If you like your employer sponsored health plan.....

[FaninAma]

You probably won't be able to keep it.
http://www.breitbart.com/Big-Government/2013/11/14/insurance-cancellations-just-beginning

I hope you are loving this hope and change.

BTW, there is no way in hell the insurance companies will now allow Obama to change the mandates of Obamacare and let more people keep their old, cheaper plans. The system collapses if he does that. Welcome to the way things are done in the blue states.

[badger]

I voted for McCain and Romney. Don't blame me ;)

So did Oklahoma... all of it. Every country. Don't blame us :D

[FaninAma]

I voted for McCain and Romney. Don't blame me ;)

So did Oklahoma... all of it. Every country. Don't blame us :D
Badg, I don't. Oklahomans are good people who, by and large, use their common sense.

[yermom]

is there a condensed version that shows that Obama causes this, and not employers trying to save money and insurance companies deciding they want your business anymore?

mostly i just see a lot on inflammatory statements, not long on real facts

[Soonerjeepman]

all I know is I tried looking at insurance for my son.

He is 18 in HS
My school plan is OUT OF POCKET $800 a month if I include him.
He has had his own (both kids do, daughter is now 21) since 14/15.
I pay $165 a month. I looked a other plans now that he is 18, before that Ks said ONLY BcBS.
SOME are a little cheaper but HUGE deductibles, 5K to 10K and only 50% co-insurance.

So, if poor folks can afford the older CHEAPER insurance how in the hell will they do this?

[badger]

Badg, I don't. Oklahomans are good people who, by and large, use their common sense.

I wonder if this will result in 100.1-200 percent poverty line households getting to keep Insure Oklahoma. my understanding was that the reason the level got dropped to 100 percent to be eligible was because those above it would be eligible for Obamacare subsidies... but if the system is glitched all to hell resulting in only about 300 completing enrollment (about 17K applied I think)...

or is this just a private insurance thing.

I wouldn't expect any accommodation for our state from this administration, as Oklahoma and its elected officials have made it clear what they think of the president and his political party... but I would think higher of them if they did

[badger]

all I know is I tried looking at insurance for my son.

He is 18 in HS
My school plan is OUT OF POCKET $800 a month if I include him.
He has had his own (both kids do, daughter is now 21) since 14/15.
I pay $165 a month. I looked a other plans now that he is 18, before that Ks said ONLY BcBS.
SOME are a little cheaper but HUGE deductibles, 5K to 10K and only 50% co-insurance.

So, if poor folks can afford the older CHEAPER insurance how in the hell will they do this?

This reminds me of one of the parents on here saying that FAFSA's plan for their daughter's higher education financing was little loans for the student and big loans for her daddy.

If your son was totally independent (I think you have to be married, be in the armed services, or otherwise declared legally exempt), perhaps the monthly payment would be lower?

[FaninAma]

is there a condensed version that shows that Obama causes this, and not employers trying to save money and insurance companies deciding they want your business anymore?

mostly i just see a lot on inflammatory statements, not long on real facts

The mandates for covered services will raise prices just as they are doing in the private insurance market. There will not be any options. One size fits all. A lot of companies will still offer insurance plans but it will cost more. Some companies will drop the option to cover spouse and children. Some companies will cut hours of some employees so they fall below the hours mandated for coverage. Some companies will cut the number of employees to get undert the magic 50 number and some companies will simply pay the penalty.

The CBO is the source of the article. Denying that there will not be a similiar effect on the employer sponsored market as what we are seeing with the private market is silly.

[Bourbon St Sooner]

is there a condensed version that shows that Obama causes this, and not employers trying to save money and insurance companies deciding they want your business anymore?

mostly i just see a lot on inflammatory statements, not long on real facts

It's called incentives bro. Basic human nature. If you wanted people to do A, why did you incentivize them to do B. Adam Smith wrote a book about it about 150 years ago. Perhaps you can read it in between Krugman articles.

I had no doubt from day 1 that the insurance companies wrote this POS, but it was the dumbass President and his half-wit minions Pelosi and Reid that shoved the thing through Congress and staked his entire Presidency on it.

[badger]

staked his entire Presidency on it.

If Obamacare is not his legacy, it would either be bin Laden hunting/killing or being the first black president*. I'm guessing the latter









*don't even remind me what his mom looked like, we all already know thx

[yermom]

The mandates for covered services will raise prices just as they are doing in the private insurance market. There will not be any options. One size fits all. A lot of companies will still offer insurance plans but it will cost more. Some companies will drop the option to cover spouse and children. Some companies will cut hours of some employees so they fall below the hours mandated for coverage. Some companies will cut the number of employees to get undert the magic 50 number and some companies will simply pay the penalty.

The CBO is the source of the article. Denying that there will not be a similiar effect on the employer sponsored market as what we are seeing with the private market is silly.



again, the law might impact the insurance companies, but it's not removing your plan, the company is

premiums have been going up every year i've had insurance

i started out with $0 out of pocket in 2001, now i'm paying about $140 a pay period now for two people and next year i think it will be ~$180, and if i had kids it might be another $50 or so.

what kind of bogus plans do you people have?

[jkm, the stolen pifwafwi]

again, the law might impact the insurance companies, but it's not removing your plan, the company is

premiums have been going up every year i've had insurance

i started out with $0 out of pocket in 2001, now i'm paying about $140 a pay period now for two people and next year i think it will be ~$180, and if i had kids it might be another $50 or so.

what kind of bogus plans do you people have?

heh, my $400/month catastrophic plan was cancelled and the cheapest thing I can get in Washington now is $960/month. Since we've tracked the eobs for 3 years, our insurance company is going to go from making $4200/year off of us to $8500. This is just a giant cash grab by these guys.

[Mjcpr]

heh, my $400/month catastrophic plan was cancelled and the cheapest thing I can get in Washington now is $960/month. Since we've tracked the eobs for 3 years, our insurance company is going to go from making $4200/year off of us to $8500. This is just a giant cash grab by these guys.

It's capitalism so it should trickle down and you'll be fine.

[achiro]

heh, my $400/month catastrophic plan was cancelled and the cheapest thing I can get in Washington now is $960/month. Since we've tracked the eobs for 3 years, our insurance company is going to go from making $4200/year off of us to $8500. This is just a giant cash grab by these guys.

You are paying more so that others will get subsidies to cover theirs. "It's not a tax" or "it's a tax". Call it whatever you want but it boils down to you pay more so others can pay less. This is not about increased profit margins for the insurance companies. In fact, obamacare has set limits on profits of insurance companies.

[badger]

Is anyone paying less at this point? Are the few that actually got to enroll paying less?

Or, are there just even more freeloaders in the system than ever before since they either want insurance but cannot afford it, or continue to not have insurance like always?

:(

It seems like this plan was billed as --- let's say hypothetically --- a situation where average joe 18-somethings could give up some of their beer (or non-alcoholic legal alternative) money each month and have health insurance instead. Maybe $10 a month. Sounds reasonable. Everyone uninsured pays $10 a month, the healthcare system gets a lot of money to pay costs that they usually have to eat, everyone's rates go down as a result, everyone wins, everyone contributes, etc.

Now that people clearly are not getting this, will voters hold those responsible accountable? November 2014 looms...

[FaninAma]

Yermom, it's called supply and demand. You and I have always paid to subsidize the low paying insurance plans especially Medicaid. Medicaid has expanded tremendously in the last decade, hence hospitals and providers charge you more to make up for the low reimbursement rates of Medicaid.

Self-Pay patients contribute a very small part to this formula.

Now,Medicaid rolls will increase by many millions. Guess what is going to happen to your premiums going forward.

[diverdog]

Badg, I don't. Oklahomans are good people who, by and large, use their common sense.

Yeah they are smart enough to have a fifth of the population work government jobs and then bitch about the government. Makes absolute sense to me.

[FaninAma]

Yeah they are smart enough to have a fifth of the population work government jobs and then bitch about the government. Makes absolute sense to me.

So, you think Oklahomans are stupid? If you work for the govern,ent you shouldn't bitch about the government?

The 4/5 of us who don't work for the government reserve the right to bitch about the government.

BTW, the Wikipedia entry for Oklahoma states that out of a population of 3.8 million 389 thousand are in the government sector. That is 1:10. Or did you mean 1/5 of all employed individuals?

[jkm, the stolen pifwafwi]

It's capitalism so it should trickle down and you'll be fine.

Heh, Self-Employment as a consultant was marginal before this mess (having to pay both 1/2s of SS and Medicare tax). Between the H1B fellers underbidding every job and this, I'm looking for an FTE position somewhere :(.

[yermom]

heh, my $400/month catastrophic plan was cancelled and the cheapest thing I can get in Washington now is $960/month. Since we've tracked the eobs for 3 years, our insurance company is going to go from making $4200/year off of us to $8500. This is just a giant cash grab by these guys.

i guess i don't get the economics of this. why can a blanket group of employees of some company get a flat rate when someone that is self employed gets boned? this is part of the problem in all this that was broken to begin with.

[achiro]

i guess i don't get the economics of this. why can a blanket group of employees of some company get a flat rate when someone that is self employed gets boned? this is part of the problem in all this that was broken to begin with.

The talking points of the dims include the whole, " well if the pubs think it's so bad they should have come up with an alternative, but they haven't offered up a single idea". The problem is that is completely untrue. There have been several ideas bounced around by the republicans, the dims havent been willing to listen at all. One plan I read included some kind of large buying group plans made up of individuals and small businesses that would allow them some of the breaks offered to the giant corporations.

[diverdog]

So, you think Oklahomans are stupid? If you work for the govern,ent you shouldn't bitch about the government?

The 4/5 of us who don't work for the government reserve the right to bitch about the government.

BTW, the Wikipedia entry for Oklahoma states that out of a population of 3.8 million 389 thousand are in the government sector. That is 1:10. Or did you mean 1/5 of all employed individuals?

Did I say Oklahomans are stupid? No. But I think they are slightly hypocritical about their anti-government stance when a good chunk of Oklahomans rely on either government employment or tax dollars.

http://www.ocpathink.org/articles/438

http://www.bizjournals.com/bizjournals/on-numbers/scott-thomas/2012/05/governments-employ-20-percent-of.html?appSession=228127093743817&RecordID=&PageID=2&PrevPageID=&cpipage=2&CPISortType=&CPIorderBy=

[yermom]

The talking points of the dims include the whole, " well if the pubs think it's so bad they should have come up with an alternative, but they haven't offered up a single idea". The problem is that is completely untrue. There have been several ideas bounced around by the republicans, the dims havent been willing to listen at all. One plan I read included some kind of large buying group plans made up of individuals and small businesses that would allow them some of the breaks offered to the giant corporations.

well, the Pubs have terrible PR people and should stop letting the Mitt Romneys and Michele Bachmanns speak for them

[jkm, the stolen pifwafwi]

i guess i don't get the economics of this. why can a blanket group of employees of some company get a flat rate when someone that is self employed gets boned? this is part of the problem in all this that was broken to begin with.

Dude I could give you a laundry list of what is wrong with the system starting with the fact that a hospital can't even tell you how much a procedure costs. Some points:

1. Each hospital acts as a monopoly within its network. The price between networks can vary by as much as $2000, but your insurance penalizes you for out of network. Doctors have no clue how much anything they need you to do costs. Finding a doctor who understood the concept of "is this necessary or a nice to have" was impossible, we ended up with PA as our primary care physician.

2. Insurance companies feed on you from both ends. They charge you a LOT of money for the discounts they've negotiated. What I was shopping for was basically a short term disability plan (they pay extreme out of pocket costs). The problem was that the closest thing to what I was looking for didn't qualify at our hospital. So if I take plan A (the one I wanted), doctor's visits are $150. If I take plan B (way more expensive), doctor's visits are $75. So I tried to negotiate a "discount plan" with the hospital for paying cash. No dice. So I end up with plan B because the $75 extra every visit pushes past my breakeven. Think about that, the hospital is giving that $75 to the insurance company. I was just trying to get them to drop it by $40, that would have been an extra $35 every visit in their pockets instead of the insurer. Unfortunately, the math be hard.

3. The biggest problem with Obamacare is that he tried to please every entity that is trying to gouge the market -> Pharma, Insurance Cos, Uninsured. The problem is that when you try to appease everyone, you end up making too much room for people to get gouged.

4. As for the person who said the bill limited the amount of profit these guys could make - If Hollywood can make the Avengers not make any money, then that should be child's play for these guys ;-).

[ouflak]

Is there even a single person whose insurance rate is going down? Because if I understand some of the arguments posted on this thread, someone's insurance should be going down somewhere. That certainly doesn't seem to be the case yet.

[diverdog]

Dude I could give you a laundry list of what is wrong with the system starting with the fact that a hospital can't even tell you how much a procedure costs. Some points:

1. Each hospital acts as a monopoly within its network. The price between networks can vary by as much as $2000, but your insurance penalizes you for out of network. Doctors have no clue how much anything they need you to do costs. Finding a doctor who understood the concept of "is this necessary or a nice to have" was impossible, we ended up with PA as our primary care physician.

2. Insurance companies feed on you from both ends. They charge you a LOT of money for the discounts they've negotiated. What I was shopping for was basically a short term disability plan (they pay extreme out of pocket costs). The problem was that the closest thing to what I was looking for didn't qualify at our hospital. So if I take plan A (the one I wanted), doctor's visits are $150. If I take plan B (way more expensive), doctor's visits are $75. So I tried to negotiate a "discount plan" with the hospital for paying cash. No dice. So I end up with plan B because the $75 extra every visit pushes past my breakeven. Think about that, the hospital is giving that $75 to the insurance company. I was just trying to get them to drop it by $40, that would have been an extra $35 every visit in their pockets instead of the insurer. Unfortunately, the math be hard.

3. The biggest problem with Obamacare is that he tried to please every entity that is trying to gouge the market -> Pharma, Insurance Cos, Uninsured. The problem is that when you try to appease everyone, you end up making too much room for people to get gouged.

4. As for the person who said the bill limited the amount of profit these guys could make - If Hollywood can make the Avengers not make any money, then that should be child's play for these guys ;-).

Very good points.

For the life of me I do not understand why they did not tweek medicare and offer it to everyone if they could not get insurance.

[achiro]

Very good points.

For the life of me I do not understand why they did not tweek medicare and offer it to everyone if they could not get insurance.
Medicare sucks and it's going broke. Using it as a blueprint or fix for anything would be a terrible idea.

[badger]

Dare I suggest that the plan that just focused on the kids first would have been a good test rollout, rather than just doing everybody at once?

This would have probably had a lot wider support too, because it's hard to call a kid a deadbeat welfare queen lazy bum blah blah

[Turd_Ferguson]

Dare I suggest that the plan that just focused on the kids first would have been a good test rollout, rather than just doing everybody at once?

This would have probably had a lot wider support too, because it's hard to call a kid a deadbeat welfare queen lazy bum blah blah

Depends on what age group they are calling kids.

[TheHumanAlphabet]

This more than anything else will doom Obamacare, doom his administration to be known as the all time worst, doom Reid and Pelosi and the dems forever. It may even kill Liberalism/Progressiveism in this country. Plenty of voters (not low info people) in this group that if you mess with what they have and like (FU Pelosi) then they will vote in droves against this crap when they lose coverage and have to spend more...

[badger]

Depends on what age group they are calling kids.

Minors. Under 18s. Not pretend kids that want to be considered adults when it comes to beer, cigarettes and voting but minors under parents insurance and income :D

[jkm, the stolen pifwafwi]

Medicare sucks and it's going broke. Using it as a blueprint or fix for anything would be a terrible idea.

The problem with medicare is that the government sucks at figuring out who is gaming the system. What they should have done was look at the model of Waste Management and trash collection. Basically, you farm out everything to private companies for a 5 year contract with the following caveats:

1. Fraud is always approved by you before they can take action.
2. All complaints are handled by the government but paid for by the companies where the complaints originate. More complaints = More out of pocket expenses for the company. Companies are held liable for any malfeasance
3. Medicare becomes a "Per person" allotment, not a price per procedure
4. Companies can negotiate with hospitals for prices of the procedures, government mandates aren't used anymore.
5. All data for procedures/prices and quantities are made available to the government

Waste Management signed 20 year contracts but I think that is a little much. They made a killing off of the local city governments because they were so much more efficient (around a 50% margin per town). However, when the contract was up, the cities squeezed the margins and they were eventually brought down to a more normal level. That is what the government does here. Basically, the first 5 years you allow them to make a killing while they ferret out the low hanging fruit. Then you squeeze them by dropping the rate/person to reflect the fraud weeded out. At this point, the companies will try to dig deeper and squeeze the population to keep up their numbers but since they pay for the federal government's complaint staff, they end up shooting themselves in the foot. At some point, you end up with a graft number rivaling private insurance.

One of the more interesting (to me) government programs that I've watched gamed is unemployment. I have a cousin who got unemployment checks for 3 1/2 years. The guy worked for cash on the side and went fishing all the time. At no point did anyone figure out that he might be a "dolist". You compare that with workmen's comp where they have hired private investigaters that follow people around.

[badger]

You compare that with workmen's comp where they have hired private investigaters that follow people around.
Perhaps if workmans comp was a government payment instead of an insurance company payment there'd be less fraud checks... speaking of, there's some fun stories out there on what private investigators see (and what they do to catch them) with fraudsters :D

[FaninAma]

JKM, I'm not sure I understand your assertion that hospitals don't know what they charge for procedures and services they provide. They know exactly what they charge and it is adjusted constantly. They also know what their payor mix is and what the individual insurance companies pay for the procedures they provide.

They play hardball with the insurance companies and providers alike that end up on their panels. It is the private physicians, especially primary care physicians, who end up taking the crumbs if they want to be listed as an in-network physician.

As CMS cuts reimbursement rates for Medicaid and Medicare, hospitals negotiate higher fees with insurance companies to make up the difference. In turn, the insurance companies increase premiums, co-pays and deductibles of their policy holders. They will also lower payous to individual providers. The end result of this process is that eventually we will see an economically imposed sytem of rationing in health care.

Higher premiums, deductibles and copays translate into less use by the insured. This will affect Medicare. I have no clue what they will do with Medicaid which has no financial disincentives built into the system to discourage overuse. That is why the rapid and significant expansion of this program is a fatal flaw in the ACA.

[DBrown]

Remember...."We had to pass it,to see what was in it".......one of the most boneheaded,dimwitted,assinine statements ever spoken!

[Soonerjeepman]

This reminds me of one of the parents on here saying that FAFSA's plan for their daughter's higher education financing was little loans for the student and big loans for her daddy.

If your son was totally independent (I think you have to be married, be in the armed services, or otherwise declared legally exempt), perhaps the monthly payment would be lower?

not thinkin...but he's a ways from that anyway..

[FaninAma]

Is there even a single person whose insurance rate is going down? Because if I understand some of the arguments posted on this thread, someone's insurance should be going down somewhere. That certainly doesn't seem to be the case yet.
The only winners with this horror are the new Medicaid recipients. Even those with subsidize plans through the exchanges will have deductibles too high to pay for the individuals and families that get these subsidized plans.

BTW, 50 to 100 million more plans will be cancelled next year when the employer mandate kicks in.
http://www.foxnews.com/politics/2013/11/20/second-wave-health-plan-cancellations-looms/

[SCOUT]

The only winners with this horror are the new Medicaid recipients. Even those with subsidize plans through the exchanges will have deductibles too high to pay for the individuals and families that get these subsidized plans.

BTW, 50 to 100 million more plans will be cancelled next year when the employer mandate kicks in.
http://www.foxnews.com/politics/2013/11/20/second-wave-health-plan-cancellations-looms/

It is my opinion, and I work in the industry, that the number you quoted is too high. However, I believe that the number is around 30-50 million.

My rationale is that plans are being renewed right now, and renewed with the understanding of what the requirements are (as of today). Given that knowledge, many of those employers will change their plans for 2014 to be compliant. However, many can't. That is why I say 30-50 million.

[jkm, the stolen pifwafwi]

JKM, I'm not sure I understand your assertion that hospitals don't know what they charge for procedures and services they provide. They know exactly what they charge and it is adjusted constantly. They also know what their payor mix is and what the individual insurance companies pay for the procedures they provide.

Obviously you've never had to call around and find this information out. I spent 10 hours of my life checking prices on an MRI that I will never get back. Not a single one of the 15 facilities I called could give me an exact price for the procedure. Every single one of them started off with the same conversation

what is your insurance?
no insurance, paying cash
we can't do it if you don't have insurance
are you refusing care because i'm paying with cash?
Let me check, please hold
Okay we can do it if you pay up front
how much will that be?
um, I don't know. it depends on who does it
what do you mean?
well each doctor charges a different price so we can take an estimate and then it will vary
okay what is the estimate and how much will it vary
[on hold for 30 minutes] (ranged in prices from $500 to $6500) the variance was between $500 and I kid you not $5500
at this point I tried to wheel and deal for a discount. no dice. none.
this same procedure with insurance would have cost me $10

[yermom]

Right, they know. They just won't tell you. It part of the game

[FaninAma]

Obviously you've never had to call around and find this information out. I spent 10 hours of my life checking prices on an MRI that I will never get back. Not a single one of the 15 facilities I called could give me an exact price for the procedure. Every single one of them started off with the same conversation

what is your insurance?
no insurance, paying cash
we can't do it if you don't have insurance
are you refusing care because i'm paying with cash?
Let me check, please hold
Okay we can do it if you pay up front
how much will that be?
um, I don't know. it depends on who does it
what do you mean?
well each doctor charges a different price so we can take an estimate and then it will vary
okay what is the estimate and how much will it vary
[on hold for 30 minutes] (ranged in prices from $500 to $6500) the variance was between $500 and I kid you not $5500
at this point I tried to wheel and deal for a discount. no dice. none.
this same procedure with insurance would have cost me $10
No, that is exactly what I am talking about. The price is pre-nogotiated with insurance companies. It is illegal to charge one patient a different price than you charge another patient. If insurance companies, especially government sponsored insurance, finds out you are doing that they will ask for a refund of payments if a physician charged the insurance more than they charged a self-pay patient.

if you want to get an accurate price quote you need to know the specific ICD-9 code of the procedure. That is how procedures are billed out.