The difference in my coverages between pre and post ACA are that some procedures are now covered at 80% that used to be 100%. That's pretty great right?? The premium and the deductible are higher and the elimination of what once were several in-network facilities is key. ACA has graciously provided my family with less coverage at a higher cost, longer trips for hospitals and specialist and a great feeling of well-being. (yeah) I am so grateful. Please keep going because your point is far from proven in my case.
That's the standard myth - that if your rates went up then you originally had an inadequate policy. Completely false. In the case at my company, the private plan and the ACA plan are almost exactly the same. Same deductible, same total out-of-pocket, same physician network, same 80/20 split after the deductible is met. There are some fees that are different, such as some office visit fees for a specialist are a flat fee (depends on the specialist, I remember some are around $80) on the ACA while on the private plan its part of the deductible & 80/20. In our case, the bureaucracy of the plan between the ACA version and the private version varies, there are slight cost differences that may or may not make a difference (good or bad) depending upon the individual, but the benefits are almost identical, and the cost of the ACA is twice the private plan. And usually when people claim a plan was "inadequate", what does that mean? Does it mean that a woman who could not get pregnant and did not have maternity coverage had an inadequate plan because she was not subsidizing other women's maternity coverage? Claiming people had an "inadequate" plan until obamacare is just a political talking point to try to explain forcing people to enter obamacare and pay exorbitant rates.
The rates went up because HHS was given authority to rule what "minimum essential benefits would be". HHS without Congress intervention ruled that health insurance was inadequate where it failed to include New Born Care, Pediatric Health care, OB-Gyn care; three of the highest costs that increase Health Insurance Premiums. And HHS did this with no regard to the need for such benefits by the individuals or families purchasing health insurance. It is obvious that individuals and couples where the woman is menopausal will never need obstetric care hence wouldn't need newborn care. So, why should they be mandated to pay for this high cost coverage/benefit? There is only one reason, and that would be to lower the average overall cost of insurance for everyone. But, we all, all taxpayers are already doing this by paying for premium subsidy for those that qualify. So we are in effect paying twice and a third time where we are still paying higher premiums to cover illegals and uninsured that are still seeking ER care. IMO our cost has tripled. This is total B.S. For the reasons of I have stated in this post; it is more than obvious our premiums have more than doubled under the PPACA.
Of course the data, which you can very easily find shows that the average increase was in the low single digits. Suggest maybe you should put more effort into figuring our why your increase is so very far above the average.
Your families experience is "norm" for those of us millions that had insurance we liked, perhaps thought we were paying too much for, but find we now pay even more for. While we pay not only to subsidize those uninsured people going to the ER but premiums for millions. Now paying more than we were in taxes and in premiums. ACA has too many problems created through poor legislation and passage of an ACT that no one understood as confirmed by Pelosi.
So you still haven't explained why you think your increases were so far out of the norm. You can maybe argue that the average increase may have been 5% or even 8 % but to have your cost double is so far on the tail end of the average that there should be a good reason. And several of my artist friends and also my brother have dropped their private pre ACA policies and have gone on the exchanges and found insurance at significant savings.
Can't reply for Vino, but here is my reply. while for many young people who never purchased insurance and are eligible for the subsidy or premium assistance; exchange insurance may now be affordable. However, (and only due to my knowledge as a health care provider), most of the insurance companies offering "exchange policies", contacted their providers and advised that if they signed on to these policies they would be reimbursed less than Medicare rates. So many of us decided not to participate. Plus, they reduced the number of choices of hospital and clinics. And, (while many won't find out until they seek treatment), more coverage is being denied. Therefore, after paying premiums for a year, you are likely to find you paid for the majority of your health care, not your insurance policy. And, on top of that, not us, the insureds or taxpayers; but the health insurance companies offering plans on the exchanges are guaranteed a bailout if they lose money. And it will be the taxpayers that pay them this subsidy.
They are not young people who have never purchased insurance nor are they eligable for subsidies. And you still haven't explained why you think your increases are so far above the norm. Maybe your decision not to participate in the exchanges was a mistake, and perhaps you should reconsider if you are unhappy with your current policy. My brother who is sixty one with a wife and two kids and is quite well off saved a significant amount by using the exchange and he is no dummy. And before you ask he has young kids at his age cause his wife is half his age.
I am sure they have but at what cost? Either they have a higher deductible, or a higher co-pay or few choices of providers, and/or when they need to use their insurance they will find that regardless of being pre approved for treatment or surgery, after the treatment is rendered and the bills submitted their insurance will find a reason to disapprove payment. This is happening far too often to our patients. Either we will not be paid for the care we rendered because the patient can't afford to pay us or the patient will be on the hook. We will only attempt collection where are patient earns enough to make minimal payments to us. Unfortunately Obama care's "transparency" was anything but. It is no more transparent than prior to the passage of the PPACA. And it still allows Private Insurance Companies to basically screw their insured individuals and the providers that treat them. Little changed in this regard. While premiums rose(confirmed by the CBO). And the number of uninsured seeking ER care has bartely if at all decreased.
When you say " our patients" I want to know just exactly what is the expertise you are claiming. Are you a physician or a clerk in the compensation department. What is your actual contact and scope with regard to patients. You have made statements like the ACA charges people with pre-existing conditions a premium which is clearly a falsehood, yet you have repeated it several times. Time to list your bonafidies since you keep claiming superior levels of knowledge uncorroborated by your postings.
I myself have a degree in medical administration and medical information and have worked for 30 years in both v.a. hospitals, private hospitals, consulted for nursing homes, taught medical transcription classes, and set up and managed private physician and surgeon practices. My husband in is physician/surgeon and have done his billing for 17 years. So I think I more of an expert than most on this site.
You fell into the PPACA trap of thinking pre-existing conditions wouldn't be considered any longer. Well, pre-existing conditions can no longer be a factor when private insurance makes a decision to insure you. But pre-existing conditions can still be a factor in determing the premium you will be charged. The most apparent is whether you are a smoker now or have been, and I suggest you don't lie when you answer this question. If you haven't smoked in the past 10 years perhaps your premium won't be much higher. But for smokers I suggest you ask how much more they are planning to charge you because of it. You just don't understand the various misrepresentations that exist within the PPACA. I guarantee you that smoking, diabetes, heart disease, liver disease, Aids and the like will cost you more, premium wise even though, you will be offered insurance. Where are before, you likely would be denied insurance. So they can't deny you insurance but that doesn't mean they can't charge you a higher premium than others. Do you get it?
Remember what Jonathan Gruber said (and what the liberal media so easily dismissed)? Well most of the public is stupid and easily fooled when it comes to health care and PPACA. Why? Because unless you work in the field daily you really can't understand how it works, the problems, the ins and outs. And unless you work in the field it is difficult to fully understand the implication of the PPACA. So he, IMO was right. Advising Obama and the Democrats that the People wouldn't understand what was going on, until after the law was passed and began taking effect. Especially, the HHS mandated minimal essential benefits that would require all insurance to include the most costly coverage regardless if the insured would ever need to use such benefits. Entirely mandated to raise premiums and further lower costs to those that needed subsidy, lowering the cost to who? the Federal Government. What a scam. Gruber so right. And the fact that he, President and the Democratic leaders were part of the scam should be illegal, and cause for prosecution. You may be stupid but I am many in the medical field were not. We knew exactly what was going on, objected to it, but were ignored by them and the sheeple.
Other than tobacco use, that's false. 42 U.S. Code § 300gg - Fair health insurance premiums Weren't you billing yourself as some kind of expert on the ACA in another thread? Perhaps best to learn some of its basic provisions first.
