Elementary Question- What Was the Purpose of Mandated "Essential Health Benefits"?

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Everyone knows that the purpose of Individual Mandate was to add healthy risks to the mix of anticipated adverse risks due to the lack of pre-existing conditions. Would ACA have gone down better if more people who had pre-ACA policies had been allowed to KEEP their existing policies?, thereby preserving their CHOICE. I don't understand why those responsible people were FORCED to buy a new policy that was often more expensive, albeit with richer benefits. I still say that consumers should have the right to exclude certain benefits such as maternity, children's dental and mental if they don't want/need them. ACA would have a lot less flak and resistance from voters if they could have chose their own coverage levels.
 
Off the top of my head I would say it was to deter the healthy people from enrolling in lower cost alternatives outside of aca plans.
 
It's not the mandatory benefits that are at issue. It's the fact that no part of this is even allowed by the Constitution despite the Supremes as usual making law instead of interpreting.

But keep it mind nothing about this was specifically for health benefits. It's 100% for control by the guberment.

Rick
 
Americans are dumb.

So dumb, we can't even make decisions about our own health on our own.

We don't know we need health insurance unless there's a mandate.

We don't know we need checkups or preventative care unless it's not only required, but free (and in some cases, you get paid for preventative visits).

We're too dumb to know what a plan should cover, what we should look for or avoid, unless there's a law telling us.

So, moral is, big brother gov't stepped in to ensure this nation of idiots doesn't mistake dirt for dinner because they know better.
 
Gruber agrees with you Ray. He even said Obamacare would not have been possible without the stupidity of the American voter.
 
The reason behind these locked in benefits is because so many people would find out too late that they lacked coverage, even though they had insurance.

To answer RayNY yes some people are stupid.

I've ran group meetings where we hand out the employee packets for January 1 and Dec 31st, the packets still look brand new. People used the plan, but never checked what they were covered and not covered for until the eob showed up.

The reason we have just about any rules in our society is because somebody messed up somewhere. The 10 essentials weren't about the smartest guy in the room, they were about the dumbest guy in the room.

Yes, yada yada a person should be responsible and all that. Should be doesn't always play out the same in real life. Do you legislate on what should be or what is?

For example my group renewals involve changing networks by the carriers. Some chains are excluded in 2017 EXCEPT for emergencies. So I will have a meeting. Explain that you can go there for an emergency, but not electively. I have to explain what elective means. Then the next question......

"what about an emergency?"
"Yes, you can still go there in an emergency and it's covered till you are discharged."

"Ok, but what about an emergency?"
"Yes, you can go there in an emergency."

"Ok, but what if I have a heart attack?"

"yup you can still go there because that's an emergency."

"Ok, you mentioned emergencies, can I go there in an emergency?"

and on and on and on.....

So yea, there are some really stupid people out there. The above was not a conversation with one person in one group.... just about every group had this discussion for their renewals for 2017.
 
Americans are dumb.

So dumb, we can't even make decisions about our own health on our own.

We don't know we need health insurance unless there's a mandate.

We don't know we need checkups or preventative care unless it's not only required, but free (and in some cases, you get paid for preventative visits).

We're too dumb to know what a plan should cover, what we should look for or avoid, unless there's a law telling us.

So, moral is, big brother gov't stepped in to ensure this nation of idiots doesn't mistake dirt for dinner because they know better.

I'll buy some of that.

I also think some major employers (a large retail store in particular) had lousy benefits and because they are self funded, where only Federal Law applies, needed EHB, so they could stop offering (and charging for) horrible benefits. There are certain parts of ACA that probably wouldn't be there if it wasn't for them. And the Womens Health and Cancer Rights Act of 98, could have been named for them, too. They also made sure nobody hit over 40 hours a week average, so they couldn't get the "good" benefits.

This is also where NY and CA are different. You don't allow companies to s!%@w their employees like we did in TX and all over the South. I particularly liked how well-man visits were covered at this company, but well-woman visits were specifically excluded until 2000ish.

So while I agree with you...maybe some corporate responsibility wouldn't be amiss, either.
 
I absolutely agree that SOME large employers with very skinny plans were at fault. The fast food industry is an example. Those skinny plans had no hospitalization coverage, or perhaps a $100 a day hospital benefit. The people who bought them were low-income and very young, without much education or experience to help them make good decisions.

So, along came these EHB regulations, which were perhaps overkill. That problem could have been repaired with some other regulations.

Yet, you can't fully blame the industries who offered such skinny plans. In their defense, they couldn't afford the premium for a better plan for a very large labor force, and at least they offered some sort of plan to folks who would probably have gone uninsured otherwise. Unfortunately, those people had better options and probably didn't know it.

The large group market is not at fault, though. A great majority of the large group market insures their employees and insures them well.

Obamacare hit the small group market and IFP market square in the jaw. The IFP market had its share of skinny plans, err, I mean "value" plans. I know that good agents didn't sell junk, but "junk" made a bad name for all of us. I think the proponents of the ACA took those bad examples, exaggerated and manipulated them, and drove home their desire to make all Americans be insured to the hilt.
 
Went to Apple Store to get wife a laptop ...it was full of young people spending their money on devices instead of insurance.
 
Everyone knows that the purpose of Individual Mandate was to add healthy risks to the mix of anticipated adverse risks due to the lack of pre-existing conditions. Would ACA have gone down better if more people who had pre-ACA policies had been allowed to KEEP their existing policies?, thereby preserving their CHOICE. I don't understand why those responsible people were FORCED to buy a new policy that was often more expensive, albeit with richer benefits. I still say that consumers should have the right to exclude certain benefits such as maternity, children's dental and mental if they don't want/need them. ACA would have a lot less flak and resistance from voters if they could have chosen their own coverage levels.


I don't think that the mandated benefits are a big part of the problem. I have big problems with the ACA overall. However, I have no major problems with MEC.

I like the fact that compliant policies include preventive care and even maternity coverage. These don't raise prices by much when the cost is spread out among all policyholders.

Mandated preventive care, dental care and prenatal care could, in the long run, reduce costs.

(A few years ago I heard a lot of rhetoric about 60-year-old women paying for maternity coverage. This is only true to the extent that 60 year old women have babies. At any age, we pay for the claims that a person our age has on average. (For simplicity's sake let's forget that younger people are to some degree overcharged and older people are undercharged.) If one out of a million five-year-olds has a massive coronary, those expenses get divided by a million and added to each child's premiums. No one complains that children have to pay for coverage for heart attacks. The same goes for 60-year-olds with maternity care.)

Policyholders aren't going to read their policies for the most part. For that reason MEC, at least in theory, is a good idea. It isn't even a new idea. Auto and homeowners policies have MEC, they just don't call it that. If auto insurance carriers were allowed more latitude who knows what they wouldn't cover and most consumers wouldn't discover the coverage deficiencies until they had a claim.

However, I would like to see higher deductible options. Why should a person with a million dollars in the bank be forced to buy a policy with a $6,000 deductible? I remember Mutual of Omaha having a $25,000 deductible policy in the 90s.

What has raised the rates, for the most part, is adverse selection and the failure of Congress to fully fund the program (although had Congress approved all the funding, we would have paid for it, just not through increased premiums).
 
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