The "Young Invincibles" Won't Participate In ObamaCare Exchanges and Why It Matters

[wbcoleman]

Why The "Young Invincibles" Won't Participate In The ObamaCare Exchanges and Why It Matters

Why The "Young Invincibles" Won't Participate In The ObamaCare Exchanges and Why It Matters

If the ObamaCare health insurance exchanges are to function properly, it is crucial that a substantial number of people ages 18-34 join them. This age group that is young and relatively healthy must purchase health insurance on the exchanges in order to "cross-subsidize" people who are older and sicker. Without the young and healthy, the exchanges will enter a "death spiral" where only the older and sicker participate and price of insurance premiums will increase precipitously.

This study finds that in 2014 many single people aged 18-34 who do not have children will have a substantial financial incentive to forego insurance on the exchanges and instead pay the individual mandate penalty of $95 or one percent of income. About 3.7 million of those ages 18-34 will be at least $500 better off if they forgo insurance and pay the penalty. More than 3 million will be $1,000 better off if they go the same route. This raises the likelihood that an insufficient number of young and healthy people will participate in the exchanges, thereby leading to a death spiral.

 

[Greenbeard]

Re: The "Young Invincibles" Won't Participate In ObamaCare Exchanges and Why It Matte

If Haley buys health insurance through Washington D.C.'s exchange, she'll be eligible for a subsidy of about $1,329 under ObamaCare to help her pay for insurance. If she puts that toward the lowest-cost Bronze plan on the exchange, about $1,541, then she'll only have to pay about $212 out-of-pocket for health insurance.

That may not seem like much, but for Haley that $212 represents about 14 percent of one of her monthly paychecks before taxes. If she instead pays the $95 fine, then she'll save $117. "I could easily use that money for groceries or transportation," she said.

Clearly, Haley has a financial incentive to forgo insurance next year, the first year that the exchanges and the individual mandate go into effect. However, she is exactly the type of young and healthy person that the exchanges must attract.

This is an example of someone who would pay $17.67 per month on premiums. To say she "clearly" has a financial incentive to be uninsured because she'll have $9.75 more in disposable income each month if she chooses that option is to say that she values health insurance less than that amount. Perhaps that's true for her, but that puts her in the minority of young people, the large majority of whom view health insurance as important, necessary, and worth the cost (worth the cost now, when they'd be paying hundreds per month for a plan that next year will cost most of them only tens of dollars per month).

 

[Helix]

Re: The "Young Invincibles" Won't Participate In ObamaCare Exchanges and Why It Matte

just put everyone on medicare at birth. if we want to call it socialism, fine. in a couple generations, it will be the status quo like SS, and only an extremely small minority will want to go back to our current failing system.

 

[wbcoleman]

Re: The "Young Invincibles" Won't Participate In ObamaCare Exchanges and Why It Matte

This is an example of someone who would pay $17.67 per month on premiums. To say she "clearly" has a financial incentive to be uninsured because she'll have $9.75 more in disposable income each month if she chooses that option is to say that she values health insurance less than that amount. Perhaps that's true for her, but that puts her in the minority of young people, the large majority of whom view health insurance as important, necessary, and worth the cost (worth the cost now, when they'd be paying hundreds per month for a plan that next year will cost most of them only tens of dollars per month).

You are overlooking the provision of O-care which allows this person to sign up for medical insurance any time she actually has medical expenses to pay. Given this, why should she overpay for insurance, even by a small amount?

just put everyone on medicare at birth. if we want to call it socialism, fine. in a couple generations, it will be the status quo like SS, and only an extremely small minority will want to go back to our current failing system.

The votes for this didn't exist in 2009-2010. Do you think the votes are there now?

 

[Greenbeard]

Re: The "Young Invincibles" Won't Participate In ObamaCare Exchanges and Why It Matte

You are overlooking the provision of O-care which allows this person to sign up for medical insurance any time she actually has medical expenses to pay. Given this, why should she overpay for insurance, even by a small amount?

Except there isn't any such provision allowing people to sign up for insurance "any time." The new individual marketplaces will have open enrollment periods, just like employer-sponsored group plans do now. That means for a few weeks a year people can newly enroll in plans or change plans. But other than during open enrollment (barring certain special circumstances), you can't just enroll in a plan because you got sick or injured.

This year's open enrollment is going to be especially long (stretching well into next year) because it's the first one ever. But in general, the marketplaces' open enrollment periods will match Medicare's open enrollment: October 15-December 7. If you incur medical expenses outside of that window, you're on the hook for them in their entirety. And really, even if you get hit by a truck during that seven week window, you're still going to incur a lot of expenses because coverage doesn't have to begin immediately.

Even with the new guaranteed issue and community rating rules, going uninsured is not risk-less. People who choose to be irresponsible can still rack up a lot of medical bills.

 

[Helix]

Re: The "Young Invincibles" Won't Participate In ObamaCare Exchanges and Why It Matte

The votes for this didn't exist in 2009-2010. Do you think the votes are there now?

no. our current employer-specific system will have to almost bankrupt the entire nation before the votes will be there. it's unfortunate, but that's the way it is.

 

[Jack Hays]

Re: The "Young Invincibles" Won't Participate In ObamaCare Exchanges and Why It Matte

just put everyone on medicare at birth. if we want to call it socialism, fine. in a couple generations, it will be the status quo like SS, and only an extremely small minority will want to go back to our current failing system.

 

[Helix]

Re: The "Young Invincibles" Won't Participate In ObamaCare Exchanges and Why It Matte

they're already receiving free care at the emergency room, and we're paying for it with our premiums. it's the most inefficient way possible to deliver health care to the uninsured.

 

[Deuce]

Re: The "Young Invincibles" Won't Participate In ObamaCare Exchanges and Why It Matte

Oh hey it's another guy who thinks illegal immigrants somehow get free insurance under Obamacare.

 

[ttwtt78640]

Re: The "Young Invincibles" Won't Participate In ObamaCare Exchanges and Why It Matte

they're already receiving free care at the emergency room, and we're paying for it with our premiums. it's the most inefficient way possible to deliver health care to the uninsured.

That too is the direct result of a gov't mandate. Placing any entitly between the patient and doctor, in this case one that will definitely take between 15% and 20% off the top for "overhead costs", is hardly the model of efficiency. Imagine the foolishness of mandating that your auto insurance policy must now include coverage for tune-ups, worn tire replacement and oil changes.

What PPACA does is to try to reduce only "out of pocket" costs, by including more in what "must be covered" and expecting that to fool folks into thinking that medical care costs have been reduced. If your employer (or other taxpayers) are paying the bulk of these added (by gov't mandate) insurance premium costs that does not "save money" - that simply robs Peter to pay Paul.

 

[Helix]

Re: The "Young Invincibles" Won't Participate In ObamaCare Exchanges and Why It Matte

That too is the direct result of a gov't mandate. Placing any entitly between the patient and doctor, in this case one that will definitely take between 15% and 20% off the top for "overhead costs", is hardly the model of efficiency. Imagine the foolishness of mandating that your auto insurance policy must now include coverage for tune-ups, worn tire replacement and oil changes.

What PPACA does is to try to reduce only "out of pocket" costs, by including more in what "must be covered" and expecting that to fool folks into thinking that medical care costs have been reduced. If your employer (or other taxpayers) are paying the bulk of these added (by gov't mandate) insurance premium costs that does not "save money" - that simply robs Peter to pay Paul.

the difference is that if i don't get my oil changed, i don't risk death. also, there's no organization which limits the supply of mechanics.

probably the only thing we will agree on is that the PPACA is not going to work.

 

[Lord of Planar]

Re: The "Young Invincibles" Won't Participate In ObamaCare Exchanges and Why It Matte

You mean they finally did a study to tell us all, what we already knew?

What a waste of money.

 

[ttwtt78640]

Re: The "Young Invincibles" Won't Participate In ObamaCare Exchanges and Why It Matte

the difference is that if i don't get my oil changed, i don't risk death. also, there's no organization which limits the supply of mechanics.

probably the only thing we will agree on is that the PPACA is not going to work.

Nonsense. By not paying for basic car maintanence your car will surely suffer major damage later, and that damage will not be covered by your auto insurance either. What organization limits the supply of medical care providers? How does PPACA address that limitted supply of care providers (doctors) - other than to say that you may now be "treated" without ever actually encountering a doctor?

PPACA was not designed to "work", it was designed to place gov't in greater control of all medical care. PPACA is acknowedged, even by its creators, to be a "first step" and not a final solution.

Most of the discussions surrounding healthcare are led by politicians who either celebrate President Obama’s Patient Protection and Affordable Care Act (2010) as a necessary first step towards equal access or view it as a direct assault on constitutional rights.

What is Universal Healthcare? | Physicians for a National Health Program

 

[Jack Hays]

Re: The "Young Invincibles" Won't Participate In ObamaCare Exchanges and Why It Matte

they're already receiving free care at the emergency room, and we're paying for it with our premiums. it's the most inefficient way possible to deliver health care to the uninsured.

I prefer subsidizing the free care in emergency rooms.

 

[Jack Hays]

Re: The "Young Invincibles" Won't Participate In ObamaCare Exchanges and Why It Matte

Oh hey it's another guy who thinks illegal immigrants somehow get free insurance under Obamacare.

There was nothing in my post about insurance for illegal aliens.

 

[Helix]

Re: The "Young Invincibles" Won't Participate In ObamaCare Exchanges and Why It Matte

Nonsense. By not paying for basic car maintanence your car will surely suffer major damage later, and that damage will not be covered by your auto insurance either.

and then you can just buy another car and neglect it, as well. it's not analogous. our current system even with insurance encourages people to wait until it's situation critical before seeking care, which makes the whole thing even more expensive.

What organization limits the supply of medical care providers?

American Medical Association - Wikipedia, the free encyclopedia

How does PPACA address that limitted supply of care providers (doctors) - other than to say that you may now be "treated" without ever actually encountering a doctor?

it doesn't. it's nearly useless.

PPACA was not designed to "work", it was designed to place gov't in greater control of all medical care. PPACA is acknowedged, even by its creators, to be a "first step" and not a final solution.



What is Universal Healthcare? | Physicians for a National Health Program

the PPACA is a watered down compromise which does little other than to let politicians claim that they did something. the preexisting condition fix and the ability to keep your kid on your plan through college are pretty much the only good parts of it. the bill should have been scrapped as soon as the public option was off the table and these two measures should have been passed independently of it.

i'm aware of all of the libertarian arguments about health care, because i used to be a libertarian, staunchly opposed to government health care. then, in 2009, i lost my job. thanks to "socialism," i was able to afford to COBRA. the stimulus dropped my price from somewhere around a thousand a month to about two hundred and forty dollars. i opted to keep my insurance, and it's a good damned thing that i did. the stress of being unemployed made me seriously ill, and i had to have a colonoscopy. due to a glitch in COBRA, i was initially sent the full bill : a little less than five grand. once COBRA kicked in, it dropped to $800. i might have been able to pay the full price, but it would have drained a lot of my savings. most likely, i probably would have put off the colonoscopy, and had i done that, i couldn't have taken the job i got in 2010.

this woke me up to the reality that our system is ridiculous. in no other first world country can you go bankrupt from a heart attack or because of your kid's broken arm. businesses should not be health care providers for their employees; it makes them much less competitive. it shouldn't be that way here, either. this should have been solved under the Truman administration.

 

[ttwtt78640]

Re: The "Young Invincibles" Won't Participate In ObamaCare Exchanges and Why It Matte

and then you can just buy another car and neglect it, as well. it's not analogous. our current system even with insurance encourages people to wait until it's situation critical before seeking care, which makes the whole thing even more expensive.




American Medical Association - Wikipedia, the free encyclopedia


it doesn't. it's nearly useless.




the PPACA is a watered down compromise which does little other than to let politicians claim that they did something. the preexisting condition fix and the ability to keep your kid on your plan through college are pretty much the only good parts of it. the bill should have been scrapped as soon as the public option was off the table and these two measures should have been passed independently of it.

i'm aware of all of the libertarian arguments about health care, because i used to be a libertarian, staunchly opposed to government health care. then, in 2009, i lost my job. thanks to "socialism," i was able to afford to COBRA. the stimulus dropped my price from somewhere around a thousand a month to about two hundred and forty dollars. i opted to keep my insurance, and it's a good damned thing that i did. the stress of being unemployed made me seriously ill, and i had to have a colonoscopy. due to a glitch in COBRA, i was initially sent the full bill : a little less than five grand. once COBRA kicked in, it dropped to $800. i might have been able to pay the full price, but it would have drained a lot of my savings. most likely, i probably would have put off the colonoscopy, and had i done that, i couldn't have taken the job i got in 2010.

this woke me up to the reality that our system is ridiculous. in no other first world country can you go bankrupt from a heart attack or because of your kid's broken arm. businesses should not be health care providers for their employees; it makes them much less competitive. it shouldn't be that way here, either. this should have been solved under the Truman administration.

The AMA may lobby well but has no power to limit the number of medical doctors, that requires gov't power/policy.

The so called "good parts" of PPACA simply raise the medical care insurance costs for all, the rest was to try to compensate for that by forcing more (all?) folks to buy "private" medical care insurance. What PPACA did was to make all medical care policy into a federal power - that will now never go away.

Basing any insurance premium costs on political correctness, while ignoring most actuarial risk factors, is an insane policy.

 

[Helix]

Re: The "Young Invincibles" Won't Participate In ObamaCare Exchanges and Why It Matte

The AMA may lobby well but has no power to limit the number of medical doctors, that requires gov't power/policy.

The so called "good parts" of PPACA simply raise the medical care insurance costs for all, the rest was to try to compensate for that by forcing more (all?) folks to buy "private" medical care insurance. What PPACA did was to make all medical care policy into a federal power - that will now never go away.

Basing any insurance premium costs on political correctness, while ignoring most actuarial risk factors, is an insane policy.

pretty much the only good that will come of the PPACA is if it messes things up enough that we end up enacting the first world system we should have passed in 2010.

my guess is that medicare for all will happen eventually. a generation of people will rage against it like SS and medicare. then eventually, it will become the status quo, and it will just seem normal.

 

[Neomalthusian]

Re: The "Young Invincibles" Won't Participate In ObamaCare Exchanges and Why It Matte

just put everyone on medicare at birth. if we want to call it socialism, fine. in a couple generations, it will be the status quo like SS, and only an extremely small minority will want to go back to our current failing system.

Even as a libertarian, the pragmatic side of my brain tells me this type of scheme may be our only real option left. But here's what else would be needed along with it:

1) Austere price controls on services
2) Some services not covered at all, left to cash-only private practices to provide competitively
3) Doctors would need to be free to easily start up on their own practices for cash-only patients.
4) Medicare Part D needs to be abolished no matter what else we do.
5) Health insurance as we currently know it would need to cease to exist. Maybe it would be extra, like to cover living expenses during time off work or something like that.

 

[Neomalthusian]

Re: The "Young Invincibles" Won't Participate In ObamaCare Exchanges and Why It Matte

and then you can just buy another car and neglect it, as well. it's not analogous. our current system even with insurance encourages people to wait until it's situation critical before seeking care, which makes the whole thing even more expensive.

The situation doesn't always become critical though. It really depends. There are some conditions which, if caught early, can be treated optimally and minimize cost. There are other conditions where people chase a diagnosis with countless visits and tests for a long, long time, spending insane amounts of money, and end up with few medical treatment options in any event.

Certain cases make for a glowing example of why preventive care is just awesome, and other cases show that preventive care has the potential to be significantly MORE expensive and wasteful. It's not an easy question to answer (whether covered preventive care is a prudent thing or not). Each case requires its own cost-benefit analysis.

 

[Helix]

Re: The "Young Invincibles" Won't Participate In ObamaCare Exchanges and Why It Matte

The situation doesn't always become critical though. It really depends. There are some conditions which, if caught early, can be treated optimally and minimize cost. There are other conditions where people chase a diagnosis with countless visits and tests for a long, long time, spending insane amounts of money, and end up with few medical treatment options in any event.

Certain cases make for a glowing example of why preventive care is just awesome, and other cases show that preventive care has the potential to be significantly MORE expensive and wasteful. It's not an easy question to answer (whether covered preventive care is a prudent thing or not). Each case requires its own cost-benefit analysis.

i don't disagree. however, cost should not be the deciding factor when it comes to getting treated. i also don't see how we could go wrong with everyone getting a physical / blood work done once a year just to know where they stand. at the very least, it would keep overall health in the front of the mind when we know that the physical is coming up.

 

[Jack Hays]

Re: The "Young Invincibles" Won't Participate In ObamaCare Exchanges and Why It Matte

i don't disagree. however, cost should not be the deciding factor when it comes to getting treated. i also don't see how we could go wrong with everyone getting a physical / blood work done once a year just to know where they stand. at the very least, it would keep overall health in the front of the mind when we know that the physical is coming up.

Of course cost should matter. Health care is a commodity, like food, clothing and shelter. Buy it or receive it as charity.eace

 

[Neomalthusian]

Re: The "Young Invincibles" Won't Participate In ObamaCare Exchanges and Why It Matte

i don't disagree. however, cost should not be the deciding factor when it comes to getting treated.

Of course it should, in any cases where the cost of treatment significantly outweighs any therapeutic benefit potential. Even a Medicare For All system would be a failure if it was providing million dollar treatments to people with a tiny percentage chance of survival, because it would turn our insurance failure into a governmental fiscal failure. Costs would simply explode.

i also don't see how we could go wrong with everyone getting a physical / blood work done once a year just to know where they stand. at the very least, it would keep overall health in the front of the mind when we know that the physical is coming up.

This costs about a thousand dollars where I live. If the likelihood of finding anything in my blood work given my age and other health factors is, say, 0.1%, then you should definitely see how we could go wrong with that sort of policy. The benefit potential of annual blood work does not outweigh its cost, at least not where I live.

 

[Helix]

Re: The "Young Invincibles" Won't Participate In ObamaCare Exchanges and Why It Matte

Of course cost should matter. Health care is a commodity, like food, clothing and shelter. Buy it or receive it as charity.eace

we're much better off individually and as a society if people don't put off important health decisions due to cost.

however, i doubt that you and i are ever going to agree on that.

 

[Jack Hays]

Re: The "Young Invincibles" Won't Participate In ObamaCare Exchanges and Why It Matte

we're much better off individually and as a society if people don't put off important health decisions due to cost.

however, i doubt that you and i are ever going to agree on that.

Au contraire. I absolutely agree that we're much better off individually and as a society if people don't put off important health decisions due to cost. I also believe that acquiring the capability to meet that individual and societal duty is an individual obligation.eace