I just had my eyes checked and bought a pair of glasses last week, after having stepped on my glasses last spring. I haven’t been insured in years, and this fall is the first time in many months I’ve had the kind of money available to replace them.
I haven’t set foot in a doctor’s office in probably six or more years.
Make me feel better about me “getting screwed” for being a self-employed, lower-class (that’s a nasty-sounding moniker, but I’m definitely sub-middle-class), guy who can’t afford insurance and certainly wouldn’t be able to afford any sort of emergency procedure or regular care if needed.
I’m not picking on you, but the system is broken for many people, and if the cost of providing reasonable and affordable care to those earning as little as I am means that some people will find paying for health care less convenient, then so be it.
Under any UHC the government would have a revenue stream (yes, taxes) to offset the cost of the glasses, vaccinations, cancer treatments, etc. So simply saying that the government is going to spend $200 as opposed to forgo $40 in revenue isn’t even part of the whole picture.
I’d also like to know where the OP finds that HSAs are going away. I’m not an expert on this subject, but all I have read is that whackos like Michelle Bachman are making up lies about private insurance being outlawed. Link. I’m curious if the OP is relying on these claims, or there’s something specific on HSAs in the bill that I’m not aware of.
HSAs are somewhat dependent on being paired with high-deductible plans, which under the new system will need to provide a higher minimum of care, making the whole HSA/HDSA thing less attractive in general. Whether this will actually eliminate the viability of HSA’s or not seems to be open to interpretation, but its a far more reasonable concern then Bachman’s ravings.
Assuming you will be screwed (you still haven’t shown that this is the case), keep these big picture points in mind:
More people will have access to medical care, which means less people will be put into financial ruin due to unexpected hospital expenses, which means more money to put into the economy, which means greater social stability.
More people will be able to afford healthcare insurance, so there will be one less reason for people to stay in jobs they don’t like, which means greater incentive for people to start their own businesses, which means more jobs and greater social stability.
Fewer people suffering because they scrimped on preventive care or couldn’t afford treatments not covered by profit-minded insurance companies.
Surely these things should outweigh the tax benefits associated with your HSA, no?
In any case, Sec. 202(a)(2) prohibits any sale of private insurance after date certain, except through the government Exchange. The Exchange puts all kinds of limits, restrictions and requirements on the policies sold through the Exchange. The policies cannot be sold on private terms set through the parties to the transaction, therefore, it’s not actually private insurance. Sec. 202(c) exempts policies outside the Exchange, like additional dental or vison coverage.
FWIW, I’m not really sure who Michelle Bachman is, outside of the references I see to her on this Board.
So, in a way it’s a race to the bottom. Right now, I can buy glasses for myself and my family, using my own money. Under UHC, I’ll be thrown back to my prior insurance, pay an additional $150+ per month for coverage that’s useless to me, and have to come up with the $150+ dollars it takes to get an exam and new glasses or contacts. Plus, I’m doing it with $100 less per month. So, really, under UHC, neither of us will get glasses when we need them.
Check out PolitiFact’s comments on this section (referred to in the article as “page 92”). In particular:
Again, I’m no expert on this particular issue, but it seems that an expert in this area is saying that people are misreading this section to mean that they can no longer buy certain types of insurance, whereas the section actually says that if you like your current plan, you can continue buying it.
Based on how Medicare/caid has effected the medical care market, it appears that insurance companies will have to up the premiums on privately insured policies to offset the discounts that UHC have negotiated with providers. If we add so many additional people to the UHC rolls, people who had been paying the market rate will be paying less through their negotiated UHC rates, and the balancing cost paid by private insurers will go up. So, the premiums will also go up.
This won’t happen just for HSCP, this will happen for everybody.
The HDCP plan I have has a $10,000 deductible, which seems bad. But, after that initial $10K, it covers everything. No network providers, no co-pays, no exemptions for certain prescriptions.
I imagine that, within 30 days or 3 months or whatever time period prior to “Y1”, I’ll get a nice little letter from UniCare, saying that my premium is now $1500 per quarter. Which prices me out of the system entirely. In addition, I also get to experience the joys of co-pays, sitting on hold for an hour to get an answer, etc., etc. That’s also a time and money cost for my family.
The article I quoted says that the law “would largely prevent insurance companies from changing benefits in these grandfathered plans or altering the premiums.”
Honestly, I could really be missing something, but the PoltiFact article was pretty convincing to me that there is a lot of misinformation on what this section really means. And I find that PolitiFact is a pretty knowledgeable and fair source, since it criticizes both liberals and conservatives on misleading statements, and also confirms truthful ones.
The bill says at Sec. 202(a)(2) that the insurer cannot change terms or conditions that were in effect as of day 1 of Y1. Which means if they change on the day before day 1 of Y1, they’re fine.
What I’m driving at is whether your understanding of HSAs and high deductible plans “going the way of the dodo” is based upon your interpretation after reading the bill, or the analysis of a health care expert.
You have asked a very interesting question, and I am interested in the answer, but the assumption that you have made throughout this thread is that insurance companies are going to want to dump people out of high deductible plans by jacking up the rates. I don’t know that this is a valid assumption, and I don’t believe you’ve cited any evidence to back up your claim.
While you could be 110% correct, I think it would be helpful and interesting to read some citations from non-partisan health care experts that would confirm or reject the assumption that MSAs and high deductible plans are going away because of this bill.
You mean the public option? UHC usually means the reform plan in general, but I think you mean specifically the gov’t run part of the plan. If that’s the case, the CBO scoring of the house bill predicts this won’t happen (indeed, the premiums for the public plan are predicted to be slightly higher then for privately run plans)(page 6 of this pdf). I’m not certain your premium won’t rise, but I doubt it will happen due to competition from the public option.
I’m basing my assumption on things I have read, like this from John Reed of the WSJ:
“These [HDCP] policies will be severely limited. The Senate plan says a policy deemed “acceptable” must have insurance (rather than the individual) pay out at least 76% of the benefits. The House plan is pegged at 70%. That’s not the way these plans are set up to work. Roy Ramthun, who implemented the HSA regulations at the Treasury Department in 2003, says the regulations are crippling. “Companies tell me they could be forced to take products off the market,” he said in an interview.”
Therefore, although HDCP are designed to act as a different kind of insurance from your standard BC/BS kind of plan, they will be forced to comply with the same measures as BC/BS. Because they cannot restructure to meet those measures and still maintain a reasonable premium, they will go away.
I don’t really see it as a partisan issue; it’s just common sense. McDonald’s is just fast food for people want $1 cheeseburgers. “Ritzy Restaurant” is more a place for the well-heeled. If a law is passed requiring all restaurants to serve US corn fed beef, then Ritzy Restaurant has a much easier time with complying with those changes, and still maintain a decent profit margin. McDonalds, on the other hand, will more than likely go out of business.
My apologies - I mean the public run option, of course.
The CBO does say the rates paid to providers will “probably be comparable” to the rates paid by insurance. I don’t have a lot of faith in this, and I usually love and trust the CBO. The use of the word “probably” scares me a little - it seems quite weasely when compared to the usual CBO vocabulary.
They use the same word six other times just in that 15 page document. In general, figuring out the likely effect of a bill over a decade of changing demographics and health technology is unlikely to be an exact science, even if they didn’t use the word “probably”, I’d say it’d be implied. Still, it’s presumably the best and least partisan estimate your likely to find.
When* we get REAL UHC (that is, single-payer, which is what I’m talking about when I say I’m pro-UHC), you won’t need your HDCP or the HSA.
That ought to make you feel better.
*Yeah, I know, I might as well put in a request for a pony while I’m at it. With compound interest, by the time we get real UHC, I could open a pony ranch.
By my calculations, you are putting aside about $3000 yearly in your HSA. However, your deductible is $10,000. What happens if one of you gets sick or injured? I’m not talking about a one-time cost but a chronic disease. What if you get diabetes? Will you spend that $10k to keep up with doctors’ appointments and pay for test strips to check your sugar twice daily and make sure you take your medications regularly even though they cost $300 a month? If you develop angina, will you pay the thousand dollars for a cardiac catheterization?
Based on my personal experience, my patients with high deductible plans are fine until they get sick. Then, they try to save money by taking medications every other day, or skipping doctor visits. Their conditions are less well-controlled, and they are more likely to end up in the hospital with complications. Sure, your insurance pays all costs after $10k, but can you afford that $10k year after year after year? Also, even assuming that the plan’s idea of covering “all” expenses is the same as yours, it can drop you if you spend too much of the plan’s money.
I don’t know you personally, but in my experience, having a high-deductible plan is a lot like gambling. Everything’s fine as long as you’re healthy but as soon as somebody gets sick, everything falls apart. The money for glasses won’t be there if you’re spending it all on the deductible each year.
This presumes that your only option, moving forward, is the insurance that’s currently offered by your husband’s insurer. Part of the point of the creation of the Exchange and the elimination of pre-existing conditions clauses and whatnot is to give people more options than whatever insurer courts your employer (or spouse’s employer) the hardest.