The problem with Ryan and his cast of ideologically stupid cohorts is they don’t don’t understand how a national economy works. But, Conservative Values!!! Stupid is as stupid does.
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One of the problems that I see in discussions of pre existing conditions restrictions prior to the ACA is that most people have no experience of dealing with the individual health insurance market. There is a widely held view that it was people with cancer and diabetes and other very serious medical conditions that were denied coverage. This is not true. Underwriters were able, and in practice did, deny coverage to anyone with any health problems in their history. They wanted to insure people who were at very low risk and avoid insuring anyone who might make a claim. My husband and I have never been eligible for group plans and, as we have moved around, have had great difficulty finding individual insurance…with problems like bladder infections and the need for counseling after a loss…cited as reasons for the denial. So my question is…would there be fixed criteria for separating out who would be eligible for the high risk pools?..or would that be left to the discretion of underwriters, as in the past. Two other aspects from our experience that most people are unaware of. When we found an insurance company to insure us…they tried to drop us when we moved to a different state…it took the intervention of a State Insurance Regulatory body to step in and make them keep us. We have also been in the situation of having a policy that was undergoing a “death spiral”. This occurs when the premiums jump due to high payouts in a particular individual policy. All the healthier people who can jump ship do…leaving the policy holders who have more health problems stuck in the plan. The increases in the premiums just continue to escalate from then on. We are currently in such a situation. My husband and I pay $1,600 a month (with $3,000 annual deductible) for our individual insurance. At 60 the plans available in the ACA marketplace were only slightly cheaper and had even higher deductibles. We are just trying to hang in there to get to Medicare eligibility. Healthcare without access to a group plan has always been a major headache for us. Most Americans are unaware of this reality and are in denial about how close they are to being thrust into this situation.
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While I don’t have experience with these high-risk pools, I believe they were a huge problem when they existed. People had to pay tens of thousands of dollars in premiums and copays/coinsurance for their care. It’s the same problem that caused the ACA rates to rise, albeit not nearly as much. Insurers are going to charge a crap-ton to insure people who aren’t healthy. The problem with the ACA was that the penalty didn’t pack enough punch for young, healthy people to want to subscribe. I assumed that the penalty would increase in subsequent years until it was high enough to enforce the individual mandate.
Intelligent post marred by many typos. For example, I think you meant genetic disorders, not generic disorders. There are many more there. You might want to explore the edit function - it’s that little pencil thing, the third symbol down there at the bottom of your comment…
Insurance companies not only avoided insuring individuals with a potential for costing them money, but if you did get insured and then got cancer or something they would investigate your past, find out you had childhood asthma or something, and drop you for withholding information on your original application. It’s called rescission, I think.
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[quote=“rickjones, post:13, topic:49704”]
They care about using that power to enrich themselves, their friends, and the top 1%.
[/quote]Great news, they might not be actual sociopaths. They might just be jettisoning 22 million policies because of straight up greed.
The hidden reason Republicans are so eager to repeal Obamacare
For the bottom 60 percent of the population — that is, households earning less than about $67,000 a year — repeal of the ACA would end up meaning an increase in taxes due to the loss of ACA tax credits.
But people in the top 1 percent of the income distribution — those with incomes of over about $430,000 — would see their taxes fall by an average of $25,000 a year.
Households with incomes of more than $1.9 million would get an extra $165,000 a year in take-home pay.
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The last paragraph is what is wrong with the opposition to the GOP.
“That is like a drop in the proverbial bucket,” Blumberg said. “They’re kidding themselves if they believe that this is enough federal funding to make care adequate and affordable for such a high need population.”
NO, they are not kidding themselves. Rather, they are knowingly lying to the American people. That is there is a difference between being dumb and being evil. The first difference is there is almost a duty to try and explain which really is to argue with stupidity. This allows stupidity to argue back.
There is no duty to argue with evil. Evil is knowing lying which means a discussion is meaningless because to evil FACTS DO NOT MATTER. Ryan, Trump and much of the current GOP are evil knowing liars. They are not kidding themselves but are telling knowing lies to Americans.
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It’s not that complicated, basically.
Sure. Establish high risk pools - with the same coverage at the same price as the rest. Guess what: the cost to the government to subsidize the high risk pool will be exactly the same as subsidizing everyone’s premiums to make them as cheap as the non-high risk only insurance would be.
The only way to reduce overall health care cost is to make treatments cheaper, make clerical and administrative overhead at the provider and insurer ends lower, make prescription drugs cheaper, get preventative and diagnostic care to everyone, and individual case management etc. Not with fooling around with pools or anything else on that end.
All these things point to regulation and single payer/one big pool type systems. All things Republicans hate so they talk about fooling around with everything else. Their real plan is to isolate people in high risk pools and then way underfund them. It’s the only way to save government money in their world, and then lowering taxes on the rich and corporations, their real goal.
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High risk pools can never be the answer. Think about it for 10 seconds. Let’s say you are covered under the ACA and it is repealed, if you are sick (or sick enough), you get funneled into a high risk pool. If you are not presently sick, you will buy insurance at some lower rate. But as soon as YOU use it, your rates go up astronomically, and you can’t afford it, sending you into a high risk pool too. What is the point of insurance if every time you really need it you are guaranteed to lose it?
And this is all without considering how those pools are defined (who is sick enough) and how “affordable” insurance of any type will actually end up being.
The idea that high risk pools is a solution to lack of insurance is only slightly less stupid than interstate insurance sales, but only slightly.
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But how are we gonna save the rich an extra 10-20% on their taxes if we don’t screw over everyone else? Think of the sad, abused, misunderstood rich people!
\I’m sorry, I can’t stop blubbering here - the thought of the rich suffering is just killing me.
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I try to take the temperature of Obamacare repeal every day. After this weekend, I think we got a little closer to that critical tipping point where the GOP effort fails. A few days ago, I was more despondent. I think the public outcry and the seeming acquiescence to that opposition by a critical slice of white voters (as reflected in the national polls…which were accurate btw) has now revealed the soft edges of the GOP position. They are not a repeal at any cost party. Ryan may be, but the rest of 'em…I’m doubtful. They’re looking for a sellable way to blame Dems for the demise of the ACA. If they can’t effectively make that case, they’ll bail quickly. I think we saw that card laid down this weekend. The public outcry plus the CBO’s rather bold statement about the economic cost of repeal gets us closer to the point that the GOP will definitively own it the way they had to own the Iraq war at some point.
I think Ezra Klein’s view that the GOP kicks the can to the states might end up being their way out. I do get the feeling that Bannon and Kushnerco is taking the temp of O-care repeal. They are prioritizing the alliance with Putin and their attempt to break up the EU and try to meddle in the French and German elections. I don’t think they want Obamacare repeal if it means that DT takes a big polling hit, which is happening right now.
The other thing I notice is that Bernie Sanders, despite his attempts to insert his issues and draw contrasts with other Dems at every turn, is now being forced to acquiesce to saving the ACA. The overwhelming force and energy of the Dem party is behind saving Obama’s achievement, not enacting single payer.
Two ironies: Obamacare is saved by Trump voters and Bernie Sanders voters acquiescing to the economic reality and clear achievements of Obama’s law.
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Think we may be reaching the tipping point of GOP members realizing they’ll cut their own throats if they repeal without something to replace. Obviously a lot of them are getting very nervous, and, in the House, the Tea Party faction may well wander off the reservation if the revenue to fund a replacement (i.e., taxes on the wealthy) is not repealed. A lot of good signs if Democrats can hang together.
I don’t know if reporters on blogs are eligible for Pulitzers, but I want to say TPM should throw Tierney Sneed’s name into the pot. For clarity of writing, shrewd political analysis, and solid substance on the details of a very complicated public policy, I don’t see her equal elsewhere on health care.
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Someone I know got rejected because they had previously taken antidepressants.
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The other problem with the Free Market/Shopping Around for Best Value model of healthcare is if you were a person with a pre-existing condition as I was, insurers didn’t want your business even if you were able to pay the market rate for it.
I had Blue Cross my entire life, first on my father’s insurance through his job and then, as a self employed person, paying for an Individual policy for over 20 years. I couldn’t let the insurance ever lapse or I would be booted off and not then insurable because of the pre-existing condition.
So, the Health Insurance Market doesn’t exactly act like other competetive markets. I can’t think of any other “product” or service where my money would be turned away.
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Good point.
Also, if time is money, this “just shop around” idea is another cost that patients have to shoulder. Every year we spend quite a bit of time during open enrollment. And then the insurance companies get everything screwed up when you change anything.
Ryan explained on CNN that idea was to allow taxpayers to “finance the coverage for those eight percent of Americans under 65” who have pre-existing conditions like cancer and other serious ailments, while you “dramatically lower the price for the other 92 percent of Americans.” But the math is not quite that simple.
Thank you, Paul Ryan, for explaining why single-payer is the most efficient way to cover everyone. Whether through your cockamamy plan or through ACA, everyone ends up paying for those who can’t afford care under the system. If taxpayers directly fund care, then at least care can be rationally allocated, instead of a helter-skelter non-system of catch-as-catch-can patchwork rent-seeking.
Fire fighting family - lots of them. Major diseases for the retired generation (lack of proper safety equipment back in the day) include all types of cancers, lung disease, and muscular/skeletal problems. Most of these older men - no women back then- are in their 60’s and 70’s now. Average life span after retirement for this group is 20 years. Going to hit them and their families very hard.
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The GOP had to be shamed into renewing funding for the 9/11 first-responders program. They. Just. Don’t. Care.
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McConnell held back the legislation for over a year despite strong bi-partisan support. Took John Stewart marching through the halls of Congress to push it to a vote.
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I like the term “Personal Responsibility Health Care Act.” It would be the ACA, but would have a Randian name the base would love.
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