Consumer Alert: Obamacare Nightmare Exchanges heading your way

[Nova78]

Consumer alert: new health care markets on the way | US National Headlines | Comcast

This fall, new insurance markets called exchanges will open in each state, marking the long-awaited and much-debated debut of President Barack Obama's health care overhaul.

Exchanges will offer individuals and their families a choice of private health plans resembling what workers at major companies already get. The government will help many middle-class households pay their premiums, while low-income people will be referred to safety-net programs they might qualify for.

But what's starting to dawn on Obama administration officials, activists, and important players in the health care industry is that the lack of consumer involvement, unless reversed, could turn the big health care launch into a dud. What if Obama cut the ribbon and nobody cared?

"The people who stand to benefit the most are the least aware of the changes that are coming," said Rachel Klein, executive director of Enroll America, a nonprofit that's trying to generate consumer enthusiasm.
Goal is to help consumers master the "metals," the four levels of coverage that will be available through exchange plans — bronze, silver, gold, and platinum.

So as as expected ,the middle class will pay up the ass while the deatbeats will pay next to or nothing.

 

[Greenbeard]

Indeed, it's a big year and a lot of folks will have their hands full getting the word out to people about the new options that will be available to them this fall.

Meanwhile, last week we found out that folks generally want their states to get going on these new marketplaces: Poll Finds Bipartisan Public Support for Creating State Insurance Exchanges Despite Continuing Party Divisions Over the ACA

Princeton, N.J.—A majority of Americans put the creation of state-based health insurance exchanges at the top of the priority list for health policy in their state this year, according to a survey released today by the Kaiser Family Foundation, the Robert Wood Johnson Foundation and the Harvard School of Public Health.

Fifty-five percent of the public, including majorities of Republicans and Democrats, say that establishing the exchanges—a key element of the Affordable Care Act (ACA) and one whose implementation has divided states along partisan political lines—is a “top priority” for their governor and legislature. So far 18 states and the District of Columbia have declared that they will create their own state-based exchanges, seven other states have opted to establish exchanges in partnership with the federal government and 25 others—some driven by resistance to the ACA—appear set to default to a federally-run exchange.

“Governors are largely splitting along partisan lines on the exchanges, but the public is not. People like the idea,” said Drew Altman, President and CEO of the Kaiser Family Foundation.

 

[tap4154]

"Low income" will be defined by each year's tax return, so a person with millions in assets who has a very low taxable income may end up in Medicaid. There is no means testing, as in normal Medicaid.

It's gonna be a HUGE mess, as millions of folks are dumped from their employer coverage, as employers opt to pay the lower tax penalty, instead of paying for the VERY expensive and more comprehensive coverage mandated by the ACA, and many folks who are asset-rich millionaires could conceivably get free care in Medicaid.

 

[Sallow]

If you have a real job..you are covered.

Dunno why this is a big deal to anyone.

 

[tap4154]

If you have a real job..you are covered.

Dunno why this is a big deal to anyone.

You must be a lifer union sloth/employee.

You have no idea how many of us self-employed are out there, who pay for our own HC insurance.

Plus you're living in Fantasyland... Many employers have already dropped employee coverage, and many more plan to, as well as shifting employees to part time to avoid the much more expensive coverage that the ACA mandates. They can pay a much smaller fine, and not have to provide coverage to anyone. Employees will be forced into the exchange to fend for themselves.

 

[Greenbeard]

It's gonna be a HUGE mess, as millions of folks are dumped from their employer coverage, as employers opt to pay the lower tax penalty, instead of paying for the VERY expensive and more comprehensive coverage mandated by the ACA, and many folks who are asset-rich millionaires could conceivably get free care in Medicaid.

In general, coverage is more comprehensive relative to current individual market insurance policies, which admittedly are shitty. The difference for people in employer-sponsored plans will be small because the minimum benefits are tagged to what plans already being sold in your state's small group market are offering (e.g. the default benchmark for essential health benefits, if a state doesn't specify otherwise, is the small group health plan with the largest enrollment in the state).

People in large group/self-insured plans (i.e. most--60%--people who get health insurance through their job) won't see any difference because those plans aren't required to offer the essential health benefits.

That said, I do look forward to seeing the millionaires clamoring to enroll in Medicaid coverage. That'll be a sight to see!

Employees will be forced into the exchange to fend for themselves.

The point of an exchange is that people in the individual market no longer "fend for themselves" in a market arrayed against them. They'll have similar consumer protections to those enjoyed by people in group plans, they'll be able to make informed decisions and send clear signals because the choices before them will be transparent and intelligible, and they'll be choosing among insurers that compete on price and quality (not clever strategies for deflecting risk). And, if they're under four times the federal poverty line, they will be eligible for some degree of financial assistance.

 

[Dot Com]

yeah. having larger pools of people and thereby lowering prices is a terrible idea.

 

[Nova78]

Cook County hit a $100 million jackpot .Beyond the cronyism, this “waiver” only serves to place the people of the greater Chicago area and Illinois further underwater fiscally
In a little noticed but crucial decision , the federal government signed off on a request by county board President Toni Preckwinkle to enroll 114,000 low-income people a year early in the Medicaid program.
For the county, the decision is worth as much as $100 million a year, since its network of hospitals and health clinics already is serving most of the patients free of charge. The tab now will be picked up by federal taxpayers under a provision of Obamacare, rather than by Cook County taxpayers alone.
In fact, during FY2012, Medicaid was underfunded by $2.1 billion. With the growing pool of patients and a shrinking number of doctors, Obamacare has only proven itself to be nothing more than a politician promising the entire country a new car, but only giving them a set of keys. Real healthcare reform is not expanding insurance while shrinking care and paying back your cronies. Real fiscal reform is not seeking federal dollars as a stopgap measure for a county and state budget drowning in debt.

 

[tap4154]

It's gonna be a HUGE mess, as millions of folks are dumped from their employer coverage, as employers opt to pay the lower tax penalty, instead of paying for the VERY expensive and more comprehensive coverage mandated by the ACA, and many folks who are asset-rich millionaires could conceivably get free care in Medicaid.

In general, coverage is more comprehensive relative to current individual market insurance policies, which admittedly are shitty. The difference for people in employer-sponsored plans will be small because the minimum benefits are tagged to what plans already being sold in your state's small group market are offering (e.g. the default benchmark for essential health benefits, if a state doesn't specify otherwise, is the small group health plan with the largest enrollment in the state).

People in large group/self-insured plans (i.e. most--60%--people who get health insurance through their job) won't see any difference because those plans aren't required to offer the essential health benefits.

That said, I do look forward to seeing the millionaires clamoring to enroll in Medicaid coverage. That'll be a sight to see!

Employees will be forced into the exchange to fend for themselves.

The point of an exchange is that people in the individual market no longer "fend for themselves" in a market arrayed against them. They'll have similar consumer protections to those enjoyed by people in group plans, they'll be able to make informed decisions and send clear signals because the choices before them will be transparent and intelligible, and they'll be choosing among insurers that compete on price and quality (not clever strategies for deflecting risk). And, if they're under four times the federal poverty line, they will be eligible for some degree of financial assistance.

You're so full of shit your jacket is brown.

Kaiser has already told me that at the end of this year my high deductible plan, which I CHOSE so I could have lower monthly premiums, will be canceled and I will have to select a more comprehensive (READ EXPENSIVE) plan, or go to the exchange.

I've read a lot of your posts on this issue and am convinced that you're just a POS paid shill from the BO Regime.

Fact is there is no means testing, and they only go by annual taxable income. So if a very rich, or even middle class individual or family shows a loss or low income for a given year, no matter the amount of their assets, under the Orwellian "exchange" they will be dumped into Medicaid. Of course, most would still pay for a good private plan, but they could "scam" the system, and it wouldn't even be a scam or illegal! (but they would be subject to the nightmare called Medicaid).

AND fact is that many folks who currently have employer-provided HC will LOSE it, you fucking LIAR.

AND the fact is that this will kill jobs, many will be hired as part time instead of full time, AND folks who pay will be paying a LOT more per month in premiums, AND there will be rationing, just as there is in Canada and the UK.

 

[dblack]

yeah. having larger pools of people and thereby lowering prices is a terrible idea.

You can lower prices even more dramatically, and get a lot more people in the pool, if you liquefy them first.

 

[dblack]

Cook County hit a $100 million jackpot .Beyond the cronyism, this “waiver” only serves to place the people of the greater Chicago area and Illinois further underwater fiscally
In a little noticed but crucial decision , the federal government signed off on a request by county board President Toni Preckwinkle to enroll 114,000 low-income people a year early in the Medicaid program.
For the county, the decision is worth as much as $100 million a year, since its network of hospitals and health clinics already is serving most of the patients free of charge. The tab now will be picked up by federal taxpayers under a provision of Obamacare, rather than by Cook County taxpayers alone.
In fact, during FY2012, Medicaid was underfunded by $2.1 billion. With the growing pool of patients and a shrinking number of doctors, Obamacare has only proven itself to be nothing more than a politician promising the entire country a new car, but only giving them a set of keys. Real healthcare reform is not expanding insurance while shrinking care and paying back your cronies. Real fiscal reform is not seeking federal dollars as a stopgap measure for a county and state budget drowning in debt.

Corporatism, uber alles.

 

[tap4154]

Cook County hit a $100 million jackpot .Beyond the cronyism, this “waiver” only serves to place the people of the greater Chicago area and Illinois further underwater fiscally
In a little noticed but crucial decision , the federal government signed off on a request by county board President Toni Preckwinkle to enroll 114,000 low-income people a year early in the Medicaid program.
For the county, the decision is worth as much as $100 million a year, since its network of hospitals and health clinics already is serving most of the patients free of charge. The tab now will be picked up by federal taxpayers under a provision of Obamacare, rather than by Cook County taxpayers alone.
In fact, during FY2012, Medicaid was underfunded by $2.1 billion. With the growing pool of patients and a shrinking number of doctors, Obamacare has only proven itself to be nothing more than a politician promising the entire country a new car, but only giving them a set of keys. Real healthcare reform is not expanding insurance while shrinking care and paying back your cronies. Real fiscal reform is not seeking federal dollars as a stopgap measure for a county and state budget drowning in debt.

This isn't HC reform in ANY way. It's a fiscal nightmare, and steals choice and freedom. It's laying the foundation for centralized federal gov't control over individuals, and begins the skid into ending America, and beginning a European "social justice" nanny state democracy.

And not even an ounce of tort reform because the greedy tort lawyers OWN Obama and the corrupt DemocRAT party.

 

[Claudette]

I think we will find the ACA will be anything but affordable to those of us who pay for our beni's and buy our own.

The taxpayers will be "subsidizing" everyone who can't buy their own coverage. Another huge entitlement that we cannot afford.

None of those idiots who passed this clusterfuck read the damned thing. We won't know whats in it till we pass it. Numbnuts Pelosi. If its like every other thing the Govt touches it will be a nightmare of paperwork, red tape and cost.

Are the POTUS, the VP, Congress and all Fed workers going to be dumped into the ACA or is it just we taxpayers who are going to get screwed??

 

[Luddly Neddite]

I think we will find the ACA will be anything but affordable to those of us who pay for our beni's and buy our own.

The taxpayers will be "subsidizing" everyone who can't buy their own coverage. Another huge entitlement that we cannot afford.

None of those idiots who passed this clusterfuck read the damned thing. We won't know whats in it till we pass it. Numbnuts Pelosi. If its like every other thing the Govt touches it will be a nightmare of paperwork, red tape and cost.

Are the POTUS, the VP, Congress and all Fed workers going to be dumped into the ACA or is it just we taxpayers who are going to get screwed??

They've had this same system for many years now and YOUR taxes pay for it. If its so bad, why don't they get rid of it and pass a better system for themselves?

Remember the asshole teepotter who threw a fit after being elected because he wasn't get insurance coverage immediately.

There's a link to an explanation of the new law in my sig that you MIGHT be interested in. If not, that's okay too.

 

[Greenbeard]

The AP's been doing yeoman's work this week to make this all intelligible. In addition to the overview in the OP, they've released a brief health care overhaul glossary and a useful Q&A on the exchanges:

Q: What's a health insurance exchange?

A: "Exchange" is just another word for "marketplace." The plans sold in the new markets will start covering patients on Jan. 1, 2014. Each state will have its own exchange serving people who buy their health insurance directly, as well as a separate one for small businesses. The vast of majority of people now covered by employer plans will not see a change.

There will be three types of exchanges at the beginning: those run by states, those run by the federal government, and partnerships. Most Republican governors opposed to "Obamacare" are letting Washington run the exchanges in their states.

For consumers, the benefits should be the same no matter who runs the exchange.

Q: How will exchanges work?

A: Exchanges are supposed to have the feel of an online travel site — think Orbitz or Expedia. Middle-class people will be able to pick from a range of private insurance plans, and most people will be eligible for help from the government to pay their premiums.

Low-income people will be steered to safety-net programs for which they might qualify. This could be a problem in states that choose not to expand their Medicaid programs under a separate part of the health care law. In that case, many low-income residents in those states would remain uninsured.

Q: How will I know if I can get help with my health insurance premiums?

A: You'll disclose your income to the exchange at the time you apply for coverage and they'll let you know. Only legal residents of the United States can get financial assistance.

The health care law offers sliding-scale subsidies based on income for individuals and families making up to four times the federal poverty level, about $44,700 for singles, $92,200 for a family of four. But do yourself a favor and read the fine print because the government's help gets skimpier as household income increases.

For example, a family of four headed by a 40-year-old making $35,000 will get a $10,742 tax credit toward an annual premium of $12,130. They'd have to pay $1,388, about 4 percent of their income, or about $115 a month. A similar hypothetical family making $90,000 will get a much smaller tax credit, $3,580, meaning they'd have to pay $8,550 of the same $12,130 policy. That works out to more than 9 percent of their income, or about $710 a month.

The estimates were made using the nonpartisan Kaiser Family Foundation's online calculator. Some people will also be eligible for help with their copayments.

Final note: Though it's called a "tax credit" the government assistance goes directly to the insurer. You won't see a check.

Q: What will the benefits look like?

A: The coverage will be more comprehensive than what's now typically available in the individual health insurance market, dominated by bare-bones plans. It will be more like what an established, successful small business offers its employees. Premiums are likely to be higher for some people, but government assistance should mostly compensate for that.

All plans in the exchange will have to cover a standard set of "essential health benefits," including hospitalization, doctor visits, prescriptions, emergency room treatment, maternal and newborn care, and prevention. Insurers cannot turn away the sick or charge them more. Middle-aged and older adults can't be charged more than three times what young people pay. Insurers can impose penalties on smokers.

Because the benefits will be similar, the biggest difference among plans will be something called "actuarial value." A new term for consumers, it's the share of expected health care costs that the plan will cover.

There will be four levels of coverage, from "bronze," which will cover 60 percent of expected costs, to "platinum," which will cover 90 percent. "Silver" and "gold" are in between. Bronze plans will charge the lowest premiums, but they'll have the highest annual deductibles. Platinum plans will have the highest premiums and the lowest out-of-pocket cost sharing.

Here's a wrinkle: The government's subsidy will be tied to the premium for the second-lowest-cost plan at the silver coverage level that's available in your area. You could take it and buy a lower cost bronze plan, saving money on premiums. But you'd have to be prepared for the higher annual deductible and copayments.

 

[dblack]

Kibbles and Bits

 

[tap4154]

The AP's been doing yeoman's work this week to make this all intelligible. In addition to the overview in the OP, they've released a brief health care overhaul glossary and a useful Q&A on the exchanges:

Q: What's a health insurance exchange?

A: "Exchange" is just another word for "marketplace." The plans sold in the new markets will start covering patients on Jan. 1, 2014. Each state will have its own exchange serving people who buy their health insurance directly, as well as a separate one for small businesses. The vast of majority of people now covered by employer plans will not see a change.

There will be three types of exchanges at the beginning: those run by states, those run by the federal government, and partnerships. Most Republican governors opposed to "Obamacare" are letting Washington run the exchanges in their states.

For consumers, the benefits should be the same no matter who runs the exchange.

Q: How will exchanges work?

A: Exchanges are supposed to have the feel of an online travel site — think Orbitz or Expedia. Middle-class people will be able to pick from a range of private insurance plans, and most people will be eligible for help from the government to pay their premiums.

Low-income people will be steered to safety-net programs for which they might qualify. This could be a problem in states that choose not to expand their Medicaid programs under a separate part of the health care law. In that case, many low-income residents in those states would remain uninsured.

Q: How will I know if I can get help with my health insurance premiums?

A: You'll disclose your income to the exchange at the time you apply for coverage and they'll let you know. Only legal residents of the United States can get financial assistance.

The health care law offers sliding-scale subsidies based on income for individuals and families making up to four times the federal poverty level, about $44,700 for singles, $92,200 for a family of four. But do yourself a favor and read the fine print because the government's help gets skimpier as household income increases.

For example, a family of four headed by a 40-year-old making $35,000 will get a $10,742 tax credit toward an annual premium of $12,130. They'd have to pay $1,388, about 4 percent of their income, or about $115 a month. A similar hypothetical family making $90,000 will get a much smaller tax credit, $3,580, meaning they'd have to pay $8,550 of the same $12,130 policy. That works out to more than 9 percent of their income, or about $710 a month.

The estimates were made using the nonpartisan Kaiser Family Foundation's online calculator. Some people will also be eligible for help with their copayments.

Final note: Though it's called a "tax credit" the government assistance goes directly to the insurer. You won't see a check.

Q: What will the benefits look like?

A: The coverage will be more comprehensive than what's now typically available in the individual health insurance market, dominated by bare-bones plans. It will be more like what an established, successful small business offers its employees. Premiums are likely to be higher for some people, but government assistance should mostly compensate for that.

All plans in the exchange will have to cover a standard set of "essential health benefits," including hospitalization, doctor visits, prescriptions, emergency room treatment, maternal and newborn care, and prevention. Insurers cannot turn away the sick or charge them more. Middle-aged and older adults can't be charged more than three times what young people pay. Insurers can impose penalties on smokers.

Because the benefits will be similar, the biggest difference among plans will be something called "actuarial value." A new term for consumers, it's the share of expected health care costs that the plan will cover.

There will be four levels of coverage, from "bronze," which will cover 60 percent of expected costs, to "platinum," which will cover 90 percent. "Silver" and "gold" are in between. Bronze plans will charge the lowest premiums, but they'll have the highest annual deductibles. Platinum plans will have the highest premiums and the lowest out-of-pocket cost sharing.

Here's a wrinkle: The government's subsidy will be tied to the premium for the second-lowest-cost plan at the silver coverage level that's available in your area. You could take it and buy a lower cost bronze plan, saving money on premiums. But you'd have to be prepared for the higher annual deductible and copayments.

Thank you David Axelrod, but we do NOT want this clusterfuck of a law which the nation cannot afford, which leads to worse care and rationing, less doctors, FAR less personal freedom and choice, less jobs, and which will be RIFE with abuse and fraud

 

[WillowTree]

yeah. having larger pools of people and thereby lowering prices is a terrible idea.

how much have the prices gone down?

 

[Staidhup]

yeah. having larger pools of people and thereby lowering prices is a terrible idea.

how much have the prices gone down?

Actually the pools will be adjusted to reflect the claims of the participants, which translates into increased participation expense. When you factor in that no one can be denied participation based on prior or current physical conditions is a clear indicator that pool claims will increase as with rates. But then again no one read the law. Talk to Senator Reid, about Varian Medical, he just learned the caps that will be in place will severely hamper one of his major supporters, now he is calling foul. If your a smoker your rates will be increased 50%. You wanted a free ride, sorry sucker, you won't be getting it. Lets here it for the new health care tax.

 

[dblack]

yeah. having larger pools of people and thereby lowering prices is a terrible idea.

how much have the prices gone down?

Actually the pools will be adjusted to reflect the claims of the participants, which translates into increased participation expense. When you factor in that no one can be denied participation based on prior or current physical conditions is a clear indicator that pool claims will increase as with rates. But then again no one read the law. Talk to Senator Reid, about Varian Medical, he just learned the caps that will be in place will severely hamper one of his major supporters, now he is calling foul. If your a smoker your rates will be increased 50%. You wanted a free ride, sorry sucker, you won't be getting it. Lets here it for the new health care tax.

Yeah. Let's hear it.

Whether bulldozing everyone into the corporate health insurance 'pools' temporarily lowers insurance rates, or by how much, is irrelevant. A one time drop in rates won't matter if health care prices continue to rise. It will simply represent a short delay in our descent into a place where none of us can get health care, regardless of who is paying for it.

As bad as it is, the real crime of PPACA isn't the gross violation of individual rights embodied in the mandate. The worse aspect is that it doesn't even address the actual problem. It simply uses the problem as an excuse to further solidify corporatist control over our lives. Fuck every single one of you who is cheering for this shit.