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Rachel’s premium is NOT paying for those who receive subsidies.
Reasonable and affordable are subjective terms.
Undocumented people do not qualify for Obamacare/ subsidies.
Greed is also a subjective term. Prior to the ACA, insurers could increase premiums based on their own profit goals. The ACA caps profits and requires insurers to demonstrate to the state why an increase is necessary. As it relates to the Individual Plan market, it’s rather simple. When claims made/ paid exceed premiums, something has to give.
Okay, I'll try to explain my viewpoint as concisely as possible:
In my opinion, it is unfair that middle-income people have to pay exorbitant insurance premiums and out of pocket medical expenses while corporations make obscene (imo) profits and many poor people pay almost nothing for their medical care.
And by "exorbitant", I mean more than 25% of their household income.
And by "obscene", I am referring to the 21% profit margin that Forbes estimated for the healthcare technology industry, making it by far the most profitable industry of all, according to the following article:
I'd advise everyone to learn how medicare / medicaid work because if they don't, they may find that their kids will have to help pay for needed medical help, this is the situation we found ourselves in, all while the poor receives unbelievable amount of help. I was shocked, my mother with a terminal disease made $5.82 a month too much and off the cliff she fell and she did not qualify for help.
Most folk receive more in Medicare benefits than they paid into Medicare. This is especially true in former traditional families whereby the male was the primary breadwinner. His Medicare taxes had to cover 2 people.
And most of this occurs during the last two years of life.
Paul Ryan’s plan was to replace Medicare with a voucher system. Vouchers could, in theory, be used to buy insurance and/ or pay for medical services. Two challenges with his approach. Insurers decline to be the primary insurer of elderly healthcare risks. And what happens if the vouchers are not sufficient to cover costs.
I had one of those "cadillac" plans before ACA taxed my Company into making changes (for the worse). I just recently got it back. Under the ACA years I had a deductable and caps.
The Federal and state governments pick up the difference, NOT those who don’t qualify for a subsidy.
The only reason to buy insurance off an exchange is to get the subsidy. Those who don’t qualify may have more alternatives in the open market.
Sort of. Used to be the enhanced silver plans that the fed picked up the cost for. By law insurers are required to offer it. It's basically almost gold insurance at bronze insurance costs for low income people. Trump admin axed the payments the federal govt used to make to insurers to subsedize those plans.
Since they're legally required to offer those plans, insurers just raised premiums across the board to do so. If you have a subsidy, no big deal. Insurance went up 200 and you got another 200 subsidy. If you don't, however, your insurance just went up by 200.
A) Pharmaceuticals vastly overcharge for their drugs, especially the popular ones people need to survive.
B) Medical professionals routinely make people get expensive unnecessary tests and also gouge you on prices.
C) Insurance companies pass all the costs onto the customer. And because healthy young people have no need for insurance, the ones who really need insurance have to pay even more.
The government was powerless to prevent A and B. So the best they could do was create a mandate that everyone must be insured. If you are young and healthy and you don't get insurance, you will pay a penalty. That was supposed to offset the costs for those who really need insurance. Well Trump got rid of the mandate...
Generally speaking, Pharma, like any business, typically charges as much as the market will bear.
The US is litigious. There is this thing, that someone has to pay.
Each state has unique malpractice regulations. A few have embedded those regulations into their state constitutions. It’s likely some tests are ordered as a defense against a potential future malpractice suit.
All businesses pass their costs onto the consumer and this includes not for profit businesses.
The ACA capped insurer’s profits. Insurers must demonstrate and justify premium increases to their state. The state, not the Federal Government approves premiums. When claims made/ paid exceed premiums, something has to give.
Insurers make their profits on Medigap and Large Group Plans, on Individual plans. If an insurer can’t adjust premiums, it will simply exit a particular line of business. Insurers have been exiting the Individual Plan Market for 25 years. It’s tough to make a buck.
All insurance, not just healthcare, mutualizes ( socializes) risks.
The age 50-64 age group represents the greatest exposure to a primary insurer. Take a look at any large scale employer. The majority of employees are younger and presumably healthier, thus cheaper to insure. This is why many employers are able to buy better insurance at costs less than one could in the Individual Plan market.
When say 2/3 of your employees are under 45 matters. They are less likely than the 50-64 year olds to have serious and costly claims.
My premiums stayed the same and now it includes dental, eyes and free gym membership.
Mine too. Then again, I am insured by my husband’s employer. We have better insurance under the ACA. No more annual/ lifetime caps on claims. Deductible has not changed.
Hubs is 72 and obviously eligible for Medicare. He has not fully enrolled because his employer’s insurance benefit is better and cheaper, considering he would need a Medigap plan and I would need an Individual Plan.
Sooner or later he will retire and it will be necessary for me to acquire an Individual Plan. For this reason, I stay on top of the costs of Individual Plans in my geo rated region of my state. I would need a Platinum Plan to equal my husband’s employee benefit. The Platinum Plan is overkill for me, right now so would likely opt for a lesser and cheaper plan.
I appreciate the challenges associated with the Individual Plan Market.
Moral of the story - It's better to be high net worth and low income. Yep, be poor (low income) otherwise they'll have their hands in your wallet.
Tax code has long favored most high and low income earners, too.
What became of the big tax cut for the Middle Class Trump said was going to be approved before the 2018 midterms? That neither his own admin nor Congress was aware of it, did not work out so well.
• As long as government criminalizes the unlicensed (unpermitted) trade in healthcare and medicine, it is not a right, but an expensive privilege.
• As long as government grants a monopoly to Allopaths to dispense pharmaceuticals from licensed sources, it is not a right, but an expensive privilege.
• As long as the AMA can shut down hundreds of schools, denounce “quacks,” and create a scarcity of trained physicians, it will be expensive to be treated by one.
• As long as government grants limited liability (“license to kill”) the remaining remedy of civil suits (malpractice) will burden the innocent with the cost for the guilty.
• As long as government grants gamblers (insurance underwriters) the privilege to cover healthcare, the patient (or payer) will be stuck with the bill for dividends, staffing, administrative overhead while suffering reduced services.
• As long as government socialism and currency debauchery are involved, the cost will go up and the quality will go down.
Suggested remedy : get government entirely out of healthcare. No more “controlled substances” or FDA. Eliminate all middlemen between the patient and the care giver. No more malpractice lawsuits - satisfaction guaranteed or your money back - and that’s all.
Most folk have a strong preference not to rely on snake oil for healthcare.
Charity systems, which are practically history now after 2010, used crowdsourcing, which is an effective way to weed out pseudodiseases (and their pseudotreatments) from those rarer conditions that actually have health-related impacts as well as severity.
This environment that the 'care' industry and the neurotic progressives who support it built up to replace it monetizes everything.
And now that President Trump repealed the penalties Obama had imposed on people who didn't sign up for Obama-approved health plans, you have a much greater choice of plans.
You can even still sign up for Obamacare if you want it.
(almost no one wants it)
What is this “Obamacare” thing?
The ACA is legislation, not insurance. If one qualifies for subsidy, one must acquire their insurance via an exchange. If one does not qualify for a subsidy, one can shop for insurance beyond the exchange. This has been true all along.
One could have driven a truck through the exemptions to avoid penalties for failure to insure their healthcare risks.
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