I’m not asking for a crystal ball, but certainly those in the know have talked about a situation like mine. If that plan, on Jan 1, has to accept someone who is in stage 4 cancer, insane and pregnant, then it certainly can’t offer the plan for $400 when it excludes that applicant today. There haven’t been studies to this effect?
jt, what state are you in? Are they doing an exchange or will they let the federal government do it? (interesting how many states are allowing a fed takeover there)
As of Oct 1 at the latest, you can purchase a plan for Jan 1 on the exchange - rates will be available before that in many areas (already published in some states).
You will pay a rate determined by age / smoker or not and the type (Bronze/Silver/Gold). Like all proper insurance, if you are high risk (cancer-insane-pregnant) the mandate means there are low risk insured customers to share the risk with you so prices may not go up.
IIRC, if you don’t like your employer’s plan, you are free to buy on the exchanges - but no subsidy. In some areas, I’d bet you could still buy outside the exchange and get a cheap policy that won’t meet ACA standards - but you will pay a fine/tax for that. Those policies will die fast if they are even available.
I doubt it. The penalty is not much of a deterrent and is designed to be poorly enforced in any case.
The government refuses to martyr any penalty protesters, and personally I say take advantage of it. If they don’t have the will to enforce it for political reasons, make them eat it.
Yeah, having shitty insurance will really show the government who is boss.:rolleyes:
Non-ACA compliant insurance is not necessarily shitty. For example, if I buy a plan with no contraception coverage, it’s not shitty. The government’s standards are arbitrary and politically motivated. A lot of darn good insurance policies will not be ACA-compliant.
http://www.npr.org/blogs/health/2012/02/15/146920376/does-contraception-really-pay-for-itself
Contraception is a bad example. Care to try again?
Free preventive care. Currently, most insurance policies require co-pays for preventive care. Does this make the insurance shitty? No.
If one were to define costing more for no benefit as shitty, yes.
You pay regardless, whether you pay the co-pay or it’s just included in your insurance. As I said, most ACA mandates are arbitrary and/or political.
There are perfectly good insurance plans that will not be ACA-compliant. And frankly, I don’t think the IRS will ever be granted the resources to verify whether YOUR insurance plan is valid, so whatever insurance you buy will probably be good enough.
I live in West Virginia. No state plans, relying on the federal exchanges.
So I pay a rate based upon age/smoking status/level of coverage, BUT pre-existing conditions aren’t considered? So if I have smoked for 40 years (but quit for the last 5) and already am dying of lung cancer, I get the policy at the same rate as someone my age who does not smoke and does not have lung cancer?
I’m trying to wrap my head around how it is irrelevant if I already have the illness, but if I am engaged in an activity that may more likely than not give me the illness at some point in time in the future (smoking) is relevant to my insurance premiums.
IOW, I pay a higher rate if I MAY get a condition, but if I already have the condition I can’t be forced to pay the higher rate. But I don’t have those pre-existing conditions, so I surely will pay a higher rate, no?
Nonsense. That’s what the medical loss ratio is about.
The mandates are about providing adequate coverage.
What are you picturing? Roadside stands where migrant workers sell insurance policies?
Do you have a cite that any reputable insurer will ignore the mandates and provide inferior coverage? And that’s what you’re talking about. Inferior. You’re literally giddy with excitement about paying more money for shittier product.
Sorry, I don’t know when the federal exchanges will publicize rates. Sometime in the next 3 months you’ll know.
Yep. In insurance jargon that is called “Community Rating” - tons of statistical data support that approach - or insurance companies would go bankrupt. Would you rather they kick you to the curb as the current system does?
It is all about shared risk. If everyone is in the (health insurance) game, the armies of actuaries who work for insurance companies will figure out rates so that the premiums of the percentage of those who don’t get cancer will pay for the higher costs of those that do.
Well, that answers my earlier question:
They are going to use the honor system. Not just for determining if your employer offers affordable health insurance, but also for determining your eligibility based on income.
So for one year, feel free to defraud the taxpayers. I’m sure many will.
Do you cheat on your taxes? Because this is the same thing.
Yes, except without the threat of getting caught.
You gonna change the subject now?
Mind you, they are working under the constraints of the sequester and a smaller government workforce. So I, personally, have no problem scaling back the rules.
Ah, the sequester, the boogeyman for everything. Actually, this is in response to the postponement of the employer mandate. The government can’t verify eligibility based on the availability of employer insurance.
The sequester will be with us for 10 years, at some point you have to stop blaming it for everything.
[QUOTE=The article in question]
The federal government will, however, conduct an audit for the states where it is managing the new insurance Web portal.
[/quote]
In those states this is subject to audit. And I’m sure if you get IRS audited, they’d find out as well, right?
The sequester is stupid, and only a fool can prefer across the board cuts to precise ones. That said, if it will be hampering the work of government for ten years, it will be a problem that needs to be dealt with for ten years.
How on Earth can it still be causing damage, yet not be blamable? Do you even think before you assert such utter drivel?
What about children or a stay-at-home spouse? It seems like there is no cap on those premiums. I must either buy or pay a tax penalty, even if the premiums for my child are not affordable.
But offers it to who? My employer offers insurance to many, but not all fulltime employees. Do I get to buy from the exchange given I’m not one of the ones they’re offering insurance to in FY14? Or do I get screwed more due to a loophole about them techically “offering insurance” despite not offering it to all?