The Dismantling of ObamaCare - Ongoing Updates.

[tonyisme]

Yeah I think they should change the rules and reestablish underwriting for the old grandfathered plans and get new premium coming in and I'm certain the government could put an infusion of money into carriers that have grandfather ndividual plans and that would help at least it would minimize the losses.... the beauty here is a lot of Physicians and Hospitals still have the old plan network contracts so people can still use their Doctors and Pharmacy plans.

 

[AllenChicago]

The health insurance market will stabilize when underwriting is allowed, and not before.

We will never see a robust IFP market as long as DC requires carriers to issue policies without asking health questions.

You'll get no argument here, Somarco. If companies are allowed underwriting, and to stay ACA-Obamacare concurrently, very few will choose to offer the guaranteed-issue plans.

 

[kgmom219]

UW is out.

If congressmen and/or senators put UW back in, they are going to lose their seats.

I'm not disagreeing that UW will fix it, I'm saying its not going to happen.

#whatsnext

 

[junkman]

Underwriting doesn't fix anything for those that can't buy coverage. Being able to exclude coverage from those that can't answer "No" the the question "have you ever had xxxx" does nothing for many. Risk pools soon increase rates to the point where only the wealthy and very sick buy. I used to help friends rig the system with husband/wife 2 person groups but that too is a hassle. One excludes. The other is priced to be worthless and promote self insuring.

Price sells. Carriers compete on price and will underwrite to a gnat's ass when allowed.

Edit: We currently paying for the uninsured by letting them go to the ER and loading the cost onto those with insurance. Switching to a payroll tax would give them better, cheaper access and make them pay something.

Several I know with money are making themselves judgment proof as a strategy to weather the next couple of years with high rates and rates increases. Sad that it's come to this but those above subsidy level are priced out.

 

[tonyisme]

For individuals ..guess the sick & healthy will be buying into medicare some how some way. The there are those who go the "share" risk plan route..the one I saw didn't require SSN (optional).

 

[somarco]

Whether underwriting returns or not remains to be seen. Without it the IFP market will collapse.

Of course it is almost there now anyway.

Odd how some are totally against underwriting when it worked for years. Carriers made money. Plans were affordable.

 

[tonyisme]

Canada has a single payer type of system. You cannot leave the country longer than hundred and eighty days to keep coverage. They tell me it takes months to get a surgery. And you must use it in the province where you live. You cannot go to another Province and use it. They have told me this.
And even if we have a single-payer system which almost certainly would be tied to Medicare ... only the citizens or residents who have worked would likely qualify. Since Medicare requires the 40 points currently. That's 10 years of working. So visitors to the USA will be SOL... if taxes to go up 25% or more then Single Payer might happen. Then the immigrants and visitors and refugees won't qualify to buy into it anyway. Non-citizens are still going to use Medical Services

 

[Ann H]

I doubt that underwriting in the IFP market will come back by a fully intentional decision. It might come back through loopholes. As the law is dismantled, there will be loopholes and unintended consequences that could give way for that sort of thing. STM and FI are examples. In fact, you can say that underwriting is here right now when you look at the STM market. In the group market, ERISA plans (Level funded and partially self-funded) have been sold all 4 years that ACA was in full effect, and they are underwritten. Groups of 51+ are underwritten. Only the 2-50 size groups and IFP are Guar Issue under the ACA rules.

There could be more underwritten ideas, but I doubt that it will be from an intentional decision of govt leaders. The govt leaders could potentially give power to states to reform their own healthcare, which causes it to come about that way, depending on the state. I've never thought it was impossible for underwriting to come back in the IFP market. I do think it is improbable that high-level leaders are planning on that method of repeal/replace.

Either way, underwriting does not solve anything when root drivers are out of control.

Participation does solve some issues, as is proven by group plans being much more stable than IFP. In many states where IFP has suffered greatly, group remains strong. However, how are you ever going to get high participation in the IFP market? And high participation still cannot counterbalance the out-of-control root issues of high cost.

It's the IFP market that is so fragile, and that is a small slice of the population. The vast majority of Americans are covered by Group, Medicare, and govt insurance. Changing the IFP market to underwritten doesn't really solve the issue, although it could release the pressure for the healthy segment of IFP buyers for a couple of years.

 

[AllenChicago]

UW is out.

If congressmen and/or senators put UW back in, they are going to lose their seats.

I'm not disagreeing that UW will fix it, I'm saying its not going to happen.

#whatsnext

Congressmen make it all too complicated. All they have to do is open the jail cell and let those who want to go through underwriting, for better premiums and a big PPO network, do so. We all know lots of clients who would jump at the opportunity to apply for a plan that fits their needs and budget once again.

Also, lots of mid-size health insurers would LOVE to get back into the market, and I'd be thrilled to sell IHC, Assurant, US Healthgroup, etc.. once again.

Those who want to stay with "ObamaCare" can do so, with the same subsidies, benefits, guarantees, EHB's etc.. that they have now. It might cost Uncle Sam more money..and it might not.

 

[junkman]

Whether underwriting returns or not remains to be seen. Without it the IFP market will collapse.

Of course it is almost there now anyway.

Odd how some are totally against underwriting when it worked for years. Carriers made money. Plans were affordable.

Underwriting ignores the problem of people not being able to pass underwriting. Risk pools were an attempt to solve the issue or at least give the appearance of solving the issue. There used to be trusts that appeared periodically the didn't underwrite. We used them to clean up groups so the group could pass. The trusts invariably went belly up. All were self funded and would leave the insured stuck with the claim when they closed.

The other problem is the continual medical trend that has been 8-10% for years and years. One sector or the other rotated thru and caused the trend. Lately, it has been RX. I blame much of that on the fact that we decided that corporations are people and are entitled to the same legal bribery of you Congress as people. We can thank the conservative courts for that genius self-serving conclusion. I'd vote for public funding of elections simply to keep the wealthy donors including corporations out. Unregulated free enterprise becomes tyrannous.

The mandate was supposed to make participation sufficient to overcome the lack of underwriting. It obviously wasn't. We also had it documented that a portion of the people are used to not having insurance and don't want to pay for it.

Competition between providers may help some but none publish price lists. When a hip replacement is upwards of $55,000, health care is unaffordable. Hips and knees are selling like hot cakes. Pull your checkbook out and ask how much a hip is and they can't tell you. Strange. I can get a price on anything else in the world but not a hip which is sold every day.

One person formed a corporation and ran the corp for president to make a point that corps are not people and shouldn't have the same rights.

We'll adjust to whatever changes come along and manipulate the system where ever possible. I had to close a bank account to access my 30 day ACA grace period this year. It saved me $1,700 but was a pita. I would have paid the bill had the carrier played nice. They didn't so screw em.

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Congressmen make it all too complicated. All they have to do is open the jail cell and let those who want to go through underwriting, for better premiums and a big PPO network, do so. We all know lots of clients who would jump at the opportunity to apply for a plan that fits their needs and budget once again.

Also, lots of mid-size health insurers would LOVE to get back into the market, and I'd be thrilled to sell IHC, Assurant, US Healthgroup, etc.. once again.

Those who want to stay with "ObamaCare" can do so, with the same subsidies, benefits, guarantees, EHB's etc.. that they have now. It might cost Uncle Sam more money..and it might not.

So much wrong with your statements as to boggle the mind. Of course those who can pass underwriting will bail. Those with subsidy only care about their cost not premium.

The real question is how do we want to deliver and pay for Healthcare and who has access.

Insurance and inherent tax advantages shifted payment from people's pocket to insurance. People quit looking at procedure price. They also don't consider price of insurance because they never see it.

I have a friend that work at Kroger. He has rich benefits but when asked would prefer cash.