This. People seemed to have the idea that the cancelled policies were all pieces of garbage, like the one I had in college that had a $25,000 benefit limit. In reality a lot of those were decent policies just excluded services that the members didn’t need, like maternity or substance abuse, and / or had a high deductible- a $10,000 deductible policy might make sense for young, healthy adults- the premiums being a lot more affordable than a policy that pays for your strep throat visit while still protecting you from financial ruin if you get cancer or in a car accident.
Here’s the thing though- they excluded coverage that the members either don’t think they’ll need or didn’t think about at all , but that doesn’t necessarily mean the members are correct. I hear a lot about people not needing substance abuse, mental health or maternity coverage , and yes, if you’re in your mid-fifties you’re probably not going to have any more children , have a really low chance of suddenly picking up a heroin addition and most mental illnesses would have likely become evident long before. But that doesn’t mean your high school or college-aged daughter who was born in your thirties or forties and still covered under your plan won’t need maternity coverage or that you won’t end up addicted to prescription medication that you began taking for legitimate medical reasons or that the child born in your thirties or forties won’t need substance abuse or mental health treatment. Same thing with the $10,000 deductible policy for the young, healthy adults- what happens when that young adult needs treatment for something bigger than a strep throat (say an appendectomy) but can’t afford the $10,000 deductible? Depending on whether it’s an emergency or not , he’ll either get treated for free (which spreads the cost to everyone else’s bill) or he goes untreated.
People bringing up older folks that tragically now have to pay for maternity and pediatric coverage that they will never use amuse me. Obamacare’s regulations are, in most cases, a massive boon to older Americans, thanks to community rating. There is a maximum 3x differential in premiums based on age. Older folks may not have pediatric or maternity costs, but in general their costs are much higher than younger people’s, and Obamacare essentially requires that younger people’s premiums subsidize older people’s. That’s why most of the “rate shock” stories are about young people.
You’d only take a $10,000 deductible if you could afford to get hit with it. Maybe you have a 401K you can borrow from, or even put it on your credit card an pay it off over a period of years. If you can’t afford it, ,yeah, it would be foolish to buy a plan with a $10,000 deductible, but for a lot of people we’re not talking about an insurmountable amount of money like $100,000 worth of cancer treatment. We actually sold quite a few of those them, the typical member seemed to be either a single adult or married in their 20s or 30s. Some of these people evidently had even more money to burn, as when they did have claims they’d go out-of-network which had a separate $20,000 deductible that does not cross apply.
My hypothetical was a single young healthy adult with no dependents, say someone too old for his parents policy and not able to get insurance through his work. If you had a teenage daughter on that policy you’d bet it would be a good idea to get maternity, substance abuse, etc.
EDIT: Also, maybe people are choosing to self-insure to a degree, using high deductible policies as a stop-loss. They’re saving X dollars per year for whatever comes up, whether they need a new roof, a new furnace, pay a health insurance deductible.
You should only take a $10 k deductible if you can afford the $10K,but that doesn’t mean those are the only people who would do it. Unless we let hospitals turn people away , even in emergencies, there will be people who buy the cheapest policy available figuring they’ll get that emergency surgery even if they can’t pay for it. You haven’t seen them because they won’t buy any insurance unless they have no choice.
And about the maternity coverage-that wasn’t specifically about your example. It just seems like a lot of people believe that it’s self-evident that a couple in their mid-fifties doesn 't need it. Some couples in their mid-fifties don’t need it and others do-same as couples in their thirties.
I’ve never bought an individual insurance policy, so this is a serious question. Are they so individualized that I could buy a policy that excludes any treatment that I know I’ll never need (say coverage for an appendectomy because I’ve already had one) or are there certain standard policies and people choose from that menu (so that both men and women end up with a policy that covers both prostate and uterus ,even though an individual person needs one or the other) ?
And this is why Obamacare is destined to collapse.
Obama may be very popular among young people, but when it comes to their wallet, there will be a great deal of hesitation.
It is no secret to the young that they are being asking to pay for costly health care premiums with high deductibles that they feel are unnecessary. (Young people always feel like they will live forever.)The young realize that they are being *forced * (remember that they are mandated to participate in Obamacare) to pay these costs solely to subsidize the elderly and poor. Young people may not be very vocal in their opposition to “their” President’s call to do the “right thing” and buy health insurance, but they are certainly going to do everything thing they can to avoid opening their wallet for something they consider to be unnecessary, especially if they are being forced to do it.
And without almost universal participation in Obamacare by the young people in the US, the numbers will not come even close to adding up and the whole scheme will collapse.
Well, I think this got kind of far from the original question, but…
I have a pre-existing condition. Mine is genetic. I can do nothing about it. **I am signing up. **This is my only hope to have affordable health care. This is it. And almost 50% of the ENTIRE population (including about 1/4 of all 18-34 year olds) is considered by insurance companies to have a “pre-existing condition.” So people need to wait for the facts before making claims that nobody is signing up.
Ugh, I hate that no-editing-after-five minutes rule… The addendum was: The reason most people don’t know this is that they have coverage through employers. If you are self-employed, you are stuck.
No, at least not in my area. I was self-employed for 10+ years, and all the insurance policies I looked into pretty much only excluded pregnancy, unless I opted for additional coverage. I was never given a choice to exclude other things.
I did only limit my search to what I considered “real” policies - that is, not catastrophic-only coverage, not fly-by-night companies, etc. I shopped around between places like Blue Cross/Blue Shield, United, and other “big-name” companies.
This concept gets a lot of press, but I’m not sure it’s true. First off, I’m pretty sure that in a few years, the penalties will be high enough that it will be cheaper to get a low-level plan.
But secondly, I’m not sure I believe that young people are quite this stupid. I remember going for a few years without health insurance coverage in my early twenties, because my employer didn’t offer it and I was too old to be on my parent’s plan. I remember being rather freaked about this, and if I could get coverage with the rates I see quoted to 20-somethings, you bet I would have. I can’t believe I am the only 20-something who realized how screwed I’d be without coverage.
We’ll write a group policy to exclude or include anything HR wants as long as it’s legal. Individuals have to pick from one of our standard policies. Some of our policies exclude maternity benefits, and for some of them you can either include or exclude substance abuse benefits. It’s a mandate that mental health care be included on all policies, and Minnesota also has all kinds of other mandated benefits, from insulin pumps to wigs for certain conditions.
“In a few years”. How is the system going to survive while this “in a few years” period passes? The poor, the elderly and the “pre condition” individuals need the coverage (money) NOW.
Also remember that the monetary penalties for not signing up can only be taken out of a tax return refund due to the person who hasn’t signed up. If the “non sign up ee” has no declared income (works for cash under the table) or chooses the “right” number of dependents on their tax form and is not owed any tax refund, no penalty can be paid.
The IRS cannot take money out of your bank account (or make you sell your car) to pay the penalty for not signing up for Obamacare.
Young people know that they have few assets that could be taken to pay for their medical expenses. And if they had no insurance and were involved an accident, no emergency room would turn them away. The same would be true if they developed a serious medical condition like cancer. Just show up at the emergency room and some level of care would be administered.
No, not really. There are just 500 babies a year in the US born to women over 50, and most aren’t “oops” pregnancies since the odds of needing donor eggs or other fertility treatments is extraordinarily high past 50. Twice as many people are hit by lightening every year than have a baby over the age of 50.
I wonder how many people are just going to “game the system”–not sign up at all and go about their lives until they find a strange lump/have ominous internal pains/get in a car wreck and then immediately sign up for insurance before they make it to the hospital. It’s not against the rules, is it?
As said earlier threatening to withhold tax rebates is a pretty toothless way to enforce compliance for a crowd that isn’t likely to get rebates to begin with. I know I never have. As part of the “young invincibles,” why would I spend thousands per year for insurance I’ll never need? I may as well just pay the fine. Or even better, not at all.
You didn’t start from the beginning-there are a lot more than 500 high or college- aged daughters covered on their over- 50 parent’s policies. And those parents need the coverage as much as the thirty year old couple does.
Anecdotal evidence suggests a huge number of Americans are planning to simply pay the fine for not having insurance. $95 a year is a joke. That’s 8 bucks a month! Even when it eventually goes up to $600/year, that’s still cheaper than any healthcare policy you could ever hope to find.
Also, an issue that’s just beginning to be noticed (by the media, that is) is that seemingly all of the Obamacare policies come with high deductables, meaning that even if you have a policy, you’ll still face high out-of-pocket costs before the policy does you much good. That’s another factor that’s pushing people to say “Fuck it, I’ll pay the fine.”
Well, no, I suppose not, but isn’t that the whole point of enrollment periods? My understanding is that I can’t suddenly decide in July that I need health insurance and get enrolled that week.
Exactly right. People who have good employer-provided coverage don’t realize what the ACA plans require in terms of deductibles and out-of-pocket maximums (at least from my experience looking at what’s available to me). Nearly all of them have very large deductibles that have to be met before payments are made. And then the co-insurance payments continue.
Not wanting to get too far from the OP’s question, I’d say part of the issue is that the number of uninsured has been over-estimated and over-hyped. Most people get insurance from their employers. You have people on some type of government insurance. Then you have people - mostly young and healthy, but not all - who simply don’t want to pay for insurance and figure they don’t have enough assets to worry about. They can get care in emergency rooms and not pay for it, and don’t have any significant income or assets to come after. They aren’t going to lose their food stamps, Section 8 housing or welfare.
Then you have people like me who are self-employed and have insurance, but find the ACA plans unaffordable and unappealing.
Yeah, the design is you will have to sign up between October and December of each year for the following year. But I believe I have read about exceptions due to job loss or unexpected occurrences, no?
Really? Comparing the Obamacare plans to what I paid for insurance when I was self employed, the Obamacare is better. Not by a ton, but enough that it would make sense for me to change. I’m surprised to hear that you got it cheaper pre-Obamacare.