[Winstonm]

bd71, on 2013-November-09, 18:10, said:

The Supreme Court decision did NOT give states the right to opt out and not run their own Exchange...that was always part of the law. The SC decision allow states to opt out of the Medicaid expansion and still retain the federal subsidies for their pre-existing Medicaid programs.

You are correct. Thanks for pointing out that error.

[FM75]

For those of you who want to read the bill - hey, you can if you want. Good luck understanding it.

https://www.govtrack...111/hr3590/text

If you want a nice, printable copy...
http://www.gpo.gov/f...11hr3590enr.pdf
You will want to visit Staples before you print this - at 906 pages - if you print on both sides you can get by with just a single ream of paper.
The table of contents is 12 pages. I wonder if that would fit in a BBO post. LOL

Yes, you can be sure that most of your congressmen did not read it - you will see why.

As to Winston's comment. Sorry, when I said "voters ... should go back to grade school" the voters that I was talking about were the congressmen who voted for it. It is hard to blame the voters who elected their fools - they never had a chance to read it first. (Congressmen used here referring to all of Congress, not just the House of Representatives). Perhaps we should add their staffers in the group that needs to go back to grade school - or maybe they are smart and just liars.

Note also when it was signed. Well after it was clear that the White House had already identified the problem of people getting their health care plans canceled.

As to the guy who so clearly stated that the plan allows any existing plan to be kept, I challenge you to find the wording to support that claim!

[Winstonm]

FM75, on 2013-November-10, 15:39, said:

For those of you who want to read the bill - hey, you can if you want. Good luck understanding it.

https://www.govtrack...111/hr3590/text

If you want a nice, printable copy...
http://www.gpo.gov/f...11hr3590enr.pdf
You will want to visit Staples before you print this - at 906 pages - if you print on both sides you can get by with just a single ream of paper.
The table of contents is 12 pages. I wonder if that would fit in a BBO post. LOL

Yes, you can be sure that most of your congressmen did not read it - you will see why.

As to Winston's comment. Sorry, when I said "voters ... should go back to grade school" the voters that I was talking about were the congressmen who voted for it. It is hard to blame the voters who elected their fools - they never had a chance to read it first. (Congressmen used here referring to all of Congress, not just the House of Representatives). Perhaps we should add their staffers in the group that needs to go back to grade school - or maybe they are smart and just liars.

Note also when it was signed. Well after it was clear that the White House had already identified the problem of people getting their health care plans canceled.

As to the guy who so clearly stated that the plan allows any existing plan to be kept, I challenge you to find the wording to support that claim!

I appreciate your response but once again I have to ask: what is your complaint? Are you simply bitching about the implementation or do you have something substantive to contribute about the law itself or why healthcare reform is not needed?

[Cthulhu D]

Using the dark magic of looking at the table of contents.. "29 CFR 2590.715-1251 - Preservation of right to maintain existing coverage" is where you want to go. It notes the specific conditions under which you can retain a plan, and the circumstances under which it would be ruled to be significantly changed (e.g. if the price increases by more than medical inflation, if copays increase by more than medical inflation etc).

It's farcical to expect this to be more simply written, regulation is complex and needs similar treatment.

[kenberg]

FM75, on 2013-November-10, 15:39, said:

For those of you who want to read the bill - hey, you can if you want.

Right after I finish Remembrance of things Past. Or after I win the lottery, whichever comes first. Since I don't buy lottery tickets and I don't own any Proust, it's a close call on which that will be.

[Zelandakh]

awm, on 2013-November-08, 18:14, said:

The funny thing about that statement is that insurers cancel policies all the time, replacing them with more expensive policies with higher deductibles. I don't think Obama's statement was intended (or taken, by anyone serious) to mean that your existing policy would be locked in for all time... only that the ACA would not force insurers to cancel or modify the existing policy.

In fact a lot of continuing policies are "grandfathered in" despite failing to meet some of the requirements in the new law. But not all of them. I'm curious what the real breakdown of cancellations is among: 1. Cases where the insurance company wanted to significantly modify the policy on their own and then blamed it on ACA vs. 2. Cases where ACA forced a modification of the policy. I'd bet there are actually a lot of the first case. And of course there is the argument that some of these are "junk insurance" to begin with.

I am not American and have not followed this story in any way. However I did read a piece that said all existing policies were grandfathered in at a certain date (2009? cannot remember) and the ones being cancelled now were "singnificantly changed" after that date. How significant was not reported but it did sound as though your #1 was pretty much all of them. But try telling a voter who has had their healthcare cancelled that this is actually not the same policy as the one they have been using for the last 20 years because some clause changed somewhere in the small print. Of course that article might have been wrong, or I might have misremembered. I was surprised noone brought it up in the following discussion, since you would have thought the Dems would be pushing that line for all it is worth if true.

[Cthulhu D]

Zelandakh, on 2013-November-10, 20:14, said:

I am not American and have not followed this story in any way. However I did read a piece that said all existing policies were grandfathered in at a certain date (2009? cannot remember) and the ones being cancelled now were "singnificantly changed" after that date. How significant was not reported but it did sound as though your #1 was pretty much all of them. But try telling a voter who has had their healthcare cancelled that this is actually not the same policy as the one they have been using for the last 20 years because some clause changed somewhere in the small print. Of course that article might have been wrong, or I might have misremembered. I was surprised noone brought it up in the following discussion, since you would have thought the Dems would be pushing that line for all it is worth if true.

100% of cancellations are from cause one, as every plan that existed as of 2010 has an exemption unless it is changed outside of indexation.

[Zelandakh]

Cthulhu D, on 2013-November-10, 20:17, said:

100% of cancellations are from cause one, as every plan that existed as of 2010 has an exemption unless it is changed outside of indexation.

Then the article was correct. However Rik posted:

Trinidad, on 2013-November-09, 03:19, said:

I don't get this outrage about (not) being able to keep your current plan. As I understand it, Obamacare basically is the following:

1. Everybody needs to have health insurance.
2. That health insurance needs to meet certain standards.
3. Everybody who has health insurance that meets the standards can keep theirs if they want to.
4. For everybody else (and for those who would like to change) Obamacare will facilitate a way to obtain an insurance that meets the standards.

and got 3 upvotes without anyone pointing out that this is wrong.

It seems that it would have been politically astute to add a clause in the Act that forced insurers to warn customers that their policy was about to be invalidated at the time of the change. That would have ensured that the insurers came front and central in the resulting blame game.

[Cthulhu D]

Zelandakh, on 2013-November-10, 20:25, said:

Then the article was correct. However Rik posted:

and got 3 upvotes without anyone pointing out that this is wrong.

It seems that it would have been politically astute to add a clause in the Act that forced insurers to warn customers that their policy was about to be invalidated at the time of the change. That would have ensured that the insurers came front and central in the resulting blame game.

Rik is wrong - specifically point three is wrong. ANY PLAN AT ALL that people were enrolled into prior to May 2010 does not need to meet the requirements of the Act and can be continued if the insurance company does not modify it 'significantly' where significant changes is basically deleting coverage areas and increasing fees, copays or other charges above the medical inflation index.

It's worth noting that less than 20% of Americans are able to correctly answer yes/no questions about the actual provisions of the act (Standford conducted polling where 0% of participants were able to answer the questions correctly(!), and only 14% could get more than half the questions right) , so I strongly recommend checking primary sources rather than believing some guys understanding, because there are very good odds they are wrong. You shouldn't believe me either, but I will point you at the relevant section of the legislation: 29 CFR 2590.715-1251 - Preservation of right to maintain existing coverage.

It's fascinating how misinformed Americans are about the provisions actually - and they are somewhere between 5 (republicans) and 15 (independent voters) times more likely to support the law when someone tells them what the actual provisions are.

[Winstonm]

accidental post deleted.

[Trinidad]

Zelandakh, on 2013-November-10, 20:25, said:

Then the article was correct. However Rik posted:

Trinidad, on 2013-November-09, 03:19, said:

I don't get this outrage about (not) being able to keep your current plan. As I understand it, Obamacare basically is the following:

1. Everybody needs to have health insurance.
2. That health insurance needs to meet certain standards.
3. Everybody who has health insurance that meets the standards can keep theirs if they want to.
4. For everybody else (and for those who would like to change) Obamacare will facilitate a way to obtain an insurance that meets the standards.

and got 3 upvotes without anyone pointing out that this is wrong.

What makes you think that this was wrong? Isn't:

Cthulhu D, on 2013-November-10, 20:38, said:

that people were enrolled into prior to May 2010, if the insurance company does not modify it 'significantly'

part of "certain standards"?

While you may consider my original post as wrong, the main part of the post still stands:

Trinidad, on 2013-November-09, 03:19, said:

I don't get this outrage about (not) being able to keep your current plan. It only makes sense that many people can keep their current insurance and others can not. How can this come as a surprise?

I do have one explanation: People hear very little information and a lot of rhetoric. Facts are less important than fears.

Rik

[blackshoe]

If I have a good plan, and it's acceptable to me, and prior to ACA it was acceptable to my insurance company, and if nothing in medical economy changes to make it significantly more expensive for my insurance company, then I should be able to keep that plan. There should not be cancellations by the insurance company willy-nilly just because ACA gives them an excuse to do so. In particular, policies for single men should not be cancelled just because they don't include a maternity provision. If any of that is indeed happening, then somebody has screwed the pooch in setting up the law.

If ACA sets reasonable minimum standards, and an existing plan does not meet those standards, then an acceptable (to all parties) minimum plan should be substituted. The way this should work is the insurance company should tell the customer "your current plan does not meet minimum ACA standards. Here's one that does. It will cost X more than your current plan (X is most likely positive, but might be zero or even negative). Please review it and let us know within thirty days whether it is acceptable to you. If it is not acceptable, we will negotiate with you to achieve an acceptable resolution. Until we do achieve an acceptable resolution, or confirm that we cannot do so, your current plan will remain in effect. If we do not hear from you by (30 days from now) or if you ask us to do so, we will cancel your existing policy, and you can choose another insurance company". Apparently that is not what is happening.

[hrothgar]

blackshoe, on 2013-November-11, 11:41, said:

If I have a good plan, and it's acceptable to me, and prior to ACA it was acceptable to my insurance company, and if nothing in medical economy changes to make it significantly more expensive for my insurance company, then I should be able to keep that plan. There should not be cancellations by the insurance company willy-nilly just because ACA gives them an excuse to do so.
If ACA sets reasonable minimum standards, and an existing plan does not meet those standards, then an acceptable (to all parties) minimum plan should be substituted. The way this should work is the insurance company should tell the customer "your current plan does not meet minimum ACA standards. Here's one that does. It will cost X more than your current plan (X is most likely positive, but might be zero or even negative). Please review it and let us know within thirty days whether it is acceptable to you. If it is not acceptable, we will negotiate with you to achieve an acceptable resolution. Until we do achieve an acceptable resolution, or confirm that we cannot do so, your current plan will remain in effect. If we do not hear from you by (30 days from now) or if you ask us to do so, we will cancel your existing policy, and you can choose another insurance company". Apparently that is not what is happening.

Never thought I'd see Ed arguing for government regulation...

[blackshoe]

I'm not arguing for government regulation, I'm acknowledging that we have it, and we have to deal with it.

[Cthulhu D]

Quote

The way this should work is the insurance company should tell the customer "your current plan does not meet minimum ACA standards. Here's one that does. It will cost X more than your current plan (X is most likely positive, but might be zero or even negative). Please review it and let us know within thirty days whether it is acceptable to you. If it is not acceptable, we will negotiate with you to achieve an acceptable resolution. Until we do achieve an acceptable resolution, or confirm that we cannot do so, your current plan will remain in effect. If we do not hear from you by (30 days from now) or if you ask us to do so, we will cancel your existing policy, and you can choose another insurance company". Apparently that is not what is happening.

Your current plan meets ACA standards regardless of what your plan is, because it is protected by the grandfather clauses. That is the entire point. This is 100% about the insurance company screwing you under the pretext of regulation.

Quote

What makes you think that this was wrong?

You bolded point 2, but point 3 is the incorrect, unclear or misleading statement. The only standard is that they have health insurance of any form whatsoever. The only other requirement is that the health insurance company wishes to keep offering the same plan. Which they are allowed to, unfettered by government regulation or anything else. The misunderstanding, incorrect or misleanding component is what Zelandakh is responding to

Quote

It seems that it would have been politically astute to add a clause in the Act that forced insurers to warn customers that their policy was about to be invalidated at the time of the change. That would have ensured that the insurers came front and central in the resulting blame game.

No policies at all are being invalidated. Not one.

[kenberg]

Aboput the idea of actually reading the bill. In addition to the work that is involved, my experience is that such an approach sounds more effective than it is. I bill becomes law. Then there are interpretations. These interpretations are passed on to others, who interpret the interpretations.

My approach is more like this: Apparently a lot of cancellations are being sent out. These cancellations are for the specific policy, not for the specific policy holder. That is, if Tom Jones holds policy X, the insurance company is cancelling because it is plam X, not because the holder is Tom Jones. Is it true that "This is 100% about the insurance company screwing you under the pretext of regulation.".? It's hard to see why.. Generally insurance companies are hoping that I will take out a policy with them. I am thinking that their lawyers, who perhaps have read and at least tried to understand the law and its ramifications, have told them that they can no longer provide plan X in its current form. Perhaps their lawyers have mis-interpreted, this can happen, but it just seems unlikely to me that the CEO on his own said "Hey, great, let's cancel all of our plan X holders and blame in on the government".


Determining exactly what the rules mean is not always easy. I told a while back of an experience involving medicare. The doc wanted me to follow plan A for a problem I had and sent me to a lab. The lab said I had to try plan B first because medicare would not pay for A unless we first tried plan B. I said I wanted what the doc said I needed, and if medicare would not pay for A then I would pay for A. I got A, and medicare paid for it. I have shortened the story, this did not happen all in one day. During the struggle I got through to someone at medicare. She was very nice, she knew what she knew, she did not know about A and B. There were, perhaps, people who did know but I couldn't talk to them. The lab could talk to them. But since the lab already "knew" the answer, they wouldn't. The lab knew wrong.

A shorter version of the same point, although only medical on the periphery, occurred just yesterday. My wife had a double knee replacement yesterday and while at the hospital I had lunch at the cafeteria. They have a special: Fish, two sides, a 20 oz soft drink. Can I get coffee instead of a soft drink? No, she said. Give me coffee anyway, I said, I'll pay for it. When I got to the cashier, she said that the coffee came with the special. I suppose the rules are written somewhere, but they get interpreted. Maybe she liked me.

More medically relevant: Within a day or two there will be physical therapy plans for the knees (It's all going fine, by the way). What will insurance pay for? Well, again, I want what the doc says we should have, how to pay for it is secondary. Secondary, but hardly irrelevant. Some people actually seem to understand how these policies work (I'm genetically incapable of this), what will be paid for, and, quite often, which magic words have to be said to get the policies to pay for it. These people are worth their weight in gold, even at gold's inflated price.

The above, of course, has to do with the complexity of medical coverage as it now exists. The ACA will make it all simpler. Uh huh.

Anyway, reading the bill might be an idea, but experience makes me skeptical. A place to start though, I suppose. But if I had to read every bill that is passed before I could have an opinion I would have damn few opinions. Paul McCartney echoes in my mind "What's wrong with that, I'd like to know".

[ArtK78]

Plans get canceled all of the time. Prior to a year ago, my firm had 3 coverage options - two types of PPO plans, and an HMO plan. The firm paid part of the premium on each plan, and the employee paid the rest. There were differing premiums on the three plans - PPO Plan A was the most expensive, PPO Plan B was less expensive, and the HMO Plan was the least expensive.

About a year ago, the insurance company eliminated PPO Plan A, and that reduced our choices to PPO Plan B and the HMO Plan.

This had nothing to do with the ACA.

While it may be true that insurance companies are using the ACA as an excuse for canceling plans now, it doesn't change the fact that plans get eliminated all of the time for various reasons (although I am sure the primary reason is profitability).

[Winstonm]

kenberg, on 2013-November-12, 07:27, said:

....but it just seems unlikely to me that the CEO on his own said "Hey, great, let's cancel all of our plan X holders and blame in on the government".

For the most part, I agree with this. At the same time, the motivation for corporations is to maximize profits, not to look after their customers' best interests. This is the greatest flaw with the present system, IMO, and a valid reason for single payer. There is inherent conflict now between the insurance companies' desire to maximize profits and the consumers' needs to receive high-quality healthcare.

In a single payer, there is a desire to provide high-quality healthcare at a cost that is affordable, and, in theory, that goal should be the same for payer and customer.

But, of course, this proposal would mean everyone would have to think and act like adults, which is highly unlikely when one sees that Sarah Palin, Michelle Bachman, and Rick Perry are still considered possible presidential candidates in 2016.

[HighLow21]

Winstonm, on 2013-November-12, 09:15, said:

...the motivation for corporations is to maximize profits, not to look after their customers' best interests...

Winston, this may seem ridiculous to you, but this point is lost on most Americans.

In all sincerity, though--corporations CAN be good for the general public, but it requires that the government properly direct their actions for this to be accomplished. The government makes the rules, period (and if they fail to make the rules, the corporations will, to their own benefit).

That was the tradeoff that was made when we decided to exclude the public option. It is deeply ingrained in the American culture to choose the "free market" over government solutions, thanks to Reagan and a number of others. Obamacare was designed to do exactly this--build a system whereby corporations can make their profits, but not at the expense of the American people's health.

I, for one, am against most of my American compatriots in this respect. I am deeply distrustful of corporations and their motives, just as Adam Smith was. I'd much rather have single-payer. But the concept of "free enterprise" is part of the American bloodstream, and the whole idea behind constructing it this way was to get Republicans on board with the plan because it remains pro-profit. Instead, they just continued to oppose it, because their viewpoint is that ANY cooperation with Obama and the Dems is bad for their party. (What's best for the American people, to them, is completely irrelevant.)

Note that I use the scare quotes because we don't really have free markets or free enterprise anywhere.

But trust me when I tell you those folks you mentioned are NOT credible Presidential candidates. Some may run but will be out of the primary by the 3rd state. Chris Christie is probably about a 70% favorite to win the GOP nomination in 2016 at this point.

[dwar0123]

Winstonm, on 2013-November-07, 08:04, said:

When the more wealthy are given tax breaks, that money does not go into circulation as capital spending unless there is demand for services. When there is no demand, the money is hoarded as treasury bonds - so the government loses twice - less tax revenue plus accrued interest on the bonds.

Increase demand for treasure bonds doesn't increase the number of treasure bonds issued, it lowers the interest rate paid out and consequently decreases the future number of bonds issued. The government is only losing once here