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Link Posted: 2/16/2013 2:27:32 PM EDT
Originally Posted By LurchAddams:
The insurance companies will be able to turn currently uninsured individuals away. For individual policies, they'll say "sorry, we only accept new policies for people that are currently insured."

They can also reject people because of anything that's not health related. Like credit rating. Driver's record. Arrest records...

Originally Posted By Qweevox:
That's because next January 1 elements of Obamacare kick in. This isn't really winding down, its winding UP.

"Starting next January 1, insurance companies will no longer be able to turn anyone away because of poor health. At the same time, the federal government will begin subsidizing coverage for millions of individuals who have no access to employer plans. That means many of the people currently in the PCIP program may end up with lower premiums once the government's financial help is factored in."

I don't believe its sunk in with most people just how fundamentally changed our health care system is going to be. We'll have full blown socialized medicine within a decade. This is only the first step, it's removing the few free-market feedback loops healthcare has. It's already by and large, a "collectivized" system. So transitioning to public collectivization is going to psychologically simple, but disastrously complex and expensive.








And if you don't get insurance...the IRS fines you.
Link Posted: 2/16/2013 2:27:49 PM EDT
Democrats don't really want to leave their base with nothing to hope for. If they get everything... no reason to vote (D) again.
Link Posted: 2/16/2013 2:41:37 PM EDT
[Last Edit: 2/16/2013 2:41:57 PM EDT by DragoMuseveni]

Originally Posted By raven:
<snip>


The fate of the Democratic party in America over the next decade is tied to Obama’s healthcare reform. If it is seen to be a success, America could trend Democratic for the foreseeable future. If it fails, liberalism as we’ve known it will take a massive hit. But, so far, support for Obamacare has been waning instead of waxing. Even a recent piece by Talking Points Memo that placed the blame for Obamacare’s potential failure on Republicans noted that the law’s unpopularity with the public at large was the number one threat to its success. Democrats are getting nervous and consequently are trying to put some distance between themselves and the ACA.






So who fills the vaccum as both the GOP and Dems die off?
Link Posted: 2/16/2013 2:43:22 PM EDT
But but but! What about his mom who was calling insurance companies when she died
Link Posted: 2/16/2013 2:56:28 PM EDT

Originally Posted By raven:
Actually, this FUBAR situation may be the saving grace of the GOP. Democrat Senators are PISSED at the multitude of complications stemming from this hideous law that hurt their constituents in the pocketbook might blow back on them:

Powerful Democrats who helped write and pass Obamacare subjected the new law’s chief administrator to withering criticism at a Senate hearing yesterday. Gary Cohen, the director of the Center for Consumer Information and Insurance Oversight, testified before the Senate Finance Committee, and the Democrats on the committee—from its Chairman Max Baucus to Senators Ron Wyden, Bill Nelson, and Maria Cantwell—tore into him. Kaiser Health News has more:

Wyden pressed Cohen to help find ways to resolve a glitch in the law which may result in the denial of federal assistance to millions of Americans of modest means who could be priced out of family health coverage at work….

"We’ve got millions of people—working-class, middle-class people—who are going to be pushed into a regulatory health coverage no man&#146;s land,” Wyden said. "They are unable to afford the family coverage through their employer and ineligible for the subsidy that could be used by dependents on the exchange.”

And that’s just one senator. Each had his or her own complaints about different parts of the law’s implementation, from its elimination of funding for insurance co-operatives to the failure to meet important deadlines. The criticisms came fast and furious:

"You are overwhelmed by the details and technology, I get that point…. It seems as if the agency is taking pages out of the law,” she [Cantwell] said….

"The people of Florida are going to suffer,” he [Nelson] told Cohen. "I want someone to be held accountable for this.”

The about-face of these Democrats is a phenomenon worth pausing over. Many formerly supportiveconstituencies have grown wary of Obamacare in recent weeks as we’ve learned more about the effects it will have on the health care system. But these Senators’ 180-degree turns are something more severe.

The fate of the Democratic party in America over the next decade is tied to Obama’s healthcare reform. If it is seen to be a success, America could trend Democratic for the foreseeable future. If it fails, liberalism as we’ve known it will take a massive hit. But, so far, support for Obamacare has been waning instead of waxing. Even a recent piece by Talking Points Memo that placed the blame for Obamacare’s potential failure on Republicans noted that the law’s unpopularity with the public at large was the number one threat to its success. Democrats are getting nervous and consequently are trying to put some distance between themselves and the ACA.






And all those stupid dems will still vote for these @ss holes
Link Posted: 2/16/2013 3:03:50 PM EDT
May the fuck be in the ass of all who supported this America killing bill. How many different ways are the libs trying to destroy the USA?
Link Posted: 2/16/2013 4:15:24 PM EDT
[Last Edit: 2/16/2013 4:16:37 PM EDT by SD307]
so then I just got F again by this prick good thing I didn't vote for him huh?

Like anyone with cancer can gt any kind of insurance anywhere. The insurance companies are writing the insurance laws we will alll be their bitches.
Link Posted: 2/16/2013 4:17:26 PM EDT
Originally Posted By Chaingun:

Originally Posted By raven:
Actually, this FUBAR situation may be the saving grace of the GOP. Democrat Senators are PISSED at the multitude of complications stemming from this hideous law that hurt their constituents in the pocketbook might blow back on them:

Powerful Democrats who helped write and pass Obamacare subjected the new law’s chief administrator to withering criticism at a Senate hearing yesterday. Gary Cohen, the director of the Center for Consumer Information and Insurance Oversight, testified before the Senate Finance Committee, and the Democrats on the committee—from its Chairman Max Baucus to Senators Ron Wyden, Bill Nelson, and Maria Cantwell—tore into him. Kaiser Health News has more:

Wyden pressed Cohen to help find ways to resolve a glitch in the law which may result in the denial of federal assistance to millions of Americans of modest means who could be priced out of family health coverage at work….

"We’ve got millions of people—working-class, middle-class people—who are going to be pushed into a regulatory health coverage no man’s land,” Wyden said. "They are unable to afford the family coverage through their employer and ineligible for the subsidy that could be used by dependents on the exchange.”

And that’s just one senator. Each had his or her own complaints about different parts of the law’s implementation, from its elimination of funding for insurance co-operatives to the failure to meet important deadlines. The criticisms came fast and furious:

"You are overwhelmed by the details and technology, I get that point…. It seems as if the agency is taking pages out of the law,” she [Cantwell] said….

"The people of Florida are going to suffer,” he [Nelson] told Cohen. "I want someone to be held accountable for this.”

The about-face of these Democrats is a phenomenon worth pausing over. Many formerly supportiveconstituencies have grown wary of Obamacare in recent weeks as we’ve learned more about the effects it will have on the health care system. But these Senators’ 180-degree turns are something more severe.

The fate of the Democratic party in America over the next decade is tied to Obama’s healthcare reform. If it is seen to be a success, America could trend Democratic for the foreseeable future. If it fails, liberalism as we’ve known it will take a massive hit. But, so far, support for Obamacare has been waning instead of waxing. Even a recent piece by Talking Points Memo that placed the blame for Obamacare’s potential failure on Republicans noted that the law’s unpopularity with the public at large was the number one threat to its success. Democrats are getting nervous and consequently are trying to put some distance between themselves and the ACA.






And all those stupid dems will still vote for these @ss holes


Had to pass it to see what was in it. Any of those fucktards going to pay for not reading legislation that is part of thier fucking job? <<crickets>>
Link Posted: 2/16/2013 4:23:48 PM EDT
No shit. What scum.
Link Posted: 2/16/2013 4:29:38 PM EDT
Originally Posted By Sdsquad1:
And my two children with a chronic illness get what?


In 20 more years of Obamacare taken to it's natural conclusion?

Euthanasia.
Link Posted: 2/16/2013 4:40:47 PM EDT
Link Posted: 2/16/2013 4:43:55 PM EDT
Link Posted: 2/16/2013 6:08:52 PM EDT
Originally Posted By Mitu:
Yeah, the title is definitely misleading. Between Medicaid expansion and guaranteed issue for private payers, coverage will improve substantially (starting next year).


You are clueless..

This statement is not based on what will ACTUALLY HAPPEN, it's based on the utopian Libtard statements about WHAT SHOULD HAPPEN.

Obamacare will be the downfall of the USA simply because the rationing of care incorporated into Obamacare will drag the economy to the ground. Obamacare only works if the MEDICAL ESTABLISHMENT simply falls in line and provides extremely low cost healthcare. The Doctors simply won't do it. The hospitals will be shutting down, care will be put off, treatment will be simply "pain pills" rather than treating of the disease or disorder. The thing I really wish was that it began in full force THIS YEAR! That would put the real effects in fll force by the next election cycle. Next year only gives a few months for the people to begin feeling the pain this will cause.
Link Posted: 2/16/2013 6:13:33 PM EDT
Originally Posted By Sdsquad1:
And my two children with a chronic illness get what?


Jack and Shit, enjoy your Obamacare.
Link Posted: 2/16/2013 6:17:39 PM EDT
Originally Posted By LurchAddams:
The insurance companies will be able to turn currently uninsured individuals away. For individual policies, they'll say "sorry, we only accept new policies for people that are currently insured."

They can also reject people because of anything that's not health related. Like credit rating. Driver's record. Arrest records...



You spouting uninformed bullshit.

Link Posted: 2/16/2013 6:18:47 PM EDT
They went bankrupt, but next year they expect the insurance companies to accept everyone without so much as a rate increase.



Link Posted: 2/16/2013 6:19:48 PM EDT
Originally Posted By Mitu:
Yeah, the title is definitely misleading. Between Medicaid expansion and guaranteed issue for private payers, coverage will improve substantially (starting next year).


Depends on what you mean by coverage and "improve".

Link Posted: 2/16/2013 6:20:14 PM EDT
Originally Posted By WildApple:
How does the Life Insurance Industry get a free pass?

Everyone's entitled to affordable Life Insurance regardless of preexisting health conditions

Think of the children!


They're on the communists list, just a lower priority.

Link Posted: 2/16/2013 6:21:51 PM EDT
Obamacare was suppose to make health insurance AVAILABLE to folks with pre-existing conditions. Obama ran short on cash, and said "screw em”: no new policies for thousands of people with pre-existing conditions. Just let them wait until 2014 or perhaps later.

Obama threw this first batch of Obamacare participants under the bus. I hope that I am wrong, but I expect future participants to be thrown the under the bus as well.

Link Posted: 2/16/2013 6:21:52 PM EDT
Originally Posted By Qweevox:

Originally Posted By 2minkey:
Originally Posted By LurchAddams:
Since the election is over, Obama no longer cares about the uninsured.

"the Obama administration has begun quietly winding down one of the earliest programs created by the president's health care overhaul, a plan that helps people with medical problems who can't get private insurance."

http://hosted.ap.org/dynamic/stories/U/US_HEALTH_OVERHAUL_PRE_EXISTING_CONDITIONS?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2013-02-16-04-00-09


thank you very much, dear sensationalist/perez hiltonite.

"Designed as a stopgap solution until the law's full consumer protections are in effect next year."

That's my take as well.

Obamacare is simply ramping up. There is no unwinding. The article posted in the OP explains it.



It's ramping up, this is a sign of how wrong it will go. The far underestimated how much this plan will cost, just like they far underestimate how much the rest of it will cost.

The end result of this is higher taxes, shittier care (done by nurses and "practicioners" instead of real doctors), longer waits, etc.


Link Posted: 2/16/2013 6:25:21 PM EDT

Originally Posted By dog-meat:
Originally Posted By LurchAddams:
The insurance companies will be able to turn currently uninsured individuals away. For individual policies, they'll say "sorry, we only accept new policies for people that are currently insured."

They can also reject people because of anything that's not health related. Like credit rating. Driver's record. Arrest records...

You spouting uninformed bullshit.


Sounds like I hit a nerve.

What did I say that was incorrect? Perhaps that is too difficult for you to explain?
Link Posted: 2/16/2013 6:26:51 PM EDT
<Pelosi> "You have to pass the bill to find out what's in it."</Pelosi>
Link Posted: 2/16/2013 6:31:24 PM EDT
Originally Posted By LurchAddams:

Originally Posted By Qweevox:

Originally Posted By LurchAddams:
The insurance companies will be able to turn currently uninsured individuals away. For individual policies, they'll say "sorry, we only accept new policies for people that are currently insured."

They can also reject people because of anything that's not health related. Like credit rating. Driver's record. Arrest records...

Originally Posted By Qweevox:
That's because next January 1 elements of Obamacare kick in. This isn't really winding down, its winding UP.

"Starting next January 1, insurance companies will no longer be able to turn anyone away because of poor health. At the same time, the federal government will begin subsidizing coverage for millions of individuals who have no access to employer plans. That means many of the people currently in the PCIP program may end up with lower premiums once the government's financial help is factored in."

I don't believe its sunk in with most people just how fundamentally changed our health care system is going to be. We'll have full blown socialized medicine within a decade. This is only the first step, it's removing the few free-market feedback loops healthcare has. It's already by and large, a "collectivized" system. So transitioning to public collectivization is going to psychologically simple, but disastrously complex and expensive.



I think you are wrong. But honestly I've not studied the issue in depth. But one thing I do know is that Obamacare requires everyone to be insured, or they are levied a tax penalty, I'm pretty sure I'm reading the article in the OP correctly in that insurance companies will be unable to turn people away. Can you cite a source to support your statement? I'd like to read up on it.


Obamacare prohibits discrimination based on "health status". Companies are free to discriminate based on other "non-health status".
Insurance companies will NOT BE REQUIRED to insure anyone that walks in the door.

If the individuals in my OP can't find insurance in 2014, they will be forced to pay the fine -AND- be uninsured.

Here's the text of the law regarding discrimination.
http://thanksobamacare.org/index.php?id=9

Please feel free to post any reference that indicates that I'm incorrect here.


I'm not going to dig up a reference, but I'm a health insurance actuary and am working at implementing this mess. I see updates from lawyers weekly. We will not be able to turn someone away because he is currently uninsured. There will be "open enrollment periods" where we basically have to take anyone who walks in the door. Outside of those periods we'll have to take anyone with a qualifying "life event" like losing employer based coverage, being born, etc.

And frankly, there's no reason other than health status to turn anyone away provided they want to pay. If we try to come up with fancy modeling techniques that use things like credit score, address, etc. as a proxy for health status I'm reasonably sure we'll be breaking the law as well though I'm less sure on that.

The benefit from anything attempts to get a healthier population through marketing is very much dampened by the risk adjustment mechanism anyway.

Risk adjustment is where every health plan has to calculate an "average health status" for the people they insure. The government then orders transfer payments from health plans with healthier than average populations TO health plans with sicker than average populations.


Link Posted: 2/16/2013 6:34:28 PM EDT
Originally Posted By 2minkey:
Originally Posted By LurchAddams:

Originally Posted By 2minkey:
Originally Posted By LurchAddams:
Since the election is over, Obama no longer cares about the uninsured.

"the Obama administration has begun quietly winding down one of the earliest programs created by the president's health care overhaul, a plan that helps people with medical problems who can't get private insurance."

http://hosted.ap.org/dynamic/stories/U/US_HEALTH_OVERHAUL_PRE_EXISTING_CONDITIONS?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2013-02-16-04-00-09

thank you very much, dear sensationalist/perez hiltonite.

"Designed as a stopgap solution until the law's full consumer protections are in effect next year."

Obama is discontinuing this "stopgap solution" because he no longer cares about the uninsured. They were able to get coverage during the election years -- that's certainly not a coincidence.

This is another example of poor planning for Obamacare implementation.



okay so you have special insight into his secret thoughts on the uninsured...?

try as hard as you want to to make this into some kind of massive obama hypocrisy.

it gets more entertaining the more absurd it gets.




It's ending because they underestimated the cost of the program up front and it has now run out of the allocated money 10 months short of its target lifespan. A sign of things to come imo. This entire law is going to be FAR more expensive than anyone pushing it would admit up front.

Link Posted: 2/16/2013 6:38:42 PM EDT
Originally Posted By badfish274:
Originally Posted By 1raggedhole:
Some have told me to expect 2-300 percent increases in the rates. Private health insurance is finished. It is only a matter of time.


I bet the actuaries are making nooses for themselves as we speak. What a shit sandwich.

"Oh, you're an actuary? You can no longer do your job. Its unfair."


We'll have plenty of work to do under obamacare. It will be miserable work pushing numbers around to comply with the law.

Risk adjustment, rate filings, HHS audits, etc.

All the bureaucratic shit I hate about my job becomes 100% of it and the fun stuff, like actually predicting risk goes away.

After a few years of being busy following the marching orders of HHS, they'll pass single payer, or put some "public option" that runs at a loss thanks to taxpayer funding and underprices everything else into the exchanges.

Then the zombie that is private insurance will have it's head finally blown off.

Link Posted: 2/16/2013 6:43:06 PM EDT
Originally Posted By krpind:
I'm in the Texas high risk pool. My premiums are by law 2X what the exact same policy would cost anyone else. I got a letter last week saying due to obamacare the program was ending in Jan 2014 but they were unsure what the process would be for otherwise uninsurable people to get insurance, but this program would no longer be needed since all companies have to accept people with per existing conditions. I've had this coverage about 8 or 9 years probably.

Surely Obama will save me right?


Hit up the federal obamacare exchange in October for open enrollment for a 1/1/2014 effective date. I think it will be a federal one anyway since TX declined to build their own.

I'm not sure what your price difference will be. It depends on how different TX's current regs are from what obungocare will mandate and I'm not knowledgeable in that market.

Keep an eye on healthcare.gov this fall. You'll have to apply during the open enrollment period.

Link Posted: 2/16/2013 6:46:35 PM EDT
Originally Posted By wolfstar:
Originally Posted By Mattl:
Originally Posted By Sdsquad1:
And my two children with a chronic illness get what?



Sub standard care from a doctor Nurse Practitioner trained in and imported from a third world country who is underpaid and overworked.





Is this spoken from experience? Or is this your professional/personal bias?

Most ARNPs/DNPs/ ect that I have worked with have been very competent. I only have only encountered one bad nurse practitioner and she was employed by a private practice physician. Her gross incompetency and high levels patient dissatisfaction also spoke poorly on his judgment and professionalism.
Overall, my personal experience is that nurse practitioners generally have better professional competency than physician assistants. The only negative aspect I encounter with NPs is that many of them drank the Kool-Aid in nursing school or working as RNs and love socialized medicine and tax payer funded social crusades.
Link Posted: 2/16/2013 6:52:08 PM EDT

Originally Posted By dog-meat:
Originally Posted By LurchAddams:

Originally Posted By Qweevox:

Originally Posted By LurchAddams:
The insurance companies will be able to turn currently uninsured individuals away. For individual policies, they'll say "sorry, we only accept new policies for people that are currently insured."

They can also reject people because of anything that's not health related. Like credit rating. Driver's record. Arrest records...

Originally Posted By Qweevox:
That's because next January 1 elements of Obamacare kick in. This isn't really winding down, its winding UP.

"Starting next January 1, insurance companies will no longer be able to turn anyone away because of poor health. At the same time, the federal government will begin subsidizing coverage for millions of individuals who have no access to employer plans. That means many of the people currently in the PCIP program may end up with lower premiums once the government's financial help is factored in."

I don't believe its sunk in with most people just how fundamentally changed our health care system is going to be. We'll have full blown socialized medicine within a decade. This is only the first step, it's removing the few free-market feedback loops healthcare has. It's already by and large, a "collectivized" system. So transitioning to public collectivization is going to psychologically simple, but disastrously complex and expensive.



I think you are wrong. But honestly I've not studied the issue in depth. But one thing I do know is that Obamacare requires everyone to be insured, or they are levied a tax penalty, I'm pretty sure I'm reading the article in the OP correctly in that insurance companies will be unable to turn people away. Can you cite a source to support your statement? I'd like to read up on it.


Obamacare prohibits discrimination based on "health status". Companies are free to discriminate based on other "non-health status".
Insurance companies will NOT BE REQUIRED to insure anyone that walks in the door.

If the individuals in my OP can't find insurance in 2014, they will be forced to pay the fine -AND- be uninsured.

Here's the text of the law regarding discrimination.
http://thanksobamacare.org/index.php?id=9

Please feel free to post any reference that indicates that I'm incorrect here.


I'm not going to dig up a reference, but I'm a health insurance actuary and am working at implementing this mess. I see updates from lawyers weekly. We will not be able to turn someone away because he is currently uninsured. There will be "open enrollment periods" where we basically have to take anyone who walks in the door. Outside of those periods we'll have to take anyone with a qualifying "life event" like losing employer based coverage, being born, etc.

And frankly, there's no reason other than health status to turn anyone away provided they want to pay. If we try to come up with fancy modeling techniques that use things like credit score, address, etc. as a proxy for health status I'm reasonably sure we'll be breaking the law as well though I'm less sure on that.

The benefit from anything attempts to get a healthier population through marketing is very much dampened by the risk adjustment mechanism anyway.

Risk adjustment is where every health plan has to calculate an "average health status" for the people they insure. The government then orders transfer payments from health plans with healthier than average populations TO health plans with sicker than average populations.



>> We will not be able to turn someone away because he is currently uninsured.
That may be your company's decision, but it's not a legal requirement. Again, please feel free to provide a reference that indicates I'm wrong.

I agree that the Obama team sorely underestimated the cost of this mess.
Link Posted: 2/16/2013 6:53:59 PM EDT
Originally Posted By regalrocket:
Originally Posted By Sdsquad1:
And my two children with a chronic illness get what?


So after one child with a chronic ilness you can't afford you have a second....

Children are not needs, they are wants.


Damn that's a pretty shitty thing to say
Link Posted: 2/16/2013 6:59:32 PM EDT
if Obamacare is a Tax how can they Tax people with no income or no insurance?
Link Posted: 2/16/2013 7:02:56 PM EDT
Originally Posted By ACfire:
if Obamacare is a Tax how can they Tax people with no income or no insurance?


If you do get a job be assured you won't be getting a tax refund and they will probably take the fine out of your wages.

They said one of the major financial contributors to the plan would be those who are fined. The IRS will see to it.


Link Posted: 2/16/2013 7:04:07 PM EDT
Bush's fault
Link Posted: 2/16/2013 7:09:41 PM EDT
[Last Edit: 2/16/2013 7:14:19 PM EDT by dog-meat]
Originally Posted By LurchAddams:

Originally Posted By dog-meat:
Originally Posted By LurchAddams:

Originally Posted By Qweevox:

Originally Posted By LurchAddams:
The insurance companies will be able to turn currently uninsured individuals away. For individual policies, they'll say "sorry, we only accept new policies for people that are currently insured."

They can also reject people because of anything that's not health related. Like credit rating. Driver's record. Arrest records...

Originally Posted By Qweevox:
That's because next January 1 elements of Obamacare kick in. This isn't really winding down, its winding UP.

"Starting next January 1, insurance companies will no longer be able to turn anyone away because of poor health. At the same time, the federal government will begin subsidizing coverage for millions of individuals who have no access to employer plans. That means many of the people currently in the PCIP program may end up with lower premiums once the government's financial help is factored in."

I don't believe its sunk in with most people just how fundamentally changed our health care system is going to be. We'll have full blown socialized medicine within a decade. This is only the first step, it's removing the few free-market feedback loops healthcare has. It's already by and large, a "collectivized" system. So transitioning to public collectivization is going to psychologically simple, but disastrously complex and expensive.



I think you are wrong. But honestly I've not studied the issue in depth. But one thing I do know is that Obamacare requires everyone to be insured, or they are levied a tax penalty, I'm pretty sure I'm reading the article in the OP correctly in that insurance companies will be unable to turn people away. Can you cite a source to support your statement? I'd like to read up on it.


Obamacare prohibits discrimination based on "health status". Companies are free to discriminate based on other "non-health status".
Insurance companies will NOT BE REQUIRED to insure anyone that walks in the door.

If the individuals in my OP can't find insurance in 2014, they will be forced to pay the fine -AND- be uninsured.

Here's the text of the law regarding discrimination.
http://thanksobamacare.org/index.php?id=9

Please feel free to post any reference that indicates that I'm incorrect here.


I'm not going to dig up a reference, but I'm a health insurance actuary and am working at implementing this mess. I see updates from lawyers weekly. We will not be able to turn someone away because he is currently uninsured. There will be "open enrollment periods" where we basically have to take anyone who walks in the door. Outside of those periods we'll have to take anyone with a qualifying "life event" like losing employer based coverage, being born, etc.

And frankly, there's no reason other than health status to turn anyone away provided they want to pay. If we try to come up with fancy modeling techniques that use things like credit score, address, etc. as a proxy for health status I'm reasonably sure we'll be breaking the law as well though I'm less sure on that.

The benefit from anything attempts to get a healthier population through marketing is very much dampened by the risk adjustment mechanism anyway.

Risk adjustment is where every health plan has to calculate an "average health status" for the people they insure. The government then orders transfer payments from health plans with healthier than average populations TO health plans with sicker than average populations.



>> We will not be able to turn someone away because he is currently uninsured.
That may be your company's decision, but it's not a legal requirement. Again, please feel free to provide a reference that indicates I'm wrong.

I agree that the Obama team sorely underestimated the cost of this mess.


No one is going to turn away someone for simply being uninsured. Why do you think the insurance industry fought to get a purchase mandate put into the law?

I can see companies trying to identify mathematical flaws in the risk adjustment mechanism and then target their marketing to individuals who fit into those cracks, but beyond that, there's not much they can do.

Even if they law allowed it, they sure as hell aren't going to be turning away all uninsured. And turning away some people for being uninsured, but accepting other uninsured (where the deciding factor is some proxy for health status) is an invitation for a lawsuit, or for having HHS or the states kick you out of the exchanges. Not going to happen. Even if you wanted to try, good luck doing it to people enrolling through an obungocare exchange.

As for your reference I refuse to look at the obamination that is the actual law and regs on the weekend, maybe monday, so here's something from kff in the meantime:

http://policyinsights.kff.org/en/2013/february/why-premiums-will-change-for-people-who-now-have-nongroup-insurance.aspx


Access to coverage

The ACA addresses access to coverage in two fundamental and related ways. First, insurers must accept all applicants, including those with pre-existing conditions, during open enrollment periods and charge sick people and healthy people the same premium.



btw kff is a great resource to learn what they law and regs actually say.

Link Posted: 2/16/2013 7:12:09 PM EDT
[Last Edit: 2/16/2013 7:13:13 PM EDT by ACfire]

Originally Posted By Teltech:
Originally Posted By ACfire:
if Obamacare is a Tax how can they Tax people with no income or no insurance?


If you do get a job be assured you won't be getting a tax refund and they will probably take the fine out of your wages.

They said one of the major financial contributors to the plan would be those who are fined. The IRS will see to it.



Wouldn't depend on one's W-4?

What was the enforcement provision in the law? From what I have heard, but have yet to find any info on, is there is no enforcement in the Law other then withholding one's return.
Link Posted: 2/16/2013 7:18:21 PM EDT
[Last Edit: 2/16/2013 7:18:39 PM EDT by dog-meat]
Originally Posted By LurchAddams:
That may be your company's decision, but it's not a legal requirement. Again, please feel free to provide a reference that indicates I'm wrong.




One more from Kaiser, this is better:

http://www.kff.org/healthreform/upload/8399.pdf




Guaranteed availability and renewability – The proposed rule would require insurers to accept all
applicants for all individual and small group market policies, regardless of health status, occupation,
or other risk factors. Only limited exceptions to this guaranteed issue requirement would apply:
 Open enrollment periods for individual health insurance – Small group issuers would be
required to guarantee issue coverage year-round; but in the individual market, issuers could
restrict the sale of policies to initial and annual open enrollment periods. At other times during
the year, issuers would have to permit special enrollment opportunities of at least 30 days for
individuals with qualifying events (such as a change in family or dependency status or the loss of
eligibility for other coverage – similar to special enrollment rules that have applied to group
health plans for many years).


Click on the link that doc to the market rules for actual regs.
Link Posted: 2/16/2013 7:18:22 PM EDT
Originally Posted By ACfire:

Originally Posted By Teltech:
Originally Posted By ACfire:
if Obamacare is a Tax how can they Tax people with no income or no insurance?


If you do get a job be assured you won't be getting a tax refund and they will probably take the fine out of your wages.

They said one of the major financial contributors to the plan would be those who are fined. The IRS will see to it.



Wouldn't depend on one's W-4?

What was the enforcement provision in the law? From what I have heard, but have yet to find any info on, is there is no enforcement in the Law other then withholding one's return.


I'm really not sure of the specifics other than to say that if the IRS is involved with collecting the fines, they will be paid one way or another.
If it's anything like collecting any other back taxes there will be penalties, wage garnishment, forfeiture, etc.
Link Posted: 2/16/2013 7:33:15 PM EDT
[Last Edit: 2/16/2013 7:34:07 PM EDT by WildApple]

Originally Posted By Truth2882:
Originally Posted By regalrocket:
Originally Posted By Sdsquad1:
And my two children with a chronic illness get what?


So after one child with a chronic ilness you can't afford you have a second....

Children are not needs, they are wants.


Damn that's a pretty shitty thing to say

That's cold
WTF?
Link Posted: 2/16/2013 7:33:36 PM EDT
Originally Posted By Mattl:
Originally Posted By Sdsquad1:
And my two children with a chronic illness get what?



Sub standard care from a doctor trained in and imported from a third world country who is underpaid and overworked.



Veterans affairs eh.
Link Posted: 2/16/2013 7:43:21 PM EDT
Originally Posted By regalrocket:
Originally Posted By Sdsquad1:
And my two children with a chronic illness get what?


So after one child with a chronic ilness you can't afford you have a second....

Children are not needs, they are wants.


Unless you know this guy personally, which I doubt, you need to engage your brain BEFORE your mouth, DICKHEAD!!

I have children, 1 of which has a chronic illness; Chronic/terminal illness doesn't neccesarily happen at birth, it can happen at any time in life!
Link Posted: 2/16/2013 7:45:30 PM EDT
Originally Posted By badfish274:
Originally Posted By 1raggedhole:
Some have told me to expect 2-300 percent increases in the rates. Private health insurance is finished. It is only a matter of time.


I bet the actuaries are making nooses for themselves as we speak. What a shit sandwich.

"Oh, you're an actuary? You can no longer do your job. Its unfair."


Death is unfair. Vote for me and I'll ban aging.
Link Posted: 2/16/2013 7:48:30 PM EDT
Welcome to my world. Waiting for 2014, hope I can afford it.
Link Posted: 2/16/2013 7:55:51 PM EDT
It's a big shit sammich and everyone will have to take a bite.

When the taste is found not to be to folk's liking it will just be a short time till single payer HC is inacted.

You ain't seen nothing yet.
Link Posted: 2/16/2013 9:51:32 PM EDT
Originally Posted By dog-meat:
No one is going to turn away someone for simply being uninsured.


How much of a role does that play in your risk analysis, anyways?
Link Posted: 2/16/2013 10:26:25 PM EDT
Originally Posted By shooter69:
Democrats don't really want to leave their base with nothing to hope for. If they get everything... no reason to vote (D) again.


There's no such thing as "everything". Only "more".
Link Posted: 2/16/2013 10:39:49 PM EDT
Originally Posted By WildApple:

Originally Posted By Truth2882:
Originally Posted By regalrocket:
Originally Posted By Sdsquad1:
And my two children with a chronic illness get what?


So after one child with a chronic ilness you can't afford you have a second....

Children are not needs, they are wants.


Damn that's a pretty shitty thing to say

That's cold
WTF?



No its a fucking stupid thing to say. When your child it born they don't hand you a fucking card saying oh yeah here is the disease he's going to have in 5 years.
Link Posted: 2/17/2013 3:34:53 AM EDT
Originally Posted By badfish274:
Originally Posted By dog-meat:
No one is going to turn away someone for simply being uninsured.


How much of a role does that play in your risk analysis, anyways?


Very little. It is only used to administer "pre existing condition" exclusions as far as I know. We do include the impact of those periods in pricing, but that's not done at a member by member level.

Under hippa prior coverage can alter the length of those periods:

http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html

Posted Via AR15.Com Mobile
Link Posted: 2/17/2013 10:45:38 AM EDT
[Last Edit: 2/17/2013 10:59:23 AM EDT by wolfstar]
Originally Posted By sigman:
Originally Posted By wolfstar:
Originally Posted By Mattl:
Originally Posted By Sdsquad1:
And my two children with a chronic illness get what?



Sub standard care from a doctor Nurse Practitioner trained in and imported from a third world country who is underpaid and overworked.





Is this spoken from experience? Or is this your professional/personal bias?

Most ARNPs/DNPs/ ect that I have worked with have been very competent. I only have only encountered one bad nurse practitioner and she was employed by a private practice physician. Her gross incompetency and high levels patient dissatisfaction also spoke poorly on his judgment and professionalism.
Overall, my personal experience is that nurse practitioners generally have better professional competency than physician assistants. The only negative aspect I encounter with NPs is that many of them drank the Kool-Aid in nursing school or working as RNs and love socialized medicine and tax payer funded social crusades.


The point wasn't to put down Nurse Practitioners. They are to be respected for what they've done to reach the level of Nurse Practitioner. The point was that a lot of people are going to stop becoming doctors. And those that are doctors are going to seriously considering quitting or retiring because of Obamacare. Actually, I can see a time in the future where one will feel lucky to be seen by a Nurse Practitioner. Eventually, the shortage of those qualified to treat patients will become so low that you will have to wait months, if not years, to be seen by a specialist doctor. Orthopedic M.D., for example.

Need a new hip? Kneecaps? We'll put you on the list. Let's see, we can schedule you for February of next year.

Isn't that the way it works in countries with socialized medicine now?
Link Posted: 2/17/2013 10:50:18 AM EDT

Originally Posted By LurchAddams:
Obamacare was suppose to make health insurance AVAILABLE to folks with pre-existing conditions. Obama ran short on cash, and said "screw em”: no new policies for thousands of people with pre-existingconditions. Just let them wait until 2014 or perhaps later.

Obama threwthis first batch of Obamacare participants under the bus. I hope that I am wrong, but I expect future participants to be thrown the under the bus as well.



No, the next batch won't be thrown under a bus. They'll be shoved into an oven.
Link Posted: 2/17/2013 10:56:44 AM EDT
Originally Posted By skebe:
SURPRISE!


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