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ACA eliminated the lifetime caps on coverage, exclusions for pre-existing and existing conditions and instituted individual and family maximums for out of pocket costs. The max out of pocket for a family is $12, 250.
Apparently not.
Quote:
According to the law, the limits on out-of-pocket costs for 2014 were $6,350 for individual policies and $12,700 for family ones. But in February, the Department of Labor published a little-noticed rule delaying the cap until 2015.
“Under the [one-year delay], many group health plans will be able to maintain separate out-of-pocket limits for benefits in 2014. As a result, a consumer may be required to pay $6,350 for doctors’ services and hospital care, and an additional $6,350 for prescription drugs under a plan administered by a pharmacy benefit manager.”
Yep. We're right back where we started. But now, people (on average) will be paying a lot more for insurance and health care.
Really?
Which insurers sold private non employee sponsored group health care policies that did not contain a mass of exclusions, relative low lifetime caps and reasonable annual out of pocket expense caps?
Many of the former sub -prime policies were issued by niche insurers who did not have the weight to negotiate steep discounts via PPO with hospitals and medical practices.
When comparing and contrasting anything, it is necessary to compare benefits and costs.
Which insurers sold private non employee sponsored group health care policies that did not contain a mass of exclusions, relative low lifetime caps and reasonable annual out of pocket expense caps?
We don't have that with Obamacare, either. Read my last post.
Mine decreases $250 per month with a lower deductible. I'm 60 and a smoker. Thank you, youngins, for paying part of my premiums. In my book, you're dolls!
Their choice; get it? Just what the cons have been asking for-options. Options, baby!
The cons were shrieking for years about the need for "catastrophic" plans. Now that they've got them, they don't like what they see! Just like "shut down the government" turned into, "We didn't mean the WH, the national monuments and the national parks".
"Be careful what you wish for. . . "
Oh this irony of it all ....
Go back to Hillary Care ( modeled on what was then the conservative Heritage Foundation plan) developed in the early 90's, that mandated all employers to provide group healthcare insurance benefits with a minimum of an 80% subsidy and anticipated creating regional exchanges for the self -employed.
Back then, the Republicans were outraged by requiring all employers to insure and subsidize by a minimum of 80%. In contrast, ACA exempts 96-99% ( varies by source) of small businesses and does not mandate a minimum subsidy. According to the Kaiser Foundation 94% of employers with 50-199 employees offer healthcare insurance and 98% of those employers with more than 199 employees offer healthcare insurance. Less than 1% , roughly 10,000 out of 5.7 million businesses would be subject to the no coverage penalty under ACA.
Back then, the Republicans sought to protect the politically appointed state insurance commissions and so ACA defaulted the exchanges to the state level. It was originally contemplated ( near fatal flaw) that a maximum of 5 states would not develop their own insurance exchanges, despite government paying them to do so.
Reality is only 17 states currently run their own health insurance exchanges, 27 states have a federally-run marketplace and six states have a hybrid of both. In terms of project development, this is called scope creep. Developing a federal exchange for 5 states is vastly different than developing one for 45 states, given each state continues to have their own unique insurance laws that can and do change, different insurers, different healthcare marketplaces and uninsured populations.
Perhaps had this been known upfront, the decision would have been made to roll out ACA on a state by state basis instead of a big bang approach. It's water under the bridge at this point.
I get the impression that many who are knocking Obamacare plans do not realize that there is a huge amount of personal choice involved. Just like this thread started with - "see your premium (singular)" they erroneously assume that there is one and only one option much like employer plans. Nothing is further from fact. There are literally dozens and dozens of options in many states. In fact, nearly as hard as using the ACA website is trying to decide what is the best plan for your family. I love the choice. It's about time!
There are 6 insurers and more than 350 plans in my state.
I can and do appreciate that this is not the case in all states.
When politically appointed state insurance commissioner vows to do everything in their power to not comply with nor enforce ACA within their state, it matters.
Oh---- now that would be excellent irony and will prove Ted Cruz was right all along.
They're going door to door here trying to sign people up for obamacare and the best thing about obamacare is how terrible it is, the total lack of interest in it.
Oh -- and the fact that all those 50 million uninsured can no longer be an issue at election time.
Some states :
Enacted legislation prevented or hindering the ACA navigators from doing their job and/or
Chose not to develop their own healthcare exchanges, and/or
Refused to increase their Medicaid threshold despite objective experts showing its going to save the state money in the longer run, and/or
Refused to provide zero factual information about ACA on their state websites, and/or
Told the people to not by insurance, and/or
Have insurance commissions who have made it clear they will not enforce ACA.
That these are the same states with the majority of uninsured in the U.S. is a tad ironic.
Keep em barefoot and uninsured is the subliminal state motto.
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