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Why do you think that you have such a small selection of plans to choose from? Along with the small HMOs which directly lead to poor insurance and low enrollments?
Surely you aren't that naive. But believe whatever.
Out of curiosity, are you originally from Charleston? I spent some time there during college years. Got to know the place pretty well. But that was a long time ago.
Why do you think that you have such a small selection of plans to choose from? Along with the small HMOs which directly lead to poor insurance and low enrollments?
Surely you aren't that naive. But believe whatever.
Out of curiosity, are you originally from Charleston? I spent some time there during college years. Got to know the place pretty well. But that was a long time ago.
I think we're going to have to agree to disagree on this issue. I do thank you for offering a thoughtful debate though. Obviously, I am distressed at the personal impact I am having.
No - originally from Georgia and lived here for about 20 years now. It's still a wonderful place and full of friendly people. You should visit again - our foodie scene here is quite robust now. Lots of fresh, local ingredients and some outstanding chefs. Plus, our population is so darn nice!
For my county, there are a similar number of plans offered but only four insurers.
That how it is in Illinois too, before and after Obamacare we have 4 insurers. Pre Obamacare we have 80 plans and in 2014 we will have 40 plans.
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Originally Posted by southbel
Most are HMOs, one EPOs, and the one non-exchange PPO. Yet, the offerings are still slim compared to pre-Obamacare. Even the same insurers have much, much smaller networks now.
That's why I think it is an issue specific to your state. If you go to ehealthinsurance and punch in random zip codes for SC you only get offered 4 plans. BCBS also offers health plans in SC, but those plans aren't on the website. Now for most places, the only thing that changes is the number of plans available, but there is still plan type variety. For example, in Carroll, IA you have 10 PPO plans and 10 nonPPO plans. In Grand Rapids, MN all the choices are PPO, and in Paris TX 12 of the plans are PPO.
Quote:
Originally Posted by southbel
Previously, my choices entailed making sure I got the benefits I wanted to pay for (I have no need of maternity and did not get that rider for example). However, under with these new plans, it's the networks that are at issue. Obamacare mandated they have a specific reimbursement rate and this resulted in smaller networks with less choice for the consumer. It's a cause and effect thing. The effect for me was reduced access.
Obamacare does not dictate what rate the insurance companies reimburse at. Obamacare cut Medicare reimbursement rates, but Medicare was supposed to be cut years ago. They've basically been relying on Congressional waivers for 10 years.
That how it is in Illinois too, before and after Obamacare we have 4 insurers. Pre Obamacare we have 80 plans and in 2014 we will have 40 plans.
That's why I think it is an issue specific to your state. If you go to ehealthinsurance and punch in random zip codes for SC you only get offered 4 plans. BCBS also offers health plans in SC, but those plans aren't on the website. Now for most places, the only thing that changes is the number of plans available, but there is still plan type variety. For example, in Carroll, IA you have 10 PPO plans and 10 nonPPO plans. In Grand Rapids, MN all the choices are PPO, and in Paris TX 12 of the plans are PPO.
Obamacare does not dictate what rate the insurance companies reimburse at. Obamacare cut Medicare reimbursement rates, but Medicare was supposed to be cut years ago. They've basically been relying on Congressional waivers for 10 years.
I've been on healthcare.gov, our state's insurance commissioner's site, ehealthinsurance, and the health insurances' company sites. Pre-Obamacare, we had twice as many insurers in the state. Now, I'm limited to four. Only one of those offers a PPO. I say that Obamacare is the cause of the low reimbursement rates because that's what our local hospitals and doctors are claiming. Seems odd they would all coordinate on message like that. It's possible, I will give you that, but would be odd nonetheless.
The question I cannot get answered though is if it is my state, as has been claimed, what exactly is my state doing to cause this? I ask this because everything I see and read in our local news claim it's the Federal policies causing this issue and not a state policy change.
I've been on healthcare.gov, our state's insurance commissioner's site, ehealthinsurance, and the health insurances' company sites. Pre-Obamacare, we had twice as many insurers in the state. Now, I'm limited to four. Only one of those offers a PPO. I say that Obamacare is the cause of the low reimbursement rates because that's what our local hospitals and doctors are claiming. Seems odd they would all coordinate on message like that. It's possible, I will give you that, but would be odd nonetheless.
The question I cannot get answered though is if it is my state, as has been claimed, what exactly is my state doing to cause this? I ask this because everything I see and read in our local news claim it's the Federal policies causing this issue and not a state policy change.
I wasn't saying or implying that your state caused this, but that the issues you are experiencing might be specific to you state. Medical mutual pulled out of SC and that could be why you can't find a good PPO insurance, but the question is why. Why did insurers pull out of SC and not IA when IA has less people. Why do people in northern MN still have plenty of options and not people in SC? I don't know the answer, but these are questions that I am wondering.
I've been on healthcare.gov, our state's insurance commissioner's site, ehealthinsurance, and the health insurances' company sites. Pre-Obamacare, we had twice as many insurers in the state. Now, I'm limited to four. Only one of those offers a PPO. I say that Obamacare is the cause of the low reimbursement rates because that's what our local hospitals and doctors are claiming. Seems odd they would all coordinate on message like that. It's possible, I will give you that, but would be odd nonetheless.
The question I cannot get answered though is if it is my state, as has been claimed, what exactly is my state doing to cause this? I ask this because everything I see and read in our local news claim it's the Federal policies causing this issue and not a state policy change.
Well, your state is offering the least in the way of health options that they can plausibly get by with. They refused the Medicaid expansion. And refused to set up a state ACA exchange. Your exSenator (who fought this law as hard as he could while in office) is now president of the Heritage foundation. Your insurance company cancelled rather than grandfathering insurance policies (and could easily have done these, especially given what you describe).
And you don't think there are a few political implications?
EXACTLY! There are so many millions of people who so blindly spout nonsense about this reform that they just don't know a damn thing about. The policies that are canceled are being canceled because they deliver sub-standard care to their recipients. Maybe some of these policies satisfied the needs of those who owned them, but millions are actually being scammed and ripped off.
Say you have one of these "swiss cheese" plans because you are a healthy younger adult (above the 26 cutoff or your parents didn't have insurance.) You got these plans hoping you didn't see the doctors at all except in vast emergencies. You got it because premiums were lower. Now with Obamacare it costs more because it covers everything for everyone rather than giving you lower premiums for being healthy. Is it fair to them to pay more (with or without the subsidy) than before because it gives them care for things they don't need (say birth control and well woman checks for men.)
Say you have one of these "swiss cheese" plans because you are a healthy younger adult (above the 26 cutoff or your parents didn't have insurance.) You got these plans hoping you didn't see the doctors at all except in vast emergencies. You got it because premiums were lower. Now with Obamacare it costs more because it covers everything for everyone rather than giving you lower premiums for being healthy. Is it fair to them to pay more (with or without the subsidy) than before because it gives them care for things they don't need (say birth control and well woman checks for men.)
Those kind of plans are still available for those under 30, aren't they? And then there are well men checks that women don't need but are included.
Well, your state is offering the least in the way of health options that they can plausibly get by with. They refused the Medicaid expansion. And refused to set up a state ACA exchange. Your exSenator (who fought this law as hard as he could while in office) is now president of the Heritage foundation. Your insurance company cancelled rather than grandfathering insurance policies (and could easily have done these, especially given what you describe).
And you don't think there are a few political implications?
But my state is not unique in that regard. A majority of the states refused to expand Medicaid, something I would not be eligible for anyway. Our insurance not grandfathering in the policy is happening nationwide. When I look at the situation, I see a nationwide problem vice a state issue. The lack of options in this particular state IS an issue and one that I think the Dems should have listened to the GOP about. We should have been able to buy health insurance across state lines so that we have greater choice and options. I can't imagine why the Dems rejected that plan except that it was a solution offered by the GOP? That speaks to the dysfunction in DC.
But my state is not unique in that regard. A majority of the states refused to expand Medicaid, something I would not be eligible for anyway. Our insurance not grandfathering in the policy is happening nationwide. When I look at the situation, I see a nationwide problem vice a state issue. The lack of options in this particular state IS an issue and one that I think the Dems should have listened to the GOP about. We should have been able to buy health insurance across state lines so that we have greater choice and options. I can't imagine why the Dems rejected that plan except that it was a solution offered by the GOP? That speaks to the dysfunction in DC.
Yes, many states did turn those down. And some seem to be having the exact kind of problems that you describe. One might think a bit by design if one had that turn of mind. BTW, in turning down the Medicaid expansion (along with it's associated funding), the problem doesn't go away. Your hospitals lost a LOT of money on that deal. The hospitals in Texas are in an uproar over their losses, especially given that 26 percent of Texas residents don't have any kind of health insurance and some ERs are turning people away because of lack of facilities.
One could say your knuckle-dragging politicians shot themselves in the foot over this. And people such as yourself are caught in the middle.
As far as insurance across state lines, Georgia tried that experiment a few years ago and didn't attract one offer to participate.
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