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oops, type in the title: Should be ACA, not ACE. Can't correct titles, apparently.
I ran into an interesting situation recently and wondered if anyone else had heard about this. I was speaking with a representative from BCBS in another state regarding Medicare supplemental plan questions (for my retirement research), and the issue of the ACA came up in the conversation, even though it doesn't pertain to me personally, as I am turning 65 before 2014.
The BCBS rep expressed concern for 2014 in that state because although BCBS in her state was designing new policies that will meet the ACE requirements and getting ready for implementation in Oct 2013 on the state exchange, her company (BCBS) had heard that the other health insurance companies in that state were not going to participate in the ACA at all, and were not planning to offer health insurance to all applicants, regardless of health conditions, as is required by the ACA law. We both said that it sounded illegal to do that, but perhaps there are loopholes for health ins co to slip out of?
If it is possible for some health insurers to opt out of the ACA entirely, then it puts the added burden on the other companies that "play by the rules" in that they may end up with the sicker customers while the other companies continue to cherry pick the healthy customers, instead of the risk being spread around all insurance companies.
I wondered if anyone had heard of loopholes that ins companies can use to get out of the rule in 2014 to insure all applicants regardless of health conditions.
I'm not debating the pros and cons of the ACA, just asking about loopholes, if any. It's an interesting issue if these loopholes exist. Or maybe some companies are just going to take a chance on not getting caught.
Last edited by xz2y; 02-28-2013 at 02:02 PM..
Reason: typo
oops, type in the title: Should be ACA, not ACE. Can't correct titles, apparently.
I ran into an interesting situation recently and wondered if anyone else had heard about this. I was speaking with a representative from BCBS in another state regarding Medicare supplemental plan questions (for my retirement research), and the issue of the ACA came up in the conversation, even though it doesn't pertain to me personally, as I am turning 65 before 2014.
The BCBS rep expressed concern for 2014 in that state because although BCBS in her state was designing new policies that will meet the ACE requirements and getting ready for implementation in Oct 2013 on the state exchange, her company (BCBS) had heard that the other health insurance companies in that state were not going to participate in the ACA at all, and were not planning to offer health insurance to all applicants, regardless of health conditions, as is required by the ACA law. We both said that it sounded illegal to do that, but perhaps there are loopholes for health ins co to slip out of?
If it is possible for some health insurers to opt out of the ACA entirely, then it puts the added burden on the other companies that "play by the rules" in that they may end up with the sicker customers while the other companies continue to cherry pick the healthy customers, instead of the risk being spread around all insurance companies.
I wondered if anyone had heard of loopholes that ins companies can use to get out of the rule in 2014 to insure all applicants regardless of health conditions.
I'm not debating the pros and cons of the ACA, just asking about loopholes, if any. It's an interesting issue if these loopholes exist. Or maybe some companies are just going to take a chance on not getting caught.
I don't think it would be legal for them to do what they informed you they plan to do (discriminate against people with those conditions). If I understand the law correctly, that practice must end Next Year.
From what I understand. You are correct in saying that all insurance companies can choose to either sell or not sell their products via the 'health marketplaces".
From 2014,there are two new sets of rules. The first set of rules is compulsory for all insurance companies. The second set of rules are for insurance companies that want to sell via the "marketplaces".
If you want to sell via the marketplace, you will have to provide coverage's according to one of 3 standards set by the Govt (the bronze, silver or gold level plans). The advantage to both sides to use the marketplaces are the Govt rebates, which will lower the cost to many consumers (not all). Therefore lower prices to the customers should mean more policies sold.
If an insurance company wants to sell a policy that differs from the Govt plans outside of the marketplaces it can, provided it still meets the other legal minimums that come into force.
There is no legal compulsion to sell through the marketplaces. However, there is the economic incentive of Govt subsidies providing more customers.
Its a huge change for sure...
My guess is that the marketplaces will be a huge success and the companies who don't join them will loose individual customers.
(I am biased towards Obamacare.)
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