My wild guess, admittedly totally unsupported, is that the metal bands were meant to emulate the standardized plans available for Medicare Supplement insurance policies.
To assist consumers in comparing such policies, the Centers for Medicare and Medicaid Services (CMS) precisely standardized those plans. The benefits of a plan G from insurer XYZ are the same as the benefits of a plan G from insurer ABC.
CMS, not coincidentally, was involved in setting the actuarial values for the various metal plans under PPACA. PDF link
I made a post about my crappy insurance plan™ in another thread that does not meet the minimum standards to be considered a qualifying plan under PPACA.
Again, my wild unsupported guess is that a strong majority of people would consider such a plan to have quite generous coverage.
Of course, technically such a plan would not be cancelled under PPACA… it’s just that anyone insured under such a plan would have to also make a shared responsibility payment.
Gratefully I am not in the US so I get to keep my crappy insurance plan, but my point is that such a plan that fails to meet minimal coverage in any way is somehow not good enough for PPACA.
Based on what you posted there, it sounds like they could make some small changes for the things that would be required under PPACA and have little effect on premium rates. (I’ve seen several companies plans that that had 1.5% or less increases to add in the minimum essentials they didn’t have already) However, that plan would probably have too high an actuarial value to be able to be offered on one of the exchanges. We went through the same thing when we had to stop offering our top few plans because they had too high of an actuarial value.
I read the Suntimes article and the NBC articles. I wasn’t able to access the NY Times article. Let’s go through the ones I accessed:
Suntimes Article: This woman was 60 and paying and was paying $225/month for a plan. I’ve looked at plans for three friends of mine (all in CA) who were over 40 and paid comparable rates under now cancelled plans. In all cases, the plans had both yearly and lifetime caps. Which means that in the event of a catastrophe, my friends were expecting the rest of us to cover their treatment once they burned through their money. I find it extremely difficult to believe that the woman in the article did not have yearly and lifetime caps at the rate she was paying, and the article doesn’t even bother to discuss whether or not she had them.
Secondly, the article doesn’t discuss whether or not she would have been eligible for subsidies under the Medicaid expansion if FL hadn’t rejected it, or whether she’s eligible for the other subsidies under the ACA (and remember, ACA subsidies affect copays and deductibles as well). The article doesn’t even mention whether or not she looked for a plan on the exchanges: it just talks about the letter she received from Blue Cross. I have no idea from this article whether or not she had a “shabby” plan and was planning to shift catastrophic costs to the rest of us. I have no idea whether or not she’s eligible for subsidies, or if she even looked at the exchange. And I have no idea whether or not she would have been eligible for the Medicaid expansion (and if she would have been, that’s the fault of the FL legislature and the US Supreme Court).
NBC Article: This article has the exact same problems. There’s no discussion of whether or not the woman’s plan had yearly or lifetime caps, there’s no discussion of whether or not she’s eligible for subsidies, there’s no discussion whether she would have been eligible for the Medicaid expansion if VA had participated. I have no idea whether she had a “shabby” plan and who is responsible for her costs going up.
Now, I would have preferred Medicare for all, so I’m lukewarm on the ACA. But if people were planning to shift their catastrophic costs to the rest of us (and I have no idea if the women in this article were planning to do so), then it’s hard for me to get worked up that their plans were cancelled.
I tried accessing the NYT article on 2 different browsers, and it didn’t work for me.
Okay, you claim that in other threads, you’ve provided a cite showing that all of the cancelled plans were shabby. Which other threads? Why not just post the same cite again here?
Gosh, you sure do have a razor wit, don’t you? :rolleyes:
Many posters in this thread and many others have asked for a clear definition of what makes a plan “shabby”, many times. You still refuse to to provide a definition. I hereby request it again: can you explain clearly what distinguishes a “shabby” plan from one that isn’t shabby?
You ask “How many examples do you need to consider it a general truth that shabby plans were canceled?” The proposition in question is not “shabby plans were cancelled”, but rather “all the cancelled plans with shabby”. I already explained that to you very clearly and at great length. I am sure that you are intelligent enough to understand the difference between the statements “shabby plans were cancelled” and “all the cancelled plans were shabby”. Providing one example of a cancelled plan that was shabby does not prove that all the cancelled plans were shabby. Providing two examples of cancelled plans that were shabby does not prove that all the cancelled plans were shabby. Providing a million examples of of cancelled plans that were shabby would not prove that all the cancelled plans were shabby, even if you could do so.
I’ve already addressed the Mother Jones article clearly, you’ve just ignored what I said. The Mother Jones article does not make any factual statement about the 300,000 plans cancelled by Blue Cross in Florida. None. So in your mind, what are the “300,000 plans” supposed to prove?
whenever I hear the furor over cancelled plans I’m reminded of the old joke
*“Doc, will I be able to play the piano after my surgery?”
“Yes”
“That’s great, I’ve never been able to play the piano before”*
I’ve been buying private and small business health insurance for 20 years and the plans have changed EVERY SINGLE YEAR. They technically aren’t cancelled ( except for twice when the insurer’s decided they didn’t want us at any price ) but the premiums change - sometimes as much as 35%, the copays change, the benefits change and the doctors that accept the plan change - I’ve had to find new doctors several times. So I don’t see what is happening now as any more than business as usual.
And those plans have always covered a lot of services I would never need. Men in my workplace that had the EXACT SAME PLAN as myself were covered for prostate exams, Viagra and testicular cancer and I never once heard any woman complain how unfair it was that they were paying for insurance that would cover all those conditions that they could never get…just like the guys didn’t complain about paying for insurance that covered mammograms.
To lay some groundwork, the woman’s named is Sue Klinkhamer, and we recently had a thread devoted mostly to her. She was formerly an aide for a Democratic Congressman. In the past year she paid $291 a month for health insurance from Blue Cross. According to Blue Cross, she’d need to pay more than double that amount to have similar benefits next year. Democrats on this board and elsewhere have spend considerable energy attacking her as a liar, but by visiting healthcare.gov I verified the basic facts: to keep a plan with a similar deductible, she’d have to pay quite a bit more.
No you are correct in saying that I don’t know the details of Klinkhamer’s old plan or the new ones that she could buy, or how much of a subsidy she could get. Neither does anyone else on this board, or anyone in the media who’s attacking her. But you know who probably is equipped to analyze the various options available to Sue Klinkhamer and make a decision that’s best for Sue Klinkhamer? Sue Klinkhamer, that’s who. So an ideal system would be one where Sue Klinkhamer could shop freely for insurance, rather than one where the government severely restricts what she can buy.
Suppose I go intro a restaurant where the salmon entree comes with a side of broccoli. I like salmon but not broccoli, so I order the salmon. I end of paying for the broccoli even though I don’t like it and won’t eat it. But that’s okay, since I freely decided what to spend my money on.
On the other hand, suppose that the government passed a regulation saying that all restaurants must serve broccoli along with salmon, every time. That would drive up the price of salmon, and those who just want salmon would have reason to be slightly pissed.
I may, for all I know, have had health insurance in the past that covered maternity care and pap smears and other things that I, as a man, can’t use, and that’s just fine with me. But I think it’s understandable that some people would be pissed when the government requires all health insurance to cover a long list of things and thereby drives the cost of insurance up.
So, what might happen if we were to remove any gender specific coverage, and charge accordingly? If a man does not have to pay for pap smears, and a woman doesn’t have to pay for prostrate health exams, would that have some huge impact on the premiums? Frankly, I doubt that very much. Actuarial science is not my specialty, but I’m willing to guess that these sorts of “one size fits all” plans are simply easier for all concerned.
And what if that isn’t so? What if, God forbid, I am throwing a couple extra bucks per year to promote women’s health? Ensuring that they are more likely to hustle buns down to the doctors office if something seems a bit wrong with their plumbing? I find their company charming, their wisdom unavoidable, and they smell nice.
And, on balance, which gender is more likely to play football without a helmet, or any number of other pointless risks taken due to the effects of testosterone poisoning? The soft guys are just as smart as us generally, but not as likely to have occasional bursts of raw stupid.
I propose that we, the gender blessed with an upper body superiority that appears to vanish just above the neck, I propose that we, in gratitude, stand in unity and speak with a single voice:
And as it happens, I’m in agreement with you for once. I imagine that (a) long before Obamacare, many insurance plans cost the same for men and women and (b) in all cases, the difference between the proper cost for men and women could be a relatively small factor. When the media singles out cases such as men forced to buy maternity coverage and women forced to be covered for prostate cancer, it’s to highlight the absurdity of the law, not because those things are the primary drivers of higher premiums. Other parts of the law are what’s causing most of the premium increases.
This objection logged by the person who poisoned the well from the start with a biased thread title? Yeah, cry me a river. Until you accept that it wasn’t Democrats that are at fault, no one should (and to their credit, no one is) take anything you say seriously. Personally, I consider every one of your posts to be a performance piece of some outre subsection of modern art
You’re doing this intentionally, I knew it! What a barrel of monkeys your local theater troupe must be!
To answer the question yet again, a shabby plan is one that does not have the provisions mandated by the ACA. No, I don’t give a damn that you’re 90, female, unmarried, and have had a hysterectomy. You still need maternity leave in your health care. Everyone needs the same minimum plan. Its what will reduce costs for everyone overall and is a good plan. Any plan that you’re paying for that doesn’t cover the minimum, just like any car built now that doesn’t come with seat belts, should be illegal
By the way, when can I get tickets to your performance?
So #1, you can’t give me a number, so no matter how many examples of canceled shabby plans I give you, it won’t be enough
#2, you want to make the hilariously wrong connection that Obama is responsible for plans that were canceled that weren’t shabby
#3, you pretend that the articles you cited didn’t specifically mention that some plans were canceled by the insurance companies as a way to bilk people out of their money and are using the ACA rollout confusion to mask their duplicity
And #4, your show better be the best performance art piece I’ve ever seen
I ignored what you said because it didn’t make sense. Not only did not not address the other examples in the article, but you latch on to the 300,000 plans because MJ didn’t research all 300,000 though your own citations have even less facts than that. Vague weasel words are not good enough for me to prove a point, but they are good enough for you, right?
Take the case of Diane Barrette who was given a cancellation notice by her insurance company. She had a crap plan. The reporter talked to her and got her to admit that she didn’t even know her insurance wasn’t real insurance, it was a supplemental plan that didn’t pay for major things like hospitalization. She might as well have mailed me her insurance payment every month for all the good it did her.
The reporter then goes on to say that this type of plan is commonly sold by insurance companies, and given the example, it is not hard to believe that a big part of the 300,000 canceled plans are these types. Sorry, the reporter didn’t have time to do 299,999 other interviews, but its not likely you’d accept them either.
There’s also the example of noted conservative sock puppet Michelle Malkin, who based her outrage on her own canceled plan. Yet the article states that, just to piss ITR Champion off, they found out that Malkin plan had a high deductible that didn’t meet the minimum standards of the ACA. And of course they won’t tell you how they got that information, to further annoy you, because they know you will simply discount them anyways so there is no need to state that Malkin posted her canceled insurance information on her blog and intrepid reporters researched it.
And of course you didn’t comment on the link where HealthMarkets Inc. lost a suit and was ordered to pay $40 million for making the kind of false plans that the MJ article talks about and hey, are you getting catering at your weirdo anti-intellectual performance dance?
I’m glad you’ve finally provided a definition of the word “shabby” that you’re using, which of course has no relationship to any definition of the word “shabby” that appears in any dictionary. In other words, you’ve admitted the entire claim that the cancelled plans were shabby is meaningless. We define shabby plans as those that the ACA disallows, and the ACa disallows plans because they’re shabby, and it’s turtles all the way down. If we define “shabby” as “meanly ungenerous or unfair; contemptible”, as my dictionary does, we’ve no reason to classify all the cancelled plans as shabby. (For the record, health insurance plans provide maternity care, not maternity leave.)
[quote] #3, you pretend that the articles you cited didn’t specifically mention that some plans were canceled by the insurance companies as a way to bilk people out of their money and are using the ACA rollout confusion to mask their duplicity
[/quoted]
Per that study, women have higher health care costs not merely due to pregnancy related expenses. Women have a higher rate of seeking primary care even though hospitalization rates are comparable to men.
Over a lifetime, medical costs for women average about a third more than for men
A longer lifespan is cited as one major contributing factor to higher medical costs for women.
Whether men and women should pay the same premiums for health insurance is a political question. But it certainly seems the actuarial data would support charging women a higher premium.
If she was planning on covering all the costs of her own health care, sure. But the fact that she is upset about (possibly) $600+/month in insurance costs makes me very suspicious that she was planning to shift her costs to the rest of us.
I pay a lot of money in taxes. And I’m okay with subsidizing poor people’s health care. But I’ll be damned if the people who I am paying for are going to tell me that I have to subsidize their health care in the most expensive way possible.
If she had yearly/lifetime caps, then she was leeching off my wallet, and I’m glad the government won’t let her do that anymore. An ideal system is one in which poor people show a little fucking gratitude for the fact that I’m paying for their health care.
If someone truly cannot afford an exchange plan, then I’m concerned about that, and I want it fixed. But if the complaint is that people can’t continue to shift costs to me in the most expensive way possible, then I’ve got nothing but roll-eyes for that complaint.
I’m afraid you’ve lost me. You seem to be saying that before Obamacare, Sue Klinkhamer was “shifting her costs to the rest of us”, you were “subsidizing” her health care, and that she was “leeching off your wallet”, but that after Obamacare that won’t be true. That doesn’t make any sense at all. Most defenders of the law are proud of the fact that things work the other way around.