When you are paid by the government, what's the practical difference between what you pay from you salary (which you receive from the government) and what the government "subsidizes?" It's all just part of your salary package. That's true with other employers too, actually, regarding the employer-paid portion of premiums.
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Lawsuits could force feds to pay Obamacare insurers (Politico)
- Thread starter Piecake
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When you are paid by the government, what's the practical difference between what you pay from you salary (which you receive from the government) and what the government "subsidizes?" It's all just part of your salary package. That's true with other employers too, actually, regarding the employer-paid portion of premiums.
Trump believes health insurance is something you pay for $12 a year starting at 21. He has no fucking idea what they're trying to put in place.
It is a victory because ACA needs improved not destroyed. Forcing the Trump admin to support ACA will preserve it until we can get someone back in that understands that and can work on it.
The practical difference is that if rates go up on the marketplace, your paycheck still shrinks just like anyone else's.
Stumpokapow
listen to the mad man
I hate to be selfish, but my goal isn't better healthcare, it's my wife being a functional human being for the next 2-3 years. Can you pitch to me how your plan achieves this goal?
Ah yes, the wonderful "doing something". Clearly if the current situation is suboptimal, blowing the whole thing up in a way that throws a huge chunk of the economy into chaos will fix things!
You have no path. You have pure magical thinking.
Sirpopopop
Member
Let's be clear folks. The Greek Freak is not someone worth piling on, or even arguing with at all.
Here's his posting history of shitting on the left:
^That's him suggesting centrist Democrats were going to pin the Republican shootings on Bernie Sanders.
Advocating murder of Democratic Senators.
Ok, I've had enough. I can't dig further into this wormhole.
Other Anomalies:
Noted Assad Support:
Note: He also has a odd love affair with Reince Preibus:
Probably the worst is his shitty comments about overweight people:
^The above was taken from a thread about superheroes having more normal body types. This is his thoughts on that subject.
PrivateWHudson
Member
Hmmm, kind of hard to do without your details. I'll share mine instead. My wife had trouble breathing and we struggled to call an ambulance because we have a $3000 deductible. We finally did, and they gave her some O2 and took her to the ER. The ER kept her for 4 hours with some more oxygen and a steroid. That cost $5000 for the ER, and $1000 for the ambulance. My insurance "negotiated" the ER down to just under the deductible, and doesn't cover an ambulance. Now I'm on the hook for $4000 after paying $16000/year premiums. Fuck insurance companies and the decisions they make us struggle with to line their pockets.
Stumpokapow
listen to the mad man
Okay sounds like your plan is not good for me then, sorry.
PrivateWHudson
Member
Lol, nice snip. How much do you pay in insurance? Is it more than the care received by your wife? If so, that should be supplemented with tax dollars or the cost of care regulated to a realistic amount. Your insurance company isn't keeping your wife alive, doctors are and should be paid directly.
PrivateWHudson, you sound like a sociopath.
Precisely this. The sooner we stop giving a single shit about what "riles up conservatives" the better off we'll all be.
Do you... understand what health insurance is...?
I had not considered that eventuality......one which seems increasingly plausible.
If the Trump administration simply refuses to pay off debts that are owed under a court order, we'd begin to see a total loss of trust in the US government. That could severely wreck the USA's ability to borrow or issue bonds. I'm not sure that's a line Trump would cross.
Moreover, I doubt that Congress is going to stiff the insurance companies. Those corporations have a lot of power, money, and influence. I'd like to think they will get funding even through a 2/3rds veto override.
And if what the doctors and hospitals ask for is too much...?
Yes that happens, quite often too.
Suikoguy
I whinny my fervor lowly, for his length is not as great as those of the Hylian war stallions
Oh fuck, I really need to get around to watching that.
JoeyJungle
Banned
It's actually to stop their losses, not fuel their profits. This was a crucial piece of the original Obamacare legislation, because the actuaries at insurers basically couldn't know what to expect when shifting from pre-ACA to post-ACA market. Before, denying coverage was an important way to keep the insurance companies stable and prevent them from promising coverage to patients they would obviously need to pay out healthcare bills for. In post-ACA, they would need to accept everybody, and if the population they insured ended up costing more money than they took in from the healthy insured, they would have no way of making profit other than massive rate increases.
Even then, you can only raise rates so much before the cost of insurance is literally unaffordable, and you're stuck with a a small group paying very high premiums and bringing in a guaranteed profit that is still much lower than you previously had.
So then the question was how the Obama admin planned to solve this problem.
They told insurance companies not to worry about their plans becoming completely lopsided - medicaid expansion would function as a high risk pool, taking in the poorest and often sickest members of the population.
The second piece was that risk corridors would mean that if the markets still became lopsided, with insurers paying out more for coverage than they were bringing in, the federal government would essentially stop their losses after a certain point, and prevent the insurer from taking a cataclysmic loss. After they reached a certain amount in the red, the federal government would begin paying for coverage, and prevent the insurance companies from taking enormous losses as they adjusted their rates to better match the amount they would be paying out in each state.
The third piece was obviously the healthcare mandate, so that the markets wouldn't be clogged with only sick people that insurers weren't allowed to deny coverage to, and healthy people would choose to forego health insurance until they developed an illness.
Of course, the federal government expected every state to expand medicaid, because it was basically free cash handed over to the poorest population of every state. Instead the supreme court ruled that the federal government could not force states to expand medicaid, and many states (mainly rural red states that have the most expensive healthcare because they have the lowest concentration of hospitals and doctors) chose not to accept the medicaid expansion. So then their poor/sick population that didn't qualify for medicaid under the old rules but would have qualified under the medicaid expansion program had to join the general insurance pool
Then a bill from congress spearheaded by Rubio shrank the amount spent on the risk corridor program, iirc the federal government ended up paying around $0.17 for every $1.00 that was originally promised. And of course, that was one of the main reasons that led to rates increasing so dramatically for 2017.
So, uh, yeah I hope you understand the purpose of the risk pool and why some people might support this given the importance of its role in keeping healthcare costs down and the significance it had in the original vision of Obamacare/ACA.
Vox has phenomenal healthcare coverage, iirc this is an article that covers pretty much what Obamacare needs to function and what would cause it to explode: https://www.vox.com/policy-and-politics/2017/5/1/15373372/obamacare-tennessee-zero-insurers
skullmuffins
Banned
Why do you think a "true free market" for healthcare would work or be in any way an improvement over the current system? A pure free market approach fundamentally does not work in healthcare. People cannot shop around for the best price when they're in the middle of dying, people tend to pay whatever the asking cost is if their life is on the line, and some people are so sick that they would never be able to afford care in a pure market-based system.
mugurumakensei
Member
Free-market types tend to forget you can't negotiate while unconscious.
Stumpokapow
listen to the mad man
I cannot afford to ensure my wife is a functioning human being in the absence of the current environment (subsidies, minimum coverage requirements, no pre-existing conditions) we currently receive. She is not legally eligible for Medicaid and would not be even if we made $0 and the Medicaid expansion does not impact me. She does not and will not receive employer-provided coverage and my employer charges an impossibly high amount of money to add her to my coverage. I don't care about what happens more than 3 years down the road because I don't anticipate being in the United States. How does your system work for me?
PrivateWHudson
Member
Not sure why you would say that. Can I really be the only one that thinks our current health insurance system is the largest contributor to the ridiculous cost of health care, and we may be better of with it? The fact that Obama needed their blessing to enact the ACA speaks volumes to me, but what do I know.
Not much
Maybe he said that because of your utterly cavalier attitude towards harming other people that don't fit into your grand plan?
Of course you're not the only one who thinks that. But your "solution" to that problem is devastating to millions of people so I'll leave you to think a little more about why I would say that's sociopathic. Would you prefer misanthropic instead?
PrivateWHudson
Member
I would go with optimistic. People dropping dead in the streets is not something I'm in favor of. I have faith in humanity that if everything were to be on the surface, and not hidden away behind premiums and subsidies and deductibles and copays and bronze through platinum tiers and copays and everything else, that we would be able to get a clear vision on how to best care for our sick and injured.
Oh so your just obnoxiously naive and ignorant of how the GOP and the base both behave and think.
Cool
PrivateWHudson
Member
More curious to see how they would think and behave without insurance companies lobbying them and being part of their stock portfolios.
As noted, trump thinks insurance is $12/month.
Nice platitudes.
I'm sure cancer patients that are relying on the ACA right now will be right there with you as you cheer for the collapse of the exchanges.
PrivateWHudson
Member
Please, don't put words in my mouth. Some having everything, and others having hitting is not what I'm advocating.
Iorv3th
Member
Me too. I know it's not a popular opinion to have here.
Once the ACA was enacted millions of people did not suddenly get better health care or suddenly save millions of lives. Basically what it has done is make all insurance plans now only valuable as catastrophic plans because the price of the premiums and deductibles are so high the majority are never going to be able to use them.
People keep preaching this false narrative that millions will die if they repeal this, that people without health insurance is bad etc. The way it's currently set up is terrible and hurts more people than it helps. You understand that someone making 40,000$ a year would have to spend around 10-12,000 a year (25% or more of their income) to be able to use insurance the way it is set up right now?
Unless of course you are lucky enough to work for a big company that provides it for you. But then you are still going to have to pay the deductible (but it might not be as high as if you were to purchase it yourself through the marketplace).
You aren't wrong.
Chmpocalypse
Blizzard
Guess what? Under your incredibly stupid 'plan', she'd be dead.
GoldenEye 007
Member
No, ACA is not perfect. Nobody is saying that. Sure, some that liked their old situation may be worse off than before. But if ACA was so bad on the whole, there would not have been such a resistance to maintaining it like seen over the last few months.
What I do know, generally in GOP states, there has been a rejection of Medicaid expansion. Screwing millions of people out of an opportunity for more subsidies to get better plans. And obviously people will not literally fall in the streets if repealed. But I bet many will put off preventative screenings/checkups, let things get worse healthwise, then more frequently rely on emergency care to do an immediate intervention to save their life. Then declare bankruptcy when they get the bill. And some actually dependent on more affordable access to medicine/treatment they're getting now may very well actually drop dead if forced onto any Republican "plan."
I bet pregnancy rates go up because birth control is no longer free too.
Also, here's a link regarding finances. ACA contributed to reducing personal bankruptcies by 50%.
http://www.marketwatch.com/story/obamacare-helped-make-a-50-dent-in-personal-bankruptcies-2017-05-03
http://www.latimes.com/business/hiltzik/la-fi-hiltzik-obamacare-bankruptcy-20170509-story.html
Iorv3th
Member
No she wouldn't. The hospital isn't going to reject care for someone. If he didn't have insurance his cost may have even been lower. He at least wouldn't have had to pay the premiums.
You do realize that he paid for everything in this exchange anyways and his insurance company paid nothing? Essentially just taking money and providing no services?
You realize that the cost of preventative screenings/tests etc is much much cheaper than needing insurance? Seeing your GP is likely to cost you around 45-85$ without insurance. With insurance your still going to have to pay you co-pay which is going to be around the same price if not more. Me without insurance costs me around 65$ my wife with insurance from her job same thing she has to pay 120$. Because they bill insurance companies at a higher rate knowing they are going to negotiate and pay a percentage and then making the co-pay higher.
I am also dependent on expensive medicine, insulin. But it is cheaper to pay out of pocket for it then pay through an insurance company. The one thing that would be good for me would be if I worked for a big company that was forced to provide health insurance, but since i don't I have to brunt the cost.
So all people the people that now rely in the ACA to get healthcare when they never had it before are fictitious?
I guess not going to the hospital or doctor because you couldn't afford it and didn't have health insurance was a better thing?
Or having the only plans available not even cover your health issues because they could deny you the coverage you needed because of pre existing conditions? Those are also a false narrative?
What in the hell are you taking about? The hospital would take care of her? No shit Sherlock that's not the topic. The issue is that he could be now bankrupt from the hospital bills without insuranc. In what universe do you come from where hospital bills do not exist?
JoeyJungle
Banned
Neither of these are true.
https://www.cbo.gov/system/files/115th-congress-2017-2018/costestimate/52849-hr1628senate.pdf (this is from the CBO score of BCRA, image is on page 49)
CBO doesn't have a $40,000 income bracket, but the $56,000 bracket is less than half of what you claim people on $40,000 pay under current law. (actuarial value = how much a plan on average covers the costs of members receiving that plan).
And even if the deductible hasn't kicked in, you're still getting the insurance-negotiated prices for healthcare.
thanks to vox for reporting on this doc a few months back https://www.vox.com/policy-and-politics/2017/6/26/15876476/voxcare-cbo-report-bcra-senate-bill
edit:
Thanks! I thought that was the case but I wasn't sure.
Also, just to clarify, I don't think anyone's arguing that the current cost of healthcare is great. The issue is that literally every republican solution raises costs, sometimes dramatically, and most plans are expected to provide worse insurance. On top of the above CBO report above about BCRA, another example is this CBO report of the House's bill:
https://www.vox.com/policy-and-politics/2017/5/24/15688010/voxcare-cbo-report-ahca-devastating
Quote is from CBO, discussing states that would take waivers from ACA requirements.
StopMakingSense
Member
And if you are on at least a silver plan, there are many copays not subject to the deductible.
mugurumakensei
Member
Eh, seeing my GP is $120 w/o insurance. That's the most common price in the DFW area. Going to urgent care clinics or walk-in places around here is $160 with or without insurance. My insurance premiums are about 100/mo with a $3500 deductible.
As well, when I was in college, I was not eating healthy and lacked health insurance. Racked up a $40,000 bill for 3 days cause my gall bladder had to be removed. Didn't have Medicaid as my scholarship put me in a certain income bracket and Texas sucks. Didn't have insurance cause my parents were/are poor. Had to wait 7 years for that debt to fall off. $40,000 is more than combined premiums + deductible I've spent out over the past 4 years.
Iorv3th
Member
I have used the market place. My cost was around 3500$ a year but with a deductible of 7,000$.
Why would he be bankrupt? He got lucky and the insurance company negotiated his price down for him? You do realize when you do not have insurance there is a massive price difference that you pay. Likely what they 'negotiated' anyways.
I have been hospitalized a handful of times and while the bills exist they are not always as ridiculous as you would assume.
But the real problem is the cost in the first place. Why should it cost 4,000$ for a ride in an ambulance and short stay in the hospital?
Not saying people shouldn't have a system in place, but the one we have is broken.
I live in DFW area. Last charge was 45$. Normally 65$.
GoldenEye 007
Member
Ok, and blood tests, etc. when you do an annual checkup? Or what if the diabetes gets out of control? A new medication is needed? It gets worse in general and more invasive treatments are needed? What if some unrelated and unknown medical issue or accident occurs?
Subpar Spatula
Banned
You're advocating a system that does not exist.
You do not have a plan that is better.
The GOP does not have a plan that is better.
People have asked the GOP for a better plan if they replace this. It has not been given.
If the GOP did have a better system then there WOULD NOT BE resistance. It would be voted in fast.
However... there is no plan.