hoops902
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Post by hoops902 on Apr 22, 2020 11:48:58 GMT -5
It is currently there, but there is a continual push to undo the ACA. Also, a few states basically have no plans to choose from. I get that there is a push to undo the ACA (I don't see that happening) but she is arguing as if there is no ACA and a person making $15/hr will have to pay $15k a year. There might not be choices but I'm assuming each state has at least one plan available, correct? Right, this is the argument I expect to hear someone make PRE-ACA. "Isn't it awful these people are losing their jobs, we need some kind of public option for people that isn't linked to employment"... |
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hoops902
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Post by hoops902 on Apr 22, 2020 11:50:54 GMT -5
Insurance is tied to employment only so far as employees DECIDE to tie it to their employment. If you don't want it tied to your employment, go buy it on the open market. People generally CHOOSE to tie it to their employment because they can get a better deal than open market rates. ... ... It doesn't suddenly become cheaper or more affordable by not tying it to employment. ... No, not "suddenly" but it is important to understand why it is cheaper when it is provided by an employer. That employer proves a pool of people to insure. The larger that pool, the cheaper the rate more person. There are other ways that "pools" can be created and provide a lower cost than the open market insurance plans. That same pooling can be done today for folks who don't want or can't have insurance through an employer. Someone can go create that pooling without taking away people's options of having it via their workplace. |
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Miss Tequila
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Post by Miss Tequila on Apr 22, 2020 11:52:00 GMT -5
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Miss Tequila
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Post by Miss Tequila on Apr 22, 2020 11:53:20 GMT -5
Insurance is tied to employment only so far as employees DECIDE to tie it to their employment. If you don't want it tied to your employment, go buy it on the open market. People generally CHOOSE to tie it to their employment because they can get a better deal than open market rates. ... ... It doesn't suddenly become cheaper or more affordable by not tying it to employment. ... No, not "suddenly" but it is important to understand why it is cheaper when it is provided by an employer. That employer proves a pool of people to insure. The larger that pool, the cheaper the rate more person. There are other ways that "pools" can be created and provide a lower cost than the open market insurance plans. My BF used to get his insurance through the local Chamber of Commerce and he hten benefited from the pool. That went away with the ACA and his costs went up quite a bit. He was not happy at all.... |
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swamp
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Post by swamp on Apr 22, 2020 11:54:20 GMT -5
It is currently there, but there is a continual push to undo the ACA. Also, a few states basically have no plans to choose from. I get that there is a push to undo the ACA (I don't see that happening) but she is arguing as if there is no ACA and a person making $15/hr will have to pay $15k a year. There might not be choices but I'm assuming each state has at least one plan available, correct? I have no idea. |
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pulmonarymd
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Post by pulmonarymd on Apr 22, 2020 11:56:33 GMT -5
It is currently there, but there is a continual push to undo the ACA. Also, a few states basically have no plans to choose from. I get that there is a push to undo the ACA (I don't see that happening) but she is arguing as if there is no ACA and a person making $15/hr will have to pay $15k a year. There might not be choices but I'm assuming each state has at least one plan available, correct? Except the administration has no plans to reopen enrollment for people at present. Can't get it if enrollment is closed |
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hoops902
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Post by hoops902 on Apr 22, 2020 12:01:20 GMT -5
I get that there is a push to undo the ACA (I don't see that happening) but she is arguing as if there is no ACA and a person making $15/hr will have to pay $15k a year. There might not be choices but I'm assuming each state has at least one plan available, correct? Except the administration has no plans to reopen enrollment for people at present. Can't get it if enrollment is closed Huh? job loss, even if voluntary, qualifies you for special enrollment. They aren't reopening general enrollment, that doesn't impact qualifying events that give you special enrollment year-round. |
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Miss Tequila
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Post by Miss Tequila on Apr 22, 2020 12:01:52 GMT -5
I get that there is a push to undo the ACA (I don't see that happening) but she is arguing as if there is no ACA and a person making $15/hr will have to pay $15k a year. There might not be choices but I'm assuming each state has at least one plan available, correct? Except the administration has no plans to reopen enrollment for people at present. Can't get it if enrollment is closed
If you did not sign up for an Obamacare Plan during the Open Enrollment Period (November 1, 2019 to December 15, 2019), you can still get coverage during the “Special Enrollment Period.”The Special Enrollment Period is any date that falls outside of Open Enrollment. However, you or someone in your household must have what is known as a “Qualifying Life Event” to be eligible to participate in the Special Enrollment Period. A Qualifying Life Event enables you to get any one of the five Obamacare Plans. Subsidies, or discounted rates, are available if you meet certain criteria. What is a Qualifying Life Event? The most common Qualifying Life Events are listed below. You are very likely eligible if you: Lost health coverage in the last 60 days or expect to lose it within the next 60 days
www.healthcare.gov/have-job-based-coverage/if-you-lose-job-based-coverage/
Option 1: Buy a health plan through the Marketplace
If you leave your job for any reason and lose your job-based insurance, you can buy a Marketplace plan. Losing job-based coverage, even if you quit or get fired, qualifies you for a Special Enrollment Period. This means you can buy insurance outside the yearly Open Enrollment Period.
Am I missing something with the above? You are telling me that Trump won't open up the marketplace enrollment period but everything I'm reading says that losing your health insurance qualifies you for a special enrollment period.
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Miss Tequila
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Post by Miss Tequila on Apr 22, 2020 12:03:07 GMT -5
Except the administration has no plans to reopen enrollment for people at present. Can't get it if enrollment is closed Huh? job loss, even if voluntary, qualifies you for special enrollment. They aren't reopening general enrollment, that doesn't impact qualifying events that give you special enrollment year-round. Thank you! I'm realizing that she is talking out her ass and I'm done discussing anything with her. I can't tell if she truly doesn't understand these things or if she hopes that people are dumb enough to believe her. Either way, I'm done. |
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geenamercile
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Post by geenamercile on Apr 22, 2020 12:05:02 GMT -5
Nice misdirection. The market should never have been tied to employment. We should have some sort of private/public systgem, not tied to employment, so people are not tied to jobs, and will not be left bankrupt. The importance of this will become even greater as this situation goes on, as many people will lose their job, lose their health insurance as a result, and if they get sick with COVID, be left bankrupt as a result of a hospitalization. Or is there some other solution to this issue as you see it. These are all people who got their insurance thru their workplace. Unless you are one of those people who think you can pay 15-12k for insurance for your family on $15/hour Isn't that what Obamacare did? The low paid people get subsidies. I'm pretty sure no one making $15/hr is paying $15k a year for healthcare. I would be okay with this if they took away the hoop that if your employer offer insurance then you are not eligible for subsidies. Why should someone making 15K a year who doesn't have insurance can get insurance for cheap on the market place, but someone who is making 15K a year but employer offers insurance but at a high rate not? I get the concept is that the person's who employer offers insurance is subsiding it, but in reality for lower paid workers that isn't really the case, they offer it but the worker still pretty much pays. The only benefit is the group rate. |
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mary2029
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Post by mary2029 on Apr 22, 2020 12:06:39 GMT -5
From a thread I started on 3/24: 11 States Allowing Uninsured Enroll in Obamacare: link |
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Miss Tequila
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Post by Miss Tequila on Apr 22, 2020 12:07:45 GMT -5
Isn't that what Obamacare did? The low paid people get subsidies. I'm pretty sure no one making $15/hr is paying $15k a year for healthcare. I would be okay with this if they took away the hoop that if your employer offer insurance then you are not eligible for subsidies. Why should someone making 15K a year who doesn't have insurance can get insurance for cheap on the market place, but someone who is making 15K a year but employer offers insurance but at a high rate not? I get the concept is that the person's who employer offers insurance is subsiding it, but in reality for lower paid workers that isn't really the case, they offer it but the worker still pretty much pays. The only benefit is the group rate. Except there is a cap that you can be charged. I'm forgetting exactly what it is (9.8%?). I know because payroll had to go through and calculate what everyone was paying. We had two people who had to be charged lower rates for their health insurance because they exceeded the threshold. And we have fairly good insurance with a low deductible. |
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Miss Tequila
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Post by Miss Tequila on Apr 22, 2020 12:11:15 GMT -5
From a thread I started on 3/24: 11 States Allowing Uninsured Enroll in Obamacare: linkUnder the Affordable Care Act, people who lose insurance coverage when they lose their job are already allowed to buy their own insurance. But the creation of a broad special enrollment period would mean that anyone without comprehensive insurance could simply sign up for a health plan, without having to prove such special conditions. Early reports from states suggest that a recent wave of layoffs will leave millions of Americans in need of new health coverage. Thank you. The above was copied from your link. Reading comprehension seems like a lost art.... |
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buystoys
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Post by buystoys on Apr 22, 2020 12:21:07 GMT -5
It is currently there, but there is a continual push to undo the ACA. Also, a few states basically have no plans to choose from. I get that there is a push to undo the ACA (I don't see that happening) but she is arguing as if there is no ACA and a person making $15/hr will have to pay $15k a year. There might not be choices but I'm assuming each state has at least one plan available, correct? The "at least one plan" that was available to me for three years was an HMO with a $6500 dollar deductible you had to meet before anything was paid for. The premium was over $750 per month. That's an expense of $15500 per year before the insurance pays a dime. Most people can't afford that. We aren't high income, either. That OOP cost for us for three years was (year 1) almost 40% of our income, then almost 35% then 25%.
I couldn't just pick a specialist for my back surgery, I had to pick someone off their list. Fortunately I found someone really skilled, but I could have just as easily been cut on by a hack.
If someone loses their job, they can apply for coverage on Healthcare.gov at that time. That is a change that is accepted to open a new enrollment window. The same goes for losing your coverage through your employer, i.e. not enough work hours to qualify for coverage. Any significant life change impacting your coverage starts a new enrollment window. ETA: I should have read the rest of the thread to see that someone had already answered the question of enrollment.
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Miss Tequila
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Post by Miss Tequila on Apr 22, 2020 12:27:06 GMT -5
I get that there is a push to undo the ACA (I don't see that happening) but she is arguing as if there is no ACA and a person making $15/hr will have to pay $15k a year. There might not be choices but I'm assuming each state has at least one plan available, correct? The "at least one plan" that was available to me for three years was an HMO with a $6500 dollar deductible you had to meet before anything was paid for. The premium was over $750 per month. That's an expense of $15500 per year before the insurance pays a dime. Most people can't afford that. We aren't high income, either. That OOP cost for us for three years was (year 1) almost 40% of our income, then almost 35% then 25%.
I couldn't just pick a specialist for my back surgery, I had to pick someone off their list. Fortunately I found someone really skilled, but I could have just as easily been cut on by a hack.
If someone loses their job, they can apply for coverage on Healthcare.gov at that time. That is a change that is accepted to open a new enrollment window. The same goes for losing your coverage through your employer, i.e. not enough work hours to qualify for coverage. Any significant life change impacting your coverage starts a new enrollment window. ETA: I should have read the rest of the thread to see that someone had already answered the question of enrollment.
I am definitely not arguing the cost of insurance on the marketplace. I see it with DF. He has a $7k deductible and his premiums are $500 a month. He also has to pay for prescriptions. His biggest complaint with the ACA was that his cost jumped through the roof. Prior to ACA, he joined our local Chamber and bought through a pool. that went away with the ACA (no idea if that was a Chamber decision or a requirement of the ACA, I didn't know him back then). People that are lower paid do get the benefit of subsidies. Also, his costs are so high because he is self-employed. My costs are not significantly less but my employer absorbs 70% of my cost as part of my compensation. |
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weltschmerz
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Post by weltschmerz on Apr 22, 2020 14:45:26 GMT -5
Are you willing to put price controls on other segments of the economy? Limit salaries of other people? You want to do that because you do not like the cost of health care. See what happens to applications to work in healthcare if you do that Aww, therein lies the rub. You want what other countries in terms of healthcare but you want it to be a free for all with the taxpayer footing the bill. Government run anything has price controls. Medicaid/Medicare have extremely low reimbursements. If we have medicare for all then costs are going to have to be cut. Just curious.. .Canada has doctors even though they make significantly less than the US. Why would you assume that the US doctors would suddenly quit? Actually, they don't make "significantly less". Because their education is subsidized by the Canadian taxpayers, they don't have massive student loans to pay off. Their malpractice insurance isn't sky-high. They don't need to pay an an army of paper-pushers to deal with insurance. When all these things are considered, it's not that much less. |
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Deleted
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Post by Deleted on Apr 22, 2020 15:57:53 GMT -5
When you guys talk about "reasonable prices for health care," don't forget that there is already a two-tier system. People with insurance pay a negotiated rate, even on their share. People without pay sticker. Case in point: physical therapy was $4400 when BCBS denied my claim. The bill dropped to $400 when I appealed and they approved it. I actually had to pay the $400 OOP since I hadn't met my deductible. But that is a significant price differential. And I'm sure that the tiers are really more than two. Go to the doctor's office and listen while people check in. Person A has a $40 deductible, Person B has a $20 deductible, and so on. The negotiated discount differs as well. I have argued multiple times on here that there has to be a true price for health care services? If Physical Therapy can afford to treat me for $400 with BCBS, they can afford to treat me for $400 if I am self-paying. And don't give me the old song-and-dance that the uninsured will just go bankrupt and the hospital will write it off. If I had not won my appeal, I would have been paying $4400 and the hospital would not have written off anything. That is not a justification of a price differential that huge. Also, remember when retirement was tied to employment? You worked for a company for most of your life, and many people collected a pension along with their gold watch. Not all, of course, but not all people have health insurance tied to employment. Then retirement was untied, and 401ks became the norm. Companies would love to untie health care from employment; it would be a huge boost to their profitability.  |
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Deleted
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Post by Deleted on Apr 22, 2020 16:31:07 GMT -5
Buying insurance through the ACA exchange and being able to use it are two different things. Many of their plans have $10K+ out-of-pocket costs before the "policy" covers anything and many doctors won't take the cheaper plans.
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geenamercile
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Post by geenamercile on Apr 22, 2020 17:28:54 GMT -5
I would be okay with this if they took away the hoop that if your employer offer insurance then you are not eligible for subsidies. Why should someone making 15K a year who doesn't have insurance can get insurance for cheap on the market place, but someone who is making 15K a year but employer offers insurance but at a high rate not? I get the concept is that the person's who employer offers insurance is subsiding it, but in reality for lower paid workers that isn't really the case, they offer it but the worker still pretty much pays. The only benefit is the group rate. Except there is a cap that you can be charged. I'm forgetting exactly what it is (9.8%?). I know because payroll had to go through and calculate what everyone was paying. We had two people who had to be charged lower rates for their health insurance because they exceeded the threshold. And we have fairly good insurance with a low deductible. But that cap is based only on an individual plan. So while a single mother with 2 children needs a family plan, that cap doesn't take that into consideration. The market place does. |
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bobosensei
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Post by bobosensei on Apr 22, 2020 17:46:12 GMT -5
I have argued multiple times on here that there has to be a true price for health care services? If Physical Therapy can afford to treat me for $400 with BCBS, they can afford to treat me for $400 if I am self-paying. And don't give me the old song-and-dance that the uninsured will just go bankrupt and the hospital will write it off. If I had not won my appeal, I would have been paying $4400 and the hospital would not have written off anything. That is not a justification of a price differential that huge. I completely agree with you. I believe if doctors and hospitals were forced to charge a set price across the board whether you had no insurance, premium insurance, medicare, or medicaid, and they were forced to provide valid estimates for procedures that people would and could shop around. As it is they charge what they can get paid, and people without insurance or with bad insurance that have income and assets end up subsidizing medicare/medicaid rates. It shouldn't be that way. Providers should be able to charge reasonable rates for services, and that rate should be the same for everyone. When my mom was uninsured and sick she had some pill she had to take when she was hospitalized that was a ridiculous amount like 10-12k per pill per day. No one should pay that much for medicine just because they are insured to enable those that aren't to receive it for free. |
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pulmonarymd
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Post by pulmonarymd on Apr 22, 2020 18:00:12 GMT -5
I have argued multiple times on here that there has to be a true price for health care services? If Physical Therapy can afford to treat me for $400 with BCBS, they can afford to treat me for $400 if I am self-paying. And don't give me the old song-and-dance that the uninsured will just go bankrupt and the hospital will write it off. If I had not won my appeal, I would have been paying $4400 and the hospital would not have written off anything. That is not a justification of a price differential that huge. I completely agree with you. I believe if doctors and hospitals were forced to charge a set price across the board whether you had no insurance, premium insurance, medicare, or medicaid, and they were forced to provide valid estimates for procedures that people would and could shop around. As it is they charge what they can get paid, and people without insurance or with bad insurance that have income and assets end up subsidizing medicare/medicaid rates. It shouldn't be that way. Providers should be able to charge reasonable rates for services, and that rate should be the same for everyone. When my mom was uninsured and sick she had some pill she had to take when she was hospitalized that was a ridiculous amount like 10-12k per pill per day. No one should pay that much for medicine just because they are insured to enable those that aren't to receive it for free. But that only works if everyone has insurance. Emtala requires ER ti evaluate and stabilize a patient. If that patient had covid, for example, and required intubation, and was on Medicaid, we treat them at a significant loss. Add up multiple such patients, and it becomes a problem. Insurance, but especially Medicare and Medicaid underpay for medical admissions, as a result, commercial rates are charged about130% of Medicare rates. You would need to bring up Medicaid rates a large amount, Medicare rates a fair amount to even it out for commercial plans. Or, we can repeal emtala, and we can let those people die. BTW, Reagan signed the emtala legislation |
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Happy prose
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Post by Happy prose on Apr 22, 2020 18:27:04 GMT -5
Maybe health insurance wouldn't be so expensive if people didn't abuse it. I have great insurance through my employer, but a lot of money comes out of my paycheck for it. Still thankful I have it.(100% hosp, $10 dr visit co-pay, no deductible) BUT, I listen to my co-workers- Sally has a splinter in her finger, runs to Hosp for Special Surgery in NY, to see a dr she heard was 'fabulous'. Of course I made up that scenario, but this happens all the time. I think health insurance should be run like full coverage car insurance. It pays if you have a wreck, but flat tire comes out of your pocket.
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pulmonarymd
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Post by pulmonarymd on Apr 22, 2020 18:37:42 GMT -5
Maybe health insurance wouldn't be so expensive if people didn't abuse it. I have great insurance through my employer, but a lot of money comes out of my paycheck for it. Still thankful I have it.(100% hosp, $10 dr visit co-pay, no deductible) BUT, I listen to my co-workers- Sally has a splinter in her finger, runs to Hosp for Special Surgery in NY, to see a dr she heard was 'fabulous'. Of course I made up that scenario, but this happens all the time. I think health insurance should be run like full coverage car insurance. It pays if you have a wreck, but flat tire comes out of your pocket. Sounds good in theory, but if chronic care is too expensive, people cut costs. Look at what has happened to insulin prices. People don’t take their insulin and wind up in the hospital. Everyone talks about preventive care saving money, but you can’t make it prohibitively expensive or people won’t do it |
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Deleted
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Post by Deleted on Apr 22, 2020 19:49:48 GMT -5
I completely agree with you. I believe if doctors and hospitals were forced to charge a set price across the board whether you had no insurance, premium insurance, medicare, or medicaid, and they were forced to provide valid estimates for procedures that people would and could shop around. As it is they charge what they can get paid, and people without insurance or with bad insurance that have income and assets end up subsidizing medicare/medicaid rates. It shouldn't be that way. Providers should be able to charge reasonable rates for services, and that rate should be the same for everyone. When my mom was uninsured and sick she had some pill she had to take when she was hospitalized that was a ridiculous amount like 10-12k per pill per day. No one should pay that much for medicine just because they are insured to enable those that aren't to receive it for free. But that only works if everyone has insurance. Emtala requires ER ti evaluate and stabilize a patient. If that patient had covid, for example, and required intubation, and was on Medicaid, we treat them at a significant loss. Add up multiple such patients, and it becomes a problem. Insurance, but especially Medicare and Medicaid underpay for medical admissions, as a result, commercial rates are charged about130% of Medicare rates. You would need to bring up Medicaid rates a large amount, Medicare rates a fair amount to even it out for commercial plans. Or, we can repeal emtala, and we can let those people die. BTW, Reagan signed the emtala legislation That is more or less what I am arguing for. There should be a true price that you pay regardless of insurance. Medicare would pay it, Medicaid would pay it, BCBS would pay it, and the uninsured would pay it. It would no doubt be higher for everyone other than the uninsured. But that is what it actually costs just like a loaf of bread costs $3.99 at Publix. If you buy it with food stamps, it still costs $3.99. Publix isn't giving a negotiated price on bread depending on how you pay. |
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Happy prose
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Post by Happy prose on Apr 22, 2020 19:58:08 GMT -5
But that only works if everyone has insurance. Emtala requires ER ti evaluate and stabilize a patient. If that patient had covid, for example, and required intubation, and was on Medicaid, we treat them at a significant loss. Add up multiple such patients, and it becomes a problem. Insurance, but especially Medicare and Medicaid underpay for medical admissions, as a result, commercial rates are charged about130% of Medicare rates. You would need to bring up Medicaid rates a large amount, Medicare rates a fair amount to even it out for commercial plans. Or, we can repeal emtala, and we can let those people die. BTW, Reagan signed the emtala legislation That is more or less what I am arguing for. There should be a true price that you pay regardless of insurance. Medicare would pay it, Medicaid would pay it, BCBS would pay it, and the uninsured would pay it. It would no doubt be higher for everyone other than the uninsured. But that is what it actually costs just like a loaf of bread costs $3.99 at Publix. If you buy it with food stamps, it still costs $3.99. Publix isn't giving a negotiated price on bread depending on how you pay. I think there should also be a true price for health insurance. On my job, it goes by a percentage of your salary. Why? When we buy cars, I don't have to pay more than Sally. And when my one and only daughter was on my plan, I paid for 'family'. So did the guy with four kids. |
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jerseygirl
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Post by jerseygirl on Apr 22, 2020 20:27:27 GMT -5
In November 2019 the administration (Trump) released a ruling that hospitals must publicize the costs of procedures and the negotiated rates or be fined. Also not sure of date but think there has been or is planned a ruling that will stop ‘surprise’ costs from out of covered insurance costs, eg if you go to ER that is covered by your insurance plan, some doctors may not be included in the covered plan. For example you go to hospital ER with broken arm. You call your insurance company and the hospital ER is in plan. Two months later you get bill from radiologist and ortho surgeon - they’re not in your plan. Surprise- big bill not covered by your insurance
So will these help decrease medical costs? If you agree, will you give Trump some credit for lowering costs? Even if all costs aren’t lowered its a start. No this isn’t the perfect solution but a start
I’d like simple medical system that doesn’t overwhelm physician groups and hospitals with huge complex paperwork and baroque situations that’s our now medical insurance system. That would be a huge cost savings as well as obviate the maze of different costs.
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pulmonarymd
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Post by pulmonarymd on Apr 22, 2020 20:58:34 GMT -5
But that only works if everyone has insurance. Emtala requires ER ti evaluate and stabilize a patient. If that patient had covid, for example, and required intubation, and was on Medicaid, we treat them at a significant loss. Add up multiple such patients, and it becomes a problem. Insurance, but especially Medicare and Medicaid underpay for medical admissions, as a result, commercial rates are charged about130% of Medicare rates. You would need to bring up Medicaid rates a large amount, Medicare rates a fair amount to even it out for commercial plans. Or, we can repeal emtala, and we can let those people die. BTW, Reagan signed the emtala legislation That is more or less what I am arguing for. There should be a true price that you pay regardless of insurance. Medicare would pay it, Medicaid would pay it, BCBS would pay it, and the uninsured would pay it. It would no doubt be higher for everyone other than the uninsured. But that is what it actually costs just like a loaf of bread costs $3.99 at Publix. If you buy it with food stamps, it still costs $3.99. Publix isn't giving a negotiated price on bread depending on how you pay. Actually if one price was paid, Medicare and Medicaid would pay more, and private insurance would pay LESS, because they would not be subsidizing everyone else. Would be even better if everyone had insurance. Which is part of the reason the ACA was designed. Not sure why it is controversial. Otherwise we should just have the uninsured not get any care, but no one seems to have the stomach for that. As to pricing, it is an absolute mess. The charges depend on “intensity of service”. I get paid more for more complex cases. You don’t know how complex your case is, and I don’t know what.to charge until I see you. So, if you call as a new patient, we can give you a range of prices, but we do not know the charge until after we are done. Sort of like taking your car in. To do otherwise we required overhauling the billing system. One price for a service doesn’t work, unless you think someone with a cold paying the same as someone with a lung cancer |
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Miss Tequila
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Post by Miss Tequila on Apr 23, 2020 5:40:30 GMT -5
Except there is a cap that you can be charged. I'm forgetting exactly what it is (9.8%?). I know because payroll had to go through and calculate what everyone was paying. We had two people who had to be charged lower rates for their health insurance because they exceeded the threshold. And we have fairly good insurance with a low deductible. But that cap is based only on an individual plan. So while a single mother with 2 children needs a family plan, that cap doesn't take that into consideration. The market place does. In my state, the mother can take only insurance for her and she can get CHIP for her children through the state program. It rub by the states with federal funding. I can't speak to how it works in all states. CHIP provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid (from healthcare.gov). I remember oped saying her kids got chip and my cousin's daughter got CHIP because his employer only covered single plans - the jump to employee + child was cost-prohibitive |
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Miss Tequila
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Post by Miss Tequila on Apr 23, 2020 6:12:48 GMT -5
That is more or less what I am arguing for. There should be a true price that you pay regardless of insurance. Medicare would pay it, Medicaid would pay it, BCBS would pay it, and the uninsured would pay it. It would no doubt be higher for everyone other than the uninsured. But that is what it actually costs just like a loaf of bread costs $3.99 at Publix. If you buy it with food stamps, it still costs $3.99. Publix isn't giving a negotiated price on bread depending on how you pay. . Would be even better if everyone had insurance. Which is part of the reason the ACA was designed. Not sure why it is controversial. Otherwise we should just have the uninsured not get any care, but no one seems to have the stomach for that. As to pricing, it is an absolute mess. The charges depend on “intensity of service”. I get paid more for more complex cases. You don’t know how complex your case is, and I don’t know what.to charge until I see you. So, if you call as a new patient, we can give you a range of prices, but we do not know the charge until after we are done. Sort of like taking your car in. To do otherwise we required overhauling the billing system. One price for a service doesn’t work, unless you think someone with a cold paying the same as someone with a lung cancer So what will happen if liberals get their way and everyone is on a national medicare plan? Will costs be forced to go down because you don't have those of us on insurance picking up the slack for those being paid for by the government? I believe Susana was talking about things like an MRI, x-ray, etc. The pricing is different based on who is paying. The same test but a huge range of prices. |
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Miss Tequila
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Post by Miss Tequila on Apr 23, 2020 6:18:34 GMT -5
Buying insurance through the ACA exchange and being able to use it are two different things. Many of their plans have $10K+ out-of-pocket costs before the "policy" covers anything and many doctors won't take the cheaper plans. When I was shopping for DF's insurance in December, the cheaper monthly premiums had high deductibles. The more expensive plans had much lower deductibles. It is cheaper to take a very high deductible plan because you are self-insuring the deductible piece. This has is the way it was designed from the get go. The ACA forced everyone to get insurance but did squat to address the underlying cost issues. Our healthcare costs are much higher than other nations. No one wants to address that. We just want to kick the cost to the taxpayers. |
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