people. That's always been one of the major reasons buying insurance as an individual was much more expensive. That's still the case with the ACA, right? It's a marketplace for individual insurance, not group insurance. It seems it might be different if the ACA plans were negotiated by the government, so that would be an all or nothing "if your bid succeeds you get all these customers otherwise you get none" kind of thing.

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Re: What comes after the ACA?
« Reply #6341 on: October 11, 2020, 08:02:00 PM »
My impression is that at least one of the reasons the employer-sponsored health insurance, at least for large employers, was a better deal is that a large employer has a substantial negotiation advantage because they're negotiating for thousands or tens of thousands of people. That's always been one of the major reasons buying insurance as an individual was much more expensive. That's still the case with the ACA, right? It's a marketplace for individual insurance, not group insurance. It seems it might be different if the ACA plans were negotiated by the government, so that would be an all or nothing "if your bid succeeds you get all these customers otherwise you get none" kind of thing.

The real "advantage" is that there is little to no selection bias for large groups. People are on $employer_plan because they work at employer. Maybe they had a choice between a couple options, but by and large they just kinda sorta have to enroll. That was never the case with the individual market. Individual consumers pore over coverage details like hawks and are much more likely to only enroll "if it makes sense for them". That is less true when the government is paying a good chunk of the premiums, but it's still a major driver.

former player

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Re: What comes after the ACA?
« Reply #6342 on: October 12, 2020, 02:52:57 AM »
My impression is that at least one of the reasons the employer-sponsored health insurance, at least for large employers, was a better deal is that a large employer has a substantial negotiation advantage because they're negotiating for thousands or tens of thousands of people. That's always been one of the major reasons buying insurance as an individual was much more expensive. That's still the case with the ACA, right? It's a marketplace for individual insurance, not group insurance. It seems it might be different if the ACA plans were negotiated by the government, so that would be an all or nothing "if your bid succeeds you get all these customers otherwise you get none" kind of thing.

The real "advantage" is that there is little to no selection bias for large groups. People are on $employer_plan because they work at employer. Maybe they had a choice between a couple options, but by and large they just kinda sorta have to enroll. That was never the case with the individual market. Individual consumers pore over coverage details like hawks and are much more likely to only enroll "if it makes sense for them". That is less true when the government is paying a good chunk of the premiums, but it's still a major driver.
There's a big advantage to insurers in only covering an employed, working-age population.  The people insured are all physically and mentally healthy enough to hold down what is probably a full-time job, the physically and mentally disabled are mostly excluded, and those rare(ish) examples of working age people who start to need serious medical care often fall out of employment as a result and so out of the insurer's liability.

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Re: What comes after the ACA?
« Reply #6343 on: October 12, 2020, 04:30:49 AM »
My impression is that at least one of the reasons the employer-sponsored health insurance, at least for large employers, was a better deal is that a large employer has a substantial negotiation advantage because they're negotiating for thousands or tens of thousands of people. That's always been one of the major reasons buying insurance as an individual was much more expensive. That's still the case with the ACA, right? It's a marketplace for individual insurance, not group insurance. It seems it might be different if the ACA plans were negotiated by the government, so that would be an all or nothing "if your bid succeeds you get all these customers otherwise you get none" kind of thing.

ACA exchange plans are required to be community rated, so no, it's not a marketplace for individual insurance.  The insurance company has to treat everyone within the plan's area of service as a group.  However, they are allowed to charge older people more, which is generally not the case for employer-provided group insurance.  So people over a certain age should expect to pay more for ACA insurance than the total cost of their employer-provided insurance.

AdrianC

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Re: What comes after the ACA?
« Reply #6344 on: October 12, 2020, 07:26:53 AM »
Not to mention, many pre-ACA plans were cheap because they were fake insurance. They would take your money and then, the first time you needed medical care, find an excuse to label it a preexisting condition, deny the claim and cancel the plan.

The ACA put an end to this, which means that many people are paying the true cost of health care in the U.S. when they weren't before. They're also truly covered when they weren't before, but that's less obvious if you had one of the fake plans but never had to make a claim.

Unfortunately, it didn't.

https://www.healthcaredive.com/news/aca-plans-denied-nearly-1-in-5-in-network-claims-in-2017/549312/

"Affordable Care Act marketplace plans denied 19% of claims submitted for in-network service in 2017. Only 0.5% of those denied claims were appealed, according to a new Kaiser Family Foundation report."

I'm guessing most of us here would appeal, and we have the spare time to do it.

We've had several claims denied, appealed, and then paid. I don't believe it's policy at our insurance company, just bureaucratic incompetence. We're appealing a $10k charge right now. I'm confident we will win, again.

rantk81

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Re: What comes after the ACA?
« Reply #6345 on: October 12, 2020, 07:43:02 AM »
I only failed to win an appeal once. Thankfully, it wasn't for a large amount of money -- but it certainly left a bad taste in my mouth.

It was a dental claim with Aetna.

There were multiple services provided on the same day.
I had to first satisfy a deductible.
After the deductible, some services had a 50% co-insurance amount, and some had an 80% co-insurance amount.

Aetna "conveniently" (for them) arranged the order-in-which services were "processed" in such a manner, that used the services to apply toward the deductible -- as the services that would have had the 80% co-insurance.

(Even though, the services for that portion of the bill were technically administered "later", chronologically.  How do I know this?  Well, anesthesia for an extraction clearly occurs before the actual extraction.)

I lost that one, and still harbor ill-will toward Aetna over it.  Even though the difference wasn't a huge dollar amount.
Slimy, nonetheless.

pecunia

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Re: What comes after the ACA?
« Reply #6346 on: October 12, 2020, 08:57:24 AM »
My impression is that at least one of the reasons the employer-sponsored health insurance, at least for large employers, was a better deal is that a large employer has a substantial negotiation advantage because they're negotiating for thousands or tens of thousands of people. That's always been one of the major reasons buying insurance as an individual was much more expensive. That's still the case with the ACA, right? It's a marketplace for individual insurance, not group insurance. It seems it might be different if the ACA plans were negotiated by the government, so that would be an all or nothing "if your bid succeeds you get all these customers otherwise you get none" kind of thing.

ACA exchange plans are required to be community rated, so no, it's not a marketplace for individual insurance.  The insurance company has to treat everyone within the plan's area of service as a group.  However, they are allowed to charge older people more, which is generally not the case for employer-provided group insurance.  So people over a certain age should expect to pay more for ACA insurance than the total cost of their employer-provided insurance.

I think you provided a valid explanation as to why I paid so much less on the COBRA.  I am not a young early retiree.  Two years ago a co-worker turned to me and said, "We aren't young men and this is a young man's game."  So the younger age of my former co-workers is keeping my payments lower.

This is a world where enterprises exist to make a profit and to provide a service is of a far secondary concern.  I don't always like reality.

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Re: What comes after the ACA?
« Reply #6347 on: October 14, 2020, 08:47:02 PM »
Question..

Making the assumption that Trump's new pet will get elected to SCOTUS and assuming the ACA gets struck down. Note I don't think the latter is a foregone conclusion but its clearly the desire of the Repubs.

Say then " Bye-Don" gets elected and the Senate majority swings blue.. once again not a foregone conclusion but that is what The Economist magazine is projecting.

Given all that, whats to stop the Dems coming up with ACA 2.0, which is exactly the same minus the individual mandate and pushing it through prior to when the ACA is no longer available?

AdrianC

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Re: What comes after the ACA?
« Reply #6348 on: October 14, 2020, 08:57:20 PM »
Nothing that I can see. Biden is planning ACA 2.0 anyway.

Problem is if we don’t get the Senate.

maizefolk

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Re: What comes after the ACA?
« Reply #6349 on: October 14, 2020, 09:23:20 PM »
Even if the dems retake the senate, passing a brand new ACA after the original has hypothetically been struck down by the supreme court will require either using reconciliation (which limits the types of things that can be included in an ACA 2.0 quite severely relative to ACA 1.0) or genuine 100% abolishment of the filibuster. <-- which could happen but so far no one has said they'd be willing to do so.

In '09 Obama came into office with a 59/41 majority and four months after that grew to a 60/40 filibuster proof supermajority when Spector switched parties. If Biden wins the election, he'll likely have a 50-51 seat majority. There are realistic scenarios that up that to 55 and super optimistic ones that get him to 58. But there's just nowhere for a 59th or 60th seat to come from this cycle.