What do you think happens with the ACA subsidies?

[JoeB131]

ndividual coverage exchange plans created by the Affordable Care Act (ACA) have a glaring problem: nearly 12 million enrollees, or 35 percent of all exchange enrollees in 2024, do not use their benefits at all.2 For these enrollees, known as zero-claim enrollees, health coverage did not translate to health care. Many zero-claim enrollees are known as “phantoms”—people who are enrolled but not practically in the market because they are enrolled in other coverage or are unaware of their exchange plan coverage. Large insurers benefit greatly from phantom enrollment, as they collect billions of dollars in taxpayer funds to cover individuals who cost them nothing.

Guy, you are a little confused here.

Not using your benefits means "you didn't get sick that year."

You'd probably see the same number in private insurance plans.

I know that in 2022, 2020, 2019, 2018, I didn't see a doctor for anything. Didn't need to. I wasn't sick. 2024 was different because I got some testing I had been putting off for years, and my wife was added to my plan.

(I did use my dental and vision plans but that's a different issue.)

And this is what Room-Temperature IQ Republicans like you don't get. Whether a plan is run by the government or a private company, it's still socialist collectivism. You are either paying in more than you are taking out, or you are taking out more than you pay in.

 

[hadit]

Or Republicans will just cave, because TACO.

And you will then praise them for doing the right thing, as defined by you?

Or will you continue griping about them, per usual?

 

[JoeB131]

And you will then praise them for doing the right thing, as defined by you?

Or will you continue griping about them, per usual?

I don't praise people for doing the right thing for the wrong reasons.

We should have single payer or a public option, not keep trying to paper over increasingly large gaps in the system by subsidizing big insurance.

 

[hadit]

I don't praise people for doing the right thing for the wrong reasons.

The difference, however, is that you insist you know why they do what they do. You don't.

We should have single payer or a public option, not keep trying to paper over increasingly large gaps in the system by subsidizing big insurance.

Health insurance has badly distorted the healthcare system for everyone, I agree. When the price a doctor or hospital charges varies wildly for the same treatment if insurance is involved or not, there's a problem. I do believe we will inevitably slump into a socialized system, given the way everything has gotten screwed up, and will suffer the same issues all socialized systems do, with shortages, long waiting times, death panels, etc. That being said, the smart thing would be to put the government in charge of covering diagnostic and preventative medicine, as that is generally lower cost and pays big dividends. If it was truly free at the point of sale and very easy to access, more people would get screened for problems that are less of an issue if they're caught early and there would be less strain on the system for treating people with late-stage cancers that they've ignored for decades, for just one example.

 

[JoeB131]

Health insurance has badly distorted the healthcare system for everyone, I agree. When the price a doctor or hospital charges varies wildly for the same treatment if insurance is involved or not, there's a problem. I do believe we will inevitably slump into a socialized system, given the way everything has gotten screwed up, and will suffer the same issues all socialized systems do, with shortages, long waiting times, death panels, etc. That being said, the smart thing would be to put the government in charge of covering diagnostic and preventative medicine, as that is generally lower cost and pays big dividends. If it was truly free at the point of sale and very easy to access, more people would get screened for problems that are less of an issue if they're caught early and there would be less strain on the system for treating people with late-stage cancers that they've ignored for decades, for just one example.

Uh, buddy, we have "Death Panels" now.

Just ask Nataline Sarkisyan. a Cigna "Death Panel" decided that a 65% survival rate wasn't good enough to justify her liver transplant.

We will eventually go to single payer because private insurance just doesn't work.

 

[hadit]

Uh, buddy, we have "Death Panels" now.

Just ask Nataline Sarkisyan. a Cigna "Death Panel" decided that a 65% survival rate wasn't good enough to justify her liver transplant.

That's what I mean by health insurance distorting things.

We will eventually go to single payer because private insurance just doesn't work.

My dad was a family doctor his whole career. In his peak earning years, the state of Delaware mandated that he had to join an HMO or lose Medicaid funding. Since Dad didn't want an organization mandating what he could and could not do for his patients, he cut back to 3 days a week and lost a third of his patient base. The government doesn't always work so well for patients either.

The bottom line remains, whoever pays for something controls that something, and when doctors and patients depend on an insurance company or the government to pay for healthcare, they are at the mercy of the company or the government for their healthcare. At least with insurance companies, you have a little competition and could possibly find one that works better for you. With the government, you have no options at all. It's either take what they give you or die.

 

[sparky]

Uh, buddy, we have "Death Panels" now.

Just ask Nataline Sarkisyan. a Cigna "Death Panel" decided that a 65% survival rate wasn't good enough to justify her liver transplant.

We will eventually go to single payer because private insurance just doesn't work.

and what guarantees exist that single payer won't make similar decisions Joe?

~S~

 

[hadit]

and what guarantees exist that single payer won't make similar decisions Joe?

~S~

That's my point. When a third party assumes financial responsibility for medical treatment, that treatment is going to be rationed. Let that sink in for a moment. It HAS to be rationed because we can't afford to give everything to everyone. That's the painful reality, and that means that inevitably some will get more than others. The wealthy can afford to drop a lot of money on medical treatments, so they will always have what they need, unless we go the Hillarycare option and put people in prison for going outside the system.

The bottom line remains, there will always be rationing of some kind. At least with private companies, there is the possibility of competition, and public shaming still works. With the government, there is no competition and shaming does nothing.

 

[sparky]

That's my point.

yes, crosspost there hadit.....apologies....~S~

 

[sparky]

At least with private companies, there is the possibility of competition, and public shaming still works. With the government, there is no competition and shaming does nothing.

spot on hadit......when any industry ,company or business is subsidized and/or made mandatory there is no need to compete for a customer base

customer service skills become secondary

merit takes a back seat to mediocracy

~S~

 

[leftwinger]

Guy, you are a little confused here.

Not using your benefits means "you didn't get sick that year."

You'd probably see the same number in private insurance plans.

I know that in 2022, 2020, 2019, 2018, I didn't see a doctor for anything. Didn't need to. I wasn't sick. 2024 was different because I got some testing I had been putting off for years, and my wife was added to my plan.

(I did use my dental and vision plans but that's a different issue.)

And this is what Room-Temperature IQ Republicans like you don't get. Whether a plan is run by the government or a private company, it's still socialist collectivism. You are either paying in more than you are taking out, or you are taking out more than you pay in.

You left out they don't know they were enrolled. Ghost enrollees. Not all but many.

 

[SaxonJackson]

Actually, that's the way the rest of the world does it.

It's why an MRI only costs $280 in France but $1000 in the US.

Yup. And you're only on a waiting list for a year before you get your cheap MRI. God forbid you have a nail in your eye.

 

[leftwinger]

//* Ghost enrollees to show ACA is needed. Sign up a bunch of por names (fully subsidised) they dont even know they are on it? Sane as ignorant illegals floating on voter rolls. I dont make em up, I only report it back to you. *//

people who are enrolled but not practically in the market because they are enrolled in other coverage or are unaware of their exchange plan coverage.

 

[leftwinger]

Guy, you are a little confused here.

Not using your benefits means "you didn't get sick that year."

You'd probably see the same number in private insurance plans.

I know that in 2022, 2020, 2019, 2018, I didn't see a doctor for anything. Didn't need to. I wasn't sick. 2024 was different because I got some testing I had been putting off for years, and my wife was added to my plan.

(I did use my dental and vision plans but that's a different issue.)

And this is what Room-Temperature IQ Republicans like you don't get. Whether a plan is run by the government or a private company, it's still socialist collectivism. You are either paying in more than you are taking out, or you are taking out more than you pay in.

//* No confused at all. Simply reporting to all. More to come. Too much for one post. You cheese brains have to be spoon fed. *//

The surge in fraud traces back to the establishment of the Biden-era “COVID credits” that made taxpayers 100 percent fully subsidize millions of ACA plans, while loosening verification rules and allowing year-round sign-ups. These policies created irresistible incentives:

Brokers could sign anyone up, or switch existing customers, for a $0 premium plan and get paid themselves.
Insurers profited from a flood of new “members” who never filed a claim but generated monthly premium payments funded completely by American taxpayers.
Consumers, unaware they’d been enrolled, only discovered the fraud when their tax refunds disappeared.

Democrats' Failed Health Care Policies: Obamacare Fraud Results in Billions for Insurance Companies, Denied Claims for Patients - Ways and Means

Washington, D.C. – President Biden’s temporary COVID-era “enhanced” Affordable Care Act (ACA) tax credits have resulted in unprecedented fraud, with wealthy...

waysandmeans.house.gov

 

[leftwinger]

It needs a look into. Not more funding.

Across the country, innocent Americans are paying the price:

A woman living in a homeless shelter was lured into signing false paperwork and lost her HIV treatment coverage as a result. Another said she had been paid to sign up “probably five times.”
In Miami-Dade County, more supposedly low-income residents are now enrolled in free Obamacare plans than actually live there—despite most already having other health insurance or being ineligible due to their immigration status.
Ashley Zukoski (NC) lost a $4,100 tax refund after being unknowingly enrolled in a fully subsidized plan.
Michael Debriae (NC) was enrolled in a plan without his consent and was on the hook for $2,445 in owed taxes.
Amy Shepherd (GA) saw her plan switched three times without her consent, causing stress and consternation.
Conswallo Turner (TX) responded to a Facebook ad that promised “cash cards” resulting in multiple changes to her plan and dropping of coverage for her son, without her consent.
Angela Wells (TX) saw her insulin copay jump from $2 to $50 after a broker switched her plan without consent.
Evelyn Teah (IA) told regulators, “Oscar Insurance used me for a whole year. I never got a card, I never went to the doctor, but they collected every month.”
Dafud Iza (FL) pleaded guilty in a $133 million fraud scheme enrolling homeless individuals using stolen data.
Tiesha Foreman (GA) found out she owed the IRS $1,700 for a plan she never knew existed. Her family’s legitimate coverage was canceled after a rogue broker switched their policy without consent.
Randy Delaney (OH) discovered his family had a problem with their plan being switched without their consent when they went to the pharmacy to pick up insulin. “You can imagine my shock when they told us it was $1,096…” Lorie Delaney, his wife, said: “It’s just like somebody is in there just messing with your life every day.”
“I believe this is the largest health insurance fraud case ever,” said Atlanta Attorney Jason Doss, who filed a lawsuit on behalf of families across the country.

 

[Seymour Flops]

Or Republicans will just cave, because TACO.

Is that your prediction or are you just stating the obvious fact that anything "could" happen?

 

[Seymour Flops]

Actually, that's the way the rest of the world does it.

It's why an MRI only costs $280 in France but $1000 in the US.

Hmm . . . no thanks.

 

[JoeB131]

and what guarantees exist that single payer won't make similar decisions Joe?

~S~

Well, to start with, they have no profit motive to do so.

Secondly, they would be a lot more susceptible to public outrage. One call to a Congressman will straighten that shit right out.

 

[JoeB131]

Hmm . . . no thanks.

I don't waste my time on AI Garbage.

 

[JoeB131]

Is that your prediction or are you just stating the obvious fact that anything "could" happen?

NO, I just see what Trump is trying right now. he's running these laughable commercials that he's standing up to big insurance.