Another Obamacare delay: out-of-pocket expenses cap delayed

[jaichind]

http://www.cbsnews.com/8301-250_162-57598288/key-consumer-protection-in-obamacare-delayed/

"The Obama administration has quietly delayed another key element of the Affordable Care Act, the New York Times reported Tuesday, exempting some insurers for a year from the new limit on out-of-pocket expenses.

The Affordable Care Act, signed into law in 2010, explicitly set annual limits -- $6,350 for individuals and $12,700 for a family -- on out-of-pocket expenses. Mr. Obama touted the reform as one of the many consumer protections his sweeping health care law would include to make insurance more affordable. "

[7,052,770]

Very misleading.  It only applies to people with multiple different insurances.  The $6350 cap still applies, but if you have 2 insurances, it's $6350 for both, rather than making the 2 companies cooperate to a $6350 overall.  Insurance companies simply aren't going to be able to do that in 2014, so they'll have to wait until 2015.

[jaichind]

Very misleading.  It only applies to people with multiple different insurances.  The $6350 cap still applies, but if you have 2 insurances, it's $6350 for both, rather than making the 2 companies cooperate to a $6350 overall.  Insurance companies simply aren't going to be able to do that in 2014, so they'll have to wait until 2015.

Yes. This is a valid scenerio but no the only one.  Even under the same insurance company but with multiple plans or even accumulators the cap will apply to each plan and/or accumulator and not the overall plan.  So whereas the cap should cap $6350 for the entire plan now it can be $6350 for the doctor's services and $6350 for drug costs.  Another variant is the accumultors for different members of a family under a family plan.  Whereas there should be a cap of $12700 for the entire family plan, the cap will "accumulate" for each member of the household of $12700 per person. 

BTW, I am happy for this provision to be delayed, forever.  I think each consumer should be able to pick and choose.  If the consumer wants a plan with no cap and low premiums he or she should be free to buy such a plan on the market and not told what plan they get to buy or not buy.  Low-premium, high-deductible health plans are now going to be not allowed under Obamacare so people who are told that if they like their plan (low premium but high or no cap) they can keep it will find out that is not true.   This delay actually will delay them finding out about this an entire year, and after the 2014 elections, of course.

[The Free North]

BTW, I am happy for this provision to be delayed, forever.  I think each consumer should be able to pick and choose.  If the consumer wants a plan with no cap and low premiums he or she should be free to buy such a plan on the market and not told what plan they get to buy or not buy.

Dont be naive, big brother Barack obviously knows whats best for you. How can you possible be expected to run your own life! Trust us, we have drones, citizen 038248201.

[Indy Texas 🇺🇦🇵🇸]

Very misleading.  It only applies to people with multiple different insurances.  The $6350 cap still applies, but if you have 2 insurances, it's $6350 for both, rather than making the 2 companies cooperate to a $6350 overall.  Insurance companies simply aren't going to be able to do that in 2014, so they'll have to wait until 2015.

Yes. This is a valid scenerio but no the only one.  Even under the same insurance company but with multiple plans or even accumulators the cap will apply to each plan and/or accumulator and not the overall plan.  So whereas the cap should cap $6350 for the entire plan now it can be $6350 for the doctor's services and $6350 for drug costs.  Another variant is the accumultors for different members of a family under a family plan.  Whereas there should be a cap of $12700 for the entire family plan, the cap will "accumulate" for each member of the household of $12700 per person. 

BTW, I am happy for this provision to be delayed, forever.  I think each consumer should be able to pick and choose.  If the consumer wants a plan with no cap and low premiums he or she should be free to buy such a plan on the market and not told what plan they get to buy or not buy.  Low-premium, high-deductible health plans are now going to be not allowed under Obamacare so people who are told that if they like their plan (low premium but high or no cap) they can keep it will find out that is not true.   This delay actually will delay them finding out about this an entire year, and after the 2014 elections, of course.

Even if they have a deductible that's so high that they can't realistically afford it given their income?

[jaichind]

Yes. This is a valid scenerio but no the only one.  Even under the same insurance company but with multiple plans or even accumulators the cap will apply to each plan and/or accumulator and not the overall plan.  So whereas the cap should cap $6350 for the entire plan now it can be $6350 for the doctor's services and $6350 for drug costs.  Another variant is the accumultors for different members of a family under a family plan.  Whereas there should be a cap of $12700 for the entire family plan, the cap will "accumulate" for each member of the household of $12700 per person. 

BTW, I am happy for this provision to be delayed, forever.  I think each consumer should be able to pick and choose.  If the consumer wants a plan with no cap and low premiums he or she should be free to buy such a plan on the market and not told what plan they get to buy or not buy.  Low-premium, high-deductible health plans are now going to be not allowed under Obamacare so people who are told that if they like their plan (low premium but high or no cap) they can keep it will find out that is not true.   This delay actually will delay them finding out about this an entire year, and after the 2014 elections, of course.

Even if they have a deductible that's so high that they can't realistically afford it given their income?

Then they should sign up for a policy that has a lower deductible.  I am not advocating that we only have policies that only have high deductibles only that all combinations should exist and the consumer should be able to choose.  This is true for car and homeowner insurance where the consumer also needs to take into account how much he or she can afford when they choose plan of their choice in terms of the level of deductibles.

[Indy Texas 🇺🇦🇵🇸]

Yes. This is a valid scenerio but no the only one.  Even under the same insurance company but with multiple plans or even accumulators the cap will apply to each plan and/or accumulator and not the overall plan.  So whereas the cap should cap $6350 for the entire plan now it can be $6350 for the doctor's services and $6350 for drug costs.  Another variant is the accumultors for different members of a family under a family plan.  Whereas there should be a cap of $12700 for the entire family plan, the cap will "accumulate" for each member of the household of $12700 per person. 

BTW, I am happy for this provision to be delayed, forever.  I think each consumer should be able to pick and choose.  If the consumer wants a plan with no cap and low premiums he or she should be free to buy such a plan on the market and not told what plan they get to buy or not buy.  Low-premium, high-deductible health plans are now going to be not allowed under Obamacare so people who are told that if they like their plan (low premium but high or no cap) they can keep it will find out that is not true.   This delay actually will delay them finding out about this an entire year, and after the 2014 elections, of course.

Even if they have a deductible that's so high that they can't realistically afford it given their income?

Then they should sign up for a policy that has a lower deductible.  I am not advocating that we only have policies that only have high deductibles only that all combinations should exist and the consumer should be able to choose.  This is true for car and homeowner insurance where the consumer also needs to take into account how much he or she can afford when they choose plan of their choice in terms of the level of deductibles.

Car mechanics aren't legally bound to fix any car that's brought into their shop, regardless of the owner's ability to pay. People aren't cars. Someone who has a barebones auto policy and gets in a wreck is going to end up eating the cost of their car. Someone who has a barebones health insurance policy and has a major illness is going to have the hospital they're treated in eat the cost of the treatment if they can't afford to pay.

And please don't tell me your solution to that problem is to get rid of EMTALA and "let them die" because that didn't work out so well for Republicans last year.

[barfbag]

http://www.cbsnews.com/8301-250_162-57598288/key-consumer-protection-in-obamacare-delayed/

"The Obama administration has quietly delayed another key element of the Affordable Care Act, the New York Times reported Tuesday, exempting some insurers for a year from the new limit on out-of-pocket expenses.

The Affordable Care Act, signed into law in 2010, explicitly set annual limits -- $6,350 for individuals and $12,700 for a family -- on out-of-pocket expenses. Mr. Obama touted the reform as one of the many consumer protections his sweeping health care law would include to make insurance more affordable. "

Yes Democrats have been sketchy about this from the beginning. What else will be QUIETLY delayed in hopes the American public remains ignorant to the bill shoved down our throats? So much for change. Remember when he wanted to have a televised debate between both parties about health care during the 2008 primaries and then we had to twist his arm to actually get him to hold his promise?

Oh I supposed liberals will ask me a smart question now such as remember when Bush did this or said that.