Politics Obamacare

The short answer is "yes, you can".

The longer answer is "yes, you can but make sure that it's a good idea before you do".

You are under no obligation to purchase coverage from your employer under the Affordable Care Act. If, for instance, your wife has better, cheaper coverage, you can be insured under her plan and tell your employer you're not interested. If you can find coverage you like more from a state insurance exchange, you can buy it.

That said, it's unlikely that you will find comparable coverage for cheaper from the exchange. You might, so it's worth looking, but you need to make sure to compare apples-to-apples. Make sure you understand exactly what you're getting from your employer before you make a move because you could be making a mistake that will cost you a lot more down the road.

cynthetiq, it's not your HR Department's job to worry about your enrollment outside of their plan. They are only going to care about whether or not you are enrolled in their plan and how it affects their insured group. If you choose to be insured elsewhere, regardless of where, then they cease to be involved at all. Make sense?

 

Yes you can.

But in addition to what Jazz noted...consider that your employer subsidizes your plan and you would not be eligible for the subsidies and tax breaks via the Insurance Exchange if your employer-based plan is considered "affordable"

For purposes of determining eligibility for exchange subsidies, affordable employer-sponsored insurance is defined as requiring an employee contribution of less than 9.5 percent of household income for an employee-only plan that covers at least 60 percent of medical costs on average (“minimum value”). If self-only coverage costs less than 9.5 percent of household income, then both employees and their family members are ineligible for subsidies regardless of whether or not family coverage is affordable.​

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And, if your income is over 400% of poverty level, you wont get a subsidy or tax relief under any circumstances.

 

Having healthcare insurance is not the same as having access to healthcare. A high deductible plan with high co-pays can be an insurmountable barrier for some people. Combined with monthly premiums, total out of pocket costs can end up being a very high percentage of income. Then this assumes timely access to doctors and medical services. In many cases in order to keep premiums low the network of providers has been restricted. Long story short - Obamacare does not address healthcare needs. many people will end up with an insurance card, but not improved healthcare! There are better ways than Obamacare to address the underlying problems of access to healthcare and affordability. Insurance is a "promise" - and for a consumer of insurance understanding what that promise is, is very important. I would argue most don't understand this or understand what the principle debate is all about. Obamacare is not free, or even affordable healthcare for all.

 

In the short term, the ACA will have little impact on the nearly 200 million in large group (employer) plans other than providing greater consumer protections -- elimination of annual and lifetime limits, elimination of rescinding coverage after a person is hit with a serious illness, eliminating exclusion of coverage for pre-existing conditions (and even eliminating the condition of pregnancy as a pre-existing condition - yes some insurers have done this), providing new medical loss ratios requiring 80-85% of premiums to be dedicated to individual health care, new rate reviews if insurer requests premium rate increase over 10%........

Are we better off with these new requirements?

 

OK....... still don't make any since to me. I know it sounds dumb but I don't know shit about health insurance. How/where do compare apples to apples so to speak.

 

You just need to know how your current plan works - deductibles and any special things it offers - and compare it to what is being offered elsewhere. Look at what each one offers and make sure that they're as close as possible.

 

wow is this real life? i know it's missing a 1, but there's no letters associated with 1. http://dailycaller.com/2013/10/03/need-health-care-coverage-just-dial-1-800-fuckyo-to-reach-obamacares-national-hotline/line/

 

Your question, in my view, assumes these new requirements do not have costs attached to them. Who pays these additional costs? Those who pay are not better off - those who get the benefit are - it nets to zero.

However, if we make the system more efficient...but nothing in Obamacare addresses this in a meaningful manner. Cost shifting does not improve systems.

 

The additional costs for the consumer protections are covered in large part by expanding the universe of covered patients, including more young healthy patients and/or the fee if they chose not to participate.....a Republican idea. Yes, this means that some young people will pay for health care. On balance, far more people will benefit.

There are numerous provisions to make the system more efficient -- from free (no co-pay) preventive care to incentives for wellness programs, to pilot projects to test new health care delivery systems (eg accountable care organizations), to investments in improving health care technology and more.

Nothing to make the system more efficient? Bullshit.

 

You are dealing with a system that is purposefully convoluted, Obamacare adds to its complexity. As an individual, you do not have the benefit of being able to accurately assess and apply probabilities, lacking in the area of the Law of large Numbers, in order to predict the perfect plan.

For you healthcare insurance is more or less a question of what will give you peace of mind. For some they will be o.k. with a high deductible/high out of pocket (co-pays)/low premium plan. Some may want the opposite or a different combination. Or, the trade-off of certain costs for uncertain costs. Personally, I buy insurance for large uncertain costs (i.e. major illness) and I tend not to want to pay for small certain costs (i.e. I go for larger co-pays for office visits) - if two policies both cover major illness and on has no co-pay for office visits and the other has a $50 co-pay - I would tend to want to pay a lower premium for the $50 co-pay plan.

 

This checklist might help.

Ask your HR dept to help with the details of your current plan, not just if it includes certain benefits, but any limitations on those benefits.

And then compare with plans on the Insurance Exchange. You will need to work through the application process (w/o actually enrolling) to get the details of other plans. It will take some work.

 

What??? If we have numbers of people with no cost (meaning they are healthy and can actually subsidize others), and we impose costs on them how do you come up with more people benefiting. You actually have fewer people benefiting, the number being subsidized. The is the general principle of insurance, many pay small premiums for the fewer number who will have losses. You see, somewhere in your logic, you think something is coming for free. In a system of insurance in simple terms, assuming no admin. costs, no profits - every $1 in cost requires $1 premium.

Doesn't these measures require some type of review, perhaps a panel, to determine the efficiency of preventative care....because preventative care can actually be inefficient - for example people with simple sore throats being over treated with strep tests and antibiotics, generating costs that surpass benefits. Then when we get to more serious issues, perhaps life and death issues, who decides if a limited number of days of more life is worth the cost relative to allocating those resources in other areas? what would you call such a panel?

 

I dont think anything is coming for free.

I know for a fact that more people will have access to affordable insurance, both the uninsured and those with preexisting conditions, than under the current system...and I know the majority of Americans will have greater consumer protections, including restrictions on premium increases and it as a result of expanding the universe of insured people and regulating insurance companies.

By any objective measure, incentivizing preventive care and wellness programs reduce long term costs. And if you you understand anything about ACOs or other pilot programs; they are not about rationing health care or death panels.

 

Could you explain to an outsider? Why would you pay high premiums if you get healthcare insurance through your employer?

Isn't it free as part of your employment package (or at least very cheap?). If not, what's the point?

I've only ever had it as fully paid by my employer and all I've paid is tax on the benefit (mind you, it isn't a big deal over here and the taxable benefit is only valued at a few hundred a year, so I'm sure things are different over there).

 

100% is very generous!

The average is closer to employer paying 70% for family plan and 80% for single plan, with a slow trend towards employees paying more.

 

My next question is this will Obamacare ever go away? Meeting after he is not in office anymore well they try to do away with the affordable healthcare act?

 

Despite the rhetoric from the right, a recent study found that employers are not abandoning their health plans en masse as a result of the ACA....much like other recent independent studies.

 

Access to insurance has a cost. Let's not confuse issues. People pay a price for the benefit of health insurance. In a true insurance situation, the net is zero.

If as a society we want a system where people with existing conditions are subsidized, meaning, we know in advance the costs will exceed what those individuals will pay, and that subsidy is spread - I would suggest a system where everyone in society share in paying for the subsidy - that it not be a disproportional burden to some classes of people at the benefit of others - true single payer!

Americans will have a minimum level of designated consumer protections. In a highly regulated market there will be a trend to one standard. In a free and competitive market, there are incentives to exceed minimum standards. In a market with 4 or 5 competitors, legal or not there will be collusion market shares will be more or less guaranteed and the way the competitors respond to consumer needs will reflect that.

Here we go again. If the costs are X and the company's get a guaranteed margin of X+Y, if costs go up there is nothing that is going to make Y go down! The cost will be passed on to consumers. Or, taxpayers. Or, passed on to future generations in the form of debt.

Insurance companies are currently heavily regulated and will always be heavily regulated, with or without Obamacare.

In some circumstances yes. In others, no. It depends. Someone has to look into the details. Someone has to do the math. For example - prostate issues with men 70+ with other medical issues, preventive measures for slow growth prostate cancer, may very well not reduce long-term costs. It depends, there is no one solution for all -

Prostate Cancer: Weighing Options - WSJ.com

We can easily excessively spend money on testing and preventative treatment, that may not make a difference. And so it is with many similar medically related issues, all I know is that I want it to be my choice with my doctor, not the decision of some DC bureaucrat. Oh, and prior to Obamacare if a person wanted a Cancer policy in most places I am aware of they could have purchased a policy for this coverage - if that was their concern.

And if you you understand anything about ACOs or other pilot programs; they are not about rationing health care or death panels.[/quote]