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

[Torie]

The catch is that if there are too many plans, with too wide a range of coverage options, the sick will get the most coverage, and the healthy the least. That's a problem when you have cross subsidies built into the system, with the young subsidizing the old for example. If you want to afford more choices, then you need the subsidies to all come out of general tax revenues - which they should of course, but don't.

[Torie]

What also happened here is that Obama tried to keep this promise by grandfathering in plans people belonged to before 2011, but the insurance companies gamed it by switching millions of people into "new, better" plans after that date and then using that as an excuse to drop them.

Anthem in California made it clear, very clear in bold large font type,  in their disclosure documents that if you switched plans, you lost your grandfathering. That was all I needed to read, to toss it all in the trash. I simply was not going to run through the Obamacare traps if it could at all be avoided. So it might be somewhat unfair to characterize it as some underhanded bait and switch scheme by the carriers. Doing that would just invite lawsuits for fraud in the inducement as part of a pre-arranged scheme.

[Torie]

Oh no!  People are going to have to get (gasp) a different health insurance plan!  And, it's going to be cheaper and provide more comprehensive coverage and if I can't afford it, the government will help me pay?  What ever shall we do?

Where on earth do you get the idea what they'll find to replace their lost coverage with is cheaper?  You might want to read the article.

George Schwab, 62, of North Carolina, said he was "perfectly happy" with his plan from Blue Cross Blue Shield, which also insured his wife for a $228 monthly premium. But this past September, he was surprised to receive a letter saying his policy was no longer available. The "comparable" plan the insurance company offered him carried a $1,208 monthly premium and a $5,500 deductible.

What did George Schwab find on the exchanges?

Something a hell of a lot better than his old policy, I'm sure. The idea that two olds were receiving adequate coverage for $228/mo is ludicrous.

I'm the exact same age (62), and my monthly premium is  $998.00, so yes, if the numbers above are accurate, his plan must have had very limited coverage. There is no free lunch.

On the other hand, $1,208.00 with that high a deductible does sound expensive, very expensive, for North Carolina, and that is odd, since Obamacare is designed to subsidize olds. So that part does not add up, unless the pre existing condition waiver involves a very substantial additional cost, paid for by those not sick paying higher premiums than the actuarial risk situation would justify. It also suggests what will happen to the premiums of young folks who don't qualify income wise for big subsidies.

[Torie]

But isn't 'individual insurance' just some kind of con the insurance companies sell to the uninformed poors and then decline to cover them when they actually get seriously ill?

No.

[Torie]

I'm the exact same age (62), and my monthly premium is  $998.00, so yes, if the numbers above are accurate, his plan must have had very limited coverage. There is no free lunch.

On the other hand, $1,208.00 with that high a deductible does sound expensive, very expensive, for North Carolina, and that is odd, since Obamacare is designed to subsidize olds. So that part does not add up, unless the pre existing condition waiver involves a very substantial additional cost, paid for by those not sick paying higher premiums than the actuarial risk situation would justify. It also suggests what will happen to the premiums of young folks who don't qualify income wise for big subsidies.

It has a $10k deductible. Of course, $10k isn't much money really, especially when the liberals are going to screw you out of $700 a month.

In fact, Mr. Torie, someone else in a similar situation in North Carolina has uploaded a copy of their bill. Two adults in good health, children grown & gone. Likely to be 50+ years old.

Link

What is the deductible on the $1208.00 plan?  At 62, that number is very important, because the odds are quite high that the deductible will be run through. So if the deductible for the Obamacare plan is $1,000, that means about 9K is in real play that needs to be taken into account when comparing premium numbers. I run threw my deductible in about 2 months myself. It's around 5K for me when all is said and done. What I like about my plan, is that I can go to any doctor I want (almost all are part of the Anthem system), and can do so without having to waste my time with some family practitioner drone guarding the gates to the specialty that I need (dermatologist, urologist, podiatrist, surgeon, neurologist, etc.). My sex and pot doctor is not covered by my plan alas, nor my plastic surgeon. I need more coverage!  

[Torie]

I'm the exact same age (62), and my monthly premium is  $998.00, so yes, if the numbers above are accurate, his plan must have had very limited coverage. There is no free lunch.

On the other hand, $1,208.00 with that high a deductible does sound expensive, very expensive, for North Carolina, and that is odd, since Obamacare is designed to subsidize olds. So that part does not add up, unless the pre existing condition waiver involves a very substantial additional cost, paid for by those not sick paying higher premiums than the actuarial risk situation would justify. It also suggests what will happen to the premiums of young folks who don't qualify income wise for big subsidies.

It has a $10k deductible. Of course, $10k isn't much money really, especially when the liberals are going to screw you out of $700 a month.

In fact, Mr. Torie, someone else in a similar situation in North Carolina has uploaded a copy of their bill. Two adults in good health, children grown & gone. Likely to be 50+ years old.

Link

What is the deductible on the $1208.00 plan?  At 62, that number is very important, because the odds are quite high that the deductible will be run through. So if the deductible for the Obamacare plan is $1,000, that means about 9K is in real play that needs to be taken into account when comparing premium numbers. I run threw my deductible in about 2 months myself. It's around 5K for me when all is said and done. What I like about my plan, is that I can go to any doctor I want (almost all are part of the Anthem system), and can do so without having to waste my time with some family practitioner drone guarding the gates to the specialty that I need (dermatologist, urologist, podiatrist, surgeon, neurologist, etc.). My sex and pot doctor is not covered by my plan alas, nor my plastic surgeon. I need more coverage!  

2 people born in 1951. I suspect Mr. Schwab found something similar. I do not know his precise zip code of course and simply plugged in 28078.

Bronze 5500

Blue Advantage
MONTHLY COST

$126808
+   $634.04    You
+   $634.04    Your spouse
$1,268.08   Total

Family Deductible   $11,000 in-network / $22,000 out-of-network

Yikes!!!!!!

[Torie]

Family Deductible   $11,000 in-network / $22,000 out-of-network

Ummm... yeah.  I don't think 67% of the US population can take a $11,000-$22,000 family hit every year.

This is supposedly the Obamacare option no?

[Torie]

Family Deductible   $11,000 in-network / $22,000 out-of-network

Ummm... yeah.  I don't think 67% of the US population can take a $11,000-$22,000 family hit every year.

This is supposedly the Obamacare option no?

I don't know what it is or in fact if it is even real.  The guy's link doesn't work.  What I do know is there is no way 67% of the population can can handle a $22,000 deductible so it doesn't represent the ideal situation for the majority of the people regardless or pre or post Obamacare pricing.

I really wish we could talk about the average plan for the average person.

Average as in median person?  Does the median person qualify for subsidies? I readily stipulate that Obamacare is a good deal for those in line to get large subsidies. And they should get subsidies, if based on means testing, and means testing alone (not by age, etc.). Pity we have this Rube Goldberg toy to effect it all, with the cross subsidies largely done through differential insurance premiums, rather than out of general revenues, with all the attendant distortions and limitation of options available. It all makes zero sense to me.

[Torie]

One wonders why "you can't," but I understand why it might be viewed as an unhealthy curiosity. Don't you have this fantasy that in an alternative universe, you could just be totally unleashed, Mike, and just do it, and say it? Don't answer that.

[Torie]

For some reason, the moral hazard issue vis a vis folks with skeletal plans does not get mentioned enough. One can have a debate about what the minimum level of coverage should be, but there clearly does need to be a minimum. It may well be that Obamacare got the balance wrong here (choice on the one hand, moral hazard on the other), but it got the overall concept right. As many have pointed out, one would think that the moral hazard issue would be one that those on the Right would be particularly sensitive to, but no, not this time - for obvious reasons.

[Torie]

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.

That is because cross subsidies are hidden away within the premium and mandatory coverage structure of the ACA. Without that, the books would show a much bigger "deficit" for implementation of the ACA. Extending coverage to millions of people who cannot afford it, and the ACA's authors belief that some  should not pay as much as the real cost of their insurance for reasons not based on income (e.g., because they are old, have pre-existing uninsured conditions), does not come for free. But then, you already knew all of this. Now more, a lot more, are finding out about it in a hurry.

[Torie]

Yes, one must balance the moral hazard issue with the concept of choice, Brittain33 (it is highly problematical that the ACA has the right balance here vis a vis dealing with actual moral hazards versus choice, but one can debate that), but no moral hazard is being mitigated by requiring men to have pregnancy coverage or abortion coverage or birth control coverage or whatever. So that just becomes a cross subsidy (one of many embedded in the ACA regulatory system itself rather than just using tax dollars via the medicaid system), rather than requiring more coverage that it is deemed prudent to require -prudent because otherwise, one might be wiped out financially because of inadequate coverage, and/or be a burden to the taxpayers, by just not paying the medical bills at all, while still getting treated.

[Torie]

I'm sorry, are men required to get pregnancy coverage? Do men's policies cover obstetrician vistis, etc.? Speak more about that. Or is this just about the costs of pregnancy not accruing 100% to women per surcharges, but being shared among the pool of all people?

Don't know, but what I heard was the former - all the policies read the same, and not based on gender as it were. But economically, to the extent true, it does not make any difference either way. It's a cross subsidy. Again, we can do away with the cross subsidies, and just give folks subsidies based on means. Everyone will still have the means to purchase insurance with some "bronze plan" (as Muon2 puts it) minimal level of coverage.

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.

[Torie]

FWIW, I have had the same individual policy since 1984, and still have it. It has not yet been cancelled. I keep reading that all of them that are grandfathered will slowly die away (maybe because they can't sign anyone new up), but I have only 2.5 years to the Medicare finish line, and hope that I can make it without being forced into the apparent abyss (I want to pick my own doctor (almost all are within the PPO system that I have), and hire and fire them at will (which I have done quite often, until I find someone who understands customer service - I like Romney, in this context, love firing people). I cannot  endure long waiting times without going nuts, and lashing out. My time is my most precious commodity. And I don't want to wait very long for a treatment that I need to cease being miserable. Anyway, my  policy has served me very well (it never occurred to me to "fire" it). And for some reason, no matter what the government does, I tend not to be the screwee, and often the beneficiary (the latter of course unjust really). I am not sure why that is true either, but it just worked out that way.

In a perfect world, you buy a policy when a healthy young stud, that lets you do your own thing, and keep it forever, no matter what may come, and the company stays with you as well.

Thank you.

[Torie]

I bought a policy in 1984, and kept it, and never read the fine print (I just throw all of that in the trash), and sure the co-pays went up with inflation, and the premiums as I aged, and I never had a problem picking my own doctor. I never signed another damn document ever since 1984. So to me, other than the premium cost based on the age factor, and the cost of medical technology,  nothing material has changed. Nothing at all. Obviously I was incredibly lucky, hearing all these horror stories. Maybe the moral is to stay the course, both as the insurer, and the insuree.