The American Health Care Reform Act - H.R. 3121

[cpwill]

There's been no evidence of that in the states that have toyed with this approach.

That's an interesting claim - to what are you referring?

But more importantly, how can you have competition when you have different "competitors" in a single marketplace operating under different sets of rules? There's nothing level about that playing field.

Yup. Hooray for the Laboratory of Democracy.

No, not necessarily. See above in this thread.

If you have an income of zero (IE: if you lose rather than have a reduction in your income) you qualify for Medicaid. See Medicaid.

 

[Threegoofs]

:lol: as opposed to the current structure, which involves selling crappy insurance at high prices ensuring that insurance companies make lots of dough.....?
.

Yet this is precisely what the ACA DOESNT do!

The insurance it offers is not crappy at all. In fact it is designed to be quite comprehensive and offers excellent coverage for preventive services. It also is required by law to pay out 80% of premiums, thus dramatically lowering costs and raising benefits in many of the mini-med plans (you know, the ones that your side is howling about getting cancelled?).

So the concept is better insurance at lower prices, which seems to be happening over most of the nation (unless you live in Sean Hannitys universe).

 

[Greenbeard]

That's an interesting claim - to what are you referring?

To reality:

To date, only six states—Georgia, Kentucky, Maine, Rhode Island, Washington and Wyoming—have enacted laws to require, encourage or study the feasibility of allowing the sale of health insurance across state lines or the formation of interstate compacts. . .

Officials in all six states reported that no health insurers have entered the market or expressed an interest in entering the market in response to the passage of across state lines or interstate compact legislation.

That brief does a good job of walking through why these proposals tend not to work in reality but the quick answer is that they're simple-minded approaches that rely more on slogans and sloppy thinking than understanding how insurance and health care markets actually work (and thus what's wrong with them).

Our findings suggest that while proponents of across state lines proposals cite important goals--such as enhancing consumer choice, increasing compeition and making insurance more affordable—the across state lines proposals currently enacted in six states have been unsuccessful in meeting these goals. Our findings further suggest proposals do not address the true drivers of health insurance costs nor do they adequately take into account the complexity of how insurance products are sold and regulated. The proposals also underestimate the administrative hurdles necessary for full implementation. As a result, none of the across state lines laws resulted in a single insurer entering the market or the sale of a single new insurance product. Such findings suggest a cautionary tale for overestimating the ability of across state lines proposals to improve access to affordable health insurance coverage.

The biggest thud of course being heard in Georgia last year: No out-of-state insurers offer plans in Georgia

A new law that allows Georgians to buy health insurance plans approved by other states was envisioned as free-market solution that would lower prices and increase choices.

So far, the law has failed to produce results: Not a single insurer is offering a policy under the new law.

“Nobody has even asked to be approved to sell across state lines,” Georgia Insurance Commissioner Ralph Hudgens said. “We’re dumbfounded. We are absolutely dumbfounded.”

Yup. Hooray for the Laboratory of Democracy.

Speaking of slogans and sloppy thinking. The point of the federal-level across-state-lines proposals is to strip states of their ability to regulate their own marketplaces so the "laboratory of democracy" concept doesn't quite work here. That said, those proposals still manage to make an incoherent mess out of state markets.

If you have an income of zero (IE: if you lose rather than have a reduction in your income) you qualify for Medicaid.

Medicaid has always been a program based on categorical eligibility. If you don't fall into one of the eligibility categories, it's not going to matter how little income you have. That was the point of creating a new catch-all category in the ACA. It also happens to be the reason the SCOTUS struck down the Medicaid expansion. Seven of the justices felt that effectively converting the program from a program based on categorical eligibility to one that served anyone who was poor enough was too radical a transformation and effectively created a new program--participation in which could not be used a condition for getting federal funds for the traditional Medicaid program. Which is why the expansion is now optional for states.

The Court:

The Medicaid expansion, however, accomplishes a shift in kind, not merely degree. The original program was designed to cover medical services for four particular categories of the needy: the disabled, the blind, the elderly, and needy families with dependent children. See 42 U. S. C. § 1396a(a)(10). Previous amendments to Medicaid eligibility merely altered and expanded the boundaries of these categories. Under the Affordable Care Act, Medicaid is transformed into a program to meet the health care needs of the entire nonelderly population with income below 133 percent of the poverty level. It is no longer a program to care for the neediest among us, but rather an element of a comprehensive national plan to provide universal health insurance coverage.

So what you're saying is true (in the states that decided to expand Medicaid), provided the ACA remains the law instead of H.R. 3121.

 

[cpwill]

Yet this is precisely what the ACA DOESNT do!

:lol: where have you been? 60/40 insurance with an $8,000 deductible is now available to you, for the low-low price of $500 a month! Or, the plan doesn't actually include the providers near you. Or, you're getting pushed onto Medicare, whose results are indistinguishable from being uninsured.

Just because it says "obamacare" before it doesn't make it good insurance or what people want. It just means it includes a bunch of extraneous crap that was put in there to buy off key political interest groups.

So the concept is better insurance at lower prices, which seems to be happening over most of the nation (unless you live in Sean Hannitys universe)

Oh, I'm aware of the concept - I'm just also aware that the methodology is built on deeply flawed assumptions about health insurance, and so the concept isn't demonstrating itself.

 

[Threegoofs]

:lol: where have you been? 60/40 insurance with an $8,000 deductible is now available to you, for the low-low price of $500 a month! Or, the plan doesn't actually include the providers near you. Or, you're getting pushed onto Medicare, whose results are indistinguishable from being uninsured.

I guess I havent been on the right wing websites you frequent. The things I've seen is that you now have fairly reasonable plans with fairly decent copays for basic preventive services. No longer do you see plans where deductibles are paid before dollar one of insurance is paid out. And I'm pretty sure people are being 'pushed' onto Medicaid, not Medicare (unless I missed something dramatic), and I'm guessing most of those people dont consider it being 'pushed'. And the results for Medicaid are indistiguishable from being uninsured??? Thats a joke, right?

Just because it says "obamacare" before it doesn't make it good insurance or what people want. It just means it includes a bunch of extraneous crap that was put in there to buy off key political interest groups.

Really? Extraneous crap? Like contraception I assume. Because I cant see how preventive services are catering to key political interest groups, unless you count healthier people as a key political interest group. (come to think of it... you probably do. Healthier people because of the ACA will tend to vote democratic, I guess. Rather than being too sick or broke to make it to the polls).

I think very few insurers would consider contraception as a major cost center. Its covered right now on virtually every decent healthcare plan, because insurers understand how cost effective it is. IUD implantation or oral contraceptives given via insurance is much lower cost than the resultant maternity and child care that result from carving out those benefits. Therefore insurers would probably be covering contraception (and maternity services - healthy babies are cheap babies) without a mandate in the law anyway.

 

[cpwill]

I guess I havent been on the right wing websites you frequent.

:lol: dude the only right wing website I need to frequent to learn about that is this one. People are losing decent plans in return for more expensive crappy ones. You think it's all great coverage at lower prices? Go ask JumpingJack what her experience has been.

The things I've seen is that you now have fairly reasonable plans with fairly decent copays for basic preventive services.

If that's the case then it is very possible the plans you are seeing are old, as Obamacare requires no copay for quite a few preventative services, despite the fact that according to the CBO, they are not cost-efffective.

No longer do you see plans where deductibles are paid before dollar one of insurance is paid out.

Yup - that's one of the problems. Insurance policies that pay the first dollar result in greater healthcare costs, as consumers have reduced incentive to economize. That is also why such policies cost more.

And I'm pretty sure people are being 'pushed' onto Medicaid, not Medicare

You are correct - that was a typo

I'm guessing most of those people dont consider it being 'pushed'.

If your private plan is taken from you and your income puts you into Medicaid when you go to sign up, you aren't exactly being given a whole lot of choices.

And the results for Medicaid are indistiguishable from being uninsured??? Thats a joke, right?

Sadly not. "Indistinguishable", in fact, is one of the better findings.

Really? Extraneous crap? Like contraception I assume.

And prostrate exams for 60 year old post-menapausal women, sure. Also, addiction coverage for 53 year old tee-totalers, HIV screenings for nuns, and maternity coverage for 33 year old men, etc., etc., so on and so forth.

Because I cant see how preventive services are catering to key political interest groups

:shrug: Well, for a single recently-in-the-news example, take the abortifacient "morning after" pill that multiple Catholic organizations are suing over because being forced to provide it forces them to violate their religious faith. The administration put that in and is going to defend it despite it's questionable violations of the Firsts Amendment because A) it's a sop to feminists and B) William Schultz is General Counsel at HHS, and took quite a lot of money back in the day from Barr Pharmaceuticals (who makes the pill) to make sure that it does. And the other contraception providers are right in line as well, pressuring law-makers and hiring the right talent - after all, you gotta spend money to make money, right?

Any law this complex, wide-reaching, and intrusive provides huge possibilities to use the coercive power of the state to steer money your way - and the companies who can do so are more than willing to purchase the people who wrote the law in order to ensure that they do. A mandate here, a "minimum requirement" there, all this is billions in guaranteed revenue for specialized providers - do you really think they aren't willing to spend millions to get it? Surprise! - Democrats love money from corporations just as much as Republicans do, and the rest of us get stuck with the tab.

Healthier people because of the ACA will tend to vote democratic, I guess. Rather than being too sick or broke to make it to the polls).

Yeah.... I think I'll take the 4.8-ish million who have been kicked off their plans against the 100,000 or so who have successfully put plans in their "cart" (though not, apparently, actually purchased them) without too much worry. Thus far the effect of this legislation has been to rather significantly increase the rolls of the uninsured. There is a reason Democrats are running as fast as they can from this disaster, and it's not because they hate healthy people.

 

[Threegoofs]

The above post is way to riddled with misinformation for me to respond to comprehensively. No time....

I'll just call one thing out- 4.8 million people are NOT losing insurance. They are being changed over from ****ty plans to decent plans. Some may have to pay more, but most will pay less.