Senator Max Baucus : Redefining "The Public Option"

[Care4all]

You are confused. Under HIPAA, the company can only look back six months to exclude you from coverage in the group plan for pre existing conditions or can cover you for everything but the pre existing conditions if its group plan allows that. The exclusion can be for a period of up to 12 months, but at the end of the exclusion period the company can look back over the last six months and exclude you again if "medical advice, diagnosis, care, or treatment was recommended or received during the 6 months". In this manner, you could be excluded forever from the group plan.

Frequently Asked Questions about Portability of Health Coverage and HIPAA

Nonetheless, a six month look back period is much shorter than insurance companies would like, however, people who go to work everyday are likely to be healthier than those who cannot make it to work, and as people become sicker, they are more likely to lose their jobs and their health insurance. Insurance companies would prefer a five year look back period to a six month look back period, and a five year look back period would produce lower group rates than a six month look back period does, but the higher group rates the six month look back period produces is somewhat mitigated by the fact that sick people tend to drop out of coverage, but that will not happen under any of the plans now being considered. That means group rates as well as individual rates are going to increase because of the exclusion of a look back period and because the plan will have to continue to pay the costs of people who become too sick to work and would have previously dropped out.

In principle, the shorter the look back period is, the higher the risk to the insurance company and the higher the group premiums are; the higher the drop out rate for sick people, the lower the risk to the insurance company and the lower the group premiums are. Therefore, insuring everyone at standard rates, no look back period, and requiring insurance companies to continue paying health care costs even after some one can no longer work or even pay his/her premiums will raise the cost of health insurance for everyone whether he/she is insured by a group plan or an individual policy. There are no free lunches to be had here.

I have no idea why you think I am opposed to health co-ops. I like the concept and have no problem with the experiment, but since we have had health co-ops and other non profits for decades I see not reason to think these new ones will have any more effect on health care/insurance costs than the ones we already have have had.

yes, i was confusing you with someone else...

ok, what you say does make sense...

but i will say, not one company's insurance in my or my husbands 25-30 year work history, did not cover preexisting conditions from the day the work insurance policy began.

so right now they are at a 6 mo. looking back period but will be going to no months looking back period?


wonder how much higher the costs will go?

According to the estimates from the guy from the University of Michigan, they will go up between 10% and 15% just for the coverage of pre existing conditions. Costing an employee with a family of four another $520 to $780 a year.

Insured might pay more under Obama plan - Health care reform- msnbc.com

Capping out of pocket expenses will cause them to go even higher and requiring insurance companies to continue coverage even after the person becomes too ill to work and pay premiums will cause them to go even higher.

The higher premiums go, the more likely some who now have insurance will be forced to drop it and the fewer who will be enabled to buy with the money available for subsidies. I just don't think it is possible to significantly increase access without at the same time taking steps to significantly lower health care and health insurance costs and nothing that will significantly lower health care and health insurance costs on an ongoing basis in included in any of the plans now under consideration.

sheesh...for a blue cross/bs Anthem individual insurance policy, covering my husband and i, who are both approaching our 50's, with no preexisting conditions and no prescription drugs that we have been prescribed that we have to take regularly, and both non smokers, covering 80% of medical costs, with a $2000 dollar deductible on some things, before they pay a dime, is $2100 a month, $25,000 a year for the 2 of us, here in maine....I CAN NOT IMAGINE it getting any higher than THAT? individual policies on the free market is where the problem lies...the group policy with an employer is 1/3 this amount...why is that?

 

[obama2ndterm]

the latest Senate Finance Committee compromise bill would reportedly allow insurance companies to charge most employers more to insure women employees - this while the current system that Republicans are defending includes rescission which itself allows for pre-existing conditions to include being beaten by your spouse or being pregnant.

Every woman in this country supporting the Republicans and the status quo is directly or indirectly also supporting canceling or precluding insurance for battered women or pregnant women.

 

[toomuchtime_]

yes, i was confusing you with someone else...

ok, what you say does make sense...

but i will say, not one company's insurance in my or my husbands 25-30 year work history, did not cover preexisting conditions from the day the work insurance policy began.

so right now they are at a 6 mo. looking back period but will be going to no months looking back period?


wonder how much higher the costs will go?

According to the estimates from the guy from the University of Michigan, they will go up between 10% and 15% just for the coverage of pre existing conditions. Costing an employee with a family of four another $520 to $780 a year.

Insured might pay more under Obama plan - Health care reform- msnbc.com

Capping out of pocket expenses will cause them to go even higher and requiring insurance companies to continue coverage even after the person becomes too ill to work and pay premiums will cause them to go even higher.

The higher premiums go, the more likely some who now have insurance will be forced to drop it and the fewer who will be enabled to buy with the money available for subsidies. I just don't think it is possible to significantly increase access without at the same time taking steps to significantly lower health care and health insurance costs and nothing that will significantly lower health care and health insurance costs on an ongoing basis in included in any of the plans now under consideration.

sheesh...for a blue cross/bs Anthem individual insurance policy, covering my husband and i, who are both approaching our 50's, with no preexisting conditions and no prescription drugs that we have been prescribed that we have to take regularly, and both non smokers, covering 80% of medical costs, with a $2000 dollar deductible on some things, before they pay a dime, is $2100 a month, $25,000 a year for the 2 of us, here in maine....I CAN NOT IMAGINE it getting any higher than THAT? individual policies on the free market is where the problem lies...the group policy with an employer is 1/3 this amount...why is that?

Maine has the fourth highest health insurance rates in the country, after Massachusetts, Connecticut and New Hampshire, I believe. The Baucus plan would try to pay for some of the costs of the bill by imposing an excise tax on "Cadillac" health insurance plans, and Maine's rates are so high that even ordinary plans might fall into the "Cadillac" class and have to pay this tax in time according to your Senator Snowe, and she is saying this might keep her from voting for it.

Individual policies cost more than group policies for two reasons. First, although it varies from company to company, employers pay an average of about 70% of the cost. Second, since overwhelmingly Americans get their health insurance from their employers, there is not much competition in the individual market to drive costs down. If insurers were able to sell national policies across state lines and employees were free to apply the company contribution to the purchase of an individual policy, competition would intensify and premiums would fall perhaps allowing some one like yourself to find a policy that could let you pocket some of the money you are now paying for health insurance. Companies choose health insurance plans that best address the needs of the company, not the ones that best address the individual needs of its employees.

 

[PI2]

Baucus represents less than three tenths of a percent of the American population and has been co-opted by the money he receives from the Health care industry.
He should be stripped of his chair and go broil a trout or a moose burger or whatever they do in Dumbass Montana.

 

[Ame®icano]

Senator Max Baucus : Redefining "The Public Option"

 

[Contumacious]

Everything's a "Crisis" these days. .

Yes, indeed, bureaucrats love crisis and emergencies. The History of the US shows that the most bold face usurpations occurred during "emergencies"!!!!!!!!!!!!!!!!!!!!!!!!!!!!


.

 

[VaYank5150]

the latest Senate Finance Committee compromise bill would reportedly allow insurance companies to charge most employers more to insure women employees - this while the current system that Republicans are defending includes rescission which itself allows for pre-existing conditions to include being beaten by your spouse or being pregnant.

Every woman in this country supporting the Republicans and the status quo is directly or indirectly also supporting canceling or precluding insurance for battered women or pregnant women.

I REALLY hope you have something to back this up? Can you provide a link to this info?

 

[Care4all]

According to the estimates from the guy from the University of Michigan, they will go up between 10% and 15% just for the coverage of pre existing conditions. Costing an employee with a family of four another $520 to $780 a year.

Insured might pay more under Obama plan - Health care reform- msnbc.com

Capping out of pocket expenses will cause them to go even higher and requiring insurance companies to continue coverage even after the person becomes too ill to work and pay premiums will cause them to go even higher.

The higher premiums go, the more likely some who now have insurance will be forced to drop it and the fewer who will be enabled to buy with the money available for subsidies. I just don't think it is possible to significantly increase access without at the same time taking steps to significantly lower health care and health insurance costs and nothing that will significantly lower health care and health insurance costs on an ongoing basis in included in any of the plans now under consideration.

sheesh...for a blue cross/bs Anthem individual insurance policy, covering my husband and i, who are both approaching our 50's, with no preexisting conditions and no prescription drugs that we have been prescribed that we have to take regularly, and both non smokers, covering 80% of medical costs, with a $2000 dollar deductible on some things, before they pay a dime, is $2100 a month, $25,000 a year for the 2 of us, here in maine....I CAN NOT IMAGINE it getting any higher than THAT? individual policies on the free market is where the problem lies...the group policy with an employer is 1/3 this amount...why is that?

Maine has the fourth highest health insurance rates in the country, after Massachusetts, Connecticut and New Hampshire, I believe. The Baucus plan would try to pay for some of the costs of the bill by imposing an excise tax on "Cadillac" health insurance plans, and Maine's rates are so high that even ordinary plans might fall into the "Cadillac" class and have to pay this tax in time according to your Senator Snowe, and she is saying this might keep her from voting for it.

Individual policies cost more than group policies for two reasons. First, although it varies from company to company, employers pay an average of about 70% of the cost. Second, since overwhelmingly Americans get their health insurance from their employers, there is not much competition in the individual market to drive costs down. If insurers were able to sell national policies across state lines and employees were free to apply the company contribution to the purchase of an individual policy, competition would intensify and premiums would fall perhaps allowing some one like yourself to find a policy that could let you pocket some of the money you are now paying for health insurance. Companies choose health insurance plans that best address the needs of the company, not the ones that best address the individual needs of its employees.

max baucus IS the antichrist!

btw, we could not afford the individual plan....

it is a long story, but we get healthcare from matt's job, i don't work...it is around $350 a month for our share....but believe it or not, THAT is still unaffordable for us....due to many personal reasons...

my husband is a disabled vet, more than 30% disabled, so he qualified for VA health coverage, but took out the plan at work that covers us both...so that i could have insurance.

WELL, I had the stupid stupid silly silly idea that MAYBE if he just got his health care from the VA, though inconvenient due to the distance, we could SAVE money by buying an individual policy for me, and kill his private coverage.... plus the policy from his work is a real crap policy that covers the bare minimum after $1500 deductible....

SHEESH, was I way wrong.....WAY, WAY WRONG!!

i searched the net and came up with this bc.bs Anthem plan that individuals can buy...put in the info for myself and it was $1200 plus just for me, the 2 of us the $2100 a month...just utterly FLABBERGASTING to me! sheesh...

WHY would healthcare be so expensive here in maine? you can buy a home in bangor, about 30 miles from here...for 60k? No one but the very luckiest gvt workers or those maybe in southern maine near Portland, make much money....but most here, just get by...fishermen, lobster-men, small farms, lumber jack, working in a mall or hospital or shoreline hotel in the summer, or a papermill...they had a big manufacturing base in shoes until the us government opened up making shoes in hong kong, then china and brazil legal for import..... when ships were made of wood, they had ship building businesses that did quite well up here....for a time...

in my county, the average income for male is not quite $18k and female is about $16k...even $250 a month for health care with an employer is unaffordable when you consider the oil costs to heat up here....

OUTSIDE of all that, we moved here 3 years ago, and we both love the slow, mundane, yet survivalist life! makes us feel alive! more than any amount of monetary wealth could...been there, done that!

care

 

[toomuchtime_]

sheesh...for a blue cross/bs Anthem individual insurance policy, covering my husband and i, who are both approaching our 50's, with no preexisting conditions and no prescription drugs that we have been prescribed that we have to take regularly, and both non smokers, covering 80% of medical costs, with a $2000 dollar deductible on some things, before they pay a dime, is $2100 a month, $25,000 a year for the 2 of us, here in maine....I CAN NOT IMAGINE it getting any higher than THAT? individual policies on the free market is where the problem lies...the group policy with an employer is 1/3 this amount...why is that?

Maine has the fourth highest health insurance rates in the country, after Massachusetts, Connecticut and New Hampshire, I believe. The Baucus plan would try to pay for some of the costs of the bill by imposing an excise tax on "Cadillac" health insurance plans, and Maine's rates are so high that even ordinary plans might fall into the "Cadillac" class and have to pay this tax in time according to your Senator Snowe, and she is saying this might keep her from voting for it.

Individual policies cost more than group policies for two reasons. First, although it varies from company to company, employers pay an average of about 70% of the cost. Second, since overwhelmingly Americans get their health insurance from their employers, there is not much competition in the individual market to drive costs down. If insurers were able to sell national policies across state lines and employees were free to apply the company contribution to the purchase of an individual policy, competition would intensify and premiums would fall perhaps allowing some one like yourself to find a policy that could let you pocket some of the money you are now paying for health insurance. Companies choose health insurance plans that best address the needs of the company, not the ones that best address the individual needs of its employees.

max baucus IS the antichrist!

btw, we could not afford the individual plan....

it is a long story, but we get healthcare from matt's job, i don't work...it is around $350 a month for our share....but believe it or not, THAT is still unaffordable for us....due to many personal reasons...

my husband is a disabled vet, more than 30% disabled, so he qualified for VA health coverage, but took out the plan at work that covers us both...so that i could have insurance.

WELL, I had the stupid stupid silly silly idea that MAYBE if he just got his health care from the VA, though inconvenient due to the distance, we could SAVE money by buying an individual policy for me, and kill his private coverage.... plus the policy from his work is a real crap policy that covers the bare minimum after $1500 deductible....

SHEESH, was I way wrong.....WAY, WAY WRONG!!

i searched the net and came up with this bc.bs Anthem plan that individuals can buy...put in the info for myself and it was $1200 plus just for me, the 2 of us the $2100 a month...just utterly FLABBERGASTING to me! sheesh...

WHY would healthcare be so expensive here in maine? you can buy a home in bangor, about 30 miles from here...for 60k? No one but the very luckiest gvt workers or those maybe in southern maine near Portland, make much money....but most here, just get by...fishermen, lobster-men, small farms, lumber jack, working in a mall or hospital or shoreline hotel in the summer, or a papermill...they had a big manufacturing base in shoes until the us government opened up making shoes in hong kong, then china and brazil legal for import..... when ships were made of wood, they had ship building businesses that did quite well up here....for a time...

in my county, the average income for male is not quite $18k and female is about $16k...even $250 a month for health care with an employer is unaffordable when you consider the oil costs to heat up here....

OUTSIDE of all that, we moved here 3 years ago, and we both love the slow, mundane, yet survivalist life! makes us feel alive! more than any amount of monetary wealth could...been there, done that!

care

Health insurance rates are based mostly on the costs from providers, claims experience, competition and government taxes and regulations. I don't know much about Maine, but until recently Maine's public plan, Dirigo, was party paid for by a tax on private insurers and that probably drove up insurance rates from those companies. Dirigo is currently closed to new customers, due to financial difficulties I believe, but if it reopens, you might check on whether it has cheaper rates for you.

Dirigo Health Agency Home

 

[obama2ndterm]

pass a single payer bill with 51 and mid terms are won easily. Stop worrying abiut the minority they are meaningless!

 

[Care4all]

Maine has the fourth highest health insurance rates in the country, after Massachusetts, Connecticut and New Hampshire, I believe. The Baucus plan would try to pay for some of the costs of the bill by imposing an excise tax on "Cadillac" health insurance plans, and Maine's rates are so high that even ordinary plans might fall into the "Cadillac" class and have to pay this tax in time according to your Senator Snowe, and she is saying this might keep her from voting for it.

Individual policies cost more than group policies for two reasons. First, although it varies from company to company, employers pay an average of about 70% of the cost. Second, since overwhelmingly Americans get their health insurance from their employers, there is not much competition in the individual market to drive costs down. If insurers were able to sell national policies across state lines and employees were free to apply the company contribution to the purchase of an individual policy, competition would intensify and premiums would fall perhaps allowing some one like yourself to find a policy that could let you pocket some of the money you are now paying for health insurance. Companies choose health insurance plans that best address the needs of the company, not the ones that best address the individual needs of its employees.

max baucus IS the antichrist!

btw, we could not afford the individual plan....

it is a long story, but we get healthcare from matt's job, i don't work...it is around $350 a month for our share....but believe it or not, THAT is still unaffordable for us....due to many personal reasons...

my husband is a disabled vet, more than 30% disabled, so he qualified for VA health coverage, but took out the plan at work that covers us both...so that i could have insurance.

WELL, I had the stupid stupid silly silly idea that MAYBE if he just got his health care from the VA, though inconvenient due to the distance, we could SAVE money by buying an individual policy for me, and kill his private coverage.... plus the policy from his work is a real crap policy that covers the bare minimum after $1500 deductible....

SHEESH, was I way wrong.....WAY, WAY WRONG!!

i searched the net and came up with this bc.bs Anthem plan that individuals can buy...put in the info for myself and it was $1200 plus just for me, the 2 of us the $2100 a month...just utterly FLABBERGASTING to me! sheesh...

WHY would healthcare be so expensive here in maine? you can buy a home in bangor, about 30 miles from here...for 60k? No one but the very luckiest gvt workers or those maybe in southern maine near Portland, make much money....but most here, just get by...fishermen, lobster-men, small farms, lumber jack, working in a mall or hospital or shoreline hotel in the summer, or a papermill...they had a big manufacturing base in shoes until the us government opened up making shoes in hong kong, then china and brazil legal for import..... when ships were made of wood, they had ship building businesses that did quite well up here....for a time...

in my county, the average income for male is not quite $18k and female is about $16k...even $250 a month for health care with an employer is unaffordable when you consider the oil costs to heat up here....

OUTSIDE of all that, we moved here 3 years ago, and we both love the slow, mundane, yet survivalist life! makes us feel alive! more than any amount of monetary wealth could...been there, done that!

care

Health insurance rates are based mostly on the costs from providers, claims experience, competition and government taxes and regulations. I don't know much about Maine, but until recently Maine's public plan, Dirigo, was party paid for by a tax on private insurers and that probably drove up insurance rates from those companies. Dirigo is currently closed to new customers, due to financial difficulties I believe, but if it reopens, you might check on whether it has cheaper rates for you.

Dirigo Health Agency Home

I think the majority of the citizens in this state must be without insurance because i was reading up on the hospital near me...very small one, maybe 30 beds at best...and it said that 10% or 15% of their patients that come in without insurance...the hit has to be taken by the hospital all on its own for 'compassionate reasons before the State comes in to help any, if at all....i THINK this is regulated by the state, for you to be a hospital here???

If this is the case....also with most people not having insurance, the hospital probably tries to make up some of their losses by charging insurance companies more for each plan they negotiate with them? I dunno?

 

[LibocalypseNow]

As usual the politicians are screwing this whole thing up. There is a consensus for God's sake. Most Americans do agree that our Health Care System needs to be improved. So there is a consensus for this. They're making this thing much more complicated than it has to be. Instead of passing this behemoth legislative boondoggle which no on in Congress is going to read entirely,they should just take it apart and address each issue individually and with separate pieces of legislation. These types of massive spending bills never work out well in the end. There are problems with health care and most people agree on that. So lets just approach it with a bit more caution and begin where most people agree. Today's Politicians just love to manufacture this whole "Crisis" atmosphere so they can panic the people and then rapidly shove their boondoggles down our throats. There really is no need for such "Crisis" fear mongering. America will go on and so will the rest of the world if they decide to take their time to get it right. Just slow down and tackle each issue individually. What's the rush? This country has survived this long and i'm sure it will go on surviving if they do decide to take their time. I know this all sounds reasonable & logical but we are talking about Congress aren't we? Unfortunately i don't expect them to listen to me though as i really have gotten used to them not listening to the People. Lets all just hope they get it right in the end though.

 

[Contumacious]

As usual the politicians are screwing this whole thing up. There is a consensus for God's sake. Most Americans do agree that our Health Care System needs to be improved.

But the fascists want to drive a stake right through healthcare hearts ....to them that's reform.

 

[obama2ndterm]

For profit health care companies should go!

 

[Contumacious]

For profit health care companies should go!

Nahhhhh, you should go,