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Get a ****ing grip. Why else would United Health pull out of the worlds 12th largest economy if it weren't for adverse affects of ACA? For schits and giggles? Because it likes watching profits go down the drain?
Perhaps because United Healthcare had a small minute segment in that market? And simply couldn't compete?
You do live in South Carolina. And I do agree that is a problem. I wouldn't say that SC if the most progressive state going. Probably the worst going in that category. I do like Charleston as a city though. In fact, my daughter went to college there ( for the first two years - COC).
I have no idea about the choices you are being offered there. I did look at the plans offered there. The prices didn't seem very high (to me), even the gold plan. But I don't know anything about the providers there nor specifically what's provided in those plans.
As far as HMOs are concerned they certainly are not liked in Charleston. I also looked at the Medicare Advantage plans offered there (which are HMOs) and their ratings are very poor. As far as ACA is concerned it definitely seems that HMOs are the de facto standard and likewise, will predominate thru the country. Perhaps SC might have to decide to enter into the current century (ie, put idiotic politics aside)?
And yet our insurance market was able to meet my needs just fine until the Federal gov't overreach. I'm personally not a fan of HMOs either. I have always gone for PPOs. All of the plans being offered on the exchange are EPOs or HMOs. I did find one non-exchange plan that is a PPO. It's a turd but at least it offers 'some' semblance of out of network coverage. The cost for a gold plan PPO is around $1K. There are no platinum plans offered.
Since I am not eligible for subsidies, what exactly could SC have done to change my situation since insurers are doing this because of Federal mandate?
And yet our insurance market was able to meet my needs just fine until the Federal gov't overreach. I'm personally not a fan of HMOs either. I have always gone for PPOs. All of the plans being offered on the exchange are EPOs or HMOs. I did find one non-exchange plan that is a PPO. It's a turd but at least it offers 'some' semblance of out of network coverage. The cost for a gold plan PPO is around $1K. There are no platinum plans offered.
Since I am not eligible for subsidies, what exactly could SC have done to change my situation since insurers are doing this because of Federal mandate?
Really now. SC is politically living in the 19th century. And because of that, the choices that many people there have today. I 'm not knocking the state. I thought seriously about attending Clemson. It is just politically waaay behind the times. To its detriment. But the same is true of several southern states.
Really now. SC is politically living in the 19th century. And because of that, the choices that many people there have today. I 'm not knocking the state. I thought seriously about attending Clemson. It is just politicallyss waaay behind the times. To its detriment. But the same is true of several southern states.
I don't think it is. I think it has a different political philosophy than that of progressive states but that hardly makes it antiquated. We've been attracting businesses and new residents through our lower taxes and business friendly regulations. But, as it pertains to Obamacare, what could SC have done to change a situation like mine? It was a Federal mandate. The only thing SC had control over was not expanding Medicaid. Since that was never open to me as an option anyway, it had no impact on my issue.
Here's the thing - my situation is not unique to SC. There have been a multitude of articles which have laid out one case after another that are similar to my own. The issue is the Federal mandate which had created this fiasco. There were less invasive and more consumer friendly ways to solve the uninsured and underinsured issues that previously existed. For those of us with perfectly adequate insurance, we are getting penalized so these small groups could benefit. How, in any world, is that fair?
I don't think it is. I think it has a different political philosophy than that of progressive states but that hardly makes it antiquated. We've been attracting businesses and new residents through our lower taxes and business friendly regulations. But, as it pertains to Obamacare, what could SC have done to change a situation like mine? It was a Federal mandate. The only thing SC had control over was not expanding Medicaid. Since that was never open to me as an option anyway, it had no impact on my issue.
Here's the thing - my situation is not unique to SC. There have been a multitude of articles which have laid out one case after another that are similar to my own. The issue is the Federal mandate which had created this fiasco. There were less invasive and more consumer friendly ways to solve the uninsured and underinsured issues that previously existed. For those of us with perfectly adequate insurance, we are getting penalized so these small groups could benefit. How, in any world, is that fair?
I know. Alabama has the same problem BCBS is predominant there. And they sold health insurance based on medically related criteria. Which is now illegal. Which raised the price of their health policies tremendously. Same is likely true in SC.
From what I've read some companies did not grandfather their plans (which they were allowed to do) simply because of the 80/20 rule. In short, they felt that they could make more simply by canceling the old policies and going with newer, more expensive ones. Or else going the ACA exchange route.
Get a ****ing grip. Why else would United Health pull out of the worlds 12th largest economy if it weren't for adverse affects of ACA? For schits and giggles? Because it likes watching profits go down the drain?
This is NOT about the ACA! Insurance companies leave state markets ALL THE TIME. The company that I used to work for stopped offering coverage in the state of Ohio effective this year, for instance. We didn't put out a competitive bid so we lost the right to operate in that state under several of our programs. Anyone and everyone who had our medicaid managed care plan in the state of Ohio had to find other insurance and other doctors starting this year.
Don't tell me I don't know about the industry that I WORK IN!
This thread and the link provided is nothing but political propaganda! I feel bad for the man suffering in the story, but his loss of coverage has absolutely NOTHING to do with the ACA. Even if the ACA was never even imagined his coverage very well may have been dropped because that is what insurance companies do all the time. Their purpose is to make a profit. When markets become unprofitable, they exit that market or drop certain coverages. My former employer also almost stopped coverage for members in Kentucky. Luckily, good negotiations got them the premium increase that they needed from the state government so that the company could stay profitable.
For the man in the story. He needs to research into everything that he could possibly get coverage for. While reading his plight, I can't help but think that he actually does not understand all the options he has. With such advanced cancer he should be eligible for Medicare and possibly also a county funding medicaid program (I am assuming he doesn't work, given the extensive progression of his cancer). He can then have access to numerous managed care and advantage plans that can get him the coverage that he needs.
The only thing that would truly help this man is a full nationalized healthcare system. He would then have easy access to any doctor in the country he wants to see. His plight is rare. I am sorry he is losing his coverage. But his loss of coverage is NOT about Obamacare. And Obamacare is going to provide access to insurance for millions of Americans in similar states of suffering as he is.
no, that is only part of it: we were told, more than once we could keep our doctor, now you join the crowd that wants to blame the insurance companies and maybe even Bush or Clinton...Face it, the plan was not thought out, we were lied to and it should be scraped. Maybe the next time a sensible plan can be worked out. About the only decent thing Obamacare does is allow people with pre-existing conditions to be covered. Even the kids under 26, is questionable, unless they are still in school.
It gets so tiring trying to get facts across to people who have absolutely no effing CLUE as to how health insurance and provider networks in this country work!
Read my post that I wrote out for AeroGuyDC for some enlightenment.
And yes, that people with pre-existing conditions can now be covered under commercial insurance plans is a great thing. Unfortunately, it also exposes insurance companies to an economical term called adverse selection.
The mandate is in place to negate the effects of adverse selection. If we get rid of the mandate to buy insurance then one of two things will happen with health insurance in America.
1) Insurance companies will go bankrupt.
2) Premiums will skyrocket to unprecedented highs to cover the costs of adverse selection.
The coverage until 26 is a good thing. It is harder than ever these days for America's youth to find decent jobs that offer insurance and millions of America's youth have pre-existing conditions.
Well, unless obama and those dems know exactly what is in each plan, and what each individual considers "junk" then maybe you are correct...however, knowing this would also mean they know the individuals health issues (HIPPA) violation....
That is true. Most of the dropped plans though are individualized plans rather than group plans (say with your employer or union.) The issue is many are low priced for a reason (they cover this but not that and have high deductibles.) The solution, Obamacare's bronze which is still high deductibles that cover more at a higher price.
Quote:
Originally Posted by Weichert
Doctors in/out of plans happens. It is common. Lots of doctors (even hospitals) have refused some health insurance companies. And some insurance companies drop doctors. Especially in HMOs.
This happens yearly similar to the individual plans. It depends on several things. Obamacare has turned off some doctors and in turn start up cash-only practices where you pay flat fees rather than the smaller co-payments..
Quote:
Originally Posted by CravingMountains
It gets so tiring trying to get facts across to people who have absolutely no effing CLUE as to how health insurance and provider networks in this country work!
Read my post that I wrote out for AeroGuyDC for some enlightenment.
And yes, that people with pre-existing conditions can now be covered under commercial insurance plans is a great thing. Unfortunately, it also exposes insurance companies to an economical term called adverse selection.
The mandate is in place to negate the effects of adverse selection. If we get rid of the mandate to buy insurance then one of two things will happen with health insurance in America.
1) Insurance companies will go bankrupt.
2) Premiums will skyrocket to unprecedented highs to cover the costs of adverse selection.
The coverage until 26 is a good thing. It is harder than ever these days for America's youth to find decent jobs that offer insurance and millions of America's youth have pre-existing conditions.
There is good with Obamacare however there is bad that comes with it as well. It is a far from perfect law, partially because of the way it was passed. I for see the adverse selection happening unless the penalties are raised because most people will pay less in the penalty than they will for healthcare. In particular, the youth (over 26) who the system is banking on to off-set the sick and elderly.
That is true. Most of the dropped plans though are individualized plans rather than group plans (say with your employer or union.) The issue is many are low priced for a reason (they cover this but not that and have high deductibles.) The solution, Obamacare's bronze which is still high deductibles that cover more at a higher price.
This happens yearly similar to the individual plans. It depends on several things. Obamacare has turned off some doctors and in turn start up cash-only practices where you pay flat fees rather than the smaller co-payments..
There is good with Obamacare however there is bad that comes with it as well. It is a far from perfect law, partially because of the way it was passed. I for see the adverse selection happening unless the penalties are raised because most people will pay less in the penalty than they will for healthcare. In particular, the youth (over 26) who the system is banking on to off-set the sick and elderly.
This is a good and a bad to find in every piece of legislation. Our old healthcare system had a LOT more bad in it. Obamacare is not without flaws. I hope Republicans begin to listen to the American people and work to IMPROVE the law. The people have spoken enough that we do not want it repealed.
You can't stand there with a strait face and say that knocking down these junk insurance scam policies is a bad thing. If you do you have absolutely no credibility. The policies that the AHCA knocks down are scam policies that cover little to nothing. They are more dangerous than having no insurance because you have no insurance and yet think you do. Its a scam. Slant head Hannity and others are so desperate that this is their last hope to knock this law down. Its over and done. Suck it up get used to it. In a few years they will look like the idiots they are.
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