Impeding changes to our Health Care system

[TheMercenary]

Originally Posted by SamIam

Here are two tidbits I gleaned while perusing the Center on Budget and Policy Priorities’ site.

Insurance exchanges are only for a certain class of people. Not anyone can enter one.

[SamIam]

It is my understanding that the question of who will qualify for health exchanges is still up in the air as legislatures try to reconcile the House and Senate version of the health care bill. I keep finding different articles that say different things. Which ones are right?

[TheMercenary]

From what I understand, anyone who can get insurance through their employer has to get it that way. In fact when we changed to a new company they mandated that people took insurance with them to be employed. It caused a huge problem for some people as they tried to figure out if it was legal and those who had insurance via spouses or Tricare went back and forth with them for a few months until the finally gave in, but you had to provide them with proof that you actually had it. I think they were anticipating the coming changes in the reform. But basically you had no choice to get it on your own. And the new companies premiums are about $300 more per month on the family plan and the ductable is twice what our previous company offered. So basically they can do anything they want.

Originally Posted by SamIam

It is my understanding that the question of who will qualify for health exchanges is still up in the air as legislatures try to reconcile the House and Senate version of the health care bill. I keep finding different articles that say different things. Which ones are right?

As I understand it, both the House and Senate will allow large employers (those that currently offering employee coverage) into the Exchanges after a period of time (2-3 years after implementation) so that am employer now only offering 1 or 2 options to employees will be able to offer more options to employees in the future.

The Senate bill also allows new employees of these large employers to choose a plan from the Exchange as soon as they are created.

The biggest difference between the plans is that the Exchanges are administered at the federal level in the House version and at the state level in the Senate and the state can chose to restrict or expand access to the Exchange.

[classicman]

Originally Posted by SamIam

I keep finding different articles that say different things. Which ones are right?

Short answer is we don't know yet.

[SamIam]

Yeah, I figured that, too. All this debate and we are like the blind men each assigned to feel one part of an elephant and then describe what the elephant must look like.

[TheMercenary]

Originally Posted by Redux

As I understand it, both the House and Senate will allow large employers (those that currently offering employee coverage) into the Exchanges after a period of time (2-3 years after implementation) so that am employer now only offering 1 or 2 options to employees will be able to offer more options to employees in the future.

Highly unlikely according to Ron Wyden, a Democratic senator from Oregon.

http://www.nytimes.com/2009/09/17/op...yden.html?_r=1

The Senate bill also allows new employees of these large employers to choose a plan from the Exchange as soon as they are created.

The exchanges are a fantasy. Few exist in the US. No one can be sure the will work as designed. Esp the people who do know about them. It was a dreamed up idea that has failed in Mass and is going to fail on a National level.

Originally Posted by TheMercenary

Highly unlikely according to Ron Wyden, a Democratic senator from Oregon.

http://www.nytimes.com/2009/09/17/op...yden.html?_r=1

The exchanges are a fantasy. Few exist in the US. No one can be sure the will work as designed. Esp the people who do know about them. It was a dreamed up idea that has failed in Mass and is going to fail on a National level.

The Wyden column is from September, in reference to one of the first versions of the Senate bill.

The final Senate bill gives flexibility to the states to determine how large employers (that currently offer insurance) can enter the Exchange 2-3 years after implementation. The House bill is more straight forward - large employers are allowed to enter the Exchange after that implementation period.

The source? Read the legislation.

You may think it is a fantasy and that insurance companies will not chose to participate in an Exchange that gives them access to 30+ million customers. I think they will chose to particiate...or at least enough to provide consumer choice at affordable rates.

I think its worth a shot and that the companies want the business and you have already declared it a failed fantasy.

It doesnt make either one of us right or wrong....just a difference of opinion.

[TheMercenary]

Oh, the insurance companies will gladly participate, that is why they let the insurance insiders help craft the Bill. Of course this is a huge win for them that is what I have been saying all along. This will make them quite a bit richer. It remains to be seen whether or not they will allow open access to the exchanges. To date there is no evidence that they will allow those who get insurance through their employers to enter the exchange. They basically have those people by the balls and will continue to charge them ever increasing rates and co-pays.

So the $10-20 million that the insurance industry has pumped into a media campaign in the last few months to kill the bill is just a publicity stunt because they like the legislation so much.

Just as dealings with the Obama administration and congressional Democrats soured last summer, six of the nation's biggest health insurers began quietly pumping big money into third-party television ads aimed at killing or significantly modifying the major health reform bills moving through Congress.

That money, between $10 million and $20 million, came from Aetna, Cigna, Humana, Kaiser Foundation Health Plans, UnitedHealth Group and Wellpoint, according to two health care lobbyists familiar with the transactions. The companies are all members of the powerful trade group America's Health Insurance Plans.

http://undertheinfluence.nationaljou...ed-chamber.php

BTW, the Exchange can also regulate (or negotiate) premiums, co-pays and administrative costs, selecting the most favorable for inclusion in the Exchange.....more in the House version than the Senate's, which as I have noted, gives far more flexibility to the states.

The anti-trust provisions, again the House version is better, would also provide the mechanism (ending anti-trust exemption) for further controls.

added:

sam...here is a good explanation of the Exchanges in the House and Senate bills:



In conclusion, if one believes the Exchanges are just a "fantasy", nothing is likely to change that.

[TheMercenary]

'can also regulate (or negotiate) premiums' is not a mandate to do so or hold down costs for the already insured. The majority of companies, including medical device manufactures, have all stated they intend to pass any costs or increased taxation on to the consumers and insured. The difference between the Hose version and the Senate version is huge with the difference between state based exchanges and a nationally based exchange is significant.

In the end there is very little in the new bill that will hold down costs or control costs to the already insured. The insurance companies are happy with the compromise as they gain 30 million new sources of income, paid by the individual or paid for by the taxpayers, matters not to them. 10 million dollars is pissing in the wind for insurance companies, sort of like that BS number of how many jobs the current Congress has created with their whorish spending and artifically proping up the economy.

[TheMercenary]

CBO estimates that the cheapest plans for small businesses, by 2016, will approach $20,000 for a family. That is a SIGNIFICANT increase in costs. And that is for the cheapest plan. And they are not even sure if their numbers are correct.

Yea, I would say the insurance companies are going to come out way ahead in this Bill, and so does the CBO.

In general, however, small employers would provide plans with a greater
amount of coverage than Bronze plans, as they do under current law. The
average premiums in 2016 for plans provided by small employers cited in
the recent analysis by CBO and JCT—about $7,800 for single policies and
$19,200 for family policies—differ from the amounts cited above for
individual Bronze policies primarily because the average actuarial value of
coverage purchased by small employers would be substantially higher than
the Bronze level (about 85 percent, CBO estimates, rather than 60 percent).
The premiums for specific employers could deviate significantly from those
averages for various reasons.

http://www.cbo.gov/ftpdocs/108xx/doc...ronze_Plan.pdf

Originally Posted by TheMercenary

CBO estimates that the cheapest plans for small businesses, by 2016, will approach $20,000 for a family. That is a SIGNIFICANT increase in costs. And that is for the cheapest plan. And they are not even sure if their numbers are correct.

Yea, I would say the insurance companies are going to come out way ahead in this Bill, and so does the CBO.

http://www.cbo.gov/ftpdocs/108xx/doc...ronze_Plan.pdf

CBO also said premiums wont increase for most Americans and the plan is deficit neutral at the least and will likely result in deficit reduction long term...and you discount both.

So I do like how you cherry pick CBO data.

[TheMercenary]

Originally Posted by Redux

CBO also said premiums wont increase for most Americans and the plan is deficit neutral at the least and will likely result in deficit reduction long term...and you discount both.

Basically the CBO has updated their info. According to their own statements as posted they do not think that there will be NO increases... Deficit neutral is bullshit for those who are going to pay increased premiums and co-pays. So stop with your White House talking points and lies from the the Administration. So far they have failed.

So I do like how you cherry pick CBO data.

No Cherry Picking, only a post of the latest update of the CBO response as of Jan 2010.

Originally Posted by TheMercenary

Basically the CBO has updated their info. According to their own statements as posted they do not think that there will be NO increases... Deficit neutral is bullshit for those who are going to pay increased premiums and co-pays. So stop with your White House talking points and lies from the the Administration. So far they have failed.

No Cherry Picking, only a post of the latest update of the CBO response as of Jan 2010.

Of course you are cherry picking.

Updated their information? Nope.

The latest CBO letter you posted was in regard to ONE component, ONE specific level of coverage (bronze) to be offered through the Exchange (which you think is a fantasy) in response to a request from ONE senator.

It supplements.....not replaces or updates. It doesnt change the overall "score" that CBO provided on the overall Senate bill that was adopted. If you know anything about the CBO scoring process, you would know that. But that requires someone interested in the full analysis and not just those pieces cherry picked to support a pre-disposed opinion.

And deficit neutral has nothing to with what any individual will pay...it refers to the impact on the federal budget.

added:
White House talking points and lies?

Have you forgotten the "death panels" and the Medicare scare tactics, the "government rationing", the industry "studies" that fudged the costs to their benefit and all those endless partisan opinion columns with an agenda that misrepresented the facts and that you flooded the discussion with.... not to mention the sudden tsunami of inane pictures you "contributed" to the discussion recently (I was actually embarrassed for you with that childish outburst until I realized that you would never man up and admit it was an over-reaction.)

Cherry picking again?