In it, she says her Anthem plan was canceled due to the ACA, and that many others’ have been as well, and that the new plans they are given as somehow equivalent (or something?) to the old plans are more expensive, and that Anthem is no longer offering individual PPOs for some reason related to the ACA.
My general question is just, are these facts, and are they straightforwardly facts, or are there other facts that would tend to put further light on these facts? That kind of thing.
I looked at the sidebar, that answered my questions as to motive:
Law Enforcement vs. The Second Amendment | Elisabeth Meinecke
Cortney O’Brien
Great: Report Reveals Shortage of Primary Care Doctors in DC Days Before Obamacare Arrives | Cortney O’Brien
Leah Barkoukis
Samuel L. Jackson to Obama: Stop Dropping Your G’s, “Be F*ing Presidential” | Leah Barkoukis
Guy Benson
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Study: Yes, Obamacare Will Raise Premiums Significantly | Guy Benson
Daniel Doherty
**Piers Morgan and Second Amendment Supporters Finally Agree on Something? **| Daniel Doherty
Pre-ACA it was possible for anyone to purchase an inexpensive catastrophic policy. The ACA limits those policies to those under 30. All others must buy something else with greater benefits, coverage (and cost).
I know this because I got a similar letter (I am 64) - telling that my plan was no longer available.
I’d say it’s accurate, then, to say Obama was wrong when he said everyone will be able to keep their current plan if they chose. Does this seem GQ-ably factual to you guys?
My insurance plan through Regence is being discontinued in its current form. The new “equivalent” plan at a Bronze Level is about 60% more expensive, and it screws with the copay structure in a way that really pisses me off.
The reason for these changes has do with the ACA definition of “minimum essential coverage” - in other words, some old plans didn’t provide enough benefits and that’s why they were so cheap. So the insurance companies are now offering different plans.
I would also say that the term “cancellation” is a little bit inflammatory. Insurance companies change their plans around all the time. A few years ago (before ACA), I received a similar notice saying that my particular health plan was changing to a new name with different benefits and pricing. As with this change, I could either do nothing and transition to a suggested new plan, or I could contact the insurer to make a different choice.
On the other hand, Obama could argue that no plan has been made illegal… insurance companies are still allowed to offer plans that don’t provide minimum essential coverage. But those kinds of plans are obviously going to be less popular (because you won’t avoid the penalty for lack of insurance) and so many plans are being changed or discontinued. If you want to split hairs that way, you could weasel out a justification for what Obama said… but you’d be splitting those hairs so fine, you might need a permit for a nuclear reactor.
I’m pretty sure what he meant was that people will not be forced by the feds to give up their current plans and buy a government plan. However, that doesn’t mean that businesses can’t say “fuck this” and change their offerings - which they could feel free to do prior to the ACA too, mind you.
I can see a scenario, though, in which a person doesn’t want to risk bankruptcy from a catastrophic medical event, but would still come out ahead financially by paying for a super-cheap, truly catastrophic policy, and also paying the penalty for not having a policy that meets the ACA requirements.
For the most part, your employer dropping coverage is a great boon. You see, you’re not eligible for subsidized insurance through the exchanges if you are covered under an employer plan.
Now let’s look at where I was two years ago. I was making @ $25,000 per year, and my employer’s Bronze plan was costing me nearly $100 every two weeks. Couldn’t afford it really, but at my age and issues, could not afford NOT to have it. After the last increase, I joked that the next year I’d be on the paper plan, then the lead plan, then the wood (box) plan.
According to the subsidy calculator here, I could get a subsidized Bronze plan for $40 every two weeks, a savings on my part of 60%. (I note the numbers have changed a bit)
So frankly, if I was still employed in that shithole job (and not making several times that now) I would be BEGGING them to drop employer coverage and rallying the troops to demand it so that we could get better and cheaper insurance through the state exchange.
So let those people keep banging that drum about how horrible it is that employers are dropping their coverage and how terrible Obamacare is. Just wait until all those people find out how much better off they are without it, because the backlash on those who did everything they could to stop it is going to be fierce.
Yeah, technically you could keep your plan - but as mentioned to avoid a penalty, you or your employer would need a second plan to cover what the el cheapo plan does not. Oddly, nobody offers a “fill the gap” plan that I’ve heard of - simpler for the health insurance company to cancel the existing offer and offer a plan that meets ACA criteria.
It’s the same as why nobody offers auto insurance with a $10,000 deductible.
So Obama didn’t take away your cheap but inadequate plan, your insurer did. But in a way, you probably would not have stayed on that plan - because you couldn’t afford it and a good plan too.
There’s 3 key changes that ACA is making that make the “keep your old plan” statement impossible for most people. Only a small fraction of insurance plans did not commit one of these fraudulent acts.
All of these things are almost indisputably better for you as a beneficiary. An insurance plan that covers you against some possible catastrophic risks, but leaves the chance of you getting an illness that is treatable but the cost is above the lifetime benefit cap or the treatment is arbitrarily excluded in the fine print of the insurance policy that you had no practical way to challenge is not good protection.
Furthermore, the pre-existing condition nonsense meant that there was a very real chance you might get sick and lose your job, or lose your job due to no fault of your own, and get diagnosed with an expensive but fixable illness during a brief period of time when not covered. (those COBRA premiums are extremely expensive and beyond the ability of most people to afford for very long). This is also a nasty screw-you over loophole that was perfectly legal within the old system.
Medical care costs so much today at sticker price that not even the members of the “top 1%” can afford to pay the bills for routine severe illnesses. If the illness won’t kill you in the next day or so, but will certainly kill you if not treated, it is perfectly within the rights of hospitals to let you die.
No matter how you slice it, fixing these loopholes is a good thing for the average adult who is considered a well paid and valuable member of society. This does not help only the “poor, destitute (usually black) scumbags” that aren’t covered by insurance right now because society does not believe they deserve it.
Hey BTW I’ve been wondering about this. I have insurance through my employer, and my family could be covered by this insurance as well, but it would cost over a thousand dollars a month to add that on. Does this mean, under ACA, that each of my family members is eligible for coverage through an employer (namely, my employer) and so is ineligible for subsidies? Or are you eligible for subsidies so long as you are (low enough income and) not eligible through your own employer?
As of now, my small business ( one of those that has a plan that covers 3 people ) is leaning towards dropping the coverage and giving each employee an extra $600 a month - the cost of our insurance now- to buy on the exchanges.
If the preliminary pricing is accurate, then we will have the choice of a platinum plan for what we are paying now, or we could each choose individually to go cheaper and pocket the extra money.
Even with only 3 people, we have always had trouble finding a single plan that fits all of us and insurers seem to cancel us on a regular basis, forcing us to switch plans annually ( the other 2 people on the plan aren’t nearly as healthy as me). This has been a problematic in terms of keeping our doctors.
And some current health insurance offerings are little more than scams and the government is right to count them as real insurance. In addition to some of the ultra-high deductible plans many low-income employers offered cheap plans that covered routine doctors visits and such but had ridiculously low annual benefit caps, something like $2000 per year.
I cannot say if this is true of Anthem or not, but a number of insurers are dropping PPOs (having already dropped most HMO offerings) in a number of states because people are only buying HDHPs. It’s the way of the future, or something.
I would expect that your SO could claim that s/he isn’t eligible through their own employer and get a subsidized plan covering the kids.
BTW, the Bronze plan I mentioned through that earlier employer was shit. For example, my diabetes test strips were essentially not covered and cost me well over $50 a box. Under my present employer’s HSA plan (for which I pay only $25 every two weeks, but put $90 (for now) in the savings part trying to build it up to the deductible), they cost me $2.06.
This is a good strategy for small business, but make sure you’re familiar (and compliant) with the rules for Sec 125 benefit plans. It’s not a terribly high hurdle, but you definitely don’t want to be shooting from the hip. In particular, (to quote IRS materials) the “written plan must specifically describe all benefits and establish rules for eligibility and elections.”
My son’s plan is cancelled effective 1 January 2014. I’m still waiting to hear from Kaiser as to the equivalent plan and cost but I’m not overly optimistic.
This is false. It was possible for anyone without a preexisting health condition to get an inexpensive catastrophic policy. There are/were some states which offered a group pool for preexisting condition sufferers. But not “anyone” had access to these.
Plans that no longer offer or are terminating plans are doing so VOLUNTARILY. The claim that it’s due to ACA (PPACA) is misleading. The plans which may be terminating are likely not compliant with new regs. And rather than bringing those plans up to spec, they decided to instead terminate them.
Anything you’re reading today or in the past about rates on the exchange and possible increases is SPECULATIVE.
Because these new plans must be available to anyone, including those with existing, chronic, and expensive conditions - which previously these people (many of them at least) had no coverage, there is no claims history/experience from which to gauge what it will now cost to cover these people.
Actuaries are pretty much at a loss over this and they are guessing. Any SPECULATIVE rate increases you’re reading about could conceivably go the other way - cheaper - as well.
Once the exchange goes live on 10/1, then you can see ACTUAL rates for the first year. It’s anyone’s guess what happens to costs after that.
I’m not sure what you mean about speculative rates. At this point in the game, there are real numbers available.
My insurance company provided me with the actual rates for the 2014 plan they’re recommending as a replacement for my discontinued plan. And I can find actual rates for 2014 plans on Washington state’s health exchange.
