ACA meltdown thread

[Soklous]

No, it was a direct change of a Obamacare. As were literally 100s of thousands of others documented factually. I don’t understand why you would choose to negate my personal story and my sisters misfortune. I don’t appreciate it at all. So goes the politics board and the jerks here like you.

[Deleted User 75]

Pretty sure insurance and health care rates were skyrocketing prior to obamacare and will coninue to do so after obamacare's demise.

Maybe do some research....



They were definitely rising, as to be expected with an aging population.

...but health insurance companies not being able to deny coverage to high risk individuals absolutely made the cost to relatively healthy people sky rocket.

That's how insurance companies make a profit. Pick and choose who to insure based on various risk factors, take in more than goes out in medical bills....when they're forced to take on high risk individuals then they have no choice but to pass that added cost onto the other people they insure via higher premiums...that way they can still make money.


Kinda like if you are a shitty driver and get in wrecks constantly your car insurance goes up...and if you wreck so much that they're continously losing money on you then eventually they totally deny to provide car insurance to you. That's risk management. If they had to provide collision coverage for everyone regardless of how crappy a driver they are then the car insurance rates of good drivers would have to go up to help cover the bad drivers, otherwise they'd go out of business.

[Deleted User 75]

Health insurance was never meant to be for "everyone" regardless of health. Insurance isn't designed to be universally available to everyone.

I think Healthcare should be universally available to everyone....but it can't be done via the traditional insurance model. It doesn't work.

[zsn]

That's how insurance companies make a profit. Pick and choose who to insure based on various risk factors, take in more than goes out in medical bills....when they're forced to take on high risk individuals then they have no choice but to pass that added cost onto the other people they insure via higher premiums...that way they can still make money.

This the reason why for-profit health insurance is based on fraud. The insurance company cannot serve in the best interest of both the shareholder and the customer at the same time, by definition. They serve their customers by paying for their care; this means that they are not acting in the best interest of shareholders. They act in the best interest of shareholders by denying paying for care (legitimately or otherwise); this means that they are not acting in the best interest of the customer.

In this conflict, it is not hard to guess who wins most often.

[Deleted User 75]

That's how insurance companies make a profit. Pick and choose who to insure based on various risk factors, take in more than goes out in medical bills....when they're forced to take on high risk individuals then they have no choice but to pass that added cost onto the other people they insure via higher premiums...that way they can still make money.

This the reason why for-profit health insurance is based on fraud. The insurance company cannot serve in the best interest of both the shareholder and the customer at the same time, by definition. They serve their customers by paying for their care; this means that they are not acting in the best interest of shareholders. They act in the best interest of shareholders by denying paying for care (legitimately or otherwise); this means that they are not acting in the best interest of the customer.

In this conflict, it is not hard to guess who wins most often.

Exactly.

That's why all the insurance agents in my office drive Mercedes Benz vehicles to work.

Health insurance is for healthy people to hedge their risk of the unknown. It's not designed to be used by "everyone" as a part of the health care model.

[Deleted User 75]

But there are a lot of rich people in the insurance industry that don't want insurance to go away completely. So they'll agree to cover everyone and then make premiums rise until they're seeing the profit they desire. It's a slippery slope.

I'd prefer health insurance go away completely and we move towards universal health care.

[Mjl]

No, it was a direct change of a Obamacare. As were literally 100s of thousands of others documented factually. I don’t understand why you would choose to negate my personal story and my sisters misfortune. I don’t appreciate it at all. So goes the politics board and the jerks here like you.

How was it directly from Obamacare? Did previous policy not meet new minimum standard of care?

[Shirley]

Over the past five years, according to a 2018 report from Sen. Claire McCaskill (D-Mo.), the prices for each of the 20 most prescribed brand-name drugs for Medicare Part D beneficiaries increased 12 percent a year, on average — about 10 times higher than inflation.

This Is Why Your Drug Prescriptions Cost So Damn Much

When the Republican-controlled Congress approved a landmark program in 2003 to help seniors buy prescription drugs, it slapped on an unusual restriction: The federal government was barred from negotiating cheaper prices for those medicines. Instead, the job of holding down costs was outsourced to the insurance companies delivering the subsidized new coverage, known as Medicare Part D.

The ban on government price bargaining, justified by supporters on free-market grounds, has been derided by critics as a giant gift to the drug industry. Democratic lawmakers began introducing bills to free the government to use its vast purchasing power to negotiate better deals even before former President George W. Bush signed the Part D law, known as the Medicare Modernization Act.

All those measures over the last 13 years have failed, almost always without ever even getting a hearing, much less being brought up for a vote. That’s happened even though surveys have shown broad public support for the idea. For example, a Kaiser Family Foundation poll found last year that 93 percent of Democrats and 74 percent of Republicans favor letting the government negotiate Part D prescription drug prices...

There are far more lobbyists in Washington working for drug manufacturers and wholesalers than there are members of Congress...

For each of the last 13 years, more than 60 percent of the industry’s drug lobbyists have been “revolvers”—that is, lobbyists who previously served in Congress or who worked as congressional aides or in other government jobs. That raises suspicions that lawmakers and regulators will go easy on the industry to avoid jeopardizing their chances of landing lucrative lobbying work after they leave office.

Probably the most notorious example was the Louisiana Republican Billy Tauzin. He helped shape the Part D legislation while serving as chairman of the House Energy and Commerce Committee. In January 2005, just days after he retired from the House, he became the drug industry’s top lobbyist as president of a powerful trade group, the Pharmaceutical Research and Manufacturers of America, or PhRMA. He remained in that job—which reportedly paid him $2 million a year—until 2010.

“It was pretty blatant but an accurate reflection of the way pharma plays the game, through campaign contributions and, in Billy’s case, way more than that,” said US Rep. Jan Schakowsky, an Illinois Democrat who has been a leading proponent of government price negotiations...
________________________________________________________________________________________

House Ways and Means Chairman Kevin Brady, speaking at Cleveland Clinic health care panel during the RNC, said Republicans would not agree to let Medicare negotiate prescription drug prices, as presumptive Republican presidential nominee Donald Trump has proposed.



President Trump will lay out on Friday a broad strategy to reduce prescription drug prices, but in a break from one of his most popular campaign promises, he will not call for Medicare to negotiate lower prices with drug manufacturers, senior administration officials said.

[ousdahl]

https://www.npr.org/2018/12/14/67700062 ... titutional

Federal Judge Strikes Down Affordable Care Act As Unconstitutional

[Deleted User 89]

he’s a conservative bush appointee though, so...

[Deleted User 62]

That's how insurance companies make a profit. Pick and choose who to insure based on various risk factors, take in more than goes out in medical bills....when they're forced to take on high risk individuals then they have no choice but to pass that added cost onto the other people they insure via higher premiums...that way they can still make money.

This the reason why for-profit health insurance is based on fraud. The insurance company cannot serve in the best interest of both the shareholder and the customer at the same time, by definition. They serve their customers by paying for their care; this means that they are not acting in the best interest of shareholders. They act in the best interest of shareholders by denying paying for care (legitimately or otherwise); this means that they are not acting in the best interest of the customer.

In this conflict, it is not hard to guess who wins most often.

That's why all the insurance agents in my office drive Mercedes Benz vehicles to work.

LMAO

[seahawk]

he’s a conservative bush appointee though, so...

I thought that Capital C Conservatives disapproved of "activist judges."

[DCHawk1]

Nothing activist about it.


O'course, at the same time, the ruling will be overturned.

[seahawk]

Let's see, DC says "nothing activist" about the decision, law professor says, "exercise of raw judicial activism." Who to believe?

So nothing changes for the time being. And nothing should change. The legal arguments in previous rounds of litigation over the ACA may have been weak, but they were not frivolous.

This case is different; it’s an exercise of raw judicial activism. Don’t for a moment mistake it for the rule of law.

https://www.washingtonpost.com/opinions ... 87c1344aff

[Deleted User 89]

didn’t the SUPREME COURT already uphold the aca as constitutional?

[twocoach]

Pretty sure insurance and health care rates were skyrocketing prior to obamacare and will coninue to do so after obamacare's demise.

Maybe do some research....



They were definitely rising, as to be expected with an aging population.

...but health insurance companies not being able to deny coverage to high risk individuals absolutely made the cost to relatively healthy people sky rocket.

That's how insurance companies make a profit. Pick and choose who to insure based on various risk factors, take in more than goes out in medical bills....when they're forced to take on high risk individuals then they have no choice but to pass that added cost onto the other people they insure via higher premiums...that way they can still make money.


Kinda like if you are a shitty driver and get in wrecks constantly your car insurance goes up...and if you wreck so much that they're continously losing money on you then eventually they totally deny to provide car insurance to you. That's risk management. If they had to provide collision coverage for everyone regardless of how crappy a driver they are then the car insurance rates of good drivers would have to go up to help cover the bad drivers, otherwise they'd go out of business.

OK, I'll take your advice.

http://www.milliman.com/mmi/

"The Milliman Medical Index is an actuarial analysis of the projected total cost of healthcare for a hypothetical family of four covered by an employer-sponsored preferred provider organization (PPO) plan. Unlike many other healthcare cost reports, the MMI measures the total cost of healthcare benefits, not just the employer’s share of the costs, and not just premiums. The MMI only includes healthcare costs. It does not include health plan administrative expenses or insurance company profit loads."

"Good news: At 4.5%, the MMI’s annual rate of increase is nearly the lowest in 18 years. Only last year was lower, at 4.3%. Over the 18 years since the MMI was first measured in 2001, the annual rate of increase has averaged 7.4%. But for eight years in a row now, the rates have been below that average. As discussed later in this report, although the MMI’s dollar amount continues to grow, the rate at which it grows is clearly slowing."

So it sounds to me like the average yearly increases in the total cost of healthcare have been LESS than it was prior to the creation of Obamacare. Thank you for spurring me to research that. It appears that the research does not support your assumptions.

[Deleted User 75]

"Unlike many other healthcare cost reports, the MMI measures the total cost of healthcare benefits, not just the employer’s share of the costs, and not just premiums.The MMI only includes healthcare costs. It does not include health plan administrative expenses or insurance company profit loads "


When I get done golfing I'll dig in more. I'm not dismissing your article. It's got some interesting facts worth thinking about.

[Shirley]

This ruling was the definition of "judicial activism".

This was also a huge gift to the American people.

I can't wait to see republicans forced to (at least appear to) resolve their decades of hypocrisy on providing meaningful, impactful health care to the American people. Especially after their attempt to lie to the American people about being in favor of protection for pre-existing conditions in the last weeks of the recent midterms, despite being hellbent on repealing the ACA for years and years.

#lulz

It's hard to overstate what a gift this ruling is if you care about health care, or politically, if you're a democrat.

[DCHawk1]

This was a inevitable, though weak and flawed ruling, given Roberts' "tax" justification and Republican nullification of that tax. Undoing an overtly activist re-interpretation of the law is, by definition, not activist. Even if its mistaken.

You should all settle down.

[seahawk]

If this were not solely an activist and political opinion, why did the Trumpies request that the judge hold off on issuing it until after the midterm election? Why did Judge O'Connor not do so? Again, this is the absolute height of judicial activism.

I'll ask again who to believe, DC or a law professor?

“It’s absolutely ludicrous to hold that we do not know whether the 2017 Congress would have wanted the rest of the ACA to exist without an enforceable mandate, because the 2017 Congress did exactly that when it zeroed out the mandate and left the rest of the ACA standing,” Gluck said. “He effectively repealed the entire Affordable Care Act when the 2017 Congress decided not to do so.”

Even conservative lawyers agree:

Ted Frank, a lawyer at the Competitive Enterprise Institute who is critical of the ACA, called the decision “embarrassingly bad” because “you’re twisting yourself into knots” to reach a particular conclusion.

https://www.eastbaytimes.com/2018/12/15 ... w-invalid/