CDZ Can we have a serious discussion of how to fix the Affordable Care Act?

[richstacy]

Just to establish that the ACA is not doing great, I give a list of links that one can read to see the nature of the problems.

Sky rocketing insurance premiums so far, not reducing
Obamacare Insurance Premiums Set to Skyrocket Yet Again

It appears that enrollments are shrinking.
It’s official: Obamacare debuts with more canceled plans than enrollments

Aetna appears to be withdrawing from the ACA exchanges
Aetna pulling back from ObamaCare in blow to health law

And the Co-ops are steadily declining as well.
The Ruins: Two More Obamacare Co-Ops Collapse, Only One-Third Remain (For Now)

But what are the successes?

Millions of people now have insurance that never did. A great amount of stress on the public hospitals for free (uninsured care) has been lifted.

From Wikipedia:

Annual or lifetime coverage caps on essential benefits were banned.[73][74] Prohibits insurers from dropping policyholders when they get sick.[75]

A partial community rating requires insurers to offer the same premium to all applicants of the same age and location without regard to gender or most pre-existing conditions (excluding tobacco use).[76][77][78] Premiums for older applicants can be no more than three times those for the youngest.[79]

Preventive care, vaccinations and medical screenings cannot be subject to co-payments, co-insurance or deductibles.[80][81][82] Specific examples of covered services include: mammograms and colonoscopies, wellness visits, gestational diabetes screening, HPV testing, STI counseling, HIV screening and counseling, contraceptive methods, breastfeeding support/supplies and domestic violence screening and counseling.[83]

The law established four tiers of coverage: bronze, silver, gold and platinum. All categories offer the essential health benefits. The categories vary in their division of premiums and out-of-pocket costs: bronze plans have the lowest monthly premiums and highest out-of-pocket costs, while platinum plans are the reverse.[60][84] The percentages of health care costs that plans are expected to cover through premiums (as opposed to out-of-pocket costs) are, on average: 60% (bronze), 70% (silver), 80% (gold), and 90% (platinum).[85]

Insurers are required to implement an appeals process for coverage determination and claims on all new plans.[75]

Insurers must spend at least 80–85% of premium dollars on health costs; rebates must be issued to policyholders if this is violated​

These are some serious benefits to the American people that the health insurance industry fought for decades. This is good stuff, but what is discouraging people from signing up?

Seems to me that, since the GOP abstained from helping to construct the ACA, the leftwing radicals got to monopolize the product.

One size fits all plans that force men to take pregnancy coverage, the exclusion of Catastrophic care plans with very high deductibles that can be combined with health savings accounts to cover most if not all of the deductibles and other costs were ignored and not included.

What do you think could be done, reasonably to reform the ACA?

We could have a serious discussion but no one has clue how to fix this mess.

 

[Indeependent]

Just to establish that the ACA is not doing great, I give a list of links that one can read to see the nature of the problems.

Sky rocketing insurance premiums so far, not reducing
Obamacare Insurance Premiums Set to Skyrocket Yet Again

It appears that enrollments are shrinking.
It’s official: Obamacare debuts with more canceled plans than enrollments

Aetna appears to be withdrawing from the ACA exchanges
Aetna pulling back from ObamaCare in blow to health law

And the Co-ops are steadily declining as well.
The Ruins: Two More Obamacare Co-Ops Collapse, Only One-Third Remain (For Now)

But what are the successes?

Millions of people now have insurance that never did. A great amount of stress on the public hospitals for free (uninsured care) has been lifted.

From Wikipedia:

Annual or lifetime coverage caps on essential benefits were banned.[73][74] Prohibits insurers from dropping policyholders when they get sick.[75]

A partial community rating requires insurers to offer the same premium to all applicants of the same age and location without regard to gender or most pre-existing conditions (excluding tobacco use).[76][77][78] Premiums for older applicants can be no more than three times those for the youngest.[79]

Preventive care, vaccinations and medical screenings cannot be subject to co-payments, co-insurance or deductibles.[80][81][82] Specific examples of covered services include: mammograms and colonoscopies, wellness visits, gestational diabetes screening, HPV testing, STI counseling, HIV screening and counseling, contraceptive methods, breastfeeding support/supplies and domestic violence screening and counseling.[83]

The law established four tiers of coverage: bronze, silver, gold and platinum. All categories offer the essential health benefits. The categories vary in their division of premiums and out-of-pocket costs: bronze plans have the lowest monthly premiums and highest out-of-pocket costs, while platinum plans are the reverse.[60][84] The percentages of health care costs that plans are expected to cover through premiums (as opposed to out-of-pocket costs) are, on average: 60% (bronze), 70% (silver), 80% (gold), and 90% (platinum).[85]

Insurers are required to implement an appeals process for coverage determination and claims on all new plans.[75]

Insurers must spend at least 80–85% of premium dollars on health costs; rebates must be issued to policyholders if this is violated​

These are some serious benefits to the American people that the health insurance industry fought for decades. This is good stuff, but what is discouraging people from signing up?

Seems to me that, since the GOP abstained from helping to construct the ACA, the leftwing radicals got to monopolize the product.

One size fits all plans that force men to take pregnancy coverage, the exclusion of Catastrophic care plans with very high deductibles that can be combined with health savings accounts to cover most if not all of the deductibles and other costs were ignored and not included.

What do you think could be done, reasonably to reform the ACA?

We could have a serious discussion but no one has clue how to fix this mess.

When large Corporations come back to the US and offer Health Benefits once again we won't need the ACA.