4 ms·

That average ACA insurance plan also covers almost nothing. All health insurance is not equal.

meetingthrower 3y ago
Totally false. I've been on ACA silver plans and all expense paid corporate plans. At the end of the day the true costs are pretty equivalent - $20K for a family of 4 per year in cash going to insurance/healthcare. With ACA, that is subsidized massively downward for lower incomes. And the employee pays some. And if you are truly poor (in most states) you get free medicaid plans.
- nobody9999 3y ago
  >And if you are truly poor (in most states) you get free medicaid plans. The quality of care for Medicaid patients is generally crap. Go and ask your doctor if they accept Medicaid patients, or even those on ACA plans. I'd wager the answer is a big 'no'. The differences in quality of care and levels of access are stark, with most Employer subsidized insurance >> ACA plans >> Medicare >> Medicaid.
  - meetingthrower 3y ago
    Again, 100% false on ACA. (I would agree that medicaid is a PIA, but it's free!) The ACA plans are run by the same carriers as employer plans in my state. Blue Cross, Harvard Pilgrim, etc. Networks are exactly the same. Price is equivalent. If you are paying less through your employer it is because employer is paying insurance company or self insuring instead of paying you the cash. For many industries, especially blue collar, it would actually be much better for employees to do ACA plans as they would pay much less for their healthcare post subsidies. The ACA has been such a boon for small businesses and entrepreneurs - before ACA you basically couldn't get insurance. Now it is actually a non issue.
    - nobody9999 3y ago
      >Again, 100% false on ACA. (I would agree that medicaid is a PIA, but it's free!) The ACA plans are run by the same carriers as employer plans in my state. Blue Cross, Harvard Pilgrim, etc. Networks are exactly the same. Price is equivalent. If you are paying less through your employer it is because employer is paying insurance company or self insuring instead of paying you the cash. Sorry for the late reply. That may be true in your state[0], but in mine all the insurers that have employer plans (although providers made sure to ask whether your plan was ACA or not -- "we don't accept ACA plans!" before then) have left the ACA marketplace. I admit that they did try to raise premiums 20-30% a year before quitting the marketplace -- I declined to pay that much more, although premiums have risen that much and more with the insurers still on the ACA marketplace. So, while there may be places where the ACA provides decent coverage at a reasonable rate, there are other places (sadly, like where I live) that it does not. On the whole, I'm glad the ACA exists, as it provides insurance to many who could never have afforded it in the past. That said, it's far from what we really need -- a single payer system like Medicare, but for everyone. [0] I live in New York.
nobody9999 3y ago
>That average ACA insurance plan also covers almost nothing. All health insurance is not equal. That's absolutely the case. I have an ACA plan and in order to get decent coverage (as well as a $600 deductible and $5900 annual out-of-pocket costs) along with significant co-pays for hospitals and durable medical goods, I pay nearly $15,000/year. And premiums just keep going up and up -- something like 15-20%/year, while more and more stuff (all radiology[0], many drugs and pretty much anything other than routine care and consults) requires pre-approval from third-parties engaged by the insurance company who generally take several weeks to make determinations, which can significantly delay urgently needed care. Even worse, many providers refuse to accept plans sold on ACA marketplaces, which, in many cases, leaves the providers who are accepting Medicaid[1] and Medicare[2]. Those are generally not the top tier, despite the huge premiums (in my case, nearly USD$1100/month -- just for me) charged by the insurers. Here in the US, we need a single-payer solution in the worst way. The profit motive for healthcare distorts things in so many ways -- with patients getting poor coverage/care and providers getting squeezed by insurers to tweak their quarterly numbers. It's disgusting. [0] https://en.wikipedia.org/wiki/Radiology https://en.wikipedia.org/wiki/Radiology [1] https://en.wikipedia.org/wiki/Medicaid https://en.wikipedia.org/wiki/Medicaid [2] https://en.wikipedia.org/wiki/Medicare_(United_States) https://en.wikipedia.org/wiki/Medicare_(United_States) (not to be confused with the AU program of the same name -- they aren't similar)

Totally false. I've been on ACA silver plans and all expense paid corporate plans. At the end of the day the true costs are pretty equivalent - $20K for a family of 4 per year in cash going to insurance/healthcare. With ACA, that is subsidized massively downward for lower incomes. And the employee pays some. And if you are truly poor (in most states) you get free medicaid plans.

nobody9999 3y ago
>And if you are truly poor (in most states) you get free medicaid plans. The quality of care for Medicaid patients is generally crap. Go and ask your doctor if they accept Medicaid patients, or even those on ACA plans. I'd wager the answer is a big 'no'. The differences in quality of care and levels of access are stark, with most Employer subsidized insurance >> ACA plans >> Medicare >> Medicaid.
- meetingthrower 3y ago
  Again, 100% false on ACA. (I would agree that medicaid is a PIA, but it's free!) The ACA plans are run by the same carriers as employer plans in my state. Blue Cross, Harvard Pilgrim, etc. Networks are exactly the same. Price is equivalent. If you are paying less through your employer it is because employer is paying insurance company or self insuring instead of paying you the cash. For many industries, especially blue collar, it would actually be much better for employees to do ACA plans as they would pay much less for their healthcare post subsidies. The ACA has been such a boon for small businesses and entrepreneurs - before ACA you basically couldn't get insurance. Now it is actually a non issue.
  - nobody9999 3y ago
    >Again, 100% false on ACA. (I would agree that medicaid is a PIA, but it's free!) The ACA plans are run by the same carriers as employer plans in my state. Blue Cross, Harvard Pilgrim, etc. Networks are exactly the same. Price is equivalent. If you are paying less through your employer it is because employer is paying insurance company or self insuring instead of paying you the cash. Sorry for the late reply. That may be true in your state[0], but in mine all the insurers that have employer plans (although providers made sure to ask whether your plan was ACA or not -- "we don't accept ACA plans!" before then) have left the ACA marketplace. I admit that they did try to raise premiums 20-30% a year before quitting the marketplace -- I declined to pay that much more, although premiums have risen that much and more with the insurers still on the ACA marketplace. So, while there may be places where the ACA provides decent coverage at a reasonable rate, there are other places (sadly, like where I live) that it does not. On the whole, I'm glad the ACA exists, as it provides insurance to many who could never have afforded it in the past. That said, it's far from what we really need -- a single payer system like Medicare, but for everyone. [0] I live in New York.

nobody9999 3y ago

>That average ACA insurance plan also covers almost nothing. All health insurance is not equal. That's absolutely the case. I have an ACA plan and in order to get decent coverage (as well as a $600 deductible and $5900 annual out-of-pocket costs) along with significant co-pays for hospitals and durable medical goods, I pay nearly $15,000/year. And premiums just keep going up and up -- something like 15-20%/year, while more and more stuff (all radiology[0], many drugs and pretty much anything other than routine care and consults) requires pre-approval from third-parties engaged by the insurance company who generally take several weeks to make determinations, which can significantly delay urgently needed care. Even worse, many providers refuse to accept plans sold on ACA marketplaces, which, in many cases, leaves the providers who are accepting Medicaid[1] and Medicare[2]. Those are generally not the top tier, despite the huge premiums (in my case, nearly USD$1100/month -- just for me) charged by the insurers. Here in the US, we need a single-payer solution in the worst way. The profit motive for healthcare distorts things in so many ways -- with patients getting poor coverage/care and providers getting squeezed by insurers to tweak their quarterly numbers. It's disgusting. [0] https://en.wikipedia.org/wiki/Radiology https://en.wikipedia.org/wiki/Radiology [1] https://en.wikipedia.org/wiki/Medicaid https://en.wikipedia.org/wiki/Medicaid [2] https://en.wikipedia.org/wiki/Medicare_(United_States) https://en.wikipedia.org/wiki/Medicare_(United_States) (not to be confused with the AU program of the same name -- they aren't similar)