applecorped
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Increased 21.5% over previous year is a correction?
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CBO: Obamacare costs revised downward, again. Finds lower than expected premiums.
- Thread starter Peephole
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Increased 21.5% over previous year is a correction?
Skeptic Ginger
Nasty Woman
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Why wouldn't it count when it comes to health insurance?
Not to mention some people's insurance costs actually have gone down. My insurance rate went down two years in a row when normally it was scheduled to go up every year because it's based on age.
Crossbow
Seeking Honesty and Sanity
Did you actually read my posting?
If not, then please do so now and then determine if your question is still valid or not.
Thanks.
Spock Jenkins
Muse
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I'm speaking to the public claim of savings when something only goes up 10% vs. the expected 15%. It's still an increase. I don't see that as savings. Savings, in my mind, should be presented in parenthesis as a negative number. An item actually costing less than in prior years, not just a reduction in the anticipated increase.
Aside from that, health care costs are tricky. Premiums may go down, but if deductibles, co-pays, and co-insurance costs increase - are we really saving? As an example (which I started another thread on a while back) - I took the kids to an annual check up that cost a $20 co-pay in 2014. Because of changes in the way they bill - the same appointment cost over $180 in 2015. $40 co-pay, plus splitting out items that were included under the "office visit" umbrella in prior years becoming billable under deductible and/or co-insurance costs apart from the co-pay. This is our out-of-pocket cost above and beyond what the practice billed and the insurance paid. The amount the insurance company paid went down from over $170 to less than $50. Yay - savings (and more profit) for them!
Aside from that, health care costs are tricky. Premiums may go down, but if deductibles, co-pays, and co-insurance costs increase - are we really saving? As an example (which I started another thread on a while back) - I took the kids to an annual check up that cost a $20 co-pay in 2014. Because of changes in the way they bill - the same appointment cost over $180 in 2015. $40 co-pay, plus splitting out items that were included under the "office visit" umbrella in prior years becoming billable under deductible and/or co-insurance costs apart from the co-pay. This is our out-of-pocket cost above and beyond what the practice billed and the insurance paid. The amount the insurance company paid went down from over $170 to less than $50. Yay - savings (and more profit) for them!
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Ziggurat
Penultimate Amazing
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You are confused. That CBO report details federal spending, not premiums.
I've always wanted to serve as a member of a death panel. But so far no one has asked me.
Emily's Cat
Rarely prone to hissy-fits
Resident Health Actuary reporting for duty...
There could be several tings going on, and they may not be *directly* attributable to ACA. To be able to provide reasonable insights, I would need to know the following:
- Do you have more than, or less than 50 employees at your company that are eligible for health insurance coverage?
- Approximately what percentage of eligible employees have elected to take coverage through your company-offered insurance?
What state are you in?I see MA, so never mind.
The rules vary by the size and type of market - very big employers who self-fund (they pay their medical costs and pay the insurer only for administrative services and claim adjudication) have different rules than small group employers, who have slightly different rules than individual purchasers.
In addition, different types and sizes of market are more or less affected by what happens in ACA covered markets. So very big self-funded employers see virtually no effect from ACA, whereas small groups can potentially see very large effects both directly and indirectly.
Border Reiver
Philosopher
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Up here the former government was counting the unused sick leave of public servants a contingent liability. The proposed solution - abolish sick leave for periods for periods of more than 5 days (fortunately, this wasn`t put into effect before the most recent election).
sunmaster14
Penultimate Amazing
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My business just has two people - me and my partner (business partner, not romantic). I'm 50, and he's 33. He joined my plan in 2014 when his wife went to part-time work (before that, he was on her plan). The only change for 2016 (our year starts April 1) is that he had twins last year, so he has triple the number of kids (I have two older ones). The plan is a low deductible HMO. Nothing special about our expenses I don't think.
Emily's Cat
Rarely prone to hissy-fits
Given that, then yes, your increases are very likely due to ACA
They may not be a reflection of better or worse risk borne by the company that provides your insurance. They could also be an affect of that carrier making a pretty bad guess at what it would cost.
Right now, the ACA small group market (employers with <50 employees), is pretty unstable. It's all up & down all over the place... although it's unfortunately more up than down
Blue Mountain
Resident Skeptical Hobbit
Have you shopped around for other suppliers? A common complaint raised about single-payer systems is "there's no choice!" You're in a country that offers you freedom of choice in your healthcare insurance provider. Are you taking advantage of it?
sunmaster14
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No, except for the high premiums, I am happy with my plan. For me, the cost of switching is not worth it. As usual, I expect to free-ride off the cost-conscious decisions of other consumers, and I hope that their switching will keep BCBS's premiums in line. I do this for pretty much everything. I don't do much price comparison when I shop. I guess I'm a deadbeat in that regard.
Anyway, BCBS released a new report about how much more costly Obamacare exchange enrollees are than individual members prior to Obamacare, or employer-based members. Apparently, the Obamacare enrollees incur about 20% more health costs, and this is higher than was expected. I guess this explains the big hike in premiums in general.
Yep- people who really need health insurance are making use of this opportunity to get health insurance. Who would have thought?No, except for the high premiums, I am happy with my plan. For me, the cost of switching is not worth it. As usual, I expect to free-ride off the cost-conscious decisions of other consumers, and I hope that their switching will keep BCBS's premiums in line. I do this for pretty much everything. I don't do much price comparison when I shop. I guess I'm a deadbeat in that regard.
Anyway, BCBS released a new report about how much more costly Obamacare exchange enrollees are than individual members prior to Obamacare, or employer-based members. Apparently, the Obamacare enrollees incur about 20% more health costs, and this is higher than was expected. I guess this explains the big hike in premiums in general.
And if we provide health insurance and the associated health services to the people who really need it, it is going to cost more money than if we simply let those people suffer and die without access to health care. I guess that is one possible choice. Or we could go back to the system where these people waited until they were very ill and then went into the ER of hospitals, which was both less effective medically and more expensive financially.
I agree- every health insurance organization, every insurance organization, does best if it enrolls only the people who will never use it. For health insurance, any plan needs to spread the cost of its ill patients out among a larger group of healthy people. That is the very nature of insurance and it doesn't work any differently for any insurance scheme.
As I see it, this is a strong argument for a government single payer system which inherently balances the sick and the healthy enrollment. Having multiple plans as we do now allows (currently) healthy people to seek better rates and "dumps" the (currently) ill on plans that must take them and therefore must charge higher rates. Also this is a clear incentive for plans to offer cheaper rates by offering poorer payouts (often hidden as best as possible in the contract wording) or to deny or complicate attempts to obtain payouts. Finally, I will point out that many of the people who seek out plans with cheap rates and dicy payouts because they are currently healthy and "will not need much healthcare" may well be surprised by events in their future. I doubt I cost my insurance company more that $200 dollars a year until a few years ago, when a routine office visit lead to a $200,000 hospital stay. Thankfully I had paid an extra contribution for the more expensive insurance plan at work, and my insurance company paid for almost all of it. And I am only alive today because they did. If I had gone with the cheaper plan (and even that was only affordable because of the portion paid by my employer) I would have severely damaged the financial status of not just me, but my wife and kids.
Insurance by it's very nature means one pays in money and hopes not to "get it back" in payouts due to disasters. Costs have to be balanced by having a large enrollment of people who will not use the insurance much, to compensate for the minority who will. If a single payer plan (or just a tax-run government health plan) doesn't sound good to anyone here, then come up with an alternative. Or recognize that the only other choice is to allow sick people to suffer and to sometimes die unnecessarily.
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sunmaster14
Penultimate Amazing
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Thanks for the unenlightening non sequitur. The point is that there were certain claims and projections made about Obamacare by its advocates. Detractors pointed out that there would be significant gaming of the system by savvy health care consumers, despite the individual mandate. Young, healthy people would still refuse to buy health insurance, and older, sicker people would take advantage of the guaranteed issue, as well as the community rating (keeping their premiums down) to get implicitly subsidized health care (in addition to any explicit subsidies on offer by Obamacare).
The claims and projections were what they were, and the law was sold to the public according to those claims and projections. The reality is considerably worse than was claimed or "expected." There's really only three choices: the advocates got unlucky; or the advocates were flat out wrong and only the detractors were right; or the advocates were lying.
Personally, I'm partial to believing the third option. I think the insurers knew this was going to happen and expected to lose money, but didn't mind because the government was going to reimburse them for 95% of their losses by way of the risk corridors. Of course, they're screwed now, at least temporarily, thanks to Rubio's gutting of the risk corridors through some sneaky little legislating.
The claims and projections were what they were, and the law was sold to the public according to those claims and projections. The reality is considerably worse than was claimed or "expected." There's really only three choices: the advocates got unlucky; or the advocates were flat out wrong and only the detractors were right; or the advocates were lying.
Personally, I'm partial to believing the third option. I think the insurers knew this was going to happen and expected to lose money, but didn't mind because the government was going to reimburse them for 95% of their losses by way of the risk corridors. Of course, they're screwed now, at least temporarily, thanks to Rubio's gutting of the risk corridors through some sneaky little legislating.
The ACA is in a bit of trouble, as of late:
"Still, the fact that these patients are sicker than expected is putting some insurers in a financial bind. Several have reported big losses and have questioned whether they can afford to remain in the Obamacare market. This group includes UnitedHealth (UNH), the nation's largest insurer, which expects to lose nearly $1 billion on Obamacare in 2015 and 2016 and may not participate in 2017.
Some Blue Cross plans have also come under pressure.
Highmark, the nation's fourth-largest Blue Cross plan with members in Pennsylvania, West Virginia and Delaware, said its Obamacare members are older, have more chronic conditions and consume more health care services than its employer plan members. As a result, the company has lost more than $773 million in its first two years on the exchanges. It called the losses "unsustainable."
http://money.cnn.com/2016/03/30/news/economy/obamacare-patients-blue-cross-blue-shield/
Obamacare could never function as a long-term solution, but it's had to fill that role since the GOP won't do anything but vote to repeal it. The mandate that requires people have insurance should have a much more expensive penalty which cannot be avoided by simply finagling your taxes so you don't get a return.
Even that probably won't solve it's problems, but it would be a start.
"Still, the fact that these patients are sicker than expected is putting some insurers in a financial bind. Several have reported big losses and have questioned whether they can afford to remain in the Obamacare market. This group includes UnitedHealth (UNH), the nation's largest insurer, which expects to lose nearly $1 billion on Obamacare in 2015 and 2016 and may not participate in 2017.
Some Blue Cross plans have also come under pressure.
Highmark, the nation's fourth-largest Blue Cross plan with members in Pennsylvania, West Virginia and Delaware, said its Obamacare members are older, have more chronic conditions and consume more health care services than its employer plan members. As a result, the company has lost more than $773 million in its first two years on the exchanges. It called the losses "unsustainable."
http://money.cnn.com/2016/03/30/news/economy/obamacare-patients-blue-cross-blue-shield/
Obamacare could never function as a long-term solution, but it's had to fill that role since the GOP won't do anything but vote to repeal it. The mandate that requires people have insurance should have a much more expensive penalty which cannot be avoided by simply finagling your taxes so you don't get a return.
Even that probably won't solve it's problems, but it would be a start.
sunmaster14
Penultimate Amazing
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Well, to a large extent they knew they were setting their rates too low. This was done at the behest of the administration in order to make the optics of the Obamacare transition look better. The health insurers were willing to go along with it because the risk corridors made it so the government would reimburse almost all of their losses in the first three years (after which the insurers would raise prices on their "sticky" customers until they were profitable). The insurers are squealing like stuck pigs, however, because the government is reneging on its promise to reimburse them for their losses. As a consequence, the insurers are raising premiums faster than they intended (and what the administration wanted).
theprestige
Penultimate Amazing
You'd think everybody, but apparently the numbers are higher than projected. So whoever made the projections seems to have missed it.
thaiboxerken
Penultimate Amazing
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i have a few friends that are alive now because of the ACA. This is not hyperbole, the had no health insurance prior to the ACA and ER care would not have sufficed to treat their illnesses. But some people are paying a little bit more for health insurance, so let's repeal the ACA and let the poor die.
Emily's Cat
Rarely prone to hissy-fits
Apparently the CBO didn't think. The health actuaries of the nation, we all thought. But the fed somehow managed to convince itself (and a lot of consumers) that this wasn't the case.
Akshully....
ACA ends up overcompensating for higher-risk insureds and overpenalizing for lower-risk insureds. The health organizations that are doing well are those that have managed to enroll a somewhat riskier population - which also means they use more services. The companies that are losing their shirts are, for the most part, those that successfully attracted a disproportionate share of the young and healthy.
It's a whole new world out there.
I'm gonna snip here, because this premise, while well-thought out for pre-ACA business, is no longer accurate. The risk adjustment mechanism in place with ACA produces an inverse result. And since those risk adjustments must be taken into consideration when setting rates, it simply isn't how this marketplace works anymore
That said, there are still some pretty big problems. The underlying cost of care has still risen because the new entrants to the pool have higher health burdens. This results in a higher water-level. Almost everyone's premiums have gone up (there are exceptions at the individual level). The market is also still very unstable. There's a really long lag between when the experience is incurred and when the financial outcomes are known - this makes it exceedingly difficult for actuaries to effectively set prices. There's a lot more "guesswork" involved in our projections than there used to be.
There are also some weird intersections between federal regulations and state laws in some places that produce some odd problems, but they're quite varied so I won't really get into the ones I know of
.