How Affordable Care Plan is Working in some states

[CFrance]

There is an interesting article in The New York Times here http://tinyurl.com/mbq5zs2 "Health Plan Cost for New Yorkers Set to Fall 50%" about how the premiums for individuals are going to fall due to the exchanges set up in NY having created competition in the marketplace.

According to the article, similar reductions in individual premiums are supposedly taking place in all states that have set up exchanges--CA and OR, for two examples.

I admit to being a proponent of the Affordable Care Act. I hope it works. I hope it works for my children and theirs, because the system we have now is causing my children to underinsure themselves. Now if we could somehow rein in the hospital costs so they become similar to those in other first-world countries.

This will be my only comment. Nothing will ever change my mind about this subject. I invite others to give their opinions. But please read the article first, and its addenda.

[Avista]

Great article! Thanks for posting!

[graciegirl]

There is an interesting article in The New York Times here http://tinyurl.com/mbq5zs2 "Health Plan Cost for New Yorkers Set to Fall 50%" about how the premiums for individuals are going to fall due to the exchanges set up in NY having created competition in the marketplace.

According to the article, similar reductions in individual premiums are supposedly taking place in all states that have set up exchanges--CA and OR, for two examples.

I admit to being a proponent of the Affordable Care Act. I hope it works. I hope it works for my children and theirs, because the system we have now is causing my children to underinsure themselves. Now if we could somehow rein in the hospital costs so they become similar to those in other first-world countries.

This will be my only comment. Nothing will ever change my mind about this subject. I invite others to give their opinions. But please read the article first, and its addenda.

That is indeed comforting news. I had heard all kinds of bad stuff would happen. I hope it works too.

[Irishmen]

The ACA is a tax designed to redistribute wealth. Health Care is the vehicle to do so. Nothing govt run is going down in costs.

[Golfingnut]

There is an interesting article in The New York Times here http://tinyurl.com/mbq5zs2 "Health Plan Cost for New Yorkers Set to Fall 50%" about how the premiums for individuals are going to fall due to the exchanges set up in NY having created competition in the marketplace.

According to the article, similar reductions in individual premiums are supposedly taking place in all states that have set up exchanges--CA and OR, for two examples.

I admit to being a proponent of the Affordable Care Act. I hope it works. I hope it works for my children and theirs, because the system we have now is causing my children to underinsure themselves. Now if we could somehow rein in the hospital costs so they become similar to those in other first-world countries.

This will be my only comment. Nothing will ever change my mind about this subject. I invite others to give their opinions. But please read the article first, and its addenda.

:coolsmiley: It will work.

[gomoho]

My concern is no where in this article did it talk about the deductible, out of pocket maximums, or what might be covered. Interesting everything I read in the Wall Street Journal says exactly the opposite - premiums will rise and so will deductibles. We'll just have to wait and see. I think I'm grateful I'll be on medicare!

[Villages PL]

The announcement came from Gov. Andrew Cuomo which makes me suspect that this rosy low-premium prediction may be biased. Right now the goal is to get as many people as possible to sign up, and talk of low premiums may be designed to provide encouragement. You know what they say: "If it sounds too good to be true, it probably is." :)

[mickey100]

There is an interesting article in The New York Times here http://tinyurl.com/mbq5zs2 "Health Plan Cost for New Yorkers Set to Fall 50%" about how the premiums for individuals are going to fall due to the exchanges set up in NY having created competition in the marketplace.

According to the article, similar reductions in individual premiums are supposedly taking place in all states that have set up exchanges--CA and OR, for two examples.

I admit to being a proponent of the Affordable Care Act. I hope it works. I hope it works for my children and theirs, because the system we have now is causing my children to underinsure themselves. Now if we could somehow rein in the hospital costs so they become similar to those in other first-world countries.

This will be my only comment. Nothing will ever change my mind about this subject. I invite others to give their opinions. But please read the article first, and its addenda.

Great article. Thanks for posting. :bigbow:

[eweissenbach]

Most of those who have been vehemently opposed to the AHCA have no idea how the law will affect them or anyone else. Many of them oppose it simply because they see it as Obama's plan and they oppose him so strongly that they, like rush Limbaugh, want him, and anything he proposes to fail. As I have alleged all along, there will be beneficial repercussions, and there will be unforeseen consequences, as there are with any major legislation - think about how many times social security has been changed for example. It will likely be amended and tweaked many times as the real-life results become evident. It was changed and amended during the process by both parties as well as the "input" by special interests, so that the final law was and is almost impossible for most citizens to fully understand and digest. In fact, I would argue few experts really have a grasp on the totality of its impact.

[janmcn]

Most of those who have been vehemently opposed to the AHCA have no idea how the law will affect them or anyone else. Many of them oppose it simply because they see it as Obama's plan and they oppose him so strongly that they, like rush Limbaugh, want him, and anything he proposes to fail. As I have alleged all along, there will be beneficial repercussions, and there will be unforeseen consequences, as there are with any major legislation - think about how many times social security has been changed for example. It will likely be amended and tweaked many times as the real-life results become evident. It was changed and amended during the process by both parties as well as the "input" by special interests, so that the final law was and is almost impossible for most citizens to fully understand and digest. In fact, I would argue few experts really have a grasp on the totality of its impact.


You are absolutely correct about everything in your post. When Medicare was introduced in 1965, many states refused to participate. That law has also been tweaked over the decades since passing, but one party is not interested in acting to improve the Affordable Care Act only voting 40 plus times to repeal it.

The Massachusetts Health Care Law, which the ACA was patterned after and which has been in effect for a number of years has an 87% approval rating, while it covers 90 plus % of the adult population and 100% of children. MA has some of the best health care in the country and few other states could match those coverage numbers.

Where is the healthcare plan from the opposing side? They have had ample opportunity to come up with their own plan since the ACA was signed in 2009.

[Bogie Shooter]

My concern is no where in this article did it talk about the deductible, out of pocket maximums, or what might be covered. Interesting everything I read in the Wall Street Journal says exactly the opposite - premiums will rise and so will deductibles. We'll just have to wait and see. I think I'm grateful I'll be on medicare!

Is that suprising coming from the Wall Stree Journal?

[njbchbum]

My concern is no where in this article did it talk about the deductible, out of pocket maximums, or what might be covered. Interesting everything I read in the Wall Street Journal says exactly the opposite - premiums will rise and so will deductibles. We'll just have to wait and see. I think I'm grateful I'll be on medicare!

The announcement came from Gov. Andrew Cuomo which makes me suspect that this rosy low-premium prediction may be biased. Right now the goal is to get as many people as possible to sign up, and talk of low premiums may be designed to provide encouragement. You know what they say: "If it sounds too good to be true, it probably is." :)

agree with you totally! i got more meaningful concern from reading the bottom half of the article and the comments/fears. tried to remain hopeful after reading the headline, but the promises made when the legislation was voted on kept creeping into my consciousness.

[ilovetv]

The fact that NY has had the highest-priced individual premiums in the country, and why that was, may be why the costs in that state appear to be coming down. This Washington Post column gives some good insights:

"....New York has, for two decades now, had the highest individual market premiums in the country. A lot of it seems to trace back to a law passed in 1993, which required insurance plans to accept all applicants, regardless of how sick or healthy they were. That law did not, however, require everyone to sign up, as the Affordable Care Act does.

New York has, for 20 years now, been a long-running experiment in what happens to universal coverage without an individual mandate. It’s the type of law the country would have if House Republicans succeeded in delaying the individual mandate, as they will vote to do this afternoon. The result: a small insurance market with very high insurance premiums.

(My note as I see it: Fewer people in the risk-sharing pool to pay for the higher-risk, more expensive patient claims in the pool means each one pays for a bigger piece of the claims-payout pie. With more payers, their slice of the claims/expenses pie would be less.)

For years New York has had one of the most heavily regulated insurance markets in the country. The 1993 reforms not only required insurers to accept all customers; they also mandated that insurers charge everyone the exact same price. Young or old, healthy or sick, it doesn’t matter in New York: Everyone gets the same deal.

This is great for someone who is sick and old who, in other states, might get charged a sky high rate or rejected altogether. It’s not great though for the young and healthy, who end up footing a bigger chunk of the bill for all those more expensive beneficiaries......"

Here’s why health insurance premiums are tumbling in New York (http://www.washingtonpost.com/blogs/wonkblog/wp/2013/07/17/heres-why-health-insurance-premiums-are-tumbling-in-new-york/)

[DaleMN]

It's working!....vote to repeal it for the umpteenth time. :mad:

[Villages PL]

http://www.heritage.org/research/reports/2010/09/obamacare-increases-health-insurance-premiums

The above link explains the following 12 factors that will contribute to higher healthcare premiums.

1. Mandated Benefits

2. No Cost-Sharing for Previntitive Services

3. Limits On Cost-Sharing (on Covered Items) and Limits on Deductibles

4. Minimized Youth Discount

5. Elimination of the Good Health Discount

6. No Annual or Lifetime Limits on Health Benefits and Mandated Coverage of Children Under 26

7. No Pre-Existing Conditions Exclusion and Guarantee Issue

8. Cost-Shifting Because of Low Medicare Reimbursement Rates

9. Taxes on Insurers, Pharmaceutical Companies, and Medical Device Makers

10. Dificulty of Inforcing the Mandate

11. Adverse Selection

12. Increased Demand for Health Care


"Wishes Do Not Trump Common Sense"

[wendyquat]

My concern is no where in this article did it talk about the deductible, out of pocket maximums, or what might be covered. Interesting everything I read in the Wall Street Journal says exactly the opposite - premiums will rise and so will deductibles. We'll just have to wait and see. I think I'm grateful I'll be on medicare!

You are much more optimistic than I am about being on Medicare which has been severely cut already. I guess we will see!

[eweissenbach]

Obamacare Increases Health Insurance Premiums (http://www.heritage.org/research/reports/2010/09/obamacare-increases-health-insurance-premiums)

The above link explains the following 12 factors that will contribute to higher healthcare premiums.

1. Mandated Benefits

2. No Cost-Sharing for Previntitive Services

3. Limits On Cost-Sharing (on Covered Items) and Limits on Deductibles

4. Minimized Youth Discount

5. Elimination of the Good Health Discount

6. No Annual or Lifetime Limits on Health Benefits and Mandated Coverage of Children Under 26

7. No Pre-Existing Conditions Exclusion and Guarantee Issue

8. Cost-Shifting Because of Low Medicare Reimbursement Rates

9. Taxes on Insurers, Pharmaceutical Companies, and Medical Device Makers

10. Dificulty of Inforcing the Mandate

11. Adverse Selection

12. Increased Demand for Health Care


"Wishes Do Not Trump Common Sense"

AMAZING!!! The Heritage Foundation opposes the AHCA! That is shocking, almost as shocking as the fact that MSNBC endorses it. Please spare me the wing-nut propaganda.

[Villages PL]

AMAZING!!! The Heritage Foundation opposes the AHCA! That is shocking, almost as shocking as the fact that MSNBC endorses it. Please spare me the wing-nut propaganda.

But gov. Cuomo's announcement was not "wing-nut propaganda"?

[njbchbum]

if all of this rate reduction is due to competition - why did we get AHCA instead of the ability to cross state lines to purchase insurance?

[eweissenbach]

if all of this rate reduction is due to competition - why did we get AHCA instead of the ability to cross state lines to purchase insurance?

Seek the truth - don't fall for the propaganda.

[Bucco]

Most of those who have been vehemently opposed to the AHCA have no idea how the law will affect them or anyone else. Many of them oppose it simply because they see it as Obama's plan and they oppose him so strongly that they, like rush Limbaugh, want him, and anything he proposes to fail. As I have alleged all along, there will be beneficial repercussions, and there will be unforeseen consequences, as there are with any major legislation - think about how many times social security has been changed for example. It will likely be amended and tweaked many times as the real-life results become evident. It was changed and amended during the process by both parties as well as the "input" by special interests, so that the final law was and is almost impossible for most citizens to fully understand and digest. In fact, I would argue few experts really have a grasp on the totality of its impact.

I sincerely hope you are right...I really do. Should not affect old guys like me, but younger folks need to pay attention.

My opposition is and always has been that I thought the goal was to reduce healthcare costs and it "seems" to be having an opposite effect.

I sure hope you are right.

[njbchbum]

i heard some talking head report today that the aca needs healthy youg people to procure health insurance [hopefully thru the exchanges] rather than pay the fine for not doing so.

how is that gonna happen if they can remain on their parent's health insurance policy 'til they are 26 years old? isn't that a big chunk of the young people the aca is depending on?

[Bucco]

Seek the truth - don't fall for the propaganda.

So you really believe this bill is cutting health costs ?

I hope you know this is a serious question and not a political thing

[Villages PL]

The Massachusetts Health Care Law, which the ACA was patterned after and which has been in effect for a number of years has an 87% approval rating, while it covers 90 plus % of the adult population and 100% of children. MA has some of the best health care in the country and few other states could match those coverage numbers.

If the Massachusetts Health Care Law (passed in 2006) was so wonderful, why is it that no other state followed their example? Everything was worked out so they had the MA template. But there were no takers.

Several years later, the federal government comes along and says, in effect, "if no one likes it, we will force it on everyone". Isn't that what it boils down to?

[Golfingnut]

I think it is a wonderful plan

[tomjbud]

My only complaint about the affordable care act is that it does not go far enough. The U.S. is the only developed country that does not have a universal, single-payer system. Canada, Japan, Australia, and most European countries have such systems. By any objective measure, they spend less on health care than the U.S. and achieve far better results. Those opposed to such a system for the U.S. will dwell on the occasional horror stories about poor care under these systems, while ignoring the poor care, high costs and unnecessary procedures which are a regular part of our dysfunctional health care system.

[ilovetv]

If you actually read the article the o.p. linked, the assertions made are based on fact and reality, with a full bibliography in which the source studies can be seen.

Below is one example from the article. The last sentence is a real concern based on all the twenty-somethings I know, who include our kids and many friends' and neighbors' college-graduate kids who are either uninsured, under-insured, or are still on their parents' insurance while unable to get a job in their degree area and their student loan payments are looming as they work part-time as waiters and retail clerks....

"4. Minimized Youth Discount

The average 60-year-old consumes about six times as much health care as the average 20-year-old, but the AHCA mandates that insurers charge the oldest individuals in the risk pool no more than three times the lowest rate.

As a result, young individuals will pay much more than the actuarially fair amount for their premiums. Management consulting firm Oliver Wyman estimated that premiums will rise by 45 percent for those age 18–24, 35 percent for those age 25–29, and 26 percent for those age 30–34.[4]

[spk7951]

So you really believe this bill is cutting health costs ?

I hope you know this is a serious question and not a political thing


Some people really do believe this bill will lower health care costs. But for us that is not what is happening. Our monthly out of pocket went up $225 per month this year. When checking with my wife's former employer and our health care provider they placed the blame for the increase squarely on this bill and advised us to expect another increase in 2014.

A few months ago I watched a business news interview with the CEO of Aetna. One of the questions asked of him was about some of the mandated "free" coverages to be provided as part of the bill. He matter of factly stated that there is no such thing as "free" coverage but that the cost for such items will be spread out over all policies/individuals.

[Golfingnut]

If it costs more for everyone to have coverage, then I am all for it. You must separate medical care from luxury material, medical is a necessity not a bigger house or fancier car. The greed for more more more must be replaced with common decency for our fellow man. I know people that drive a Mercedes but will not help the less fortunate with basic survival.

[ilovetv]

If it costs more for everyone to have coverage, then I am all for it. You must separate medical care from luxury material, medical is a necessity not a bigger house or fancier car. The greed for more more more must be replaced with common decency for our fellow man. I know people that drive a Mercedes but will not help the less fortunate with basic survival.

Most people intended to benefit from the current healthcare reform are people who live paycheck-to-paycheck and are barely able to make their modest mortgage payments, NOT people wanting a Mercedes or a McMansion.

And the other side of your Mercedes-driving acquaintances is that many, if not most, DO help the less fortunate in ways other than just pushing for more government dependency and "giving" programs. You don't know what charitable giving and high tax rates every expensive car driver submits on his tax returns.

I know quite a few people who are small business owners who treated themselves to a Mercedes or BMW 20-30 years after risking their house, IRAs and everything they had to start a business and keep it solvent and keep their employees employed and having some basic health insurance!

70% of jobs in the USA are provided by small business, and the way they help the "less fortunate" is by providing a JOB. If the small business owner drives a Mercedes or a Rolls Royce, he has earned it. And also, the corporate executive has earned it too, by starting at the very bottom in an entry-level position paying barely above minimum wage, and based on erratic commissions that disqualify many from even getting a mortgage for a decent, not grand, home of their own for many years.

[Golfingnut]

OK. Pay them minimum wage, keep them hungry and on their knees, but for the love of God we that have made it in this tough economy must do whatever we can to insure every American has proper health care and not some inner city emergency room only when death is imminent. We in this country seem to celebrate the fact that we have millions of well educated and hard working people that cannot afford healthcare insurance for their families.

[graciegirl]

///

[Villages PL]

My only complaint about the affordable care act is that it does not go far enough. The U.S. is the only developed country that does not have a universal, single-payer system. Canada, Japan, Australia, and most European countries have such systems. By any objective measure, they spend less on health care than the U.S. and achieve far better results. Those opposed to such a system for the U.S. will dwell on the occasional horror stories about poor care under these systems, while ignoring the poor care, high costs and unnecessary procedures which are a regular part of our dysfunctional health care system.

Don't forget to ask, "what else makes those countries the same, and why are they not the economic powerhouse that we are?" (Well, not lately, but usually) Compare gross domestic product, for example. The healthcare system you choose may have an effect on the whole economic system.

[janmcn]

What is the alternative to the Affordable Care Act? For the past four years, all we hear is repeal and replace. Where is the replacement plan? Was it the plan that was so popular a year ago that did away with Medicare and instead gave people vouchers to go buy their own insurance? What happened to that idea?

Criticism of the ACA would be much more viable if there was an alternative plan to compare it with.

[Villages PL]

What is the alternative to the Affordable Care Act? For the past four years, all we hear is repeal and replace. Where is the replacement plan? Was it the plan that was so popular a year ago that did away with Medicare and instead gave people vouchers to go buy their own insurance? What happened to that idea?

Criticism of the ACA would be much more viable if there was an alternative plan to compare it with.

http://paulryan.house.gov/healthcare/

[njbchbum]

If it costs more for everyone to have coverage, then I am all for it. You must separate medical care from luxury material, medical is a necessity not a bigger house or fancier car. The greed for more more more must be replaced with common decency for our fellow man. I know people that drive a Mercedes but will not help the less fortunate with basic survival.

golfingnut - an honest and liberal enough emotion...but...in the city where i live, we taxpayers believe that our state and federal taxes are paying for quite a bit for our less fortunate bretheren and are saying enough, enough, enough!

i do resent those who want a larger monthly welfare check - bad enough they are irate that their allowance now comes on a plastic debit card that does not buy unauthorized items! i want a larger social security check and cola adjustment in my pension, too. difference is, i worked 40 yrs to earn my govt handout and pension.

i resent those who will not lift a finger to help themselves. i do resent the fraud that is rampant in the food stamp and other social aid programs - that our elected officials refuse to eliminate. how is it that the work truck for the flooring business is parked in a local driveway overnite [nite after nite and wknds] has pa tags and a pa tele number and local address on the truck? why is it not registered in the state of nj? why don't the local police enforce the required change in registration? i do resent those who cross our border illegally in search of a better life by taking advantage of what this country has to offer. why can't they do it legally as my ancestors did?

how much must a person pay to be considered a decent member of society? do we shortchange our families and our lifestyle to support another family and their lifestyle? where do you suggest we draw the line? how much do those folks who own the mercedes pay in taxes that get siphoned to help others with basic survival?

[gomoho]

I wonder if those that are so anxious for the rest of us to GIVE more in the form of taxes volunteer more of their own money than is owed on April 15th to help all these folks. You always have the option of adding of few thousand to your tax bill to help those in need - it's your right as an American citizen.

[tomjbud]

Health Care | U.S. Congressman Paul Ryan (http://paulryan.house.gov/healthcare/)
Sounds a lot like the Affordable Care Act to me.

[janmcn]

If the Massachusetts Health Care Law (passed in 2006) was so wonderful, why is it that no other state followed their example? Everything was worked out so they had the MA template. But there were no takers.

Several years later, the federal government comes along and says, in effect, "if no one likes it, we will force it on everyone". Isn't that what it boils down to?



Other states do not have innovative, forward thinking governors like Governor Mitt Romney to get these plans passed. Texas, for example, would like to keep 50% of its residents uninsured, even though TX has some of the best healthcare in the country. Mississippi insists on being 50 out of 50 for providing healthcare to it's residents.

It's all about what standard of living or what quality of life people choose.