The Terrifying Stakes Of Repealing Obamacare Without A Clear Replacement

[Macaquerie]

If they do repeal Obamacare, it won't go into effect until at least after the 2018 midterms, so that Republicans in Congress will be sheltered from the inevitable electoral fallout. They will presumably spend the next four years or so coming up with a replacement plan, and if and when they've drafted and passed that, take another four years before it actually goes into effect.

[Machismo]

The overall cost is negative because healthcare spending is $2.6T less than where it would be without the ACA. By repealing ACA, you are advocating the increasing of healthcare costs and increasing the deficit.

The ACA contains both savings and taxes. The taxes don't apply to people that are not high income, meaning that they are not a cost for anyone but rich people. So you want to explode healthcare spending to unsustainable rates, as before the ACA, despite your phony concerns, remove the cost control measures that have brought healthcare inflation to a record low, kick 30M off healthcare insurance so that they can go broke or die if they get sick, in order to give a tax cut to the rich.

The exchanges are not faltering, enrollments are at record highs. You've shown no examples, so that makes you a liar. Like when you linked to an article insinuating healthcare inflation is out of control when in fact it's at record lows, which was another lie. Your claim that ACA made the healthcare spending problem worse when in fact it has made it better, also a lie.

Until you put down the ideology, stop ignoring the debunking of your nonsense, and get with the facts, you cannot be helped.

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It doesn't favor insurance companies because ACA regulates the % of premiums that insurers must pay out for healthcare (60% to 90% depending on plan type). This effectively caps the profit margin from health policies (they can still squeeze profits from other non-policy related areas like administration).

Getting insurance on the same day you need it would bankrupt insurance companies, but would not bankrupt the government. That's why single payer systems work in every other advanced country, providing more coverage than the US, at cheaper prices, and with better health outcomes (it's effectively a free lunch).

You are flat out delusional... $2.6 trillion less...

The taxes count, end of fucking story. Just because other people are paying them, doesn't mean it's not getting paid. Until you grasp that simple concept, you aren't even in the same conversation.

I provided sources, you summarily dismissed them.

Luckily, we won't have to find out, because the ACA is going away.

[Mormolyce]

I had an operation last year. I am uninsured.

It cost me nothing.

Sure the wait time was ages (because it wasn't urgent/life threatening) and public hospitals aren't exactly luxury resorts, but hey, pretty good for $0.

That's what universal healthcare is. Just to keep things in perspective.

[Deleted]

It's so cute hearing Trump supporters say "Well I'm sure Trump is not gonna repeal it without a plan" BWAHAHAA

[Shadowferal]

Second:
This is the attitude of being a welfare queen because the moment you need healthcare somebody else already paid for you to have the system in place.

Don't make incorrect inferences. I'm not on welfare. I have a job.
And considering my age, I'll be on medicare long before I'll need any other health insurance.

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If they do repeal Obamacare, it won't go into effect until at least after the 2018 midterms, so that Republicans in Congress will be sheltered from the inevitable electoral fallout.

If they don't...and all they do instead is talk about it, there will be fallout.

[Barael]

The Terrifying Stakes Of Replacing Obamacare With Trump Steaks

[Barnabas]

As a physician, I have not seen the ACA favor me or my co-workers. What I've observed in the past 8 years is increased red tape / administration with the actual caregivers expected to tighten the belt (no cost of living increase, wage cuts, more work but stable wage, and/or lay-offs).

For patients? Some good, some bad...

How did the ACA mandating people buy insurance not favor the insurance companies and hospitals (or so the administrators thought)?

How often do you get no shows? Has it been an increase like doctors have told me?

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becuase they have allready said they plan to replace those parts they get rid of. A start would be removing the penalty for not having it. Pretty fucking dumb to fine people money for not being able to afford somthing.

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go look it up, you need alot more than what republicans have.

Within the next 4 years it will be repealed and replaced.

[Garnier Fructis]

Wouldn't it be better if it went down instead of up? Or at least if it slowed even more? What's the point of spiking Trump for wanting to deliver something that is good for all?
When Obama was raving around with his Obamacare all he had for it was saying it will be better and a lot of people saying it will not be. Would repealing Obamacare have such a large popular support if it was so good?

Yes, because groupthink isn't always correct. If a bunch of people are totally mislead on how Obamacare affected prices, e.g. like you, then it's completely reasonable that a bunch of people want to get rid of it even if doing so would fuck them over.

It would be great if prices slowed more or even went down. I don't doubt that Trump wants to do that. But so far that's basically what his plan amounts to. "I want to do this, this and this, MAGA!" but with essentially no specifics on how we're actually gonna achieve any of that shit.

[Fugus]

Republicans had a full plan on the table while obamacare was being passed, put together by a medical doctor congressman, the democrats just wouldn't let it be voted on. Republicans have a plan now, denying it won't make it any less so. They're easy enough to find if you want to look. And obamacare rates went up faster than in previous years. Some people though found their rates go up much higher than others because obamacare outlawed several plans, meaning that people who were on discount plans found the next best plan sometimes 4x more expensive, and since they made to much for subsedies, had to drop their healthcare as a result.

You may say that the republicans haven't offered one that isn't worse, but that's a matter of perspective, Obamacare has a very bad reputation out there, more people say they'd prefer healthcare the way it was before Obamacare, than the current state of obamacare.

What is this mythical plan the had on the table at the same time as Obamacare? Because all I heard of was Romneycare which was essentially just another Obamacare. And saying they have a plan even when they don't as you have done won't make it so either.

And I know Obamacares rates went up in the past year, I never said otherwise. I said that insurance rates slowed their increases after Obamacare's passage. And most of the ones I have heard where their rates went up it was due to them having junk plans that covered virtually nothing.

And again, I never said Obamacare had a good reputation, it was a half measure when a full measure was needed. I don't even care for it. I said that it was still superior to what we had before and anything that the republicans have brought forward. And from what I have heard, the majority still say they prefer the ACA to what we had prior. And is the truth, the ACA, despite all it's faults, is still superior to what it replaced and would have been even better if it hadn't been blocked in multiple states including my own driving rates up higher or they hadn't removed the ability to buy into medicare which would have been a huge help.

The fact remains, that the republicans have proposed no plan that is superior to it. And even Trumps description of his plan he claims to have seems to either be describing the ACA anyways and just renaming it instead or a single payer solution which the republican party doesn't want and would rather rip than own dicks off and throw in down a river than let it pass.

[Zan15]

As a physician, I have not seen the ACA favor me or my co-workers. What I've observed in the past 8 years is increased red tape / administration with the actual caregivers expected to tighten the belt (no cost of living increase, wage cuts, more work but stable wage, and/or lay-offs).

For patients? Some good, some bad...

How did the ACA mandating people buy insurance not favor the insurance companies and hospitals (or so the administrators thought)?

Favored health insurance companies so much they are all dropping out because they don't have time to count all that money.


15-20% limitation on profits & expenses did not even cover expenses, they were losing money so they dropped out. Don't really need much more proof then that.

[judgementofantonidas]

Why not? Do you not have forced auto-insurance? What about liability insurance? Why should people be forced to have that.

I rather force people to have insurance that they pay at least a little bit for, then them showing at the emerg without insurance, and getting covered fully on the tax payers dime.

vehicles are a luxury.
your life is not.

[Zan15]

You're going to have to prove this, because I've never had an insurance policy that worked like this in my lifetime.

i worked for an insurance company for 25 years, doing contracting. this policy and benefit is in almost every plan CIGNA sells. Its also in almost every plan Aetna sells. of course none of this stops a self funded corporate plan chosen by your company from doing the opposite. your company makes this choice not the insurance companies. The option is standard, non standard is to remove it to save money and pass on cost to the insured.


if you go to the ER and then are hit with several out of network providers bills, like anesthesia, er physician, specialist bills they will be paid at the in-network level of benefits.


if you have cost sharing, like a 20% in-network coinsurance, it will cost you more then an in-network provider.....because they have no contract with this provider an most likely have to pay their 80% share off billed charges, where a contracted doctors allowance would be much much lower.


but you won't owe as much as you would if they applied a out of network level of benefit of say 40% out of network coinsurance.


Most people think they are being paid out of network when in fact they are being paid in network benefit you just owe a lot more because there is no contractual agreement between that doctor and your insurance company. '

Normally you would get billed say 500 dollars, contract rate of an in-network doctor is 100 dollars and you owe 20% = 20 bucks
Out of network doctor. Billed 500 dollars, no contract rate so rate is 500 dollars, you owe 20% = 100 bucks.

There is nothing an insurance company can do about this since they don't have a contract, they could charge you 50000 if they wanted to. This is what happens with 99% of anesthesiologist since they are hardly ever contract because they know even without contracts they would be needed 99% of the time and no one has a choice.






this is also law in NY plans, as well as 24 states in total have some kind of protection.




The solution is Medicare type single payer, where even if you are not contracted or participating you can only bill for up to 125% of Medicares contractual rate...federal law today.

[Tinykong]

i worked for an insurance company for 25 years, doing contracting. this policy and benefit is in almost every plan CIGNA sells. Its also in almost every plan Aetna sells.

This isn't proof, this is just you posting more information without a citation.

[Zan15]

This isn't proof, this is just you posting more information without a citation.

This isn't proof, this is just you posting more information without a citation.

sigh, no idea why i would have any benefit from lying to a total stranger....but ok....



25 states have laws, not sure what more you want. you can google surprise billing and get all the state laws you want.

also the ACA rules prevent it as well, which is easily googled. They can't be charged the higher out of network copay/deductible/coinsurance for emergency services where they did not have the ability to choose.


i can give you specific examples if you want, here is an example of some of their standard policies. All of which could be found by a simple google search.

i could give you more specific information from plan benefits, but i think those companies would be pissed. Some plan booklets can also be found on line if you want to read through them


https://cignaforhcp.cigna.com/public..._nonparlab.pdf

Administrative Policy

Cigna reimburses covered laboratory and pathology services from non-participating laboratories and
health care professionals at the applicable out-of-network benefit level (if available).

Covered Services from a non-participating laboratory or non-participating health care professional may
be reimbursed at the customer's in-network benefit plan level in limited circumstances if:

• Laboratory and pathology services are associated with a true emergency service visit.

• Federal or state law requires that laboratory and pathology services are to be paid at the innetwork
benefit level.

• Laboratory and pathology services are not available from a participating laboratory and the
services are Covered Services (medically necessary and a covered benefit). Services will be
reviewed to determine if Cigna's Network Adequacy Policy applies.



it will still cost you more money because they can bill whatever they want, but it will be paid at the in-network level...not out-of network since you had no control over having to use them


Or how about aetna

https://www.aetna.com/individuals-fa...work-care.html

You are covered for emergency care

You are covered for emergency care. You have this coverage while you are near your home or traveling. That includes students who are away at school.

When you need emergency care (for example, due to a heart attack or car accident), go to any doctor, walk-in clinic, urgent care center or emergency room. When you have no choice, we will pay the bill as if you got care in network. You pay your plan’s copayments, coinsurance and deductibles for your network level of benefits.

We’ll review the information when the claim comes in. If we think the situation was not urgent, we might ask you for more information and may send you a form to fill out. Please complete the form, or call Member Services to give us the information over the phone.

just in case you missed it
When you have no choice, we will pay the bill as if you got care in network
When you have no choice, we will pay the bill as if you got care in network
When you have no choice, we will pay the bill as if you got care in network

[Zeta333]

How often do you get no shows? Has it been an increase like doctors have told me?

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Within the next 4 years it will be repealed and replaced.

unless 8-9 democrats vote for them it wont be repealed.

[Zan15]

How often do you get no shows? Has it been an increase like doctors have told me?

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Within the next 4 years it will be repealed and replaced.

problem is it will be repealed in year 1, replaced in year 4.1

.....

[Tinykong]

sigh, no idea why i would have any benefit from lying to a total stranger....but ok....

Who said you were lying? I asked you to provide some citations, because you made a claim that doesn't seem realistic to me.

And, as I suspected:

of course none of this stops a self funded corporate plan chosen by your company from doing the opposite. your company makes this choice not the insurance companies.

None of what you just posted matters, because most people are insured by their employer, and therefore don't control whether or not the policy has this benefit.

The correct statement is "some people with some insurance plans are protected in some emergency situations from out-of-network balance billing.

Suggesting most people are is incorrect.

[Zan15]

Who said you were lying? I asked you to provide some citations, because you made a claim that doesn't seem realistic to me.

And, as I suspected:



None of what you just posted matters, because most people are insured by their employer, and therefore don't control whether or not the policy has this benefit.

The correct statement is "some people with some insurance plans are protected in some emergency situations from out-of-network balance billing.

Suggesting most people are is incorrect.

are you suggesting most people don't have this standard benefit/policy? where is your proof? Where is your citation?



These are standard plans. You are talking about the abnormal and minority. It's been years since i even seen one.
do they exist, possibly. Self funded plans can do anything they want outside of federal law because of ERISA. They can do crazy shit like give you 99% coinsurance if they wanted to, but they don't. They could even deny all hospital services and just give you a physician plan only if they wanted too.



the procedures i listed are standard operating procedures of health insurance companies. Standard.
They follow state law and ACA requirements.
Very few companies take advantage of saving money operating outside of standards.


But hey what do i know i only been in insurance for 25 years doing contracting and benefits at two companies that cover 60% of all benefit plans issued.

Guess i have to go find citation
feel free to give me your plan name, policy number and i will call your insurance company for you. don't have to give me your name or id...just the company plan #. i can ask them a generic policy question about your plan and benefits without knowing anything specifically about you

[unfilteredJW]

lol. Point right over your head.

Ask them about swiftboating.

[Lumineus]

Two ways

1. Go to emergency room and get treatment, be unable to pay bills and declare bankruptcy, taxpayers proceed to foot the bill.

Taxpayers foot the bill either way. Even with the crappiest coverage where you burn through an ungodly five figure deductible before the insurance company will pay a red cent, it's a drop in the bucket of major surgeries and proprietary meds. This outlay is subsidized via incentives to the insurance companies, which are then paid for with tax money.