More Obamacare fuckups

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Originally Posted by cwolff

Let me get this straight. Jarvan says the woman got dumped because she had a plan that wasn't good enough for ACA. I responded by saying she got 1.2 million so this isn't one of those plans. Then Jarvan's response is to attack my IQ as being insufficient in some way while misspelling principal?

It'd be funny if it weren't true.

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You do understand there are a lot more requirements for healthcare plans then JUST a lifetime max, right? Besides, How do you know her lifetime max on this plan wasn't 2 million? or 10? Do you know to what age it covered kids? Or if it covered maternity care? Maybe the plan did NOT cover preexisting conditions. Do not claim that her current plan was ACA compliant, you have no fucking clue that it was. On the other hand, you can be almost certain it wasn't.

When I worked for Aetna, there was ZERO plans that covered kids till 26. best plan I saw was the UN, which covered kids till 24, no matter what. Most covered till 21 but they had to be in school. Private plans usually are much stricter on that particular front. For example.

Btw.. here is the Kids thing from healthcare.gov... feel free to explain how most of these points make any sense at all.

If a plan covers children, they can be added or kept on the health insurance policy until they turn 26 years old.

Children can join or remain on a plan even if they are:

married
not living with their parents
attending school
not financially dependent on their parents
eligible to enroll in their employer’s plan

So a Kid that CAN enroll in a plan from their job, can instead refuse to and be covered by their parents.

A kid that makes 250k a year as an Actor can still be covered under their parents plan...

A woman that is married to someone and living with her husband ( who has his own insurance) can stay on her parents plan till 26...

What is the definition of "dependent" as it applies to the Patient Protection and Affordable Care Act (the Act)?

A group health plan or insurer may base eligibility for dependent child coverage only in terms of the relationship between a child and participant, and may not deny or restrict coverage based on factors such as financial dependency, residency, student status, employment or marital status. The health reform regulations do not provide a definition of "child" for these purposes.


These make sense in WHAT universe?

Granted, the cild part is not likely the reason they are dropping her, I am just pointing out possibilities. You on the other hand automatically think , Oh evil company is getting rid of someone that cost them money.

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Originally Posted by Thondalar

We already have Government healthcare for the poor and elderly, it's called Medicaid and Medicare. What does the ACA do, exactly?

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ACA says that people can get medicaid up to 134% of the poverty level, and also now it is available to men and women, and single people, and people without kids. Previously, it was mostly for children and pregnant women, or families.

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Originally Posted by cwolff

Did you read the article about Kentucky? They had something like 35,000 people sign up in it's first month. IN KENTUCKY!

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Do we know how many of those 35k signed up for Medicaid?

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Originally Posted by Jarvan

Do we know how many of those 35k signed up for Medicaid?

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It's Kentucky so probably 35k.

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Originally Posted by Jarvan

You do understand there are a lot more requirements for healthcare plans then JUST a lifetime max, right? Besides, How do you know her lifetime max on this plan wasn't 2 million? or 10? Do you know to what age it covered kids? Or if it covered maternity care? Maybe the plan did NOT cover preexisting conditions. Do not claim that her current plan was ACA compliant, you have no fucking clue that it was. On the other hand, you can be almost certain it wasn't.

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Are you saying that she probably had a high risk catastrophic coverage plan?

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Originally Posted by Jarvan

When I worked for Aetna, there was ZERO plans that covered kids till 26. best plan I saw was the UN, which covered kids till 24, no matter what. Most covered till 21 but they had to be in school. Private plans usually are much stricter on that particular front. For example.

Btw.. here is the Kids thing from healthcare.gov... feel free to explain how most of these points make any sense at all.

If a plan covers children, they can be added or kept on the health insurance policy until they turn 26 years old.

Children can join or remain on a plan even if they are:

married
not living with their parents
attending school
not financially dependent on their parents
eligible to enroll in their employer’s plan

So a Kid that CAN enroll in a plan from their job, can instead refuse to and be covered by their parents.

A kid that makes 250k a year as an Actor can still be covered under their parents plan...

A woman that is married to someone and living with her husband ( who has his own insurance) can stay on her parents plan till 26...

What is the definition of "dependent" as it applies to the Patient Protection and Affordable Care Act (the Act)?

A group health plan or insurer may base eligibility for dependent child coverage only in terms of the relationship between a child and participant, and may not deny or restrict coverage based on factors such as financial dependency, residency, student status, employment or marital status. The health reform regulations do not provide a definition of "child" for these purposes.


These make sense in WHAT universe?

Granted, the cild part is not likely the reason they are dropping her, I am just pointing out possibilities. You on the other hand automatically think , Oh evil company is getting rid of someone that cost them money.

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We don't know how this will play out. If it's terrible, it can be changed. Didn't they just add a means testing component to ACA? No reason they can't tweak it further and definitely no reason in our history to suggest that it won't be modified.

BTW, I'm not one of the guys saying anything about those evil insurance companies. You have me confused with another. I did say that right now is a great time for insurers to dump policies that are losing money.

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Originally Posted by Jarvan

Do we know how many of those 35k signed up for Medicaid?

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About 2/3'rds are medicaid.

Nope, it's higher than that:

32,485 enrolled in new health coverage, including Medicaid and private insurance

‣ 27,854 have enrolled in Medicaid and 4,631 have enrolled in a qualified health plan.

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Originally Posted by cwolff

Glad you asked! And the answer is that it does a lot!
1) Creates health insurance exchanges

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Why did we need the ACA to do that? It would have already happened on it's own if not for the previous system of government-muddled healthcare.

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2) Subsidizes insurance for the poor who make too much to be on medicaid/medicare

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If there was a gap in Medicaid coverage I'm sure we could have solved that by overhauling Medicaid, not introducing another thousand pages of idiotic bureaucracy.

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3) Makes it possible to get coverage with a pre-existing condition

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Why is this a good thing? If you bring a car into a dealership to trade, and it has a blown engine, will they give you full value for it? Whether you like it or not, the fact is Insurance Companies are businesses. They exist to make money (which, by the way, has some really stupid side-effects, like giving people jobs and driving economies). In order to make up for the fact that they're going to lose a shit ton of money on people with pre-existing conditions, they're going to have to raise the rates on the rest of us.

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I'm sure it does more, those are just three things it does that a majority of republicans like.

Oh, they also like the employer mandate. The used to like the individual mandate too, but now they don't.

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:deadhorse: The individual mandate proposed by the Heritage Foundation was ONLY for catastrophic coverage, and even that wasn't readily accepted by the Republican rank-and-file.

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Could be that people like it!

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Nobody I know.

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Originally Posted by cwolff

Did you read the article about Kentucky? They had something like 35,000 people sign up in it's first month. IN KENTUCKY!

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To be fair, people in Kentucky all have to share one computer, vastly reducing the server load.

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Originally Posted by Thondalar

Why is this a good thing?

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Because being unhealthy impinges on our first and most precious right: the right to life.

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In order to make up for the fact that they're going to lose a shit ton of money on people with pre-existing conditions, they're going to have to raise the rates on the rest of us.

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The reduction in our ability to pursue happiness (in the form of hookers and blow) is noted, but as our third most important right it is of course less important than our first. This is how society works. Why do you think we haven't had any revolutions in the past 100 some odd years? We treat people right, and everybody is rich.

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Originally Posted by Thondalar

Why did we need the ACA to do that? It would have already happened on it's own if not for the previous system of government-muddled healthcare.

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Would have but.... means it didn't happen until Obama and ACA.

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Originally Posted by Thondalar

If there was a gap in Medicaid coverage I'm sure we could have solved that by overhauling Medicaid, not introducing another thousand pages of idiotic bureaucracy.

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Could have but....we didn't until Obama and ACA.

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Originally Posted by Thondalar

Why is this a good thing? If you bring a car into a dealership to trade, and it has a blown engine, will they give you full value for it? Whether you like it or not, the fact is Insurance Companies are businesses. They exist to make money (which, by the way, has some really stupid side-effects, like giving people jobs and driving economies). In order to make up for the fact that they're going to lose a shit ton of money on people with pre-existing conditions, they're going to have to raise the rates on the rest of us.

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Well people aren't machines...yet! Insurance companies do not have to participate in the exchanges. They can stay out of them completely if they don't think they make money. They are being exposed to millions of people who are going to have to buy their product now though and they are competing for these new customers. Obama just expanded their market, a lot. Ya, the rates may go up for you and me. If you don't like this, then keep fighting it. Maybe this side of the argument will get enough support that it's possible to repeal the pre-existing coverage. Right now in the USA though, there is no will for this.

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Originally Posted by Thondalar

The individual mandate proposed by the Heritage Foundation was ONLY for catastrophic coverage, and even that wasn't readily accepted by the Republican rank-and-file.

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Yup, I think that's correct. They wanted to close the "free rider" loophole. It's interesting the guy who wrote this also answers your question about why we should cover pre-existing conditions better than I can:

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...it assumes that there is an implicit contract between households and society, based on the notion that health insurance is not like other forms of insurance protection. If a young man wrecks his Porsche and has not had the foresight to obtain insurance, we may commiserate but society feels no obligation to repair his car. But health care is different. If a man is struck down by a heart attack in the street, Americans will care for him whether or not he has insurance. If we find that he has spent his money on other things rather than insurance, we may be angry but we will not deny him services—even if that means more prudent citizens end up paying the tab.

A mandate on individuals recognizes this implicit contract. Society does feel a moral obligation to insure that its citizens do not suffer from the unavailability of health care. But on the other hand, each household has the obligation, to the extent it is able, to avoid placing demands on society by protecting itself…

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Originally Posted by Thondalar

Nobody I know.

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Nobody yet, but you will, and to be fair you probably do. They are just in the closet.

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Originally Posted by Tgo01

What about poor and an asshole?

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My opinion of assholes is not influenced by how much money the asshole has. An asshole is an asshole is an asshole.