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Obamacare premiums lower than expected

Posted by david52 z5CO (My Page) on
Fri, May 24, 13 at 12:55

"Health insurers in California will charge an average of $304 a month for the cheapest silver-level plan in state-based exchanges next year, according to rates released Thursday by Covered California, which is implementing the Affordable Care Act there. But many residents will pay a lot less than that for coverage.

Rates will vary by region, age and level of coverage, and many lower-income Californias will qualify for federal subsidies that will greatly lower the premiums. The plans will come in four tiers, ranging from bronze to platinum. The former will charge lower premiums, but carry higher out-of-pocket benefits, and the latter will have the highest premiums but have the lowest out-of-pocket costs.

Subsidies will be based on the cost of silver-level plans and will be available to those earning up to 400% of the poverty line -- roughly $45,000 for an individual or $92,000 for a family of four.

The state-based exchanges will open for enrollment in October. Coverage under Obamacare, as the act is known, will begin in January.

Just how much people will pay for coverage in the exchanges has been the subject of much speculation in recent months. Several estimates, including some focusing on the California market, have predicted that premium rates in the individual market would soar because more older, sicker folks would enter the exchange.

While Covered California said a direct comparison is impossible because the new plans will provide more benefits, the agency noted that the rates for individuals will be between 29% lower and 2% higher than the average premium for small employers in the state's most populous areas.

Some 13 plans from insurers including Blue Cross Blue Shield and Kaiser Permanente will be available, depending on the region. But other large insurers, including UnitedHealth (UNH, Fortune 500), bowed out.
The least expensive silver plan for a 21-year-old could cost $216 a month, but those earning only 150% of the poverty line (or $17,235 annually) may pay only $44 after receiving federal subsidies. A 40-year-old may pay $276 a month, or $40 after the subsidies.

States are slowly unveiling details of their plans, but California is the largest by far to release its rates. Some 5.3 million Californians may be eligible for coverage through the exchange, with more than 2.6 million of them qualifying for subsidies.

Oregon and Washington recently posted their rates, as well. They were also lower than some had expected.
"Many people will see rates similar to what they're paying now, or in some cases, lower -- and with substantially better benefits," the Washington Insurance Department wrote in a blog post. "We're definitely not seeing the huge rate increases that some insurers had predicted." end quote

Here is a link that might be useful: link


Follow-Up Postings:

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RE: Obamacare premiums lower than expected

Dang!

-Ron-


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RE: Obamacare premiums lower than expected

Dang? Why Dang? I would think that this would be a good thing.

~Ann


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RE: Obamacare premiums lower than expected

"The state of Texas is turning down billions of federal dollars that would have paid for health care coverage for 1.5 million poor Texans.

By refusing to participate in Medicaid expansion, which is part of the Affordable Care Act, the state will leave on the table an estimated $100 billion over the next decade.

Texas' share of the cost would have been just 7 percent of the total, but for Gov. Rick Perry and the state's Republican-dominated Legislature, even $1 in the name of "Obamacare" was a dollar too much.

"Texas will not be held hostage by the Obama administration's attempt to force us into this fool's errand of adding more than a million Texans to a broken system," Perry said.

Texas Republicans have moved steadily to the right - to where the very concept of public health insurance of any kind is looked at through narrowed eyes. Still, it's not easy to walk away from $100 billion from the federal government to help your state's poor, elderly and disabled, especially when you have powerful stakeholders like hospitals, doctors and cities clamoring for the state to take the money for their sakes.

Texas hospitals stand to lose about $7 billion.

"I don't think we will be OK, actually, especially when you consider the state cut us about $700 million a year in Medicaid payments because of the budget shortfall," says John Hawkins, a senior vice president at the Texas Hospital Association. "Now we're dealing with sequestration, which is another 2 percent.

"If you look at the president's budget, there's some additional cuts to hospitals, so I don't think it is a sustainable business model going forward if we don't do the expansion."

If your country has no national health insurance but your citizens don't have the stomach to watch the uninsured die on the hospital sidewalk, something's got to give. So there's a national expectation that doctors and hospitals will provide these uninsured populations mostly uncompensated care - and so they do. But few in the industry think this is the way to operate.

Tom Banning, chief executive officer of the Texas Academy of Family Physicians, lobbied hard but unsuccessfully for Medicaid expansion. He's beside himself with frustration.

"These people don't choose to get sick. When they do, they're going to access our health care system at the most inefficient and expensive point, which is the emergency room," Banning says. "And it's going to cost the taxpayers, and it's going to cost employers a lot of money to care for them. And we're going to be forgoing billions of dollars that the feds have set aside for the state to pay for and provide this care."

This is not about money - if it were, Texas would be taking it. This is about Obamacare. It's widely believed in Austin that Perry is seriously considering another run for president - this time without the "oops." His base is Tea Party Republicans across the country. While it might cost $100 billion for the privilege, Perry is going to be able to stand in front of them and say, "I said no to Obama when he tried to bribe my state with health care coverage for the poor."

And since it's widely believed that these would-be Medicaid recipients probably don't vote or, if they do vote, they vote for Democrats, there's no political price to pay for snubbing them.

snip -

Here is a link that might be useful: Tea party at work


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RE: Obamacare premiums lower than expected

Oh-oh, several of our regular posters who predicted an economic apocalypse or something similar (Just wait and see how much more you have to pay under Obama's healthcare plan! My rates have already shot up because of Obama care---Oh, you say Obamacare hasn't gone into effect yet? etc--and similar comments on this forum!) are going to have to eat crow--and you know how humiliating they find that--to the extent that they cannot bring themselves to do it or even admit MAYBE they were wrong in their prognostications!

Kate


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RE: Obamacare premiums lower than expected

WASHINGTON : Representative Eric Cantor of Virginia, the House majority leader, has been trying for months to remake the image of the Republican Party, from one of uncompromising conservatism to something kinder and gentler.

It isn’t working so well.

On Wednesday, Republican leaders abruptly shelved one of the centerpieces of Mr. Cantor’s “Making Life Work” agenda - a bill to extend insurance coverage to people with pre-existing medical conditions - in the face of a conservative revolt. Last month, legislation to streamline worker retraining programs barely squeaked through. In May, Republican leaders will try again with legislation, pitched as family-friendly, to allow employers to offer comp time or “flex time” instead of overtime. But it has little prospect for Senate passage.

So it has gone. Items that Mr. Cantor had hoped would change the Republican Party’s look, if not its priorities, have been ignored, have been greeted with yawns or have only worsened Republican divisions.

“We need to look at these issues through a more human lens and realize government has a role here, especially on some of these pocketbook issues,” said Representative Shelley Moore Capito, Republican of West Virginia, who expressed frustration with the lock-step opposition of the House’s fiercest conservatives. “Have we been successful? No. We’re still trying to find our way.”

The debacle on Wednesday was the worst moment yet. The Helping Sick Americans Now Act sounded like solid middle ground - a measure to actually expand the part of President Obama’s health care law that created a federal “high-risk pool” in which people with pre-existing conditions could band together to buy subsidized insurance coverage. The provision was to be paid for by siphoning money from another part of Mr. Obama’s health care law, the Prevention and Public Health Fund.

But these days, those who linger in the middle of the road end up flattened. The White House issued a stern veto threat to keep the money in the fund, which chased away Democratic votes from the Helping Sick Americans Now Act. The Club for Growth, a conservative political action committee, warned that Republicans who voted in favor of the act would have their scorecards marked down for supporting part of the health care law. L. Brent Bozell III, a conservative activist, labeled the bill “Cantorcare” - and not as a compliment.

“We often say we don’t need this Democrat big-government program, we need this Republican big-government program,” said Representative Trey Radel, Republican of Florida. “It’s time to say enough is enough.” - snip - end quote

Keep in mind that if you have pre-conditions, you very often can't buy insurance at all unless its via these state-sponsored high risk pools which cost 2X to 3X what comparable coverage would cost if you didn't have pre-conditions.

And you wonder where these tea party politicians get their insurance - wait, I know! Its through the Federal Government!!! And the Federal Government has insurance polices that won't discriminate against those with pre-conditions!!! Unlike the individuals out there that don't have that privilege.

I hate to say it, but sometimes, the only way these people would understand what goes on is if someone in their own family, not covered by the Gvt policies, were to be born with a serious birth defect and they had to go find private insurance.

Surprise, idiot, you're on you own.

Here is a link that might be useful: love that tea party some more


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RE: Obamacare premiums lower than expected

Dang? Why Dang? I would think that this would be a good thing.

Kate gave my explanation.

-Ron-


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All this means is that people will flock to California....businesses moving out to Texas and dependant class into California.....Just my thoughts


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RE: Obamacare premiums lower than expected

c6, do you really expect a mass migration? Hardly realistic--and who do you mean by the "dependent class"?


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The "dependent class" might either be a nice way to say those who are poverty stricken and have no other recourse... or it could be the new talking point code words for "those without personal responsibility suckling government teat"... I can't really tell as of yet...

Either way, poorer Texans are having that knife in the back twisted further while those in official government positions can't even tell they belong to a "universal type" insurance program, themselves, so to speak.

And while all political parties should be working together toward a better America, the division at the playground continues while they fight over who gets a turn on the merry-go-round next.

Something is drastically wrong when states refuse federal funds set aside to help the citizens, but they don't mind making a grab for funding under other names and programs that do nothing for the financially or medically challenged.


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RE: Obamacare premiums lower than expected

People have been leaving California, following the job migration, not the other way around. Some folks just suck up so much propaganda rather than check on the facts of Reality.


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RE: Obamacare premiums lower than expected

Oh-oh, several of our regular posters who predicted an economic apocalypse or something similar (Just wait and see how much more you have to pay under Obama's healthcare plan! My rates have already shot up because of Obama care---Oh, you say Obamacare hasn't gone into effect yet? etc--and similar comments on this forum!) are going to have to eat crow--and you know how humiliating they find that--to the extent that they cannot bring themselves to do it or even admit MAYBE they were wrong in their prognostications!

Maybe not so wrong................
From an LA Times Article on Aetna, UnitedHealth and Cigna opting out of Obamacare in the first year:
In March, state officials issued a report estimating that, compared with what individual policies cost now, premiums may rise an average of 30% for many middle-income residents who don't get their insurance through their employers.

Here is a link that might be useful: California Insurance Companies Opt Out


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RE: Obamacare premiums lower than expected

Well, this Californian, having been screwed by all three of the above-mentioned insurers, is happy to have them out of the game. We shall see how their business profits in an era of insurance exchanges. In the meantime, let's put this meme in context, from the link above:

"Together, in 2011, those three big insurers had 7% of California's individual health insurance market, according to Citigroup research. In contrast, Kaiser, Anthem Blue Cross and Blue Shield had nearly 87%, collectively. Anthem Blue Cross is a unit of WellPoint Inc., the nation's second-largest health insurer."

The big insurers that have opted out specialize in offering group plans to businesses. They are not "players" in the kind of program promoted by the affordable act.


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RE: Obamacare premiums lower than expected

Jodi, I pretty much know who c6 means when she/he says "dependent class." Just another shorthand for poor people, old people, children who need better schools, or anyone who needs some kind of help to survive.


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RE: Obamacare premiums lower than expected

As to the OP article linked, good hopeful news; I hope it comes true.

As to this comment:

"I pretty much know who c6 means when she/he says "dependent class." Just another shorthand for poor people, old people, children who need better schools, or anyone who needs some kind of help to survive."

Well then "dependent class" was an apt descriptor. Certainly more concise than your paragraph. If your intent is derrogatory, then how is one to describe the "dependent class" otherwise? Or is it not PC to acknowledge that this class exists at all. C'mon; get off your politically correct high donkey.


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RE: Obamacare premiums lower than expected

Look at Massachusetts:

".....there’s been too little attention given to the best evidence we have on the subject: How the extremely similar reforms in Massachusetts have worked.

Take employers. There’s real concern that companies will see the Affordable Care Act as an opportunity to drop health insurance for their employees and let taxpayers pick up the tab. For those with more than 50 full-time workers, that’ll mean paying a $2,000 to $3,000 penalty for each one, but that’s a whole lot cheaper than paying for health insurance.

The Massachusetts reforms, if anything, were even friendlier to this sort of dumping. The penalty for employers was a paltry $295 per worker. Compared to the average cost of an employer-provided health plan in the Northeast - $17,099, according to the Kaiser Family Foundation’s 2012 Employer Health Benefits Survey - that’s a pittance. It seemed almost irrational for employers to keep offering coverage.

“The benefits we were giving guys who left employer-sponsored insurance were way more generous than what the federal plan gives them,” says MIT’s Jonathan Gruber, a health economist who helped design the Massachusetts reforms. “And we didn’t have much of an employer penalty. I predicted employers would drop coverage.”

But they didn’t. To Gruber - and everyone else’s - surprise, employers expanded coverage. “In the seven years since Massachusetts enacted its law,” says a new report from PricewaterhouseCoopers, “the number of people covered by insurance through the workplace increased by about 1 percentage point, running counter to the rest of the nation, which saw employer-based insurance decline by 5.7 percentage points.”

The report argues that people simply misunderstand why employers offer health-care benefits. They’re not doing it as a favor to employees. And they’re not doing it because anyone is making them. After all, prior to the Massachusetts reforms, employers could stop covering their employees without penalty. That’s true now in every other state in the nation, too. And yet 61 percent of firms offer health-care coverage. If anything, the Massachusetts and national reforms are making it pricier, not cheaper, for them to drop insurance.

Employers offer health insurance because employees demand it. If you’re an employer who doesn’t offer insurance and your competitors do, you’ll lose out on the most talented workers. An employer who stopped offering health benefits would see his best employees immediately start looking for other jobs. That was true before the Massachusetts health reforms. And it turned out to be even truer after them.

PricewaterhouseCoopers found that Massachusetts’s individual mandate had two unexpected effects. First, it led to a lot of employees signing up for employer-based coverage they’d previously rejected. “About a quarter of the uninsured are offered employer-sponsored insurance and don’t take it,” Gruber says. “If the mandate will affect anyone, it will affect those guys.”

Second, it led some workers to march into their boss’s office and ask for insurance. The study notes that “the percentage of small employers offering coverage in Massachusetts rose from 45 percent to 59 percent between 2005 - 2011,” even though insurance premiums actually rose for small employers.

The Massachusetts experience might not prove an apt guide to the national experience. Though the Massachusetts reforms are architecturally similar to the Affordable Care Act, they didn’t have to contend with a political party working relentlessly to undermine their implementation. Moreover, Massachusetts is a relatively rich and liberal state that already had a fairly high rate of health insurance.

That said, there are a couple other reasons to expect that employers won’t be eager to drop coverage. First, because employer-provided health benefits are not taxed, employers can pay their workers more by paying them partly in health-care benefits. Let’s say an employer decides to stop offering health benefits but, in a bid to keep employees happy, promises to give them the cash value of their coverage. The employer would have to spend more on the wages than it spends on the benefits, as the wages are taxed. For the record, I think this is a very stupid way to construct our tax code, but that’s how it works.

Second, the fraction of employers actually affected by the health law’s mandate is very small. “You’ve got 5.7 million firms in the U.S.,” says Wharton’s Mark Duggan, who served as the top health economist at White House’s Council of Economic Advisers from 2009 to 2010. “Only 210,000 have more than 50 employees. So 96 percent of firms aren’t affected. Then if you look among those firms with 50 or more employees, something on the order of 95 percent offer health insurance. So it’s basically 10,000 or so employers who have more than 50 employees and don’t offer coverage.” Those companies probably employ around one percent of American workers.

Which is all to say that, for most companies, the Affordable Care Act won’t bring much change at all, and so there’s little reason to expect their behavior will change, either. And if it does change, it might not change in the direction we expect. “What happened in Massachusetts is not what I predicted,” Gruber says. “But it happened.”

Here is a link that might be useful: link


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RE: Obamacare premiums lower than expected

Thanks, Pidge... sometimes it's difficult to tell when the writer is unknown...


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All this means is that people will flock to California....businesses moving out to Texas and dependant class into California.....Just my thoughts.

No depth here. Thought you'd at least bring up sumpin' 'bout unions.

-Ron-


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"Oh-oh, several of our regular posters who predicted an economic apocalypse or something similar (Just wait and see how much more you have to pay under Obama's healthcare plan!"... "are going to have to eat crow--and you know how humiliating they find that--to the extent that they cannot bring themselves to do it or even admit MAYBE they were wrong in their prognostications!"

Of course we're not wrong. Premiums are only one area where the plan falls apart. They may well be "lower than expected" at the moment. So what? Do you really believe that will be the case in six months, or a year from now?

A government that can't pay its bills as it is, is not going to be able to pick up the yearly tab for thousands of dollars in subsidies for every poor family in the country. A little common sense is all one needs in order to figure out it's simply unsustainable.

But there's more. Turns out the promise that "if you like your plan you can keep it" isn't working either, although a lot of folks are just now figuring out why it never made sense. So unions are warning Democrats they're going to suffer at the polls if they don't do something to "fix" this turkey. (As if it were possible.)

FTA:

"Union leaders warn that unless the problem is fixed, there could be consequences for Democrats facing re-election next year.

"It makes an untruth out of what the president said _ that if you like your insurance, you could keep it," said Joe Hansen, president of the United Food and Commercial Workers International Union. "That is not going to be true for millions of workers now."

The problem lies in the unique multiemployer health plans that cover unionized workers in retail, construction, transportation and other industries with seasonal or temporary employment. Known as Taft-Hartley plans, they are jointly administered by unions and smaller employers that pool resources to offer more than 20 million workers and family members continuous coverage, even during times of unemployment.

The union plans were already more costly to run than traditional single-employer health plans.

But Obama's Affordable Care Act has added to that cost _ for the unions' and other plans _ by requiring health plans to cover dependents up to age 26, eliminate annual or lifetime coverage limits and extend coverage to people with pre-existing conditions.

"We're concerned that employers will be increasingly tempted to drop coverage through our plans and let our members fend for themselves on the health exchanges," said David Treanor, director of health care initiatives at the Operating Engineers union.

Workers seeking coverage in the state-based marketplaces, known as exchanges, can qualify for subsidies, determined by a sliding scale based on income. By contrast, the new law does not allow workers in the union plans to receive similar subsidies."

Here is a link that might be useful: Unions turning on Obamacare


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That report on the MA situation seems about right. Typical salaried employees want insurance and will keep or change jobs accordingly. Other types of workers, like myself, have never had a job with health insurance and probably never will, so some way to accommodate them has to be found, which the MA scheme has achieved.


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A little common sense is all one needs in order to figure out it's simply unsustainable.

A little common sense would look at all the rest of the developed countries in the world with universal health care. Who manage just fine.

Single payer. Obama dropped the ball on that one - of course in this country, with the greed heads running the health system, what did anybody expect?

But this - for people with pre-existing conditions, people just over the poverty line, single people over 18 but below the poverty line, people with no benefit jobs, all 40 odd million of us its a huge step forward.

And for all of you criticizing, where do you get your insurance? Taxpayer funded Medicare? Tax payer funded VA? Tax payer funded state or local Gvt? Hmmm?


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RE: Obamacare premiums lower than expected

And for all of you criticizing, where do you get your insurance?

*

I pay for it.

Blue Cross.

From what I've heard, I will likely lose my option of the primarily catastrophic with a very high deductible . I'm with Hay--I want to be able to choose what type of insurance I have, and if I want any at all.

It is no one's business what kind of insurance I have.

If I don't have any or don't pay for insurance, I don't expect tax payers to take care of me.

That's MY JOB.


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RE: Obamacare premiums lower than expected

With the bronze plan, the cheapest you can get, you'll be forced to pay the difference between a $10,000 deductible and a $6500 deductible. That might come to $75 a month.

Of course, you'll get much better coverage.


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But demi, I imagine, you own a home and have some savings they will go after if you don't pay your medical bills.

Whole different ballgame with millions of others. They might own a car and a fur coat. But no home and no $ in the bank.


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RE: Obamacare premiums lower than expected

Thought you'd at least bring up sumpin' 'bout unions.

Or 'illegals' draining medical resources.

If I don't have any or don't pay for insurance, I don't expect tax payers to take care of me.

If you experience a catastrophic illness and have no medical insurance, the taxpayers will be picking up the tab at some point.


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RE: Obamacare premiums lower than expected

An individual can get coverage through Kaiser in California for as low as $82 per month.

About seven million people in California are uninsured. Why?


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RE: Obamacare premiums lower than expected

An individual can get coverage through Kaiser in California for as low as $82 per month.

About seven million people in California are uninsured. Why?

Where'd you come up with this number? What age group are you referring to? I belong to Kaiser and before I went on Medicare, my rate per month was waaaaaaaaaaaaay beyond $82. Even on medicare it's almost twice your quoted number.

-Ron-


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I'm curious too as to the source of the cost.

Kaiser's website gives the following quotes for a 30-year-old female in Los Angeles with no pre-existing conditions:

$106/mo $50 co-pay/$5,000 deductible, no prescription benefit

$130/mo $30 co-pay/$2,7000 deductible, no prescription benefit

$145/mo $40 co-pay/$4,000 deductible with prescription benefit


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RE: Obamacare premiums lower than expected

"Kaiser's website gives the following quotes for a 30-year-old female in Los Angeles with no pre-existing conditions:

$106/mo $50 co-pay/$5,000 deductible, no prescription benefit
$130/mo $30 co-pay/$2,7000 deductible, no prescription benefit

$145/mo $40 co-pay/$4,000 deductible with prescription benefit"

Pretty affordable. I'd like a deal like that.


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RE: Obamacare premiums lower than expected

In Cleveland, Ohio, according to today's published rates, Kaiser starts at $98.86 per month. Still millions of uninsured folks in Ohio too.

So the rates increased slightly since I last checked on CA.

$3.90 a day X 365 days, divided by 12 months = $118.63 per month. That's CHEAP!

*Prices based on health insurance options available on 4/3/2013 for a non-smoking 30 year old male in CA, with an effective date of 4/15/13.

Pretty affordable? Yes, yet millions choose to be uninsured. Choose to be. I'm worried that millions will continue to choose to be uninsured, and pay the cheap penalty. Without the millions buying that cheap coverage, the rates will increase.

When I reach 65, I'm subscribing to VA benefits. Columbus VA offers superior care.

Ron, don't you believe it's reasonable that your rate at 65 would be higher than a 30 year old?

This post was edited by brushworks on Sun, May 26, 13 at 8:48


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RE: Obamacare premiums lower than expected

Ha ha ha ha ha! Here's another "unexpected" gift from Obamacare. Enjoy!

FTA: "In the rush to achieve its passage, many of the act's provisions were not fully conceived, resulting in unintended consequences that are inconsistent with the promise that those who were satisfied with their employer-sponsored coverage could keep it," Kinsey Robinson, president of the United Union of Roofers, Waterproofers and Allied Workers, said last month. “I am therefore calling for repeal or complete reform of the Affordable Care Act.”"

Here is a link that might be useful: Uh oh


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RE: Obamacare premiums lower than expected

Millions CHOOSE to be uninsured? Are you sure about that?

What if the real truth is, millions don't have that spare money laying around every month, no matter how frugally they live?

The only way some would ever be able to afford insurance is if the premium were $5 or under every month. Some folks don't have guaranteed, set incomes... they might vary from nothing to just enough to get by... and there might be so many pre-existing conditions... who knows?

How do we treat people who fall into those sorts of categories?

Just the other day, I heard my husband talking to a friend of his, and they were talking about the various meanings behind the saying, "I'm so broke". To some, this means they still have a savings, and can access several thousand in cash... to others, this may mean a savings and maybe $100 or so in viable cash. To others, broke means there's no money to be had from savings or the pocket... not even enough to scrape together $20.

I think various people have different interpretations of what being broke really means.


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brush, Kaiser is not available in all parts of California.

That HMO has been in and out of Ventura County in the last decade. The lower prices are based on Kaiser owning the hospital, clinics, and medical offices -- which pretty much means a larger urban/suburban area. Expanding into counties outside of its base means contracting with existing facilities, and the availiabity of Kaiser becomes iffy.

My mother had Kaiser's Senior Advantage and was told that her policy would not be renewed as Kaiser was leaving Ventura County. A decade later and now there's another try in Ventura; once burned, twice shy.


Another factor that you're not taking into consideration is the federal subsidies for lower-income individuals and families which did not exist prior to ACA.


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RE: Obamacare premiums lower than expected

Second that - rates with Kaiser are excellent if you are in an area where you can use their hospitals, doctors, etc. Often half what you can find elsewhere.

Which is an interesting phenomenon and may explain why so many private doctors are quitting individual practices and working for larger and larger outfits like Kaiser - who they have to compete with.


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Nancy,

I realize that, but Kaiser is located in metropolitan areas, where most Californian's live.


Kaiser Permanente is a health management organization (HMO) that is based in Oakland, California. As of December 2008, it had more than six-and-a-half million members in California alone, and served the following areas in the State: East Bay, Golden Gate, South Bay, Valley, Fresno, North East Bay and Stanislaus County in northern California; and Coachella Valley, Kern County, Orange County, the Valleys, western Ventura County, Inland Empire, metropolitan Los Angeles/West Los Angeles and San Diego County in southern California.

Services at these hospitals include emergency care, pediatrics, women's health, radiology, pharmacy and, depending on location, even acupuncture.

Jodik,

Good point. So what you're saying is if you can't afford $82 at Kaiser now, you can't afford $82 to participate in Obamacare?

That's MY point. Why are so many uninsured if Kaiser is so cheap? I consider cheap anything less than my policy, and that's more than 10 times cheaper.

Who pays for the subsidies? That's what I thought.


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RE: Obamacare premiums lower than expected

If I put myself in the shoes of someone working at McDonalds making $9 an hour, 30 hours a week, to begin with there is no way I could afford a $4,000 or $5,000 deductible in the first place, so why bother paying for any of these policies?

And I'd just keep my fingers crossed that I don't get sick and hospitalized. Broken bones and such, ER and stiff the hospital for the bill.

If I'm hospitalized, I'd do like so many people in that situation - work with the hospitals and doctors to some pressure on the company so my illness gets covered under workmans comp or something.

Or just go bankrupt. Its not as if they're going to recover anything of value from me. I just start over.


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RE: Obamacare premiums lower than expected

Why are so many uninsured if Kaiser is so cheap?

One, it isn't as 'cheap' as you would like us to believe -- large deductibles and no prescription benefit, plus premiums increase according to age of the insured. Throwing out the $98 figure and think it applies to a middle-aged person is fantasy. If I were a lower-wage and contemplating a pregnancy with those large deductibles (and no prescription benefit), I would not be able to afford it.

Two, there are many counties not listed on Kaiser's coverage; regardless of urban/suburban centers there are still large areas of CA not covered, which adds up. Two and a half - even within those counties listed above, proximity is everything; many areas in Los Angeles aren't particularly close to a Kaiser facility.

Three, see David's comments above.


I still think that a single-payer plan is the best option for univeral health care in the U.S.


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Last sentence, I wholeheartedly agree, Nancy. It is the plan that is to be our future and the plan that should have been embraced by the reps in the first place.


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RE: Obamacare premiums lower than expected

"Every now and again, a political pundit is required to stand up and admit to the world that he or she got it wrong.

For me, this would be one of those moments.

For quite some time, I have been predicting that Obamacare would likely mean higher insurance rates in the individual market for the “young immortals” and others under the age of 40. At the same time, my expectation was that those who fall into the older age ranges would benefit greatly as their premium charges would be lowered thanks to the Affordable Care Act.

It is increasingly clear that I had it wrong.

Yesterday, Covered California - the name given to the healthcare exchange created pursuant to the Affordable Care Act that will serve the largest population of insured citizens in the nation - released the premium rates submitted by participating health insurance companies for the three health insurance program categories (bronze, silver and gold) established by the Affordable Care Act, along with the catastrophic policy created for and available to those under the age of 30.

Upon reviewing the data, I was indeed shocked by the proposed premium rates - but not in the way you might expect. The jolt that I was experiencing was not the result of the predicted out-of-control premium costs but the shock of rates far lower than what I expected - even at the lowest end of the age scale.

So, why the all too popular narrative that Obamacare would mean unaffordable healthcare premium costs for so many Americans?

Setting aside the never-ending nonsense peddled by the opponents of healthcare reform, everyone from the Congressional Budget Office to numerous private actuaries have warned that premium shock could be expected to set in once the public began to see the reality of what Obamacare would mean to their pocketbooks. And yet, the only real jolt to the system being felt by these public and private prognosticators today is utter amazement over just how reasonable the California prices have turned out to be.

How did the CBO and the actuaries get it so wrong?

As Jonathan Cohn of The New Republic correctly points out:

“One reason for the misplaced expectations may be that actuaries have been making worst-case assumptions, even as insurers - eyeing the prospects of so many new customers - have been calculating that it’s worth bidding low in order to gobble up market share. This would help explain why premium bids in several other states have proven similarly reasonable. “The premiums and participation in California, Oregon, Washington and other states show that insurers want to compete for the new enrollees in this market,” Gary Claxton, a vice president at the Kaiser Family Foundation, said via e-mail. “The premiums have not skyrocketed and the insurers that serve this market now are continuing. The rates look like what we would expect for decent coverage offered to a standard population.” snip

more at the link

Here is a link that might be useful: from Forbes


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RE: Obamacare premiums lower than expected

About those "lower than expected" premiums...

FTA: "To keep premiums from being even higher, insurers limit access to doctors and hospitals. Blue Shield of California, for example, will offer an exchange plan that includes only 36% of its regular physician network.

For the uninsured, it's better than no coverage. But for the rest, a 50% premium hike for fewer choices is not an improvement. Yet New York Times columnist Paul Krugman hailed Covered California as "an overwhelmingly positive experience."

If you want the federal subsidy available to individuals earning up to $45,960 a year (and households of four with $94,200 combined income), you have to buy on the exchange. The trade-off is limited access. Blue Shield offers care at UCLA Medical Center to its regular customers but not customers with exchange plans.

Out Of Pocket

Insurers everywhere are concluding that low cost will be king on exchanges. Most exchange customers will be low-income, sensitive to price differences and dependent on a federal subsidy. To compete on cost, these insurers are limiting networks to hospitals and doctors willing to accept lower-than-customary fees.

This is Wal-Mart style health care, similar to Medicaid. Only a small fraction of doctors are willing to accept these fees.

In Maine, consumers are upset to learn that they will have to change doctors and hospitals and possibly travel long distances for care covered by an exchange plan."

No doubt there will be more "unexpected" news to come...

Here is a link that might be useful: Downgrade with Obamacare


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RE: Obamacare premiums lower than expected

I think that when fully implemented at the end of this year people will have a different opinion, We are only now seeing a small tip of the ice berg. time will tell.

Have a great day


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