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GWB upped the age of coverage to 25 and the ACA only moved it a bit but gets all the credit. DJT wants to keep the preexisting conditions part and do away with

by ccrush 10y ago

GWB upped the age of coverage to 25 and the ACA only moved it a bit but gets all the credit. DJT wants to keep the preexisting conditions part and do away with the fines for not having insurance and increased costs of forcing insurers into the ACA by repealing it and replacing it with interstate insurance competition without the bureaucracy of a government managed program. Too bad everyone thinks Obama was a holy man for putting together the garbage that is the ACA, and thinks of any improved solution as an assault on his legacy.

fencepost 10y ago
> keep the preexisting conditions part and do away with the fines for not having insurance Mandatory enrollment is what makes it possible to have that preexisting condition part - the basic idea of this (or any) insurance is that it spreads the risks over a larger pool of people, with the insurance companies taking a cut of the money for administrative costs and profit. If you want to require that the insurance companies cover high-risk preexisting conditions without providing an increased customer base to spread those costs over then you'd better be prepared to see insurance companies go under. > increased costs of forcing insurers into the ACA Insurers don't have to participate in the ACA exchanges, and in fact many don't do so. Some participated in the beginning but decided there wasn't enough profit to be made or were losing money, so they've pulled out of the exchanges since then or have significantly raised their rates for their exchange plans. As an example of this, I believe United Healthcare (or its exchange-specific subsidiaries) no longer participates in most exchanges as of 2017 (http://money.cnn.com/2016/04/19/investing/unitedhealthcare-obamacare-exchanges-aca/index.html http://money.cnn.com/2016/04/19/investing/unitedhealthcare-o...). Interstate insurance competition isn't going to make it any cheaper to insure someone with a preexisting condition, or do you think that your local hospital is going to suddenly say "Oh, ccrush has insurance provided by a company in Montana! We can't charge San Francisco rates, we have to charge Montana hospital rates!" If you do think that, go talk to some hospital billing folks and they'll be happy to correct you. One thing that the ACA did put in is capping the amount that insurance companies could spend on non-medical expenses, including both administration and profit. All the stuff early on about non-compliant plans having to shut down? That was for crap insurance with high premiums, higher deductibles, crappy service, etc. but with EXCELLENT profit margins. After all, if I can sell insurance but drop you when the bills start to come in, then all of those premiums you paid me are profit.
mikeyouse 10y ago
GWB most certainly did not up the age of coverage to 25. Prior to the ACA, nearly every employer-based coverage plan stopped dependent coverage at 19-years old or upon college graduation. Those that allowed older children would refuse dependent coverage if the children's employer offered health care, which meant that if you got a entry-level job out of high school at a company that offered insurance at any price, you couldn't use your parents' insurance. After the ACA, every plan, employer-sponsored or exchange-based, must offer dependent care up until 26-years of age. 2.5 million <25-year olds gained health insurance in the first year after the expansion, which was before the mandate was in place. The ACA gets credit for the expansion since it caused the expansion.

by ccrush 10y ago

fencepost 10y ago

> keep the preexisting conditions part and do away with the fines for not having insurance Mandatory enrollment is what makes it possible to have that preexisting condition part - the basic idea of this (or any) insurance is that it spreads the risks over a larger pool of people, with the insurance companies taking a cut of the money for administrative costs and profit. If you want to require that the insurance companies cover high-risk preexisting conditions without providing an increased customer base to spread those costs over then you'd better be prepared to see insurance companies go under. > increased costs of forcing insurers into the ACA Insurers don't have to participate in the ACA exchanges, and in fact many don't do so. Some participated in the beginning but decided there wasn't enough profit to be made or were losing money, so they've pulled out of the exchanges since then or have significantly raised their rates for their exchange plans. As an example of this, I believe United Healthcare (or its exchange-specific subsidiaries) no longer participates in most exchanges as of 2017 (http://money.cnn.com/2016/04/19/investing/unitedhealthcare-obamacare-exchanges-aca/index.html http://money.cnn.com/2016/04/19/investing/unitedhealthcare-o...). Interstate insurance competition isn't going to make it any cheaper to insure someone with a preexisting condition, or do you think that your local hospital is going to suddenly say "Oh, ccrush has insurance provided by a company in Montana! We can't charge San Francisco rates, we have to charge Montana hospital rates!" If you do think that, go talk to some hospital billing folks and they'll be happy to correct you. One thing that the ACA did put in is capping the amount that insurance companies could spend on non-medical expenses, including both administration and profit. All the stuff early on about non-compliant plans having to shut down? That was for crap insurance with high premiums, higher deductibles, crappy service, etc. but with EXCELLENT profit margins. After all, if I can sell insurance but drop you when the bills start to come in, then all of those premiums you paid me are profit.

mikeyouse 10y ago

GWB most certainly did not up the age of coverage to 25. Prior to the ACA, nearly every employer-based coverage plan stopped dependent coverage at 19-years old or upon college graduation. Those that allowed older children would refuse dependent coverage if the children's employer offered health care, which meant that if you got a entry-level job out of high school at a company that offered insurance at any price, you couldn't use your parents' insurance. After the ACA, every plan, employer-sponsored or exchange-based, must offer dependent care up until 26-years of age. 2.5 million <25-year olds gained health insurance in the first year after the expansion, which was before the mandate was in place. The ACA gets credit for the expansion since it caused the expansion.