Trump Won, Vows Day 1 Full Repeal. Lets Discuss.

[Key2Success]

Are you little mad or big mad?

The Trump presidency will be a disaster. Good luck if he even lasts 2 years.

Are you in denial or do you have your head in the sand?

Donald Trump did not steal your money.

Donald Trump did not start our race war.....Obama did.

Donald Trump did not leave any US soldiers in Benghazi to be slaughtered and desecrated by Muslims.

Donald Trump did not send the US Navy to fight for Syrian Al-Qaeda.

Donald Trump did not arm ISIS and systematically exterminate Christians throughout the Middle East.

 

[kgmom219]

Key 2...get a grip. What the Trump Presidency does or does not vs what Obama did or did not is not the purpose of the thread.

Stop hijacking threads.

The issue is what the heck happens now????

What did you tell your clients today? I've got people in the 600% range crying because Trump is screaming repeal and they aren't going to have coverage on Jan 20.

 

[myinsurebiz]

I hope Trump does repeal it . . .

God bless Trump and God bless America!

 

[Yagents]

Good analysis:

Republican Health Care Reform: Destruction or Refinement? | The Alan Katz Blog

 

[RayNY]

Assuming this selling over state lines idea means "comply with your situs state, sell in any state, even if you don't comply with their laws", looks like Oklahoma might be the new home of health insurance.

Minimal mental health parity (group only, and only for severe mental illness). Gets out of the substance abuse and nervous issue coverage so many other states have.

No rate review. Self explanatory.

Allows rate bands. Allows rating for health (+/- 25% per class), and industry (15%). This means you can advertise your "best case scenario" rate on a quote, even if it might be 50% higher in reality.

Allows community rating, community rating by class, adjusted community rating, or rating under all 3 systems. Flexibility is always good.

Relatively low 6% corporate income tax rate. (TX/NV/WA/WY/SD/OH have none, but have gross receipts taxes, which are unfavorable to health insurance with it's slim profit margin).

Relatively low labor costs, tax breaks/incentives for new businesses, and surprisingly good infrastructure (internet, for example) are all positives too.

 

[yorkriver1]

Interesting..most of the subsidy patients that I have were Hillary voters. I've found that the opposite is true of what is said in the Media. Most of the people that vocally supported Trump were educated white collar, and those that vocally supported Hillary were mentally disabled (some undiagnosed), or poorly educated and without stable incomes.

In my Southern state, it's a mix. Those who don't like Obamacare but are deeply grateful to get a health plan with a tax credit, now that they have lost their blue collar job with benefits, are in for some kind of awakening, or they will be fine since they are values voters.

 

[junkman]

To all that say "it's Obama's fault", the good news is that that son of a bitch is gone and no everything that he caused will go back to being lovely.

I personally don't like Trump's core values - self-centered, racist, liar, thief as outlined above. It's easy to deal with those you disagree with if they keep their word. Unfortunately, I haven't seen any sign that Trump does.

The Repubs have forgotten the fact that Bush went into Iraq AND didn't pay for the resulting 15 yrs of war. We forget that the excuse was weapons of mass destruction and not letting weapons inspectors in. A congressman & small contingency went over there and told Sadam's people that Bush was going to blow them away if inspectors weren't let in. The Iraqis said "they're coming anyway" but then decided to let them in. We went in and have had a cluster **** since then. We use similar chicken soup excuses most of the time we invade.

I have plenty of disagreements with Obama. I happen to believe that we should know about it when our government is committing crimes and that the crimes should be stopped. Obama has prosecuted more whstleblowers who should be considered heros than any president.

Hackers were all over Hillary. They would have found the same thing had they hacked Trump. I don't let either party off the hook. The DNC was behind Hillary to the point of being deceitful and actively supporting her when they need to be neutral. I note that only major party candidates were in the debates. Both parties are culpable and consequently, the majority of people didn't hear from the Libertarians or Green Party for example.

Back on topic: We always have to choose between alternatives available now. Next year will be different, not necessarily better but different. We frequently don't like the choices but still have to pick one - or not. None of the carriers is paying commission it TN. It doesn't matter. I'll still advise current clients because they're also friends.

My renewal for the cheapest plan BC has is $20,000. Farm Bureau is $17,000. Then there is the Exchange with crappy networks and UHC's STM which uses their commercial network. I always discounted Share arrangements but will glace at a couple as possible bridges to next year. In the end, I'll pick one.

Carriers will have the coverage mandate or underwriting with the authority to rate or exclude or they won't write fully insured contracts. Participation requirements are in place on group contracts for a reason - to assure no adverse selection. The mandate is there for the same reason. Carriers will come up with an ASO arrangement if the Government wants to pay them a fee. If not, carriers will use their infrastructure to pay claims on another product. They don't care. They thought they could provide their service and make money on ACA. They were wrong and are moving on.

Health insurance has been a problem for years but the premiums were afforded. People wanted a "change" and got it with ACA. Now we have Trump and need to be more specific. We need change that reduces the cost of healthcare (not insurance but health care). That may mean finding a way to push payment back onto people instead of insurance. I don't see changing the payer from carriers and premiums to single government payer and taxes as doing anything to mitigate underlying cost. Having blanket 1st dollar coverage like Medicare will be prohibitively expensive.

Parameters are: We need everyone covered to prevent adverse selection. We have to decide whether to include poor people or not. Old rules left them out but we didn't admit it. Assuming everyone is covered, plan design could be richer at lower income levels. To do otherwise excludes the poor from access because ...... shocker: they have no money.

I'm willing to pay $10,000 for a HDHP. That much can be in the budget. $20,000 is not gonna happen. At 20k, I'll take my chances and spend the difference on staying healthy with clean eating, gym daily, bike riding, swimming and sailing. I'll buy some morphine and go off and die when the time comes.

 

[kgmom219]

Assuming this selling over state lines idea means "comply with your situs state, sell in any state, even if you don't comply with their laws", looks like Oklahoma might be the new home of health insurance.

Minimal mental health parity (group only, and only for severe mental illness). Gets out of the substance abuse and nervous issue coverage so many other states have.

No rate review. Self explanatory.

Allows rate bands. Allows rating for health (+/- 25% per class), and industry (15%). This means you can advertise your "best case scenario" rate on a quote, even if it might be 50% higher in reality.

Allows community rating, community rating by class, adjusted community rating, or rating under all 3 systems. Flexibility is always good.

Relatively low 6% corporate income tax rate. (TX/NV/WA/WY/SD/OH have none, but have gross receipts taxes, which are unfavorable to health insurance with it's slim profit margin).

Relatively low labor costs, tax breaks/incentives for new businesses, and surprisingly good infrastructure (internet, for example) are all positives too.

2/3 of Oklahoma land is under Federal Control-as Indian Reservations. The infrastructure is in place, because the Feds put it there. Whether or not the Indians have a computer is another conversation.

While I agree that on paper it looks good, there are huge issues in OK with getting quality labor. Its not that the jobs aren't available, its finding people to fill them. (Ask HCSC how that's going to for them)

And if the state lines thing goes to OK, because of their lousy mental health coverage, that's just sick. Literally.

Oh...if someone decides to move there, make sure you get your passport first. Their drivers license doesn't comply with the new Real ID law and the OK legislature refuses to do anything about it. Next year, you will not be able to use an OK drivers license to get/renew a passport and in 2018, it will not be acceptable for boarding airplanes.

 

[djs]

Local carriers are sending more members to providers in that area. Thus, they have more negotiating power in that region. They have more accurate experience and risk profiles. Thus, they can have lower rates.
..... <snip> .....
A company in a state without those regulations could make a product that doesn't have any of that, and sell it in NY. Since GI, pre-ex, and additional mandatory benefits raise costs, a product without those benefits would be cheaper.

I've never understood the thought process of more = cheaper. This goes against the law of supply and demand for physical type of products. Granted, in the software world, it works that way where the product is virtual, but when you have a limit to the amount of something, more demand tends to raise pricing, not lower it. For fairness, it actually plots to an inverted bell curve, where minimal pricing has a certain level of demand, but after that point, pricing goes up.

....

I've also never understood buying my health care out of state. Okay, I might be able to get a cheap plan in Oklahoma, but traveling from California to Oklahoma to see an in network doctor might just eliminate the savings!!!!


The good news / bad news is everyone here is talking about repeal. They have always talked about repeal and REPLACE. You are probably going to see some serious shifts, but in general, I don't think from an agents perspective, much will change. Basically the same, minus the mandate / tax penalties, is probably a good way to look at the starting position. The question is how does it get paid for much more then what will be different to the consumer.

Dan

 

[sam816]

I've never understood the thought process of more = cheaper.


Dan

I can see that when a carrier has a large group of members, it has more negotiating power facing pharmaceuticals, medical groups, etc. this is why single payer makes sense.