5 ms·
The parent comment is exaggerated, but I think the point is that prior to ACA, employer-provided plans tended to be cheaper and have lower deductibles largely b
by mdorazio 8y ago
The parent comment is exaggerated, but I think the point is that prior to ACA, employer-provided plans tended to be cheaper and have lower deductibles largely because insurance companies were able to drop or deny coverage whenever they felt like it for individual plans to keep their margins up. While logically true, this is roughly equivalent to hearing from an old coworker that South Africa was a great place to be white under apartheid...
I think it's also worth exploring how much of the difference in financial cost of health insurance plans is due to time + annual overall increases in healthcare cost in the US. ACA was passed 9 years ago. Even under the previous 9 year annual percentage increase averages, you would expect healthcare costs to be at least 20% more expensive than they were in 2010, regardless of ACA.
- WalterSear 8y agoIt's more extreme than your example. The parent is ignoring the fact his great healthcare experience is predicated on them being able to drop him the moment they could, when his illness became too expensive. Ending pre-existing conditions was the game changer in the AMA. Treating people is obviously more expensive than not treating them.
- mrosett 8y agoThat's just not how it worked with employer insurance. Perhaps they could drop your whole company, but the insurer couldn't unilaterally cancel a single employee's plan.
- pnutjam 8y agoNo, but sick individuals, or those with sick family members are lousy employees... wink... wink..
- WalterSear 8y agohttps://www.chicagobusiness.com/article/20140918/NEWS03/140919814/centegra-sued-after-firing-employees-with-high-health-care-bills https://www.chicagobusiness.com/article/20140918/NEWS03/1409...
- Someone1234 8y agoI know someone who pre-ACA had employer insurance who was dropped by that insurance after they got skin cancer. The official reason was lying during the application process (10+ years earlier). They forgot to list childhood Asthma on their application form ten years earlier.
- mrosett 8y agoWould the ACA prevent that kind of scam? I genuinely don't know.
- WalterSear 8y agoThe incentive is gone, since preexisting conditions are no longer a disqualification.
- dsfyu404ed 8y agoThe incentive is still very much there. You just can't use a preexisting condition as your excuse anymore.
- WalterSear 8y agoI would argue that the incentive was implicit and fundamental to the nature of the business, because it provided agents with a method to pick and choose their clients. By inducing lapses in insurance coverage, insurance companies were able to convert illnesses under active treatment into preexisting conditions.
- Someone1234 8y agoYou aren't required to complete an application form when you sign up anymore, so they don't even ask you medical questions.
- WalterSear 8y agoThere were plenty of cases where they would raise an employer's premiums and let them know why, and sick people lost their jobs and their insurance.
- FireBeyond 8y agoWitness all sorts of horrible behavior, like employers saying "Sorry, all, no raises this year, because one of your coworkers was using so much of our health insurance pool that they raised our rates!"
- tptacek 8y agoYes: if you go back in time, health care costs go down, because they've been rising rapidly over the past 20 years. But the only thing that happens at the point in time when the ACA passed is that the rate of growth in cost falls.
- ameister14 8y agoThat's not really true, though. Costs as a % of GDP went down from '05-06 and went up slightly from '06-07. In real numbers, in 2008-2009, the increase in overall cost per year was actually lower than in 2014-2015, when the exchanges opened. You're right that the rate of growth in Medicare cost fell after the ACA passed, but that's much more specific than overall cost delta.
- JamesBarney 8y agoSomething very relevant happened in 2008-2009.
- tptacek 8y agoIt also impacted prices all the way into 2012, by moving people out of full-time employment and onto COBRA, and by reducing the number of young people on health insurance plans.