Healthcare Thread (really "Sickcare" in America)

[broken iris]

What's also interesting about the ACA is that support has drop below 40% now that it's a few weeks from implementation when it was 60% during the last election period. It goes to show how well the good aspects of the law like "free" preventative care and the prohibition on discrimination based on per-existing conditions were marketed to the public versus the exchanges and subsidies which are so complex no one is 100% if even the backbone infrastructure will be up and running in 19 days. (Or even if they have really have to be.)

[Green Habit]

According to HuffPo, Trader Joe's has followed the current trend and is cutting coverage for everyone who works under 30hrs/week. They will provide a $500 check to help offset the cost of coverage on the ACA exchanges.

I'm waiting for the perverse situation to pop up where people in retail can't afford to work only 29.5 hours a week, so they'll have to get two jobs and work 59 hours a week.

Getting two jobs in a weak economy to boot.

Especially if it's a weak job market to begin with....

[BurtReynolds]

this thread title always makes me laugh for some reason.

[broken iris]

Good news team, in it's first week of operation liberal paradise Maryland (where I live) signed up an eye-popping 326 people for it's ACA-mandated healthcare exchange.

http://www.marylandhealthconnection.gov ... date_2.pdf

At this rate it will take a mere 47 years to signup everyone in the state without employer provider health insurance.

[Peeps]

i cant believe they pulled theraflu from shelves cause some kids figured out how to operate child proof caps

[Soma.]

I just hit a month without smoking and fuck your avatar, Jerry.

[Peeps]

oddly enough it has been a month since i pulled a gun on someone, so right back at you

[Soma.]

Oh, that's good. I like that.

[broken iris]

http://www.usatoday.com/story/news/nati ... e/2993105/

1st Delaware resident signs up for Obamacare
Kelly Bothum, The (Wilmington, Del.) News Journal 11:46 a.m. EDT October 16, 2013

SELBYVILLE, Del. — She needed seven hours of waiting on the phone and sitting in front of her computer, but Janice Baker can claim something few people in the First State can at the moment: She has signed up for health coverage through Delaware's insurance marketplace.

Officials from the Delaware Department of Health and Social Services declared Baker the first confirmed resident to have enrolled in the marketplace, which opened Oct. 1 as part of the roll-out of the Affordable Care Act also known as Obamacare.

The marketplace aims to help an estimated 90,000 Delawareans without health insurance, along with anyone hoping for a better deal on coverage, find a plan to meet their needs.

But crossing the marketplace finish line — where the prize is a chance at affordable health coverage — was more of a marathon than a sprint for Baker, 59, who owns the Heavenly Hound Hotel in this town of 2,000 on the Delaware-Maryland border along with her husband, Joseph.

It required repeated effort online and over the phone, frustrating experiences shared by millions across the country who tried to sign up only to be sent away because of overwhelming demand and glitches in the www.healthcare.gov website.

"I started looking right at Oct. 1. I had made several attempts online to enroll and activate my membership. I could not get in to save my life," Baker said Tuesday.

She switched to the phone, dialing the toll-free number that the government set up. But after 1½ hours on the phone, her sign-up attempts were for naught when the representative's computer locked up. If that wasn't enough, the same thing happened the next time she called.

Not until Baker went online after clearing her computer's Internet browsing history, cookies and other temporary data — a suggestion she said she found on the www.healthcare.gov site — did she have success.

"Right after that, I was able to apply," Baker said. "It might not be the government computers. It may be your own sitting in front of you."

Rita Landgraf, secretary of the Delaware Department of Health and Social Services, acknowledged glitches in the sign-up process in the past two weeks. Upgrades to the system and troubleshooting suggestions like the one Baker tried should reduce the problem, she said. And thanks to a change in the state's website, visitors can explore their health coverage options and potential costs before setting up an account.

"My thought is now that we have Janice, we're going to see more and more people successfully getting through the screens and getting through the enrollment," Landgraf said.

Under the new law, everyone is required to have health insurance by 2014 or pay increasing fines.

In addition to the phone and online options, marketplace guides are available to help people navigate the sign-up process. Landgraf said more than 1,000 people have contacted the marketplace guides in Delaware though it's not known how many have gone through the enrollment stage.

Despite the snafus, Baker said she's grateful for a chance to buy insurance on the marketplace. Previously, she had been paying $1,600 a month for a company insurance policy for her and her husband. But after her husband was approved for his own coverage, she had to find her own.

During her hunt, Baker was turned down three times because of what she called minor pre-existing health conditions. In the new marketplace, no one can be turned away because of a pre-existing condition.

In Baker's new plan, she will be paying $700 a month for individual coverage, almost $150 less than the cost of her previous coverage.

That makes the wait on the phone and the frustrations online worth it, she said.

"I was thrilled to be able to have this happen," Baker added. "This is so much better than the policy before. I was very impressed."

One down, ~89,999 to go.

[Harry Lime]

Tell me if true:

With the ACA, you can apply for subsidies without revealing your annual income.

If yes, wtf?

[simple schoolboy]

Tell me if true:

With the ACA, you can apply for subsidies without revealing your annual income.

If yes, wtf?

Maybe initially, but come tax time they will probably figure it out and assess you a penalty. Similarly, if you properly receive subsidies and your income increases above the threshold (400 percent of poverty line) you will have to pay a penalty.

For more penalty fun, a tax preparation company recently informed the Obama administration that the cut off for being charged the $95 for not having insurance coverage is mid february, while open enrollment in the exchanges lasts until March.

[shinkdew]

[MadTIGERmaN]

Is any Pearl Jam fan really that shocked that the health care websites are crashing under the high demand

[broken iris]

Interesting point from the National Review:

One key worry is based on the fact that what they’re facing is not a situation where it is impossible to buy coverage but one where it is possible but very difficult to buy coverage. That’s much worse from their point of view, because it means that only highly motivated consumers are getting coverage. People who are highly motivated to get coverage in a community-rated insurance system are very likely to be in bad health. The healthy young man who sees an ad for his state exchange during a baseball game and loads up the site to get coverage—the dream consumer so essential to the design of the exchange system—will not keep trying 25 times over a week if the site is not working. The person with high health costs and no insurance will. The exchange system is designed to enable that sick person to get coverage, of course, but it can only do that if the healthy person does too. The insurers don’t yet have a clear overall sense of the risk profile of the people who are signing up, but the circumstantial evidence they have is very distressing to them. The danger of a rapid adverse selection spiral is much more serious than they believed possible this summer. They would love it if the administration could shut down the exchange system, at least the federal one, until the interface problems can be addressed. But they know this is impossible.

[malice]

Interesting point from the National Review:

One key worry is based on the fact that what they’re facing is not a situation where it is impossible to buy coverage but one where it is possible but very difficult to buy coverage. That’s much worse from their point of view, because it means that only highly motivated consumers are getting coverage. People who are highly motivated to get coverage in a community-rated insurance system are very likely to be in bad health. The healthy young man who sees an ad for his state exchange during a baseball game and loads up the site to get coverage—the dream consumer so essential to the design of the exchange system—will not keep trying 25 times over a week if the site is not working. The person with high health costs and no insurance will. The exchange system is designed to enable that sick person to get coverage, of course, but it can only do that if the healthy person does too. The insurers don’t yet have a clear overall sense of the risk profile of the people who are signing up, but the circumstantial evidence they have is very distressing to them. The danger of a rapid adverse selection spiral is much more serious than they believed possible this summer. They would love it if the administration could shut down the exchange system, at least the federal one, until the interface problems can be addressed. But they know this is impossible.

I don't think this is an invalid point but I do wonder just how much evidence there is to be had after three weeks.
I'm guessing the longer it takes to resolve, the higher the impact obviously, but even with various issues surrounding health insurance coverage in Massachusetts, and there were many when it became mandatory, most of the uninsured population signedup, and we weren't given the number of options available through this program now. it seems to be more affordable than in Massachusetts?
that can go a long way in forgiving red tape problems...
also, is there much information available (any?) on how long they expect ui problems to persist?

[broken iris]

Interesting point from the National Review:

One key worry is based on the fact that what they’re facing is not a situation where it is impossible to buy coverage but one where it is possible but very difficult to buy coverage. That’s much worse from their point of view, because it means that only highly motivated consumers are getting coverage. People who are highly motivated to get coverage in a community-rated insurance system are very likely to be in bad health. The healthy young man who sees an ad for his state exchange during a baseball game and loads up the site to get coverage—the dream consumer so essential to the design of the exchange system—will not keep trying 25 times over a week if the site is not working. The person with high health costs and no insurance will. The exchange system is designed to enable that sick person to get coverage, of course, but it can only do that if the healthy person does too. The insurers don’t yet have a clear overall sense of the risk profile of the people who are signing up, but the circumstantial evidence they have is very distressing to them. The danger of a rapid adverse selection spiral is much more serious than they believed possible this summer. They would love it if the administration could shut down the exchange system, at least the federal one, until the interface problems can be addressed. But they know this is impossible.

I don't think this is an invalid point but I do wonder just how much evidence there is to be had after three weeks.
I'm guessing the longer it takes to resolve, the higher the impact obviously, but even with various issues surrounding health insurance coverage in Massachusetts, and there were many when it became mandatory, most of the uninsured population signedup, and we weren't given the number of options available through this program now. it seems to be more affordable than in Massachusetts?
that can go a long way in forgiving red tape problems...
also, is there much information available (any?) on how long they expect ui problems to persist?

There are plenty of unofficial numbers and dates floating around, but a lot of the content on the Internet refers to the exchanges as "Obamacare" vice "ACA", so I don't trust it. North Dakota did report that roughly 40 people had gotten to the point where the insurers got their paperwork from the federal exchange, which may sound low, but it means some level of functionality is there.

[stip]

Some good news about Obamacare. This is coming from an ideologically aligned think tank, for disclosure purposes.

http://www.americanprogress.org/issues/ ... 0-billion/

[broken iris]

Some good news about Obamacare. This is coming from an ideologically aligned think tank, for disclosure purposes.

http://www.americanprogress.org/issues/ ... 0-billion/

Shenanigans.

Do they really think for-profit, public traded insurance companies are just going to eat that kind of loss for the common good?

[stip]

isn't that the point of the competition? Even though cartelization would be in the interest of the companies they aren't able to do that, and so they are forced to start the arms race to the bottom price point?

Was there as specific thing you were referring to? I only skimmed the article. I just posted it here because there's so much gloom and doom regarding Obamacare.

[broken iris]

isn't that the point of the competition? Even though cartelization would be in the interest of the companies they aren't able to do that, and so they are forced to start the arms race to the bottom price point?

Was there as specific thing you were referring to? I only skimmed the article. I just posted it here because there's so much gloom and doom regarding Obamacare.

We estimate that a 16 percent reduction in premiums will lower the total cost of tax credits by about 21 percent. As the example above illustrates, the percentage reduction in the tax credit will often be much greater than the percentage reduction in the premium. Because the amount that individuals pay is fixed at a percentage of income, a reduction in premiums will result in a proportionally larger reduction in government spending.

In its May 2013 baseline, CBO projected that the tax credits would cost $920 billion through 2023. But CBO made this projection before data on actual premium rates became available. A 16 percent reduction in premiums will lower this cost by about 21 percent, or about $190 billion.

Without looking at their methodology it appears they are suggesting the current price underrun will be persistent until 2023 and average out across all the entrants in the ACA exchanges. That's pretty unlikely given the diversity in premium costs already being reported, the history of price increases in healthcare costs, and the fact that we don't yet know how many people are seeing which rates. We don't even know how many people are getting to the point were rates are being presented and there are lots of reports of the estimates that the federal exchange is displaying are not correct due to errors in the software.

I'd also like to point out that's not like the government is not going to return that projected $190 billion in lower subsidy costs to the tax payers. It'll probably just spend it on more anti-brown-people missiles.