Co-pay, deductible, and premium cost...what stops them from skyrocketing?

[SHRED]

What, in this current health insurance "reform", keeps the cost of these at affordable levels?

At what level of income is a person eligible for subsidization?


----

[leftstreet]

1. That's why Obama wants a PO - to keep the insurance companies honest

:beer:

[SHRED]

2. He does?

I missed that one.

[leftstreet]

5. But...but...he SAID

And the insurance reforms that I've already mentioned would do just that. But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange.

http://www.whitehouse.gov/the_press_office/remarks-by-the-president-to-a-joint-session-of-congress-on-health-care/

[SHRED]

6. KEYWORD: "said"

[leftstreet]

7. oh

what a surprise!

NOT

[DJ13]

3. The charity and goodwill of those honest corporate insurance companies

I think Im going to be sick.
:puke:

[leftofcool]

21. Me too

[mdmc]

4. Pagin public option

anyone?

[Lil Missy]

8. What's stopping them now?

[girl gone mad]

11. The fact that people can opt out of the insurance market..

and pay out of pocket, travel to foreign pharmacies and clinics or do without care.

Which is why taking that control away via mandates is insanely irresponsible.

[Lil Missy]

31. That's the republican position, but it doesn't help people who CANNOT AFFORD INSURANCE, nor

do they have the funds to travel to foreign clinics and pharmacies. Jeezus.

[latebloomer]

9. Apparently, nothing

There was no regulation on their insatiable greed now, and there will continue to be none.

We're not allowed to rile up the insurance companies.

[depakid]

10. Same sort of thing that's stopped them from skyrocketing in states that have regulatory power

Like say, California and Oregon.

Not sure what the exact levels of income are (there's a formula for that) but my understanding is that subsidization is limited to high deductible, high copay plans with provisos for some limited, up front utilization for preventative care and screenings.

[Better Believe It]

12. The Health Insurance Rate Authority stops them! Oh damn. It's been yanked from the bill.

Who would have thunk?

[laughingliberal]

13. People up to 133% of FPL will be eligible for Medicaid

After that there will be subsidies to for people who are at up to 400% of FPL. Subsidies start at the lower income levels to limit people to paying not more than 3% of their income for premiums and regress up the income scale to those at 400% of FPL who will be limited to paying 9.8% of their income. After that a person is responsible for the entire premium. If the premium exceeds 17% of their income they will be given a waiver so they will not be fined for failing to obtain insurance.

[SHRED]

15. Will the IRS be the enforcer?

[laughingliberal]

20. yes. nt

[Political Heretic]

26. That doesn't answer the OP question at all.

[eridani]

33. Yep. Good luck in their hunt to find a doctor who will see them n/t

[Luciferous]

35. That doesn't mean that we are stopping costs from skyrocketing though.

All that means is that the government is subsidizing skyrocketing costs.

[madrchsod]

14. oh crap du`s expert on the healthcare bill must be posting somewhere else tonight.

[subterranean]

16. Plans in the exchange will have limits on deductibles and out-of-pocket costs.

You'll be eligible for sliding-scale subsidies up to 400% of the Federal Poverty Line.

As for premium increases, I'm pretty sure they'll have to get approval from some regulatory official.

[SHRED]

17. What if you choose to retire...

...at 55?

What if your income is "optionally" lower?


----

[laughingliberal]

22. No, they won't have to get approval from some regulatory agency

That was not in the bill at all. Diane Feinstein did introduce a bill to give HHS authority to evaluate and decide on requested premium increases but that was shot down by the Senate parlimentarian today as being undoable under reconciliation.

As for the limits on out of pocket costs and deductibles for the bronze plan (which is the one people will get with the subsidies), they are:

Actuarial value: 60%
Deductible: $2000
Out of pocket maximum: $5000 individual; $11,900 for family plans

There is no subsidy for these costs, just for the premium.

[subterranean]

25. Then I sit corrected.

That Bronze plan doesn't look too attractive. I wonder what the premiums will be for that.

[laughingliberal]

28. Premiums for the bronze plan will depend, like all the others. on age and a couple of other factors

like smoking. The subsidies will depend on your income.

[Political Heretic]

27. Subsidies don't stop premiums from rising, and don't cover the full ammount.

So what part of that is an answer to the OP question?

In fact, subsidies would only encourage insurance companies to raise rates.

[Luciferous]

37. Exactly. If the government is willing to shell out for this, why wouldn't they take advantage of it?

It's a massive giveaway to insurance companies.

[unblock]

18. i think they have to return a particular percentage of premiums as claim payments

so no matter what the contruct is in terms of copays, deductibles, premiums, and whatever else they concoct, they can only keep a certain percentage.

of course, the entire pie can get much larger, but their percentage is still limited.

meaning, despite copays and deductibles, they still have to pay 85% (or whatever the number is) of premiums out in claims.

[laughingliberal]

24. The MLR of 85% is an easily manipulated level

20 years ago the average MLR (without any regulations) was over 90%.

[Ean Juan]

19. People with employer insurance should expect savings of $0-300 per year

In premiums. Most of those with individual insurance will see significant reductions in the premiums they pay, thanks to the subsidies.

Factcheck.org: "What CBO said (see Table 1) is that for those who are in group policies, there would be no significant change in premiums, compared with what would be paid under current law. For those in large groups, there would be somewhere between no change at all and a 3 percent decrease in premium cost. For small groups, the change could fall between a 1 percent increase and a 2 percent decrease.
The only significant increases would be seen by those who buy their policies individually, CBO said. For those persons, the average premium per person would be between 10 percent and 13 percent higher."

http://factcheck.org/2010/02/health-care-summit-squabbles/

[Abq_Sarah]

23. Uh-huh

Once again the self employed get the shaft.

[martymar64]

29. nothing

[martymar64]

30. nothing

[Kitsune]

32. Nothing. That's the way they want it.

And the insurance mafia always gets what it pays for.

[branders seine]

34. nothing.

they will.

[gmoney]

36. Free market competition!

:rofl: :rofl: :rofl: :rofl: :rofl: :rofl: