Executive order to gut the ACA possibly incoming?

[Deleted]

I very much suspect that you don't, or you'd feel awfully silly trying to imply that anyone else is an idiot while making this statement.

First off, I never implied that anyone was an idiot. Second, refute what I said. Please point out how the CSR's were not subsidies given to the insurance companies to cover the fail of Obamacare.

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Are you asking me why I paid $700 for no having insurance on my taxes?

What? Why did you refuse to get Obamacare and instead pay the fine? Was Obamacare not affordable for you? I thought it was the AFFORDABLE Care Act?

[ati87]

Pretty much every recent review has found that, until this action, the ACA had settled into stability. No more insurers appeared ready to leave the market, and those who were having issues were having them specifically because of Trump's actions, both actual and in his implied - and now realized - threats to the ACA.

As a human being, you should be held to some standards. Start right now.

And to be specific it's the red states who have the most issues because just like Jesus said ''take care of you're neighbour unless they get sick, then just let them die to preserve the white superior middle-eastern race''

[Xeones]

What? Why did you refuse to get Obamacare and instead pay the fine? Was Obamacare not affordable for you? I thought it was the AFFORDABLE Care Act?

I think I looked into it and then forgot to sign up.

[Zan15]

Confirmed in your assumptive mind only.

Confirmed by you not wanting to confirm where you get insurance from and the odds of where you could get it from.

i could prob look at your post history and come to a conclusion but its just not worth the extra effort when you have basically just given it away with silence.

i'll continue to Assume...since there is a good chance you are getting tax subsidized health insurance

[Deleted]

Confirmed by you not wanting to confirm where you get insurance from and the odds of where you could get it from.

i could prob look at your post history and come to a conclusion but its just not worth the extra effort when you have basically just given it away with silence.

i'll continue to Assume...since there is a good chance you are getting tax subsidized health insurance

Okay, buddy, you continue to assume.....

[Zan15]

Okay, buddy, you continue to assume.....

well based on your post history of living through desegregation, was in the 7th grade

"My school was a "bussing" school. In 7th grade, they bussed all the black kids in from the projects. This was 8 years after the MLK riots of 1968,:

so that puts it at 1976. in 7th grade you are 13 ish. so puts your birth around 1963. puts you at 54.



So not old enough for Medicare, and not of age to be drafted....so possibly not a vet...Tho possible you served.
so you either get your insurance through the workplace or govt assistance / vet.


so the 3 possible sources of your insurance is all subsidized by tax write offs/incentives/tax payers


Which really puts into doubt you really have an issue about the legality of ACA subsidies vs just wanting to destroy Obama's legacy which you have admitted was a wonderful thing a few times.


why so hateful of obama that you want people to lose insurance or have to suffer financially because of it?

[Deleted]

well based on your post history of living through desegregation, was in the 7th grade

"My school was a "bussing" school. In 7th grade, they bussed all the black kids in from the projects. This was 8 years after the MLK riots of 1968,:

so that puts it at 1976. in 7th grade you are 13 ish. so puts your birth around 1963. puts you at 54.



So not old enough for Medicare, and not of age to be drafted....so possibly not a vet...Tho possible you served.
so you either get your insurance through the workplace or govt assistance / vet.


so the 3 possible sources of your insurance is all subsidized by tax write offs/incentives/tax payers


Which really puts into doubt you really have an issue about the legality of ACA subsidies vs just wanting to destroy Obama's legacy which you have admitted was a wonderful thing a few times.


why so hateful of obama that you want people to lose insurance or have to suffer financially because of it?

LOL - wow, stalker much? BTW - I am 53, will be 54 in 2 weeks. Good deduction. Had you bothered to stalker more, though, you would have seen that I have stated my age many times.

You are leaving out other possibilities, like - I am on Obamacare, I am on Obamacare but make way too much money to get those subsidies, I am not on Obamacare and not insured, I belong to an insurance association (like the Tennessee Farm Bureau or Medi-Share)...but keep speculating, and drawing assumptions.

[Zan15]

LOL - wow, stalker much? BTW - I am 53, will be 54 in 2 weeks. Good deduction. Had you bothered to stalker more, though, you would have seen that I have stated my age many times.

You are leaving out other possibilities, like - I am on Obamacare, I am on Obamacare but make way too much money to get those subsidies, I am not on Obamacare and not insured, I belong to an insurance association (like the Tennessee Farm Bureau or Medi-Share)...but keep speculating, and drawing assumptions.

based on percentages i had to go with the more likely option

btw if you are on Obamacare, even though lets say you would not get the subsidies, you will get the rate increases for the loss of everyone else subsidies. they will spread the rate increases to everyone including you if you had non subsidized plan. So its safe to say you would not cut your own foot off, you seem way to educated and bright to do that.


Farm Bureau won't be selling ACA plans next year but they did benefit from the subsidies this year.

Weird that the govt somehow should not be in the insurance business but is in the farm business full tilt. Recipients of Subtotal, Farming Subsidies from farms in Tennessee totaled $2,508,000,000 in from 1995-2014. So in essence insurance brought through this organization is subsidized by tax payers and i bet 99% of them don't even realize it. On top of that they are pretax subsidized as well.

Medi-Share is a scary option, but also subsidized though being tax free organization and pre tax benefits.


if you are uninsured you are the worst kind of subsidized patient. if anything happens to you, the hospital you go to will be forced to service you and the risk to other folks whom have insurance is that you cannot afford your bill and they have to pick up the bad debt through higher prices.


i mean don't you see the pattern. just about everyone is subsidized in one way or another for their health insurance /health care already. to pick apart the ACA without seeing the whole picture speaks volumes over your true reason why you support this change.

[Rasulis]

This is funny as hell.

Saturday, October 07, 2017
Covered California to middle-class enrollees: There (may be) gold in them thar hills

Update (!) Oct. 11, 2017: CoveredCA has gone live with* its 2018 plan preview tool and has implemented the CSR surcharge discussed below -- 12.4% added to silver on-exchange plans only. That makes gold cheaper than silver in some areas, and CoveredCA is indeed in some cases highlighting gold plan offerings ahead of silver.

Back on August 1 Covered California, the California ACA exchange, announced a proactive approach to enable health insurers to cope with the uncertainty over whether the Trump administration (or Congress) would guarantee them continued reimbursement for Cost Sharing Reduction subsidies.

Insurers would file rate requests under the assumption that CSR will continue to be reimbursed. If reimbursement was not guaranteed by a certain date, however, a surcharge (later pegged at 12.4%) would be added to silver plans sold on-exchange. CSR is available to enrollees with qualifying incomes only if they select silver plans, and only if they buy on-exchange. ACA-compliant silver plans sold off-exchange would not include the surcharge. That surcharge is likely to be triggered on or around October 11, CoveredCA tells me (postponed from an original target of Sept. 30).

The likely results have been widely noted (e.g., here). Off-exchange, plan pricing would remain proportionate to the actuarial value offered at each metal level. On-exchange, the only buyers of silver plans should be those with incomes up to 200% of the Federal Poverty Level, for whom CSR raises the value of silver plans roughly to that of platinum.

Subsidized buyers with incomes over 200% FPL (i.e., with incomes in the 200-400% FPL range) would be making a mistake if they bought silver, since silver would be priced at a level appropriate for gold plans, or slightly above. In fact they would get a windfall if they bought gold, because the inflated price of silver would also inflate premium subsidies, which are keyed to the benchmark (second cheapest) silver plan in each region. Gold plans, which have an AV of 80%, would be cheaper or almost as cheap as silver plans at 70% AV.* The effect would be a kind of back-door CSR for subsidy-eligible enrollees with incomes over 200% FPL.

How the gold windfall would play out in California

A 12.4% hike to silver premiums alone is enough to make silver plans more expensive than gold, or roughly equally expensive. A look at 2017 offerings in California bears this out. In Los Angeles, zip code 90013*, the unsubsidized benchmark silver plan premium for a 40 year-old this year is $270. The cheapest gold plan is $287. Add 12.4% to the benchmark, and its premium is $304. The cheapest silver plan premium is $256. A CSR surcharge would put it at $288 -essentially identical to cheapest gold.

How would this play out for a subsidized buyer with an income of $24,000 -- just above the 200% FPL line? Benchmark silver at that income level would cost 6.5% of income, or $130 per month.* The tax credit at present is $140 per month. If the benchmark had the CSR surcharge appended, the tax credit would rise to $173 per month. The cheapest gold plan would cost the buyer $114 per month -- $16 below what the ACA formula deems "affordable."* Under California's standardized plan designs, the foregone silver plan would have a medical deductible of $2200 (reduced from $2500 by the "weak" CSR available at incomes of 201-250% FPL) and a drug deductible of $250. The gold deductible would be zero on both counts.

In San Francisco, zip code 94016, the story is similar (though unsubsidized premiums are much higher). For a 40 year-old, the unsubsidized benchmark silver plan is $446; cheapest silver is $444, and cheapest gold is $492. Add 12.4%, and the benchmark is $501. A subsidized buyer of cheapest gold gets a small discount below the benchmark -- and a $2200 reduction in deductible ($2500 for those with incomes over 250% FPL).

Alerting enrollees: there may be gold in them thar hills

The Covered California website engages in decision support: based on income and the buyer's reported expected level of medical care usage, it foregrounds plans deemed most cost-effective. For buyers with incomes under 200% FPL, this pretty universally means silver plans appear first. That's because CSR adds substantial free actuarial value, boosting a silver plan to 94% AV for buyers with incomes up to 150% FPL, and to 87% AV for buyers in the 150-200% FPL range.

If the CSR surcharge goes through, it stands to reason that for most subsidized buyers with incomes over 200% FPL, the site should foreground gold plans -- or possibly, for those who anticipate low medical care usage, bronze plans, which also will be discounted by the inflation of benchmark silver premiums. CoveredCA confirms:
the best value plans will continue to be shown first.* As you note, if we have to load the CSR-surcharge, that could include Gold plans for consumers with certain income and utilization needs.*
Responding to the massive federal cutback in marketplace outreach and advertising, Covered California has also announced a $5 million increase in its marketing budget for 2018. Advertising should emphasize the need for current enrollees to shop anew, and find a way to suggest that many enrollees should consider switching metal levels.

--
* Los Angeles is split into two rating areas -- and even within those rating areas, plan offerings and prices vary. Ditto for San Francisco --- in parts of which a Chinese Community Health Plan (CCHI) is available this year at $407 for an unsubsidized 40 year-old -- $37 per month below the benchmark.

[Sunseeker]

Well, there go my plans for insurance for the forseeable future. I don't make enough to buy it independently. My employer doesn't provide any and subsidies are gone from the ACA, so, yep pretty much fucked over here.

Of course, on the same note, this was the flaw with the ACA subsidies being something authorized by the Oval Office and not part of the Federal Budget, which they should have been.

[Cthulhu 2020]

Republicans made up half of the committee that drafted it, it had over 100 republican riders attached to it. They even agreed to pass it at first till they did an immediate about face and switched up to obstruction at all costs to make him look bad with the republicans refusing to get off their ass and do their jobs for 8 years and instead set records for obstructionism. And if I recall correctly, it wasn't rushed through, it took months to get through.

It was good ole Mitch the Bitch and his obstructionism that turned that into a huge deal just as it turned the debt ceiling into some huge deal and tried shutting down the nation twice to get their ways. Along with them refusing to do their job when it comes to hearing Supreme court nominees, leaving us with an illegitimate justice appointed by a president who wasn't his to nominate and refusing to look at the previous nominations all while setting a hugely dangerous precedence.

It was in the drafting process for months, but really same thing. The Trumpkins of course think that when Pelosi said that they'd have to pass it to see what was in it, that means it was "rammed through", when in reality it had been being written for months. Every new draft was available immediately for all members of congress and the senate to read right away, and it was even available online to the public to read.

The reason Pelosi said they'd have to pass it see what was in it, was the Republican propaganda machine was claiming all kinds of horrible stuff was in it. Remember "death panels"? Yeah, Republican media was turning what was a fairly tame bill into a monster. That's why, when the Fox/Breitbart guzzling crowd was asked if they thought "Obamacare" should be replaced with the ACA (and they described all of the stuff that the ACA did) they were like "OH YEAH, ANYTHING IS BETTER THAN THAT OBAMACARE WITH ITS DEATH PANELS!"

Pelosi's full quote makes it far more in context. The "we need to pass it to see whats in it" is an EXTREME abbreviation of her entire quote, which points out all of the controversy being drummed up at the time by the right wing news media. A lot of the controversial statements included stuff that the right wing news media said was going to be added to the bill in the future, but the drafters had no intention of adding. It was all for the sake of turning people against it. And of course it worked gloriously, everyone hated "Obamacare" but loved the ACA at the time. Now everyone who thought they were different things knew they got taken for a ride because of their own ignorance.

It also wasn't passed in the middle of the night with half of the Republicans absent, like some like to claim. It was passed in the late morning with everyone present. It wasn't "rammed through" in the least like they love to claim. It would have had the votes even if they had waited another few months to put it to a vote.

I do still like to have a good laugh at the expenses of the dumbasses who believe everything negative they've heard about the passing of the bill. It gives me a good idea of who is still in reality and who's off in fairy land.

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What? Why did you refuse to get Obamacare and instead pay the fine? Was Obamacare not affordable for you? I thought it was the AFFORDABLE Care Act?

It provided federal funding subsidies for states that accepted them. Conservative states chose to refuse the subsidies and fuck their poor people over just to claim that the bill didn't make things affordable, when it was the state's own refusal of subsidy money that made it less affordable.

Sucks to be poor in conservative states. But "Fuck the poor" has always been the mantra of them good conservative Christians eh?

[Orbitus]

let me ask you, where do you get your health insurance from?

Doesn't matter where he got it, his insurance is going up too.

[Zan15]

Doesn't matter where he got it, his insurance is going up too.

You are 100% correct, everything outside of Medicare/Medicaid is going to see a price bump. i would even argue that Medicare HMO's will even be impacted as insurance companies look to make up the 7 billion in lost premiums.

Just trying to make a point there is no insurance that is not subsidized at this point in one way or another by taxes/govt

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Well, there go my plans for insurance for the forseeable future. I don't make enough to buy it independently. My employer doesn't provide any and subsidies are gone from the ACA, so, yep pretty much fucked over here.

Of course, on the same note, this was the flaw with the ACA subsidies being something authorized by the Oval Office and not part of the Federal Budget, which they should have been.

but but people on ACA don't work, don't pay taxes you are all leeches...... /sarcasm

if trump really cared, and his supporters, they would have passed this as a stand alone funding bill in congress.
but they want to say its because its illegal, and those people are full of shit.
full
of
shit

[Masark]

let me ask you, where do you get your health insurance from?

Probably the Federal Compulsory Medical Insurance Fund.

[Adam Jensen]

Boom goes the dynamite

https://www.cnbc.com/2017/10/12/obam...-insurers.html

The ACA is effectively crippled with that change. Outright fucking sabotage.

He is such a piece of shit, standing there, talking about how "we're all going to get great health care" while he actively works to destroy what we've got.

[PACOX]

It begins

http://thehill.com/policy/healthcare...acare-payments

[Adam Jensen]

From YOUR POV.

From my point of view, the Jedi are evil!

[Breccia]

It continues.

Retiring GOP lawmaker: Republicans now 'own' ObamaCare

Rep. Charlie Dent (R-Pa.) argued Friday that President Trump was “ill-advised” to end key ObamaCare payments, warning that the GOP now “owns” whatever happens to ObamaCare.

“I think the president is ill-advised to take this course of action because … we, the Republican Party, will own this,” Dent, a key House moderate who is retiring from Congress at the end of his term, said on CNN.

Asked about Trump’s previous comments blaming problems with ObamaCare on former President Barack Obama, Dent pointed out that Republicans currently control the White House and have majorities in both chambers of Congress.

“Barack Obama is a former president. President Trump is the president and he’s a Republican, and we control the Congress,” Dent said. “So we own the system now. We’re going to have to figure out a way to stabilize this situation … This is on us.”

Changing the rules of the game, makes it your game. If you kick the market until it collapses, you can't blame some black guy.

[solinari6]

Well, there go my plans for insurance for the forseeable future. I don't make enough to buy it independently. My employer doesn't provide any and subsidies are gone from the ACA, so, yep pretty much fucked over here.

You actually may be OK, according to my understanding. I thought it said that by law, the insurance companies in the exchanges have to cover the government subsidies themselves (or leave the exchanges). So what they will do, is jack up the prices for those who don't qualify for any subsidy (the middle class). Those are the plans that are expected to go up 20% to cover the cost of losing the subsidies. Keep in mind some insurance companies assumed that Trump wasn't going to pay those subsidies, so they already increased their prices for 2018.

[Breccia]

I thought it said that by law, the insurance companies in the exchanges have to cover the government subsidies themselves (or leave the exchanges). .

The CBO has already predicted that insurers will leave the exchanges, leaving 5% of the country living in areas with no ACA coverage. They also said it would cost taxpayers $6 to $21 billion per year, and would spike premiums 20%.

On Friday morning, the two main health insurance industry trade groups, America’s Health Insurance Plans and the Blue Cross Blue Shield Association, issued a rare joint statement calling the payments “critical” and saying “there will be real consequences” to ending them. Consumers’ insurance choices will shrink, costs will rise and the marketplaces will become unstable, they warned.

I'm not sure that counts as "may be OK".

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Here's another:

4 ways consumers will feel the end of Obamacare subsidies

The Trump administration's announcement late Thursday that it will immediately end key cost-sharing subsidies under the Affordable Care Act could translate into higher, in some cases unaffordable, health insurance costs for consumers who rely on the individual insurance market. President Donald Trump said on Twitter that the health care exchanges are "imploding."

The president added on Friday that he considered the subsidies "almost a payoff" to the insurers, and he's ending the payments because he doesn't "want to make the insurance companies rich."

It didn't take long before New York State Attorney General Eric Schneiderman announced plans to sue the administration over the move, along with a number of other state attorneys general. Although unlikely, Congress could appropriate funds for the subsidies, which would end the longstanding legal dispute that opened the door for the administration to stop the payments.

Here's a closer look at four ways consumers are likely to get hit if the cost-sharing subsidies end.

Low-income people will face debilitating out-of-pocket costs

The cost-sharing subsidies were designed to reduce out-of-pocket costs such as deductibles and co-pays for people with incomes from 100 percent to 250 percent of the federal poverty level. About 7 million people are receiving these subsidies in 2017, more than half of the people who buy insurance on the ACA exchanges, according to data from the Kaiser Family Foundation.

Insurers provide the subsidies to consumers, and the federal government reimburses insurers for the higher costs. Those reimbursements are estimated to total $7 billion this year and as much as $9 billion in 2018. At the same time, cost-sharing payments are expected reduce low-income consumers' deductibles by as much as $3,354 each and out-of-pocket medical expenses by as much as $5,587, reported KFF.

Cost-sharing subsidies are different from the tax credits that qualified consumers receive to help offset the exchange-based premiums. Without the subsidies, medical expenses will become unaffordable for many low-income families, even if they purchase insurance.

Everyone will pay higher premiums

Without cost-sharing reimbursements from the government, insurers say they must pass along the costs in the form of higher premiums -- to all customers. Earlier this year the Congressional Budget office estimated premium increases would average 20 percent without cost-sharing subsidies. Higher premiums will affect everyone paying for a silver-level exchange plan (the only level that allows cost-sharing subsidies). And they'll especially hit people who don't qualify for government help with premium costs.

Insurers will disappear

The uncertainty over the future of Obamacare and specifically the cost-sharing subsidies had already caused a large exodus of insurers from the exchanges, leaving many counties with only one choice of insurer in the individual marketplace. Thursday's announcement could easily push many of the remaining insurers to exit the exchanges, even before open enrollment for 2018 begins. In some cases, consumers may find themselves with no affordable exchange choice and, as a result go without health care coverage.

Consumers may turn to alternative insurance plans

The cost-sharing announcement came just hours after President Trump signed an executive order that opened the door for small businesses and individuals to buy alternative types of insurance that wouldn't be subject to ACA regulations. Although the order is being challenged and is expected to take several months for government agencies to implement, consumers who can no longer afford or find exchange plans may eventually turn to these alternatives when and if they become available.

Critics, including many state insurance commissioners, worry that coverage under these plans will be far less comprehensive and actually drive up costs for consumers with preexisting conditions and serious medical conditions, which may not be covered under such plans.