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We helped a friend through this last year. Where she lived there was only two insurance providers providing ACA plans. And both were HMO only. And both only off

by erentz 6y ago

We helped a friend through this last year. Where she lived there was only two insurance providers providing ACA plans. And both were HMO only. And both only offered Silver and Bronze plans. I also checked this out in a couple of other counties and it was the same situation. (I didn’t find a single gold plan in my search.) So for a lot of people they can’t buy better plans even if they could afford it.

lotsofpulp 6y ago
That’s a result of the political compromises that had to be made in order to pass ACA, which is people didn’t want to give up their silo’d white collar employer based health insurance, and insurers can’t compete across state lines. If there was a single marketplace for health insurance where everyone had to go, there would be sufficient lives for health insurance companies to be able to offer more options.
- erentz 6y ago
  I’m 100% for single payor as IMO it’s the best compromise in the US system to achieving universal healthcare, but I do agree with you. The employer provided healthcare plans are a huge distortion and abolishing that and making people buy their own plans would be preferable to the status quo for a multiple reasons. PS. I don’t have it handy but there was a great chart breaking down changes in how people were covered over the years I saw a few months back and what was most startling was just how little coverage is from ACA plans. It’s puny. Like 10% or something. Better for those 10% than before they didn’t have it, and some things like not disqualifying for preexisting conditions were important changes, but the ACA really wasn’t this revolutionary thing many people hold it up to be. It’s more of a blip.
  - lotsofpulp 6y ago
    I disagree that pre existing conditions was revolutionary. It enabled people to get healthcare that they simply couldn’t before, because payers had the ability to decline them. Also revolutionary was capping insurance premiums for old people as a multiple of young people, thereby instituting a wealth transfer from the young to the old. This is necessary because there is no incentive for a young person to purchase insurance, and without universal taxpayer funded healthcare, this mechanism serves as a tax. It’s all one and the same, except universal taxpayer funded healthcare is unpalatable to sufficient voters, so the best we could do is this system where instead of taxes paying for other people’s healthcare, you have insurance premiums paying for other people’s healthcare.
    - lotsofpulp 6y ago
      Oops, in the above comment, I meant “I disagree that removing pre existing conditions was NOT revolutionary”.

by erentz 6y ago

lotsofpulp 6y ago

That’s a result of the political compromises that had to be made in order to pass ACA, which is people didn’t want to give up their silo’d white collar employer based health insurance, and insurers can’t compete across state lines. If there was a single marketplace for health insurance where everyone had to go, there would be sufficient lives for health insurance companies to be able to offer more options.

erentz 6y ago
I’m 100% for single payor as IMO it’s the best compromise in the US system to achieving universal healthcare, but I do agree with you. The employer provided healthcare plans are a huge distortion and abolishing that and making people buy their own plans would be preferable to the status quo for a multiple reasons. PS. I don’t have it handy but there was a great chart breaking down changes in how people were covered over the years I saw a few months back and what was most startling was just how little coverage is from ACA plans. It’s puny. Like 10% or something. Better for those 10% than before they didn’t have it, and some things like not disqualifying for preexisting conditions were important changes, but the ACA really wasn’t this revolutionary thing many people hold it up to be. It’s more of a blip.
- lotsofpulp 6y ago
  I disagree that pre existing conditions was revolutionary. It enabled people to get healthcare that they simply couldn’t before, because payers had the ability to decline them. Also revolutionary was capping insurance premiums for old people as a multiple of young people, thereby instituting a wealth transfer from the young to the old. This is necessary because there is no incentive for a young person to purchase insurance, and without universal taxpayer funded healthcare, this mechanism serves as a tax. It’s all one and the same, except universal taxpayer funded healthcare is unpalatable to sufficient voters, so the best we could do is this system where instead of taxes paying for other people’s healthcare, you have insurance premiums paying for other people’s healthcare.
  - lotsofpulp 6y ago
    Oops, in the above comment, I meant “I disagree that removing pre existing conditions was NOT revolutionary”.