Mature adults insurance premiums capped at 3 X the premium for young people...

[elehhhhna]

is a great incentive to jack young people's rates to the sky. The resulting exponential increases plus an aging population is a recipe for premium cost DISASTER.

And WTF is up w/ passing laws that kick in in 4 or 5 (or 10) years? WHY BOTHER AT ALL?

[ShortnFiery]

1. Young People to Obama ... You can serve 1 and only 1 term: YES! YOU! CAN! eom

[mzmolly]

2. Alelrod said on MTP today no one will have to purchase ins. if the cost exceeds 8% of their income.

:shrug:

[lapfog_1]

4. Not true.

He doesn't yet know what the costs will be.

What he is talking about are subsidies, which are tied to the federal poverty level.

What he is saying is that IF you are under the multiplier of the federal poverty level (at the very top of that income) the most that HE BELIEVES (based on CURRENT premiums) that you would pay is 8% of gross income.

However, it is likely over the next 4 years that premiums will rise. The cap for subsidies is set and will only rise if the federal poverty level rises. Premiums have, traditionally, greatly outstripped inflation (they are one of the biggest contributors to inflation).

So, it's not true.

My own math shows it to be more like 17% of gross income (for an older American, like me). Which is out of reach in my world. Just as out of reach as the current system.

[eleny]

6. 17% is an impossible burden

Ours went up over 30% effective next month. 17% of income would mean that it would go up another 50% for our monthly premiums as they were this past year.

I switched mine to a policy that's pretty much catastrophic coverage effective next month. As I replied in another thread, this is the first step backward for me in 38 years of buying health insurance. And, btw, we get a small subsidy from our retirement association and won't be eligible for Medicare for several years. The horizon is dismal for us.

[hfojvt]

30. not really impossible

I paid 20.76% of my $17,402 income this last year and have since October 2006. I also put an extra $897.95 in my retirement account, not including IRA contributions and the $696 they automatically take out.

[Donnachaidh]

8. isn't there also a plan in the works to DROP the Federal poverty level?

IIRC there was a post within the last week about how that level was to be DROPPED and more Americans will be thrown off the tiny bit of foodstamps and other help they were getting.

[Hannah Bell]

13. yes. i saw it too.

[laughingliberal]

16. Right. It's tied to the Consumer Price Index which has fallen slightly in 2009

Congress can block the decrease but I don't see why they would. If allowed to just go through, automatically, it will drop the amount by $7 a month. Not much you say? I've seen patients thrown off programs (Medicaid, food stamps) for making $1 per month too much to qualify.

[madfloridian]

10. And that would be under a "hardship exemption".

What if you are an average person with no hardship other than strugging to get by.

[eleny]

5. Can you please clarify something about that for me...

Did he mean that everyone's insurance premiums would be capped at 8% of our income?

I didn't see a few minutes of the interview and missed that. In fact, I haven't yet heard anyone say we'd all be capped at 8%.

Tia, mzmolly.

[mzmolly]

7. I think what he means is that you can

opt out of the mandate?

[eleny]

9. So that leaves us with no insurance. Oh great. :(

I see that someone above disagrees with you and has clarified the issue. Sounds dismal.

[mzmolly]

31. That does sound like square

one for many. :(

[subterranean]

19. I think we need to get that in writing.

[dysfunctional press]

27. and you believe him?

[napi21]

3. Postponing implementation was the oly way they could get the total cost under the limit of

$900 billion and not add to the deficit. As far as young people's rates, I believe there is also a committee or board that the ins. cos. have to get to approve rate increases.

[MH1]

11. Doesn't the medical loss ratio provision limit "jacking rates to the sky"?

Reference this informative thread:

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x7264604#7274814

[lapfog_1]

12. Nope, just the opposite.

The medical loss ratio is, in reality, another term for a COST PLUS contract.

The MLR is 15% for groups and 20% for individuals. What that means is that insurance companies are limited to a 15 or 20 percent gross profit margin. There is no incentive to limit costs. In fact, in the cost+ contracting world, there is incentive to INCREASE costs. As costs go up their profits go up (but not the profit margin).

Let's give you an example.

I'm a military contractor building widgets for the DOD under a cost+ contract. My margin is 10 percent profit. So I go build the widget but I need a hammer. Well, I COULD go down to the local ACE hardware and buy a hammer for $14.95. But this hammer is going to be using to hammer titanium, so I look for specialty hammers (never mind that any hammer will work), and I find one from Acme Titanium Hammers. Cost $150. Which do I buy.

Well I get $1.50 for going to ACE hardware and buying an adequate hammer, but I get $15 dollar for ordering the super duper hammer from Acme. hmmm. buck fifty v. fifteen. In my pocket. The jobs still gets done. Its only taxpayer money after all.

Well, sure looks like a good year for Acme Titanium Hammers!!! (and me!)

Bad year for taxpayers.

Mandates are another way of saying "taxes". So it doesn't matter if this is REALLY a check from the government or a check from a mandated consumer.

Where is the cost containment in the MLR?

The only containment will be a review board. But that's a system that can be gamed. In the health industry, replace "hammer" with "CAT SCAN" and see what happens. The doctor could order an X-ray for $200 or a CAT Scan for $2000. The insurance industry (our cost+ contractors now) will council just the opposite of their current "claim denied" policy, it will be "go ahead, get the CAT scan, I'm sure the patient needed it. In fact, standard medical procedures should dictate that ALL patients with belly aches need a CAT scan." Why, because we have created incentive for them to do so. We capped their margin, so the only way to increase profits is to increase costs. If the base medical costs increase, then the premiums have to go up too, and so to will their profits.

Game over.

[Thickasabrick]

17. That was the most understandable explanation I have read yet....thank you.

Unfortunately, I'm bummed now that I understand it.

[Romulox]

15. It does nothing of the sort--it's merely a subsidy from the young and poor to the old and rich

(which these same old and rich will then hand directly over to the insurance companies.)

[subterranean]

21. I don't understand your reasoning.

Older people will pay more than young people.
The poor will get federal subsidies, not the rich.
How does this translate into the young and poor subsidizing the old and rich?

[eridani]

32. More like fucking over the old and poor by making them pay 3 times as much

[rucky]

28. That addresses the limit above cost...

but with no cost controls, who knows what's really going to happen?

[Romulox]

14. Nobody can explain how the poorest Americans (the young) can possibly afford to support the richest

(the old) at a time when wages have been depressed for decades and unemployment, already at a high not seen since the depression, is double for younger people.

They say that no scam can work if it doesn't play on the mark's greed. This is no exception. The funding scheme proposed for this insurance company giveaway is completely and utterly illogical. :shrug:

[vadawg]

18. eek 3 times the rate, a great reason to retire to another country

who wants to spend all their retirement on paying premiums....

[DeschutesRiver]

36. Awhile back, Canada changed some of their immigration policies

one had to do with people who are children born to former Canadian citizens. From a quick glance, it seemed that I'd qualify to become a Canadian citizen, or to have dual citizenship (mom was Canadian born and raised).

I didn't explore it in depth then, but maybe I should take another look to see if I really do fit into the exemption while it is still on their books. At the time, I didn't want to totally relinquish US citizenship, nor did I want to be bound by the laws of two countries instead of one.

What my Canadian relatives always came to the States for was cheaper consumer goods like clothing and shoes, etc way back in the day. I don't recall better health care being a part of what they came here to get on their visits. In return, we just took in loads of things my mom grew up with, like Roger's Golden Syrup.

[Nikki Stone1]

20. Young people will be paying for insurance they don't use or need for 20 years.

Ah well. It looks like they are going to force this piece of shit bill through the Congressional anus.

[subterranean]

22. Contrary to popular belief, young people do sometimes get sick

and they are not immune to accidents or injuries.

[Thickasabrick]

23. But the odds are that they will not get sick which is why they typically

do not buy it if they don't have it through work.

[Nikki Stone1]

24. Exactly. And it's because they don't that they are being forced into the system.

..

[Thickasabrick]

25. And.....make them resent the party that "forced" them to do it......it's

a problem for us I think.

[Fire_Medic_Dave]

26. You've got to get money for the program somewhere. It's just a shared cost.

You are precisely right most don't need the insurance but without their payments into the system and their very few costs to the system it won't work.

[dysfunctional press]

29. as well they should.

rather than just counting on society to bail them out if something happens.

[mainer]

34. Young people get into accidents -- high cost accidents

Motorcycles. Head injuries. Etc, etc.

Years ago, I worked in a rehab hospital, and almost everyone on the head-injured and spinal-injured floors were young people. Whose lifelong medical bills will far out-cost any old person's heart attack.

[Statistical]

33. Not that I disagree with your premise but 3x is a LINEAR increase not EXPONENTIAL

Sorry the Computer Science side of my brain rebelled against the false statement.

There are no exponents in the equation m = 3y

http://en.wikipedia.org/wiki/Exponential_function

Of course "The resulting linear increase plus an...." isn't quite as catchy. :)

[mainer]

35. Young people also get pregnant.

And get leukemia and Hodgkins.