People complainign their insurance is going up with the ACA

[boomerang]

(Interesting note: while the ACA says you can't be denied insurance did ou know that you actually can? Turns out that if an insurer has an adequate network but that network is at capacity they can refuse to sign up any additional subscribers.)

Will they have waiting lists? You know, so people can brag that they just got into such and such a network? Just kidding...

 

[boomerang]

My plan, and my wife's, have required this for years. Long before ACA. Both plans have requirements that if the spouse of the insured has an employer provided plan where the employer covers > 50% of cost, they have to participate in that plan in order to be covered by the other spouses plan as well.

I think what he's saying is that there will no longer be primary and secondary insurers. You'll both be covered under one plan, or you'll each have your own plan. No more double dipping.

I've misspoken or at the very least have not been clear. If a husband and wife have different employers, each of which provide health care for their employee's, there will be no coverage provided for the spouse.

If my understanding is correct.

 

[Londo_Jowo]

My plan, and my wife's, have required this for years. Long before ACA. Both plans have requirements that if the spouse of the insured has an employer provided plan where the employer covers > 50% of cost, they have to participate in that plan in order to be covered by the other spouses plan as well.

Many employers are going to end spousal coverage if they can be covered by their respective employer's plan (Husband covered through his employer and wife through her employer).

 

[soulcougher73]

We just got our new health care premiums/options for the new year. The plan i was on is the same price this year as last year and as an added bonus our company added a HSA as well this year.

 

[Atreus21]

Is is possible that the current structure of our health care system is responsible for the high costs? Is it possible, could it be possible that a great many people who receive their income from health care expenditures do not actually produce any health care (health insurance company employees and executives, medical billing specialists, insurance brokers, company benefits plan managers, insurance and hospital advertising services, etc.)?

Obamacare cannot fail simply because our health care system was a failure before anyone had even heard of Obama. Obamacare is not even a system. If health care were a car, Obamacare would be a new paint job. If your newly-painted car breaks down for pre-existing mechanical reasons, the paint job is not the problem, though some people will blame the breakdown on account of the car having been painted blue when it was white before.

Or is it possible that healthcare costs rise because no one cares about prices? You know, just like why college tuition has risen?

 

[Pens1566]

Many employers are going to end spousal coverage if they can be covered by their respective employer's plan (Husband covered through his employer and wife through her employer).

Yes, that would be a difference. I read the original post in a different context. That would bring up interesting question about the "+ Family" option on employer provided coverages.

 

[Pens1566]

Or is it possible that healthcare costs rise because no one cares about prices? You know, just like why college tuition has risen?

Might be true for preventative/elective costs. Absolutely doesn't apply to catastrophic treatments like heart attack or trauma where one can't exactly shop around.

 

[boomerang]

We just got our new health care premiums/options for the new year. The plan i was on is the same price this year as last year and as an added bonus our company added a HSA as well this year.

Might be because of this. Do you work for a self-insured employer?

http://www.forbes.com/sites/bruceja...obamacare-large-employers-will-keep-coverage/

 

[werepossum]

http://www.forbes.com/sites/theapot...pending-by-7450-for-a-typical-family-of-four/

There you go OP... Dispute it. It's already costing me $1000 a year more... And that isn't in health care premiums, but the cap on the FSA.

I got hit by that same thing with an HSA. My out-of-pocket deductible (before insurance kicks in) was raised from $2,700 to $3,700 by Obamacare. Apparently the insurance we have because we cannot afford conventional coverage is "too good".

Everyone should understand that because the main purpose (or at least, open purpose) of Obamacare is to provide insurance to people currently without insurance, our national total spending on health care WILL go way up. That means that each of us will be spending more, except for those that our spending is supporting. There's no other way. As for why American medicine is so expensive - the Chattanooga area serves roughly half a million people. Canada has roughly 35 million people, with far lower population density. The Chattanooga area has about the same number of MRI machines as the nation of Canada. Canada has queues for advanced diagnostic and treatment equipment; we spend money to avoid those queues. There are many other factors, but that's the gist of it.

 

[boomerang]

What happens with the underground economy? The illegals, the drug dealers, the people that earn a living off the radar. The people that do not file income tax returns? The people that the IRS essentially don't know exist.

When they get the bug that's going around or an ear infection, in other words something minor and easily cured, I suppose they can find a Doctor willing to accept cash. What happens when have a compound fracture in their leg or get taken into the hospital in an ambulance and require a stent or a major invasive procedure? In other words, something costly.

When they have not complied with the law by not getting insurance on the exchange, what obligation is a hospital under at that point? How do they get reimbursed? Are they obligated to treat? Must they inform the authorities?

 

[palehorse]

I think what he's saying is that there will no longer be primary and secondary insurers. You'll both be covered under one plan, or you'll each have your own plan. No more double dipping.

I've misspoken or at the very least have not been clear. If a husband and wife have different employers, each of which provide health care for their employee's, there will be no coverage provided for the spouse.

If my understanding is correct.

Actually, and sactoking can correct me if I'm wrong, I believe ACA doesn't require spousal coverage at all.

Therefore, it's possible that your employer-provided plan can deny spousal coverage completely even if your spouse is unemployed or doesn't have an employer option of their own -- thus forcing said spouse to use the exchanges.

Sactoking?

 

[MooseNSquirrel]

I got hit by that same thing with an HSA. My out-of-pocket deductible (before insurance kicks in) was raised from $2,700 to $3,700 by Obamacare. Apparently the insurance we have because we cannot afford conventional coverage is "too good".

Everyone should understand that because the main purpose (or at least, open purpose) of Obamacare is to provide insurance to people currently without insurance, our national total spending on health care WILL go way up. That means that each of us will be spending more, except for those that our spending is supporting. There's no other way. As for why American medicine is so expensive - the Chattanooga area serves roughly half a million people. Canada has roughly 35 million people, with far lower population density. The Chattanooga area has about the same number of MRI machines as the nation of Canada. Canada has queues for advanced diagnostic and treatment equipment; we spend money to avoid those queues. There are many other factors, but that's the gist of it.

That's just flat out untrue.

http://www.theatlantic.com/magazine...american-health-care-killed-my-father/307617/

http://www.forbes.com/sites/toddhixon/2012/03/01/why-are-u-s-health-care-costs-so-high/2/

http://www.denverpost.com/opinion/ci_12523427

 

[boomerang]

Actually, and sactoking can correct me if I'm wrong, I believe ACA doesn't require spousal coverage at all.

Therefore, it's possible that your employer-provided plan can deny spousal coverage completely even if your spouse is unemployed or doesn't have an employer option of their own -- thus forcing said spouse to use the exchanges.

Sactoking?

Yes, I believe you're right. Just read of this today. Spouses and children also IIRC. I read so much damned stuff that I can never remember where I saw it to link to it. There was an oversight when drafting the law.

 

[palehorse]

Yes, I believe you're right. Just read of this today. Spouses and children also IIRC. I read so much damned stuff that I can never remember where I saw it to link to it. There was an oversight when drafting the law.

Actually, coverage for children IS required until they're 26 years of age. However, the section of the ACA that spells out that requirement is the very same section wherein mandatory spousal coverage was intentionally omitted.

It wasn't an "oversight" -- they very much want spouses to be forced onto the exchanges.

Remember, the primary goal of the ACA, as a whole, is for EVERYONE to be forced onto the exchanges...

 

[sactoking]

Actually, coverage for children IS required until they're 26 years of age. However, the section of the ACA that spells out that requirement is the very same section wherein mandatory spousal coverage was intentionally omitted.

It wasn't an "oversight" -- they very much want spouses to be forced onto the exchanges.

Remember, the primary goal of the ACA, as a whole, is for EVERYONE to be forced onto the exchanges...

You are correct that spouses do not have to be covered by an employer plan under any circumstance. Children (technically "dependants", which can be more than children) must be covered but the coverage does not have to be "affordable", meaning that the employer does not have to pay for the dependants' cost.

It's worth noting that spousal coverage wasn't intentionally omitted. The relevant language in the ACA for employers was written as "employees (and their dependants)". It was intended that spouses would be covered. However, in drafting the rules interpreting the ACA, Treasury and HHS noted that the relevant language fell under multiple jurisdictions with differing definitions of a "dependant" and the only way to properly resolve the issue was to use the Trasury definition, which does not include spouse. Had they used the PHSA definition then it would include spouse, but then the tax code would have been messed up.

 

[boomerang]

You are correct that spouses do not have to be covered by an employer plan under any circumstance. Children (technically "dependants", which can be more than children) must be covered but the coverage does not have to be "affordable", meaning that the employer does not have to pay for the dependants' cost.

It's worth noting that spousal coverage wasn't intentionally omitted. The relevant language in the ACA for employers was written as "employees (and their dependants)". It was intended that spouses would be covered. However, in drafting the rules interpreting the ACA, Treasury and HHS noted that the relevant language fell under multiple jurisdictions with differing definitions of a "dependant" and the only way to properly resolve the issue was to use the Trasury definition, which does not include spouse. Had they used the PHSA definition then it would include spouse, but then the tax code would have been messed up.

Thanks for the explanation. I've been combing through my history trying to find the article where I read this information. Multiple computers makes it a difficult task.

 

[bshole]

I'd be curious to know what percentage of job loss you'd deem to be warranted so you can have your way. /

Not sure what you are getting at. Relieving companies of supplying this service would free up a ton of money for them and make them more efficient.

 

[Londo_Jowo]

Not sure what you are getting at. Relieving companies of supplying this service would free up a ton of money for them and make them more efficient.

I think you will see both possible layoffs for non-essential personnel and reduction in hours (below the threshold required to provide health insurance) so they don't have to provide this service making themselves more profitable.

 

[bshole]

I think you will see both possible layoffs for non-essential personnel and reduction in hours (below the threshold required to provide health insurance) so they don't have to provide this service making themselves more profitable.

Um I was arguing for socialized medicine, thus NO company would be allowed to provide healthcare. The government should be the sole provider of healthcare insurance.

 

[Londo_Jowo]

Um I was arguing for socialized medicine, thus NO company would be allowed to provide healthcare. The government should be the sole provider of healthcare insurance.

That's all we don't need...government control of insurance/healthcare. Panels to determine what treatment should be provided and whether or not to deny said treatment based on age and invoke end of life counselling. Then again that should help the SS/pension shortfalls.

Hmmmmm maybe this is what Obamacare is all about, young liberals/progressives killing off the baby boomers and older conservatives.

 

[bshole]

That's all we don't need...government control of insurance/healthcare. Panels to determine what treatment should be provided and whether or not to deny said treatment based on age and invoke end of life counselling. Then again that should help the SS/pension shortfalls.

But we can trust the same corporate mendacious mercenary genuises (who just shipped all our jobs overseas)? Given the innate evilness of rich people, I would trust bureaucrats over rich vultures with my healthcare insurance EVERY day of the week. Compare America's healthcare to any other first world nation. The results speak for themselves.

 

[Londo_Jowo]

But we can trust the same corporate mendacious mercenary genuises (who just shipped all our jobs overseas)? Given the innate evilness of rich people, I would trust bureaucrats over rich vultures with my healthcare insurance EVERY day of the week. Compare America's healthcare to any other first world nation. The results speak for themselves.

So why do Canadians come to the US for treatments and operations? Could it be that their healthcare is rationed and those who can afford to do so as they would never receive such treatment/operations with their healthcare in country?

Why do so many Europeans go to Thailand for operations? Why can't they receive these operations in their own country? Flights to Thailand are cheap but not that cheap.

 

[xj0hnx]

Why weren't they complaining when it went up every year before the ACA?

People have been complaining about the raising cost of healthcare for decades. Don't be a moron.

 

[poofyhairguy]

Panels to determine what treatment should be provided and whether or not to deny said treatment based on age and invoke end of life counselling.

This is exactly what the country needs to FINALLY reign in healthcare costs. We need to be told no. We need rationing. We need the "customer is always right even if I can't afford to pay for it" mentality taken out of healthcare.

But politicians don't have the balls to push it, and insurance companies are better at marketing ("Death Panels").

So instead of it being a government system we will pay an extra 14 or whatever percent on top for private insurance "death panels" so that someone other than the politician can be the bad guy.

 

[bshole]

So why do Canadians come to the US for treatments and operations? Could it be that their healthcare is rationed and those who can afford to do so as they would never receive such treatment/operations with their healthcare in country?

Why do so many Europeans go to Thailand for operations? Why can't they receive these operations in their own country? Flights to Thailand are cheap but not that cheap.

Canadians pay MUCH less than us and are MUCH more satisfied, who would have thunk?

Put into an international perspective, however, Canada's system looks to be relatively well liked. A 2011 Gallup Poll found that 57 percent of Canadians felt "satisfied" or "very satisfied" with their access to health care services (in the United States, that number stood at just 25 percent).

Without rich bastards taking their bite, costs go down.

This probably has a lot to do with the lower unit cost of health care in Canada. An MRI that costs, on average, $1,200 in the United States comes in at $824 north of the border. It also has to do with lower administrative costs: A 2010 Health Affairs study found that doctors in Ontario, a Canadian province, spent $22,205 each year dealing with the single-payer agency, compared to the $82,975 American doctors spend dealing with private insurance companies, Medicare and Medicaid.

http://www.washingtonpost.com/blogs...-know-about-canadian-health-care-in-one-post/