HHS in 2010: 40-67% of those with individual insurance won't be able to keep it

[muon2]

Link

Sue Klinkhamer has a problem.

It’s called Obamacare.


Each year it went up a little to, as of Sept. 1, $291 with a $3,500 deductible. Then, a few weeks ago, she got a letter.

“Blue Cross,” she said, “stated my current coverage would expire on Dec. 31, and here are my options: I can have a plan with similar benefits for $647.12 [or] I can have a plan with similar [but higher] pricing for $322.32 but with a $6,500 deductible.”





Heh. Karma in a way.

I can't comment on some of the postings in this thread, but I'm surprised that this link hasn't gotten more traction. Ms. Klinkhamer was the mayor of the town next to mine and a Congressional staffer after that. Furthermore she's a Dem who strongly supported the ACA and is 60 so she falls into the age bracket of the other examples.

It's pretty clear that she either has to double her deductible or double her monthly payment.

[muon2]

But I'm also a scientist so without a sufficient fact set I would also say I can't comment on the veracity. OTOH when I personally know the person and situation in question, it's a bit of a different matter.

[muon2]

Link

Sue Klinkhamer has a problem.

It’s called Obamacare.


Each year it went up a little to, as of Sept. 1, $291 with a $3,500 deductible. Then, a few weeks ago, she got a letter.

“Blue Cross,” she said, “stated my current coverage would expire on Dec. 31, and here are my options: I can have a plan with similar benefits for $647.12 [or] I can have a plan with similar [but higher] pricing for $322.32 but with a $6,500 deductible.”





Heh. Karma in a way.

I can't comment on some of the postings in this thread, but I'm surprised that this link hasn't gotten more traction. Ms. Klinkhamer was the mayor of the town next to mine and a Congressional staffer after that. Furthermore she's a Dem who strongly supported the ACA and is 60 so she falls into the age bracket of the other examples.

It's pretty clear that she either has to double her deductible or double her monthly payment.

It's pretty clear that the woman's insurer is trying to trick her into a far more expensive plan than she could otherwise get shopping a healthcare exchange.

1) The article says that she has to buy insurance on her own because she's unemployed. That suggests she'd qualify for the most generous of subsidies. In Massachusetts, when I was unemployed, the state covered 90% of my COBRA payments and later, health insurance premiums.

2) Running her demo through healthcare.gov -- a 50+ woman in Kern County, Illinois -- I was able to find a Silver plan for $292.71 per month from Blue Cross, her current insurer. The deductible on the plan? $0.00. As someone who was covered by a Massachusetts Silver plan until he moved to California, I can attest -- Silver tends to be really good coverage that probably exceeds what most people are currently getting from their employer.



This woman will need to pay $2 more per month, before subsidy, to keep her current insurer and drop her deductible to $0. And since it's her current insurance company, she should have no difficulty keeping her current doctors.

If she'd like to drop her premiums, Bronze coverage appears to be available around $220.

FOR REFERENCE: The plan chosen is Blue Choice Silver PPO 003 via Blue Cross Blue Shield of Illinois. Click the link to see exactly what it covers.

Sue's pretty savvy with this stuff, so I'm surprised she wouldn't have checked the online options. I'll let you know what other relevant facts I find.

[muon2]

Sue's pretty savvy with this stuff, so I'm surprised she wouldn't have checked the online options. I'll let you know what other relevant facts I find.

It's hard doing a true comparison since I don't know any of the other specifics of her plan, but I'm always suspicious when a newspaper article talks about skyrocketing premiums without doing a basic check on a publicly available site to see if there are any alternatives available.

To be fair, she may not have checked the exchange because Illinois requires the use of healthcare.gov, which is still pretty wonky.

She found the quote you cited, but then she had to go to the Blue Cross of IL website and enter all her specifics to sign up for the silver plan. When she did that it comes up $444.80/mo and $6000. deductible (she doesn't qualify for a subsidy). Something doesn't seem to be working accurately at healthcare.gov if that's the real cost.

[muon2]

In a conversation this morning I ran across another 60+ woman who is having a similar experience to the case I described earlier. This case involves a widow, who's husband left enough in a nest egg for her to make too much to qualify for a subsidy. She has a different insurance company than the first case but like the other case the set of choices means a doubling of premiums or deductible. She also needs follow up surgery for work done three years ago, which was scheduled and covered on her current plan. However, it appears that new basic coverage through her insurer or the exchange won't cover that or allow her to keep her same doctor. She'll be forced to a higher level of coverage with greater expense to her.

[muon2]

Muon, interesting. If she doesn't qualify for subsidy, her income must be $70,000 a year or more, no? How much of that is annual interest from the nest egg (meaning a principal well over $1 million) and how much is his Social Security?

Definitionally, if she is not qualifying for subsidy, the "great expense" is within her range for the small number of years until she turns 65 and qualifies for Medicare.

This seems like a rather exceptional case that we can take at face value given the caveats that she can afford the hike in costs and it will only affect her until age 65, and then weigh against the millions and millions of people unable to buy individual insurance under the old regime because of cost, preexisting conditions, and failed markets who now enjoy meaningful health insurance.

What made this interesting to me was that this was was the second woman I spoke to within a week around 60 who faced this sort of increase in cost for a reduction in the benefits that mattered to them. They did get new benefits that were not part of there old plan (both mentioned that they now would have to have pregnancy care at 60). But both are pretty savvy selectors of insurance and had worked to put together the policy that best covered their risk.

What I glean from this limited sample is that the few-sizes fit all approach of the exchange means that many people who have some understanding of their risk can no longer deploy that knowledge. They must pay for coverage that can not possibly be needed, but can't select coverage that they do need with buying even more features they don't want. This is a stark contrast to our normal experience with insurance, including online insurance where you can layer on different levels of coverage in different areas to design a custom policy.

[muon2]

But what I find troubling in this is that despite the fact that it would be straightforward to create a price tree for any number of add-ons to the basic bronze package, the ACA chooses to create a very few specific bundles for offer to the public. I presume that the ACA was fiscally designed to assume that if everyone ended up with bronze the numbers would work. Therefore each separate feature above and beyond the basic minimum could have been set with its own price.  Other areas of insurance do this perfectly well as did health insurance pre-ACA.

I get that not everyone wants to get into the weeds of the details and will accept a bundled policy in exchange for their lack of knowledge. I don't get why the same system needs to create disincentives for those who are willing to put in the effort to determine their personal needs.

I'm not sure why some of you are characterizing the policies of the two cases as defective or deficient. I've taken the time to review the details with the individuals and I find nothing deficient in their current coverage. Their plans were appropriate to meet their medical needs and prevent them from being financially wiped out in the event of unexpected ill health. It appear that either of their plans could have been easily assembled from a basic bronze with selective additions of coverage appropriate to their situation in life. The data and technology are there to do this.

[muon2]

I get that not everyone wants to get into the weeds of the details and will accept a bundled policy in exchange for their lack of knowledge. I don't get why the same system needs to create disincentives for those who are willing to put in the effort to determine their personal needs.

The website signed up like 6 people out of a nation 0f $330+ million on day one.  And now you want to make things even more complicated?  let's straighten out the current mess before we layer other moving parts on it.

The law can be changed and improved.  I'm not really getting bent out of shape about a millionaire having to kick in a little more dough for their surgery.  Particularly when they are over the age of 60 and going to be on medicare soon.  Less than five years of paying whatever isn't going to kill this woman.

One of the cases I'm describing here is a former Democratic congressional staffer who was a strong proponent of the ACA at its passage. Hardly a 1%er. I don't see why she should pay double because the Feds couldn't emulate any of the number of online insurance engines that already exist.

[muon2]

One of the cases I'm describing here is a former Democratic congressional staffer who was a strong proponent of the ACA at its passage. Hardly a 1%er. I don't see why she should pay double because the Feds couldn't emulate any of the number of online insurance engines that already exist.

I think the situation is complex and we are operating in an information vacuum.  I am willing to say there is a lot I don't know.  But what I do know was there was a lengthy period where Republicans could have helped shape this thing and they chose not to.  In fact they chose to obstruct, sue, defund, and basically destroy it.  Are you at all surprised after such a process the final product is less than ideal in some instances?

I am going to wait for the website to get fixed and substantial numbers for people to sign up.  I am going to wait for a solid amount of objective data instead of a drip, drip, drip of anecdotal stories.  I've been burned too many times on the internet where people go off on a long discussions and some critical piece of information was left out intentionally or unintentionally.

I support your decision to wait for more data, and I'm not totally surprised at the product produced by this process. Most of my surprise is at what happened technologically given the resources available. I and many other Pubs were willing to work with a plan like Wyden's at the beginning of 2009. Unfortunately Obama characterized that as "too radical" despite its bipartisan support.

[muon2]

I support your decision to wait for more data, and I'm not totally surprised at the product produced by this process. Most of my surprise is at what happened technologically given the resources available. I and many other Pubs were willing to work with a plan like Wyden's at the beginning of 2009. Unfortunately Obama characterized that as "too radical" despite its bipartisan support.

No U.S. Senators were willing to work on a bipartisan plan or any plan for healthcare in 2009-2010, as shown by the lack of results or proposals from the bipartisan "gang" which negotiated through much of 2008. Robert Bennett did support the Wyden plan and is no longer a U.S. Senator as a result.

Given the pressure on U.S. Senators to conform and be whipped to filibuster on issues of major importance to the President (the stimulus, health care, immigration reform, and all judicial nominations) the dynamics of the Senate under current leadership foreclose compromise. It's unfortunate that your instincts and initiatives would not bear any fruit in the Senate, and it's inconceivable that a Republican U.S. senator could behave as you suggest.

The difference is between where the US Senate was in Mar 2009 vs Aug 2009. There was a willingness to work on a compromise in the spring and Alexander, Crapo and Graham were also on Wyden's bill. Furthermore, Corker, Grassley and Gregg had been cosponsors of the same bill the year before Obama took office.

Because the bill would completely remove any employer-based insurance, meaning no negotiable health care in contracts, the unions lobbied hard against it in the spring of '09 and the president sided with the unions on the issue of employer-based health care. Conservative opposition was building against an individual mandate, but it was really during the August recess that the Tea Party push-back in member town hall meetings moved the GOP away from any compromise position.

[muon2]

No doubt the Pubs get more of the blame here for the mess, but both parties really have egg on their faces. The Pubs to the extent of my knowledge were AWOL about the notion of getting everyone insured, and getting past the moral hazard problem, and giving folks the subsidies that they needed one way or the other to purchase bronze plans based on means. Rather, if I recall correctly, there were just into making insurance more affordable and portable, and did not get much into the subsidy business. Maybe some did (offering some subsidies - I don't think any went the universal coverage route), and no doubt the Wyden Plan had some subsidy component. But I am not sure if the Wyden Plan got there as to meeting all the basics above, and why the Dems, as Mike puts it, thought it "too radical," (is that really true, and who said that on the Dem side, or were other reasons in play?), and if someone could outline the basics of that approach to refresh my memory, that would be appreciated.

Here's an Oregonian article from July 2009.

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[muon2]

To be fair, plenty of people are going to wind up getting screwed by predatory insurance companies because of the ObamaCare switch. It's a major problem the GOP is hungry to score points off of, but has 0 interest or plan in actually solving. Instead, the GOP is going to waste time spewing more venom, bile, and nonsense in its futile attempt to fully stop a law that's already taken effect from taking effect.

Hopefully, the Republicans get their party back someday.

Please explain why Republicans should help Democrats clean up the mess they created all by themselves.  Democrats rammed Obamacare down the American people's throats, ignoring the cloture rules and public opinion polls.  Democrats own this mess - and time and again have shown themselves unwilling to compromise with Republicans on Obamacare - most recently, by EVERY Senate Democrat voting against Ron Johnson's "if you like your plan, you can keep it" bill.

The fact is that the Obama administration wrote the regulations on keeping existing plans very narrowly, to force as many people as possible into more expensive Obamacare plans as possible.

I bolded the parts that are lies.

I also italicized the parts where you think a major political party has no responsibility to work in good faith with the other for the good of the country.

I've bolded a line that is an interesting conundrum in US politics. Legislative parties can be organizations that primarily function to determine leadership of legislative chambers, but provide less control of policy votes. This type of party tends to have a lot of maverick voices within it, colloquially referred to as RINOs and DINOs. It also produces more bipartisan agreements.

In order to move policy agendas for a party there needs to be more discipline within the ranks. In many parliamentary democracies this evolves into a ruling party and a "loyal opposition" who will vote against the majority party on principle on key issues. This reflects a strong party structure and leaves the majority to their own devices to move policy forward.

The dilemma in the US is that there are many who want strong discipline in their party's ranks, but want the collaboration of weak parties from the other side. I contend that looking at other democracies one sees that these are generally mutually exclusive goals. A citizen is forced to either accept a lot of wayward voices in their own ranks that frustrate a party from within or an opposition who's goal is to frustrate the majority from without.

[muon2]

Unfortunately the concept of a loyal opposition makes a lot of sense in unicameral parliamentary systems, but none at all in a bicameral presidential system. Whether they like it or not, the Republicans control half of the legislative branch. They have a duty to the country to constructively work to solve problems, not just complain incessantly and pass legislation they know isn't going anywhere to score points with their extremist base.

That works both ways. It's not helpful when one side says we'll work with you if you start from our position. I would also interpret your statement to indicate that a loyal opposition strategy would be legitimate if there was single party control of the government.