What does it mean when an Insurance Co. Opts Out of Obamacare?

[GaMaCC]

What does it mean when an insurance company Opts Out of Obamacare? Does that mean they can't or won't write insurance in the state? If they're not part of the Obamacare network, what are the ramifications for a policy holder?

Specifically asking because Aetna just announced that in MA they may opt out of Obamacare, and I was simply curious?

 

[JakeStarkey]

They want a higher end population.

 

[Mac1958]

What does it mean when an insurance company Opts Out of Obamacare? Does that mean they can't or won't write insurance in the state? If they're not part of the Obamacare network, what are the ramifications for a policy holder?

Specifically asking because Aetna just announced that in MA they may opt out of Obamacare, and I was simply curious?

It means that the various regulations that go along with participating in that state's program have made it unattractive for that company to do business there. Health insurance companies typically aim for about a 5% net profit, and when they can't come close they just fold up their tent. The 5% goal is only a projection, and the company must have a buffer in case claim experience gets too high.

There is not an "Obamacare network". Each individual company decides whether it will participate in each individual state, and each plan has its own provider network within that state (actually, within counties). If Aetna opts out, you'll need to find another plan, hopefully your doc will be on it. Whatever, that "you can keep your doctor" thing was just fooling around, the standard response from the ACA apologists is "tough shit".

Once the ACA is able to drive enough insurers out of states and counties with costs and regulations, it will be easier to The Government to assume control of the system. Then we won't have to worry about insurers any more, because Our Great & Glorious Leaders in Central Planning will be making our decisions for us, which is what we all so desperately need, because they're special and know what's best for us.

Yay!

.

 

[GaMaCC]

So, the insurance company completely opts out of writing in the state? Now I understand how "he's" forcing this and we'll end up with the single payer option. God Help Us!

 

[boedicca]

It means it is the insurance equivalent of a bank that didn't issue subprime loans.

 

[william the wie]

It means it is the insurance equivalent of a bank that didn't issue subprime loans.

It also means that the costs associated with Ocare will lead to partial or total state collapse of state exchange states.

 

[boedicca]

It means it is the insurance equivalent of a bank that didn't issue subprime loans.

It also means that the costs associated with Ocare will lead to partial or total state collapse of state exchange states.

Which is why ObamaCare includes provisions for a Big Bailout of Insurance Companies.

 

[GaMaCC]

OK, what would drive an insurance company to not write in a particular state? ie, Aetna maybe pulling out of MA. What makes a MA worse than, say NJ or IN? I must say, it's quite confusing, why one company might pull out, but not another (sigh).

 

[Agit8r]

Well, many states have their own federated exchanges. My guess is that MA is still covered under RomneyCare, which was more progressive than the federal law.

 

[GaMaCC]

Got it, thanks to all for answering. It's hard to keep up with all the information swirling around and to know and understand what is correct and what is editorializing.

 

[LoneLaugher]

Got it, thanks to all for answering. It's hard to keep up with all the information swirling around and to know and understand what is correct and what is editorializing.

If you would like a source for accurate information regarding the ACA, just say the word and I will provide a link.

However, the "god help us" comment that you made above in regard to single payer leaves me with the impression that you are not very interested in accurate information.

 

[GaMaCC]

Well, you'd be wrong assuming I don't want accurate information.

 

[LoneLaugher]

Well, you'd be wrong assuming I don't want accurate information.

The following links take you to people who provide accurate information regarding the ACA and the impact that it has on the economy. Seek out their books, articles and media appearances.

About Aaron | The Incidental Economist

MIT Economics : Jonathan Gruber

 

[emilynghiem]

Well, many states have their own federated exchanges. My guess is that MA is still covered under RomneyCare, which was more progressive than the federal law.

I hope the difference is well noted between states voting to implement their own health care policies versus federal govt imposing mandates without citizens voting on the legislation.

If people generally agree that abortion is better off prevented than happening, yet do not agree with federal govt "imposing this as law" in place of people's free choice,
why can't people see the same applies to health care and insurance mandates.

You could prove it works better, and it STILL should be voted on directly by people first (and/or passing an amendment giving federal govt and Congress authority to make such laws on behalf of people and states), in order to pass Constitutional standards.

As long as it was not proven in advance and chosen freely, then it is faith-based and imposed by government, like establishing a national religion based on this faith that other people do not share, did not consent to, but are being penalized for if they do not follow.

People took shortcuts to push this laws bypassing Constitution procedures, until stopped by a lawsuit or otherwise amended by legislation.

This is like justifying rape or theft until someone stops you. Saying no is not enough to stop such acts as against someone's consent: This sets a dangerous precedent that something is legal until proven otherwise, although people clearly dissented, and explained citing many different laws showing the violations. Like justifying rape as "they want it anyway and say no when they mean yes." All Democrat liberal arguments for prochoice and right of consent to just say no were just thrown out the window. If we decide what's best for you, you need to follow it by law; your consent and choice don't count, because your opinion is wrong and doesn't matter. Very dangerous to abuse political power to force laws through govt that don't follow Constitutional process in order to bypass consent and representation. More sickening that liberal Democrats don't see they were the ones pushing for prochoice and keeping govt out of health choices, and went totally against this when it suited their political agenda. Scary.

 

[Geaux4it]

Got it, thanks to all for answering. It's hard to keep up with all the information swirling around and to know and understand what is correct and what is editorializing.

If you would like a source for accurate information regarding the ACA, just say the word and I will provide a link.

However, the "god help us" comment that you made above in regard to single payer leaves me with the impression that you are not very interested in accurate information.

THis is all the accurate information we need

-Geaux

Obamacare will push 2 million workers out of labor market: CBO

Obamacare will push the equivalent of about 2 million workers out of the labor market by 2017 as employees decide either to work fewer hours or drop out of the job market altogether, according to estimates released Tuesday by the Congressional Budget Office.

The analysis set off a furious debate in Washington.

The White House argued that the reduction is positive because it means Americans will forgo jobs or extra work to stay home with their children or strike out on their own as entrepreneurs. Republicans, however, said the report amounted to an “I told you so” moment and that subtracting the equivalent of 2 million workers can’t be good for the economy.

SEE ALSO: College presidents, corporate CEOs to help Obama in end-run around Congress
The CBO said the number of workers dropping out of the labor force will grow from 2 million in 2017 to 2.5 million by 2024

Read more: Obamacare will push 2 million workers out of labor market: CBO - Washington Times

 

[emilynghiem]

Well, you'd be wrong assuming I don't want accurate information.

The following links take you to people who provide accurate information regarding the ACA and the impact that it has on the economy. Seek out their books, articles and media appearances.

About Aaron | The Incidental Economist

MIT Economics : Jonathan Gruber

Here are links to spiritual healing resources
that provide free help to heal of cancer, mental and criminal illness, abuse, addiction etc:
freespiritualhealing | Resources for Healing and Forgiveness Therapy

This would have even greater impact on the economy, ending govt waste on crime and mental health addictions placated instead of cured, etc.

But wait, this spiritual healing cannot be imposed by govt. Even though it would do more to provide health care coverage for more of the population by saving resources as well as lives.

Gee, if spiritual healing must be freely chosen and can't be mandated though it works better, how come the federal govt can be used to impose health insurance mandates?

On the other hand, if the federal govt can impose health care mandates,
why not include a requirement to undergo spiritual healing? to save public resources?

if you are going to mandate one, why not the other that works better, cuts costs,
and save lives and resources so more coverage can be provided to more of the population.
possibly by redirecting taxes already spent on prison health care, and using those
resources to cover public health and services to more people w ith the same budget?

why not mandate spiritual healing instead of health insurance

 

[william the wie]

MD, MA and OR will be investigated by the house to publicize Ocare screw-ups on the state level

 

[oldfart]

Obamacare will push 2 million workers out of labor market: CBO

Obamacare will push the equivalent of about 2 million workers out of the labor market by 2017 as employees decide either to work fewer hours or drop out of the job market altogether, according to estimates released Tuesday by the Congressional Budget Office.

The analysis set off a furious debate in Washington.

The White House argued that the reduction is positive because it means Americans will forgo jobs or extra work to stay home with their children or strike out on their own as entrepreneurs. Republicans, however, said the report amounted to an “I told you so” moment and that subtracting the equivalent of 2 million workers can’t be good for the economy.

SEE ALSO: College presidents, corporate CEOs to help Obama in end-run around Congress
The CBO said the number of workers dropping out of the labor force will grow from 2 million in 2017 to 2.5 million by 2024

Read more: Obamacare will push 2 million workers out of labor market: CBO - Washington Times

Perhaps you could point me to the portion of the CBO report that makes that claim. It seem to be at odds with their official position.

Because the longer-term reduction in work is expected to come almost entirely from a decline in the amount of labor that workers choose to supply in response to the changes in their incentives, we do not think it is accurate to say that the reduction stems from people “losing” their jobs.

CBO | Frequently Asked Questions About CBO?s Estimates of the Labor Market Effects of the Affordable Care Act

 

[oldfart]

What does it mean when an insurance company Opts Out of Obamacare? Does that mean they can't or won't write insurance in the state? If they're not part of the Obamacare network, what are the ramifications for a policy holder?

Specifically asking because Aetna just announced that in MA they may opt out of Obamacare, and I was simply curious?

There are two provisions of the ACA that are at work here. First, health insurers are free to join or not join the state or federal marketplaces as they see fit. This is usually the case currently when the news reports that a given carrier is "not participating" in a given state.

Second, the ACA requires that all health insurance meet certain standards to remain eligible for favorable tax treatment. The administration delayed this provision until 2015 to allow companies to renew non-compliant policies people already had.

Everyone is still free to buy any policy any company may offer no matter how crappy it is. For example, if next year you want to buy a policy that has a $25,000 annual deductible and does not cover cancer, heart disease, or metabolic disorders; you are free to do that. You just cannot claim the medical insurance premium for income tax purposes. Realistically, only a few hospital indemnity, accident policies and similar policies will survive without being modified to meet the ten standard requirements.

 

[william the wie]

What does it mean when an insurance company Opts Out of Obamacare? Does that mean they can't or won't write insurance in the state? If they're not part of the Obamacare network, what are the ramifications for a policy holder?

Specifically asking because Aetna just announced that in MA they may opt out of Obamacare, and I was simply curious?

There are two provisions of the ACA that are at work here. First, health insurers are free to join or not join the state or federal marketplaces as they see fit. This is usually the case currently when the news reports that a given carrier is "not participating" in a given state.

Second, the ACA requires that all health insurance meet certain standards to remain eligible for favorable tax treatment. The administration delayed this provision until 2015 to allow companies to renew non-compliant policies people already had.

Everyone is still free to buy any policy any company may offer no matter how crappy it is. For example, if next year you want to buy a policy that has a $25,000 annual deductible and does not cover cancer, heart disease, or metabolic disorders; you are free to do that. You just cannot claim the medical insurance premium for income tax purposes. Realistically, only a few hospital indemnity, accident policies and similar policies will survive without being modified to meet the ten standard requirements.

There are large parts of the country where there are or were no exchange coverage policies available, failed state exchanges and other problems stacked up in the IRS and courts. Not being a lawyer I will not speculate on how and when that will change the law but wild cards are probable.