4 ms·

I'll throw another anecdote in there. The small consulting company I worked for up until 2014 switched over to reimbursing us for a portion of what we paid for

by sethev 10y ago

I'll throw another anecdote in there. The small consulting company I worked for up until 2014 switched over to reimbursing us for a portion of what we paid for an ACA plan. Before that we had a (very small) group policy that was incredibly expensive because of health problems that one person had. The ACA saved thousands of dollars in that case (without subsidies) just by having access to a larger risk pool. I've heard people complain about ACA wrt to small business but it's always very vague general terms whereas the specific cases I know about were all positive.

WillPostForFood 10y ago
Look at the data then - ACA plans are going up 22% in just this year. And that doesn't account for the skyrocketing deductibles that effectively make the plans worthless except for catastrophic illness. It may have bailed out a some people with pre-existing conditions, but in totality, it isn't a money saver, it is crushing people that have to buy individual plans, and that's not an anecdote, it is clear from the data on the cost of plans. http://abcnews.go.com/Health/health-care-premiums-rising-obamacare/story?id=43047190 http://abcnews.go.com/Health/health-care-premiums-rising-oba...
- tptacek 10y ago
  Non-ACA plans went up by a comparable amount in the years just prior to ACA; that was one of the reasons the ACA had the urgency it did at the time. Our Non-HDHP non-HSA-qualifying premiums today are more expensive, but not nearly twice as expensive, as the small group market was in 2009. But the trajectory we were on prior to the ACA was double-digit annual premium increases, so it's tough to say how much of that is ACA. Remember also that these "regulations" we're talking about are primarily things like actuarial value, spending caps, community rating, and guaranteed issue. That's not red tape! Obviously, if you're 25 years old and buying insurance, the ACA is not a particularly great value to you (unless you have a "pre-existing condition", which I'll remind you there's no due process for adjudicating --- an unexplained seizure 10 years ago is a "do-not-cover" pre-ex). But that's part of the point!
  - WillPostForFood 10y ago
    2 points. First, yes, plans started to go up before ACA, in anticipation of ACA. Second, when a plan went up 20% in 2012, it might have been an $80 hike. Now in 2017 when it goes up 20% it is an extra $240 a month. So even if the rate of increase is similar, the pain it causes is not, especially contrasted with stagnant wages.
    - tptacek 10y ago
      No, I'm sorry, but that's simply not true. Plans were going up for years. In almost a third of all years in the ten years prior to ACA, California saw double digit growth in its guaranteed-issue small group market. Also, there's no mechanism by which plans go up by double digits "in anticipation of" the ACA.
      - WillPostForFood 10y ago
        "Plans were going up for years" - yes, but not as much they went up after ACA. "[a]cross all states, from before the reform to the first half of 2014, enrollment-weighted premiums in the individual health insurance market increased by 24.4 percent beyond what they would have had they simply followed state-level seasonally adjusted trends.” And the rate increase is 49% if you don't weight enrollment, which is a better indicator of individual impact. https://www.brookings.edu/wp-content/uploads/2016/07/Fall2014BPEA_Kowalski.pdf https://www.brookings.edu/wp-content/uploads/2016/07/Fall201...
        tptacek 10y ago
        Again, you're comparing the pre-ACA California individual insurance market, in which insurers could (and actively did) simply refuse coverage to anyone they might have to provide services to, to the post-ACA California individual insurance market in which they couldn't. The correct comparison is to the California small group market, which prior to the ACA also had guaranteed issue. The small group market covered companies with low single digit numbers of employees and approximates the ACA individual market (less the adverse selection of people without benefits-providing employers). In that market, the price trends before and after the ACA are broadly comparable.

by sethev 10y ago

WillPostForFood 10y ago

Look at the data then - ACA plans are going up 22% in just this year. And that doesn't account for the skyrocketing deductibles that effectively make the plans worthless except for catastrophic illness. It may have bailed out a some people with pre-existing conditions, but in totality, it isn't a money saver, it is crushing people that have to buy individual plans, and that's not an anecdote, it is clear from the data on the cost of plans. http://abcnews.go.com/Health/health-care-premiums-rising-obamacare/story?id=43047190 http://abcnews.go.com/Health/health-care-premiums-rising-oba...

tptacek 10y ago
Non-ACA plans went up by a comparable amount in the years just prior to ACA; that was one of the reasons the ACA had the urgency it did at the time. Our Non-HDHP non-HSA-qualifying premiums today are more expensive, but not nearly twice as expensive, as the small group market was in 2009. But the trajectory we were on prior to the ACA was double-digit annual premium increases, so it's tough to say how much of that is ACA. Remember also that these "regulations" we're talking about are primarily things like actuarial value, spending caps, community rating, and guaranteed issue. That's not red tape! Obviously, if you're 25 years old and buying insurance, the ACA is not a particularly great value to you (unless you have a "pre-existing condition", which I'll remind you there's no due process for adjudicating --- an unexplained seizure 10 years ago is a "do-not-cover" pre-ex). But that's part of the point!
- WillPostForFood 10y ago
  2 points. First, yes, plans started to go up before ACA, in anticipation of ACA. Second, when a plan went up 20% in 2012, it might have been an $80 hike. Now in 2017 when it goes up 20% it is an extra $240 a month. So even if the rate of increase is similar, the pain it causes is not, especially contrasted with stagnant wages.
  - tptacek 10y ago
    No, I'm sorry, but that's simply not true. Plans were going up for years. In almost a third of all years in the ten years prior to ACA, California saw double digit growth in its guaranteed-issue small group market. Also, there's no mechanism by which plans go up by double digits "in anticipation of" the ACA.
    - WillPostForFood 10y ago
      "Plans were going up for years" - yes, but not as much they went up after ACA. "[a]cross all states, from before the reform to the first half of 2014, enrollment-weighted premiums in the individual health insurance market increased by 24.4 percent beyond what they would have had they simply followed state-level seasonally adjusted trends.” And the rate increase is 49% if you don't weight enrollment, which is a better indicator of individual impact. https://www.brookings.edu/wp-content/uploads/2016/07/Fall2014BPEA_Kowalski.pdf https://www.brookings.edu/wp-content/uploads/2016/07/Fall201...
      - tptacek 10y ago
        Again, you're comparing the pre-ACA California individual insurance market, in which insurers could (and actively did) simply refuse coverage to anyone they might have to provide services to, to the post-ACA California individual insurance market in which they couldn't. The correct comparison is to the California small group market, which prior to the ACA also had guaranteed issue. The small group market covered companies with low single digit numbers of employees and approximates the ACA individual market (less the adverse selection of people without benefits-providing employers). In that market, the price trends before and after the ACA are broadly comparable.