The “details” documents are clear as mud (my conspiracy sense says “on purpose”). Your mistake us understandable - but it is pretty obvious that no insurance policy with $6300 deductible would exempt prescription drugs, or GP and specialist office visits.
So - DeKalb county. 60 year old. $50K income. Pays at the lowest price $5.1K in premiums and has to pay everything himself until he reaches $6.3K. I am only 50, and I think I would reach that $6.3K with my medical “consumption”.
So - $11K out of $50K income. “Affordable”? Or “shockingly expensive”?
Prices have gone up outside of the exchange as well - due to Obamacare mandates about pre-existing conditions, and including all kinds of things in insurance that that 60-year-old doesn’t need. It’s not the exchanges that raised the price to “shockingly expensive”. It is Obamacare.
The PPACA defines benchmarks for affordability and takes into account the premium, but not the out of pocket maximum.
By the law’s own definition $5,100 in premiums on a $50,000 income is not affordable.
However, the PPACA does not define “shockingly expensive” in the law.
Actually, price increases slowed dramatically in 2010, 2011, and 2012, and supporters of ACA credited the health care law with that.
Now prices go up dramatically and “They just do that!”
So price volatility is normal and has nothing to do with ACA, or is ACA affecting the market? Both are true, but I don’t think there’s any way you get around all of the insurance mandates and say that doesn’t have a big effect on prices. Gay men getting maternity care and mammograms for free and old ladies getting contraception and prostate exams for free whereas before they might have chosen policies less generous in those areas is going to cost money. Simple logic.
This part in particular is nonsense. It doesn’t matter and it doesn’t cost any money for men getting maternity care coverage and mammogram coverage. It’s just Fox News BS that this affects prices. Because men never use these options, they cost the companies (and the patients) absolutely nothing.
Not so, because they are paying so that other people can pay less. If men have mammogram coverage, it means that women have it cheaper.
There’s also the “free” aspect to consider. If your prior coverage charged a $20 co-pay for various services that are now free, then that gets added to your premium.
In the case of my own employer insurance, we got no new coverages, we now just get certain things free that before had a co-pay. That pushed up our premiums. And you can’t say that the insurance company just got greedy because my company self-insures. I doubt they are gouging themselves.
And men’s prostate cancer screenings are cheaper too. And the whole system is cheaper if there aren’t twice as many policies to administer, in the name of useless gender specificity.
Or you could go rant about it on Fox, like these jamokes, if it makes you happier.
And women pay for prostate exam coverage so men can have it cheaper. Sounds like the way insurance is suppose to work to me.
If policies were written so patients had to anticipate what coverage they needed in order to get reasonable rates, no one will have coverage for rare or unanticipated medical claims, and we would end up right back where we started, with defaults on medical bills and medical bankruptcies causing health care costs to skyrocket.
For group insurance, yes, that’s the way it’s done. The group’s needs are assessed, and plans are created appropriately.
However, for the individual market, now it’s getting treated like a group market, which is going to disadvantage a lot of people who had cheap plans tailored to their individual needs.
If the language was changed such that men were not covered for maternity/mammograms etc, and women were not covered for prostate/etc, the costs would be the same. It’s all the same pot and the same money. There may be things to be concerned about, but that’s not one of them.
At the expense of people with greater needs, who cannot afford coverage, if it is available at all. That is the problem we are trying to solve. We all pay more when the uninsured rely on the emergency room, then cannot pay their bills.
Do you think some people should have to go without any insurance, so that you can pay less?
It would be like if I asked an insurance company to cover me in the case of Hulk attack – their actuaries couldn’t calculate a likelihood and financial risk for Hulk attack, so the cost and risk to the insurance company is zero. Similarly, covering a man for birth complications carries an actuarial risk of zero. That stuff is Fox News nonsense.
No. I just don’t see a reason to require a certain type of coverage when having less works fine for many people.
That also changes the whole rationale for the law, which was that if you were happy with your insurance, you were keeping it, and that the law was only extending insurance to those who had none.
The public was not told that in order to expand insurance, people who already had it would have to have their insurance improved, which is not free.
Your logic is sound for a group policy. It breaks down when we’re talking about individual policies. Basically, what the law does is it takes people in various situations and puts them all in the same pool. Which creates winners and losers. Which is the opposite of what the President promised.
We didn’t have that debate. At no point did the President or any Democrat say, “If you have insurance, we need you to pay more for better insurance so that people without can get it more affordably.”
Basically, it’s now our patriotic duty to carry comprehensive insurance whether we need it or not. Such fundamental changes in the way we view health insurance should really be discussed before passing a bill to that effect.
With regards to the ridiculous whining about men being covered for maternity and women for prostate cancer, my logic is sound and your worries are nonsense. That’s just on paper and it costs companies and individuals nothing.
