Obamacare 5 years later. Crow, anyone?

[surrogate]

I would be all for this. In the latter example, I see no reason why society should subsidize the construction industry by covering the extra average health care costs associated with it. The construction industry should be covering these costs itself, by being forced to pay the extra cost in higher health insurance premiums or in higher wages as compensation.

Wouldn't someone that got hurt be covered under a worker's compensation policy instead of their regular health insurance for any injury suffered while on the job?

This link states that the premium for a worker's compensation policy is tied to risk.

 

[RandFan]

Wouldn't someone that got hurt be covered under a worker's compensation policy instead of their regular health insurance for any injury suffered while on the job?

This link states that the premium for a worker's compensation policy is tied to risk.

As a narcissist and former WC and Liability auditor, I can tell you that it is a requirement by law unless you meet the criteria for an exemption (exemptions are state based).

Workers' Compensation Laws - State by State Comparison

I can also tell you it is absolutely tied to risk. Roofers are really high compared to clerical work. Oddly, I was surprised how high the premium was for nurses and other similar professions. Turns out they have a high rate of back problems.

 

[Emily's Cat]

But doesn't the act contain more employer mandates? Provide insurance or face fines?

Yes, but there are a LOT of loopholes and ways around it. And in many cases, the fines involved are considerably less than the cost of providing coverage.

Of course, that only applies to employees who work 30 hours per week, which is why I know people who were suddenly cut back to 29 hours per week.

Maybe in the long term it will cut that link, which would be a very good thing.

In addition to hours being cut, there's also the ability to:

• Either don't cover dependents or charge full-fare for them
• Increase the employee's portion of costs until it is closer to prevailing Individual market costs
• Reclassify one full time position as two part time positions (or some similar substitution factor)
• Divide companies into small subsidiaries, each with fewer than 50 employees, thus circumventing the fine altogether
• Probably some others that I (and those I've talked to in my industry) haven't been devious enough to come up with

 

[Skeptic Ginger]

...
Consider a friend of mine, who comes from a long line of ridiculously wealthy people. He's young, and healthy, and doesn't need insurance (because he can pay for what he needs directly). He's pretty sure that he shouldn't be forced to buy insurance.

That's what "self insured" refers to, people who have the funds to pay and don't chose to insure themselves. I don't know how the mandate addresses this but I'd be surprised with all the money in DC that they left the exception out.

...Another friend isn't wealthy... but she's young and healthy and doesn't have a lot of cash. She gets a subsidy, sure, but even so she's paying part of the cost - and that $45 a month is really more than she can spare. She hasn't had any health issues, and doesn't really foresee the need for any.
... pointing out that not everyone who complains about having to buy insurance is "short-sighted". There's a lot more involved in it than that.

Again, these are the people gambling with my money. I'm pretty sure the subsidies are sufficient. People just choose other priorities because they don't think about the fact they are gambling with other people's money.

 

[Skeptic Ginger]

... Should women pay more for car insurance? ... Statistically speaking, both have far more auto accidents than white males.

You have that backward. Men have more vehicle accidents.

 

[Skeptic Ginger]

Wouldn't someone that got hurt be covered under a worker's compensation policy instead of their regular health insurance for any injury suffered while on the job?

This link states that the premium for a worker's compensation policy is tied to risk.

Yes, on the job injuries fall under worker's comp health insurance.

 

[Emily's Cat]

You have that backward. Men have more vehicle accidents.

I was under the impression that men in their teens and twenties have more accidents, but older than that women take the cake. I could be mistaken, of course, auto insurance is not my specialty

 

[wareyin]

You have that backward. Men have more vehicle accidents.

It's my understanding that, although the numbers are close, women have more accidents per mile driven than men. Men drive more miles, so they have more accidents total.

 

[Nihilianth]

And they don't try because they heard it was too expensive.

It's like someone refusing to shop around to purchase green veggies in various different stores, because they "heard from someone that they are too expensive." Therefore, they eat 99 cent hamburgers from McDonald's, then cry about how fat they are.

 

[Z]

It's like someone refusing to shop around to purchase green veggies in various different stores, because they "heard from someone that they are too expensive." Therefore, they eat 99 cent hamburgers from McDonald's, then cry about how fat they are.

You can get a hamburger for 99 cents??? Wow... The last time I tried going into McD's, the basic burger was $1.29! (Their 'Dollar Menu' included a 3-pc Chicken Nugget and several non-meat-related items, and that was it.)

Considering the Whopper was $4.75 across the street (for just the burger), I think it's some kind of inflated-price neighborhood. But they have a Deals at the corner... Got a jumbo burrito there for a dollar!

...

sorry, way off topic...

I wasn't personally affected by Obamacare, being a Veteran; but my ex is still struggling with it. She earns next to nothing, is unofficially disabled (because apparently, inability to stand or walk due to ELS isn't a disability), and still can't get coverage. Of course, she's also... well, let's just say she lives in a world of imagination, where she does things in her mind that never quite make it to reality...

I think it was a step in the right direction. But I also think we'll need to fine-tune it over the next 10-20 years, until it does basically become socialized medicine - or until we find the miracle Homeopathic remedy for everything wrong ever (Sea water, right? It's been in contact with everything on Earth at one time or another...).

 

[Skeptic Ginger]

I was under the impression that men in their teens and twenties have more accidents, but older than that women take the cake. I could be mistaken, of course, auto insurance is not my specialty

It's my understanding that, although the numbers are close, women have more accidents per mile driven than men. Men drive more miles, so they have more accidents total.

Depends on how you define driver safety and which stats you look at. Did you look at that link?

Researchers who studied thousands of traffic accidents over a 20-year period came up with a finding that even they found surprising: Female drivers are far more likely to run into a car driven by another woman than a man.

That paragraph doesn't say women are worse drivers. It says they crash into other women drivers. That's bound to be the time of day and location where they spend more time on the road.

They cite a single study for more women driver accidents per mile driven:

Researchers at Johns Hopkins University found that female drivers were involved in slightly more crashes then men, but the difference was not all that great -- 5.1 crashes per million miles driven for men, compared to 5.7 crashes for women.

Fender bender effect? Can't tell because the link to the study is dead.

The rest of that article says men are worse drivers.


So let's look at the data, not a news report.

http://www.iihs.org/iihs/topics/t/general-statistics/fatalityfacts/gender

Per capita passenger vehicle occupant death rates during 1975 to 2013 have been about 1.8 to 2.6 times higher for males than for females. From 1975 to 2013, the rate of passenger vehicle occupant deaths per 100,000 people decreased 57 percent among males and 42 percent among females.

The data is consistent when you look at driver, as well as passenger gender.

Seventy-one percent of all motor vehicle crash deaths in 2013 were males. Males accounted for 70 percent of passenger vehicle driver deaths, 51 percent of passenger vehicle passenger deaths, 99 percent of large truck driver deaths, 71 percent of large truck passenger deaths, 69 percent of pedestrian deaths, 87 percent of bicyclist deaths, and 91 percent of motorcyclist deaths.

Men speed more and are more often driving drunk than women.

It's hard to reconcile this data with the news report. Perhaps someone else can track down whatever data they were citing so we can see what the discrepancy is.

 

[3point14]

Disregard. I really must learn to pay attention.

 

[Brainster]

The NY Times dumps this story on the Fourth of July:

Health Insurance Companies Seek Big Rate Increases for 2016

Blue Cross and Blue Shield plans — market leaders in many states — are seeking rate increases that average 23 percent in Illinois, 25 percent in North Carolina, 31 percent in Oklahoma, 36 percent in Tennessee and 54 percent in Minnesota, according to documents posted online by the federal government and state insurance commissioners and interviews with insurance executives.

The Oregon insurance commissioner, Laura N. Cali, has just approved 2016 rate increases for companies that cover more than 220,000 people. Moda Health Plan, which has the largest enrollment in the state, received a 25 percent increase, and the second-largest plan, LifeWise, received a 33 percent increase.

 

[Giordano]

The NY Times dumps this story on the Fourth of July:

Health Insurance Companies Seek Big Rate Increases for 2016

You know, I am hoping to ask for a big raise in 2016 too! Should I get together with these companies?

Yes, I'm certain that the asteroid will hit any time now and prove all the anti-Obamacare predictions correct. Eventually.

 

[Fudbucker]

You know, I am hoping to ask for a big raise in 2016 too! Should I get together with these companies?

Yes, I'm certain that the asteroid will hit any time now and prove all the anti-Obamacare predictions correct. Eventually.

It's a valid point. If ACA premiums jump by 20+ points in multiple states, it's going to look very bad.

Keep in mind though, that these are preliminary premium hikes that are being requested. They have to be negotiated with the states.

I think Brainster is going to be proven partly right: there will be some states with double digit premium increases, with the majority of states settling on high single digit increases. It won't be devastating to the ACA, but it won't look all that good either.

 

[Brainster]

It's a valid point. If ACA premiums jump by 20+ points in multiple states, it's going to look very bad.

Keep in mind though, that these are preliminary premium hikes that are being requested. They have to be negotiated with the states.

I think Brainster is going to be proven partly right: there will be some states with double digit premium increases, with the majority of states settling on high single digit increases. It won't be devastating to the ACA, but it won't look all that good either.

Consider some of the plans discussed in the NY Times article:

“Our enrollees generated 24 percent more claims than we thought they would when we set our 2014 rates,” said Nathan T. Johns, the chief financial officer of Arches Health Plan, which covers about one-fourth of the people who bought insurance through the federal exchange in Utah. As a result, the company said, it collected premiums of $39.7 million and had claims of $56.3 million in 2014. It has requested rate increases averaging 45 percent for 2016.

If their claims are the same in 2015 as they were in 2014, they would need a 42% increase just to break even on premiums and claims; that's without paying a penny in salaries or other overhead.

Federal officials have often highlighted a provision of the Affordable Care Act that caps insurers’ profits and requires them to spend at least 80 percent of premiums on medical care and related activities. “Because of the Affordable Care Act,” Mr. Obama told supporters in 2013, “insurance companies have to spend at least 80 percent of every dollar that you pay in premiums on your health care — not on overhead, not on profits, but on you.”

The New Mexico insurer would have to get premium increases of 77% to have 20% left over to pay for the lights.

At Blue Cross and Blue Shield of Minnesota, for example, the ratio of claims paid to premium revenues was more than 115 percent, and the company said it lost more than $135 million on its individual insurance business in 2014. “Based on first-quarter results,” it said, “the year-end deficit for 2015 individual business is expected to be significantly higher.”

 

[Fudbucker]

Consider some of the plans discussed in the NY Times article:



If their claims are the same in 2015 as they were in 2014, they would need a 42% increase just to break even on premiums and claims; that's without paying a penny in salaries or other overhead.



The New Mexico insurer would have to get premium increases of 77% to have 20% left over to pay for the lights.

The recent news doesn't look good. It looks like the pool of insurees in a lot of states skews old and sick without enough young healthies to balance out. That's just my takeaway after reading some articles today.

I think there's a decent chance that Brainster will be proven right, and premium increases will sky-rocket in more than just a couple states.

 

[Monketi Ghost]

 

[paulhutch]

Consider some of the plans discussed in the NY Times article:

If their claims are the same in 2015 as they were in 2014, they would need a 42% increase just to break even on premiums and claims; that's without paying a penny in salaries or other overhead.

The New Mexico insurer would have to get premium increases of 77% to have 20% left over to pay for the lights.

It amazes me that these insurance companies are so incredibly bad at estimating expenses when issuing quotes (actually with those magnitude of errors they're more accurately described as pure guesses than estimates). Once they adjust their rates they'll probably loose a lot of customers to the companies that correctly estimated expenses and where actually cheaper for the consumer once the other companies errors are accounted for.

 

[Giordano]

What I think some posters are trying to tell me is that after years of relentlessly telling untrue horror stories against Obamacare to scare people away from the associated plans, and the usual commitment of the USA to private enterprise and free choice, then people who had the choice (i.e. healthier and younger) didn't enroll as much as hoped, and the plans tended to enroll the sick and elderly people who really needed health insurance? Assuming that the health insurance companies are now calculating correctly.

More broadly, I always anticipated that it would cost more to insure people who weren't insured, and that the people first likely to enroll in these plans were the people who weren't enrolled, but needed them the most. I don't see how to insure the most sick people without it costing more. But we will have to see how it all works out, and if the usual push of private insurers for ever-increasing rates is accurate and approved. What I see is a strong argument for universal government run health care insurance to average the risk and cost over everyone. The only other choice is to not help the people who need it most.