9 ms·

A nice reminder how self-employed people got screwed over by Obamacare, and no seems to care. It is the "little yellow box" in the first graphic. Also, no men

by ArtDev 10y ago

A nice reminder how self-employed people got screwed over by Obamacare, and no seems to care. It is the "little yellow box" in the first graphic. Also, no mention of the real reason none of this really works. There is no attempt at controlling costs or even identifying the transparent pricing problem.

koolba 10y ago
It's the biggest scamola. Self employed people on he individual market are the ones bearing the brunt of Obamacare. No tax deduction for premiums either.
- maxerickson 10y ago
  What part of the costs given in section 4 of the article do they fall under? Or would they be additional spending on top of the billions shown there?
- dragonwriter 10y ago
  Self-employed people who could purchase insurance before without extremely high costs or no options due to pre-existing conditions are among those who pay higher prices than before the ACA, sure. I don't see that as a "scamola".
  - koolba 10y ago
    The scamola is that the costs aren't distributed to everybody. It's only the people on the individual market bearing them. People with employer provided coverage don't share the costs of those high risk individuals. And the companies providing them coverage deduct whatever they do spend on their cheaper plans.
    - maxerickson 10y ago
      That's wrong though, there is a tax on large investment incomes and fees on insurers (including on group coverage), and also Medicaid expansion. There were also plans for risk corridor payments, but they weren't funded. And the ACA did bend the cost curve down. That of course doesn't fix the cost problem, but it was quite likely an improvement over doing nothing.
      - koolba 10y ago
        What does investment income have to do with distributing the risk of covering sick people? (hint: nothing!) I'm referring to employers and by extension their employers, not insurers, as not paying their fair share. If you work for a large corporation that self insures (think pretty much any F500 company), you and your employees are entirely off the grid when it comes to health insurance. As such, they don't contribute to covering the statistically sicker people on the individual market. The ACA sky rocketted unsocial premiums AND deductibles AND max out of pockets. The insurance most people have through it barely qualifies as catastrophic coverage as they'd have to spend 5-10K before it even kicks in. That's on top of the 10-15K of premium dollars. It's. it health care, it's a scamola that was designed by, and for, insurance companies to rape the unsuspecting public. Sadly Obama was both stupid enough to fall for it and not ballsy enough to push further for a single payer plan. The end state now is the worst possible of all situations. People are forced to buy a product that has no cost controls associate with it. Oh and the product doesn't actually do anything.
        maxerickson 10y ago
        The investment tax (on individual investment income) and insurer fees (including fees on self funded plans at large employers) were used to pay for the ACA subsidies. So those taxes and fees inject a bunch of funds into the individual market. So no, they aren't entirely off the grid when it comes to the ACA, they kick in billions of dollars, as shown in the chart I mentioned above.
        koolba 10y ago
        Taxing investment income is totally separate money. That's just saying "we raised some taxes...". The fees for self funded plans are a joke. Seriously go look them up. They amount to less than $10 per person on those plan (per year) and on top of that the majority of it is set to be phased out or already did.
      - dragonwriter 10y ago
        > There were also plans for risk corridor payments, but they weren't funded. Not just plans, contractual obligations that are now the subject of a class action lawsuit by insurers.
    - dragonwriter 10y ago
      > People with employer provided coverage don't share the costs of those high risk individuals. Employer group plans are already large group plans that include individuals who would not have been insurable in the pre-ACA private marketplace. The exchanges were a mechanism to achieve that effect in the individual market. (And, additionally, everybody who pays taxes under the ACA was supposed to be contributing to covering the loss risk of high-risk individuals in the exchange plans, but then Republican Congresses choose not to fund the risk corridors as a means of sabotaging the ACA.)
jdblair 10y ago
Now self-employed people with pre-existing conditions can actually buy insurance. That is different and better than before the ACA.
- icantdrive55 10y ago
  Yes--anyone with a pre-existing condition can buy health insurance, but insurance companies can charge Whatever they feel like. I'm sure they will be reasonable? Expect to be a bit suprised. My hope is Americans finally wake up, and in four years, have a form of Single Payer. (In the mean time, my hope is prescription prices come down.)
- pasbesoin 10y ago
  Before the ACA, I barely managed to purchase an individual policy. As I rolled off of COBRA from my last full-time corporate job, a condition mis-diagnosed for a number of years by a urologist was finally -- at my independent urging of an ultrasound technician and their going "above and beyond" to look further than the prescribed test -- diagnosed as a minor hernia. A surgeon fit me in the same day for an initial appointment -- working with the fact that my COBRA term was ending. But after an examination, he said he wouldn't operate. The hernia was too mild. So, per a very well-regarded surgeon, there was nothing to be done. Nonetheless, my application for an individual policy was rejected. It was only because I had a long-term personal professional relationship with someone with significant seniority and status in another insurance company having a cooperative agreement with the company in question, that my rejected application received a second review. They'd made two minor mistakes in processing it, and ultimately, at a very high level within the company, they decided to remedy this by writing me the individual policy -- with exclusions for my allergies and for this minor hernia, along with the urologist's prior, incomplete diagnosis. THIS is how the insurance market was, before the ACA. Oh, and that employer-provided health insurance? You'd better not have had a gap in coverage in the... I forget, now, two? years prior. Otherwise, any and all pre-existing conditions could be excluded for coverage... for a year, I think, perhaps two, under that employer-provided coverage. Most of the bitching I hear and read about the ACA, is simply unfounded. Or, it is based on incomplete where not simply wrong information. For example, the big spike in premiums for marketplace plans, and reduction in participating insurers and plans? That was not the ACA, per se. The law had provision for making insurers whole for the first two or three years (two, I think, and I think it should have instead been five) for losses they experienced. This was to allow time for them to learn what the newly covered population was composed of and to develop actuarial studies of it by which to set more accurate future pricing. Well, you can pass any law you want. It is a separate law -- the "budget process" -- that ultimately pays for it. And the Republican Congress chose to ignore this provision of ACA law in the budget process, leaving it unfunded and thereby stiffing the insurance companies. The ACA is a failure because the Republicans wanted it to be a failure and went to great lengths to make it so. Because, to them, politics and power are more important than effective policy and public health. One other thing: The ACA has saved insurance companies lots of money (compared to estimated costs absent the ACA) in areas outside of the marketplace plans, e.g. in their traditional group coverage. Of course, they don't factor those savings in when complaining about the costs they've borne as a result of the marketplace insurance plans -- said costs, again, having been greatly exacerbated by the Republicans sabotaging the law and stiffing them, in the budget process.
analog31 10y ago
In my view, the widely stated purpose of Obamacare was to address the access problem, but not the cost problem. This was a disappointment to many people, including me, who had hoped that the law would go a lot further. But it seems to have been a necessary compromise in order to obtain passage of anything, given the interests of the medical and insurance industries.
- dragonwriter 10y ago
  > In my view, the widely stated purpose of Obamacare was to address the access problem, but not the cost problem Cost is a component of the access problem, and there were measures to address overall cost in the ACA (and overall cost growth went down with it.) In order to address the access problem, costs also needed redistributed as well as controlled, which means that classes of people that were on average better off ended up paying more of the cost, which meant that some people saw dramatic cost growth (and because the targetting wasn't perfect, there were some perverse effects in who that hit.)
  - analog31 10y ago
    That's a good point. I suppose that access is always available at some cost, so access and cost are unavoidably two sides of the same coin. My own preference remains to find a non-zero-sum solution, where access goes up but overall cost goes down. I think that in order to manage costs, the cost structure of the system has to be greatly simplified. Presently, there are too many business entities and relationships, so it's impossible to even know where the money is going. Somebody is gouging us, but we don't know who, and everybody can point to somebody else. It may be that countries where costs are lower, simply have better ways of tracking who ultimately gets paid for what.
    - dragonwriter 10y ago
      > My own preference remains to find a non-zero-sum solution, where access goes up but overall cost goes down. Compared to the pattern experienced under preexisiting policy, that's exactly what the ACA did (it wasn't enough to stop overall cost growth, but it slowed it.) Obviously, more of that effect would be better.

by ArtDev 10y ago

koolba 10y ago

It's the biggest scamola. Self employed people on he individual market are the ones bearing the brunt of Obamacare. No tax deduction for premiums either.

maxerickson 10y ago
What part of the costs given in section 4 of the article do they fall under? Or would they be additional spending on top of the billions shown there?
dragonwriter 10y ago
Self-employed people who could purchase insurance before without extremely high costs or no options due to pre-existing conditions are among those who pay higher prices than before the ACA, sure. I don't see that as a "scamola".
- koolba 10y ago
  The scamola is that the costs aren't distributed to everybody. It's only the people on the individual market bearing them. People with employer provided coverage don't share the costs of those high risk individuals. And the companies providing them coverage deduct whatever they do spend on their cheaper plans.
  - maxerickson 10y ago
    That's wrong though, there is a tax on large investment incomes and fees on insurers (including on group coverage), and also Medicaid expansion. There were also plans for risk corridor payments, but they weren't funded. And the ACA did bend the cost curve down. That of course doesn't fix the cost problem, but it was quite likely an improvement over doing nothing.
    - koolba 10y ago
      What does investment income have to do with distributing the risk of covering sick people? (hint: nothing!) I'm referring to employers and by extension their employers, not insurers, as not paying their fair share. If you work for a large corporation that self insures (think pretty much any F500 company), you and your employees are entirely off the grid when it comes to health insurance. As such, they don't contribute to covering the statistically sicker people on the individual market. The ACA sky rocketted unsocial premiums AND deductibles AND max out of pockets. The insurance most people have through it barely qualifies as catastrophic coverage as they'd have to spend 5-10K before it even kicks in. That's on top of the 10-15K of premium dollars. It's. it health care, it's a scamola that was designed by, and for, insurance companies to rape the unsuspecting public. Sadly Obama was both stupid enough to fall for it and not ballsy enough to push further for a single payer plan. The end state now is the worst possible of all situations. People are forced to buy a product that has no cost controls associate with it. Oh and the product doesn't actually do anything.
      - maxerickson 10y ago
        The investment tax (on individual investment income) and insurer fees (including fees on self funded plans at large employers) were used to pay for the ACA subsidies. So those taxes and fees inject a bunch of funds into the individual market. So no, they aren't entirely off the grid when it comes to the ACA, they kick in billions of dollars, as shown in the chart I mentioned above.
        koolba 10y ago
        Taxing investment income is totally separate money. That's just saying "we raised some taxes...". The fees for self funded plans are a joke. Seriously go look them up. They amount to less than $10 per person on those plan (per year) and on top of that the majority of it is set to be phased out or already did.
    - dragonwriter 10y ago
      > There were also plans for risk corridor payments, but they weren't funded. Not just plans, contractual obligations that are now the subject of a class action lawsuit by insurers.
  - dragonwriter 10y ago
    > People with employer provided coverage don't share the costs of those high risk individuals. Employer group plans are already large group plans that include individuals who would not have been insurable in the pre-ACA private marketplace. The exchanges were a mechanism to achieve that effect in the individual market. (And, additionally, everybody who pays taxes under the ACA was supposed to be contributing to covering the loss risk of high-risk individuals in the exchange plans, but then Republican Congresses choose not to fund the risk corridors as a means of sabotaging the ACA.)

jdblair 10y ago

Now self-employed people with pre-existing conditions can actually buy insurance. That is different and better than before the ACA.

icantdrive55 10y ago
Yes--anyone with a pre-existing condition can buy health insurance, but insurance companies can charge Whatever they feel like. I'm sure they will be reasonable? Expect to be a bit suprised. My hope is Americans finally wake up, and in four years, have a form of Single Payer. (In the mean time, my hope is prescription prices come down.)
pasbesoin 10y ago
Before the ACA, I barely managed to purchase an individual policy. As I rolled off of COBRA from my last full-time corporate job, a condition mis-diagnosed for a number of years by a urologist was finally -- at my independent urging of an ultrasound technician and their going "above and beyond" to look further than the prescribed test -- diagnosed as a minor hernia. A surgeon fit me in the same day for an initial appointment -- working with the fact that my COBRA term was ending. But after an examination, he said he wouldn't operate. The hernia was too mild. So, per a very well-regarded surgeon, there was nothing to be done. Nonetheless, my application for an individual policy was rejected. It was only because I had a long-term personal professional relationship with someone with significant seniority and status in another insurance company having a cooperative agreement with the company in question, that my rejected application received a second review. They'd made two minor mistakes in processing it, and ultimately, at a very high level within the company, they decided to remedy this by writing me the individual policy -- with exclusions for my allergies and for this minor hernia, along with the urologist's prior, incomplete diagnosis. THIS is how the insurance market was, before the ACA. Oh, and that employer-provided health insurance? You'd better not have had a gap in coverage in the... I forget, now, two? years prior. Otherwise, any and all pre-existing conditions could be excluded for coverage... for a year, I think, perhaps two, under that employer-provided coverage. Most of the bitching I hear and read about the ACA, is simply unfounded. Or, it is based on incomplete where not simply wrong information. For example, the big spike in premiums for marketplace plans, and reduction in participating insurers and plans? That was not the ACA, per se. The law had provision for making insurers whole for the first two or three years (two, I think, and I think it should have instead been five) for losses they experienced. This was to allow time for them to learn what the newly covered population was composed of and to develop actuarial studies of it by which to set more accurate future pricing. Well, you can pass any law you want. It is a separate law -- the "budget process" -- that ultimately pays for it. And the Republican Congress chose to ignore this provision of ACA law in the budget process, leaving it unfunded and thereby stiffing the insurance companies. The ACA is a failure because the Republicans wanted it to be a failure and went to great lengths to make it so. Because, to them, politics and power are more important than effective policy and public health. One other thing: The ACA has saved insurance companies lots of money (compared to estimated costs absent the ACA) in areas outside of the marketplace plans, e.g. in their traditional group coverage. Of course, they don't factor those savings in when complaining about the costs they've borne as a result of the marketplace insurance plans -- said costs, again, having been greatly exacerbated by the Republicans sabotaging the law and stiffing them, in the budget process.

analog31 10y ago

In my view, the widely stated purpose of Obamacare was to address the access problem, but not the cost problem. This was a disappointment to many people, including me, who had hoped that the law would go a lot further. But it seems to have been a necessary compromise in order to obtain passage of anything, given the interests of the medical and insurance industries.

dragonwriter 10y ago
> In my view, the widely stated purpose of Obamacare was to address the access problem, but not the cost problem Cost is a component of the access problem, and there were measures to address overall cost in the ACA (and overall cost growth went down with it.) In order to address the access problem, costs also needed redistributed as well as controlled, which means that classes of people that were on average better off ended up paying more of the cost, which meant that some people saw dramatic cost growth (and because the targetting wasn't perfect, there were some perverse effects in who that hit.)
- analog31 10y ago
  That's a good point. I suppose that access is always available at some cost, so access and cost are unavoidably two sides of the same coin. My own preference remains to find a non-zero-sum solution, where access goes up but overall cost goes down. I think that in order to manage costs, the cost structure of the system has to be greatly simplified. Presently, there are too many business entities and relationships, so it's impossible to even know where the money is going. Somebody is gouging us, but we don't know who, and everybody can point to somebody else. It may be that countries where costs are lower, simply have better ways of tracking who ultimately gets paid for what.
  - dragonwriter 10y ago
    > My own preference remains to find a non-zero-sum solution, where access goes up but overall cost goes down. Compared to the pattern experienced under preexisiting policy, that's exactly what the ACA did (it wasn't enough to stop overall cost growth, but it slowed it.) Obviously, more of that effect would be better.