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Why is it that Massachusetts can make this law work but the whole country can't? Is the rest of America too incompetent? [bold]Who cares about Massachusetts, and I have no idea if it is working or not. I certainly don't accept your word on this.[/bold]
It's a really important point, as it speaks to the validity of the ACA, which is essentially a nationwide MA individual insurance mandate. I understand it works quite well. Furthermore, something that hasn't been fully implemented, measured over time, and assessed comparatively cannot be said to have failed. Neither failure nor success will be known for five years.
Nothing I've heard against the ACA sounds any different than the past arguments against social security, unions, medicare, womens' suffrage, etc. It's all the same poisoned well of backward looking entitlement thinking.
It's a really important point, as it speaks to the validity of the ACA, which is essentially a nationwide MA individual insurance mandate. I understand it works quite well. Furthermore, something that hasn't been fully implemented, measured over time, and assessed comparatively cannot be said to have failed. Neither failure nor success will be known for five years.
Nothing I've heard against the ACA sounds any different than the past arguments against social security, unions, medicare, womens' suffrage, etc. It's all the same poisoned well of backward looking entitlement thinking.
Your turn: how can a middle class family afford $17k to $23k for health insurance per year?
Lets start with what a middle class family currently pays.
Quote:
The increased cost of health insurance is a central fact in any discussion of health policy and health delivery. As annual [bold]premiums[/bold] edged beyond $16,000 for an average family, costs are blamed for rising uninsured and "under-insurance."
Premiums. Just premiums. I don't see any MO premiums approaching that in the ACA, with the exception of gold premiums for people that earn over $80k or so.
Quote:
The institute found that out-of-pocket spending growth outpaced overall spending growth, jumping about 4.8 percent to [bold]$768[/bold] a person. Older adults, 55 to 64, spent about [bold]$1,265[/bold] out of pocket, with those under 18 incurring just $427 in uncovered costs. Women also had greater out-of-pocket expenses than men, by more than $200 a year.
This nonsense you preach about the average family spending $17 to $23k is just that: nonsense.
Let's be realistic and honest for a change and stop the worst case fearmongering. If you're a median household, you'll pay about $450 a month for silver family coverage or more for gold (which then reduces oop). Even if you (in real life as opposed to random worst case scenario life) spend more oop than the above figures - we'll say it's $2k per person just for ****s and giggles - that's a total of $5500 plus $8k, or $13,500, that is still $2500 less than the AVERAGE PREMIUM ALONE in the old scenario.
Premiums. Just premiums. I don't see any MO premiums approaching that in the ACA, with the exception of gold premiums for people that earn over $80k or so.
This nonsense you preach about the average family spending $17 to $23k is just that: nonsense.
Let's be realistic and honest for a change and stop the worst case fearmongering. If you're a median household, you'll pay about $450 a month for silver family coverage or more for gold (which then reduces oop). Even if you (in real life as opposed to random worst case scenario life) spend more oop than the above figures - we'll say it's $2k per person just for ****s and giggles - that's a total of $5500 plus $8k, or $13,500, that is still $2500 less than the AVERAGE PREMIUM ALONE in the old scenario.
Is it possible for you to be honest?
I'm not talking about worst case scenarios, I'm talking about the cost of the premium plus the deductible. That adds up to around $17,000. You pay that before the insurance even kicks in, except for a checkup. God forbid you or a family member needs to be hospitalized, you will hit the out of pocket max pretty quick and you are talking $23k.
Those are facts:
"The average premium is $916.14; the median is about the same at $923.90. The average deductible is $6,581.82 and the median is $6,000. Thus the average plan requires families that actually plan to use healthcare pay $17,575.54 (total monthly premiums plus deductible) before the plan pays much (or anything, depending on the plan); the median is $16,971.38.
The average out-of-pocket maximum is $10,854.55; the median is $12,500. Finally the maximum paid per year – the price people with conditions like cancer would be expected to pay for their “affordable” care, with premiums, deductibles, and copays (but not balance-billed and other games) – is $21,848.27 per year; the median is $22.415.96.
The plans carry average premiums by metal level of $759.14, $910.86, $1,019.28, and $1,103.20 for bronze, silver, gold and platinum respectively. Average deductibles are $10,571, $7,209, $3,633, and $1,040 and average out-of-pocket maximum amounts are $12,600, $12,026, $10,115, and $4,467. Total out-of-pocket annual costs for people who rely on the plans – the sick people the ACA was meant to help – are $21,710, $22,956, $22,346, and $17,705 (if you’re sick, buy platinum, assuming that you can afford anything)."
The plans carry average premiums by metal level of $759.14, $910.86, $1,019.28, and $1,103.20 for bronze, silver, gold and platinum respectively.
THOSE ARE THE PRICES BEFORE THE SUBSIDIES!!!!!!!!!!!!!!!!!!
A median MO family (I've been generous at $50k, really it's $44k) would pay:
BRONZE $450ish, or $5400/yr premiums
SILVER $600ish, or $7200/yr premiums
GOLD $700ish, or $8400/yr premiums
PLATINUM - not yet available in MO, but based on other states assume $800/mo and $9600 annual premiums for MO $50k family.
But you conveniently and dishonestly continue to omit the impact of subsidies. Subsidies make a huge difference. Are you deliberately illiterate?
We'll just use your figures for oop max for the sake of argument, not that most people ever come close to hitting them most of the time, but whatever, dude. For you the worst case is evidently the only case.
WORST CASE FOR EACH LEVEL:
BRONZE $450ish, or $5400/yr premiums plus 12,600 worst case cash = $18k max
SILVER $600ish, or $7200/yr premiums plus 12,000 worst case cash = $19k max
GOLD $700ish, or $8400/yr premiums plus 10,100 worst case cash = 18k max
PLATINUM - not yet available in MO, but based on other states assume $800/mo and $9600 annual premiums for MO $50k family after subsidies, plus $4500 worst case cash = $14k max
Compare that to the average FAMILY PREMIUM ALONE pre ACA, of $16k. In the current system, your family spends $16k whether something happens to them or not, regardless of income level. In the new scenario, you spend more only if something happens. Plus an average of $8k oop family max. Or, $24k pre ACA worst case, with a $16k minimum case. Pre ACA.
Now you may not think the extra $6k to $10k matters for a (slightly above) median family in a worst case year, but I think they would soundly disagree. Especially in those years in which they are healthy and they STILL have a $6k to $10k advantage over the current average.
What is your point? You continue to fail. It's called math.
The plans carry average premiums by metal level of $759.14, $910.86, $1,019.28, and $1,103.20 for bronze, silver, gold and platinum respectively.
THOSE ARE THE PRICES BEFORE THE SUBSIDIES!!!!!!!!!!!!!!!!!!
A median MO family (I've been generous at $50k, really it's $44k) would pay:
BRONZE $450ish, or $5400/yr premiums
SILVER $600ish, or $7200/yr premiums
GOLD $700ish, or $8400/yr premiums
PLATINUM - not yet available in MO, but based on other states assume $800/mo and $9600 annual premiums for MO $50k family.
But you conveniently and dishonestly continue to omit the impact of subsidies. Subsidies make a huge difference. Are you deliberately illiterate?
We'll just use your figures for oop max for the sake of argument, not that most people ever come close to hitting them most of the time, but whatever, dude. For you the worst case is evidently the only case.
WORST CASE FOR EACH LEVEL:
BRONZE $450ish, or $5400/yr premiums plus 12,600 worst case cash = $18k max
SILVER $600ish, or $7200/yr premiums plus 12,000 worst case cash = $19k max
GOLD $700ish, or $8400/yr premiums plus 10,100 worst case cash = 18k max
PLATINUM - not yet available in MO, but based on other states assume $800/mo and $9600 annual premiums for MO $50k family after subsidies, plus $4500 worst case cash = $14k max
Compare that to the average FAMILY PREMIUM ALONE pre ACA, of $16k. In the current system, your family spends $16k whether something happens to them or not, regardless of income level. In the new scenario, you spend more only if something happens. Plus an average of $8k oop family max. Or, $24k pre ACA worst case, with a $16k minimum case. Pre ACA.
Now you may not think the extra $6k to $10k matters for a (slightly above) median family in a worst case year, but I think they would soundly disagree. Especially in those years in which they are healthy and they STILL have a $6k to $10k advantage over the current average.
What is your point? You continue to fail. It's called math.
I get the math: it's obvious the ACA is increasing costs for most Americans, not decreasing it. Yet another Obama lie exposed.
And about those subsidies? Another broken promise for many:
I assume your figures come from Kaiser, but that's the average group cost:
"Annual premiums for employer-sponsored family health coverage reached $16,351 this year, up 4 percent from last year, with workers on average paying $4,565 toward the cost of their coverage, according to the Kaiser Family Foundation/Health Research & Educational Trust (HRET)."
But workers on average only contribute $4,565.00. That's why your party delayed the employer mandate. A lot of people now covered under group plans are going to be thrown into exchanges and face paying the $17-23K I cited.
You obviously didn't read the article very carefully. Or my link to average premium info, which was from the National Council of State Legislatures.
80% of her issue is that there are two non-communicating computer systems at play (exchange and Medicaid), and a child that was enrolled in Medicaid, which has limited her eligibility, and there is currently no use case for unenrolling her child in Medicaid so she can compare ACA costs for both of them to ACA for just her and Medicaid for child. Many new use cases will be uncovered as this rolls out. That is the nature of software development.
And note, very importantly, that she is still a supporter of the President and the ACA. When you're trying to make an argument against something, perhaps you should find a better example of the law failing, rather than the technical execution of its delivery mechanism or some procedural issue, failing. Hers is in the end likely a solvable problem.
And there you go again, thinking only of the worst case, and not the nominal case that most people experience most of the time. The only time my family approached the worst case was a result of pregnancy. If you assume that people will hit the worst case 1 in 5 years, which makes much more sense than your max-it-out-all-the-time scenario, the ACA is much better for most people.
That means a silver plan median family could pay $7200 for five years for premiums, we'll say they spend $3k a year on oop expenses every year, and one year they max it out for some reason. That is {[($7200+$3000) x 5] + $12,000} in the ACA scenario, versus {[($16k +$1500) x 5] + $6000} in the non-ACA scenario (assuming that non ACA has lower oop).
ACA = $63,000 in five years
Non-ACA = $93,500 in five years
I think the median family will appreciate the savings. Math, b**ch.
Last edited by STLviaMSP; 11-20-2013 at 09:03 AM..
When most people suck at math, and the subject is math, then their opinions don't really count in my book. I'm going to have to lump you into the category "sucks at math," because you clearly don't understand the concept of nominal case and worst case and just what a huge impact that has on the actual costs of health insurance post ACA. Unfortunately it is a complicated story to tell to a person without math skills. I laid it out pretty clearly half a dozen times above. Your sentence structure is a little too clean for you to be stupid, so I assume you have chosen to remain willfully ignorant, or you just suck at math. Either way, you continue to be wrong.
When most people suck at math, and the subject is math, then their opinions don't really count in my book. I'm going to have to lump you into the category "sucks at math," because you clearly don't understand the concept of nominal case and worst case and just what a huge impact that has on the actual costs of health insurance post ACA. Unfortunately it is a complicated story to tell to a person without math skills. I laid it out pretty clearly half a dozen times above. Your sentence structure is a little too clean for you to be stupid, so I assume you have chosen to remain willfully ignorant, or you just suck at math. Either way, you continue to be wrong.
Unfortunately stories like this are very easy to find:
And I must say, you might be very good at math, and you are clearly not stupid, but I have to put you into the sucks at actual facts category, which renders your opinion meaningless in my book, at least when the subject is what is actually happening in the real world. Personally I think you are too blinded by ideology. Because the main complaint that all these people have is that their costs are going up, in many cases way up, when you factor in these large deductibles and out of pocket maximums, and you keep insisting otherwise in your theoretical world based on estimates and theoretical subsidies from some online calculator and your implied assumption that no one actually will use the insurance so you ignore deductibles and out of pocket maximums.
Facts on the ground are a *****, dude.
Last edited by MUTGR; 11-20-2013 at 10:25 AM..
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