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Wed Dec 5, 2012, 08:36 PM

Obamacare: Post from Facebook

Probably won't respond, but wondering if there is an appropriate explanation.

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"Ben and I rec'd a letter today from his employer and we would like to personally thank Congress and President Obama for our health insurance increasing another $600 next year, our out of pocket deductible going up another $150, our out of pocket family deductible going up another $350 due to your "Health Reform" plan."

12 replies, 1198 views

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Response to Tennessee Gal (Original post)

Wed Dec 5, 2012, 08:38 PM

1. I really don't know but could the increases be due to the insurance co. itself

rather than the health care plan?

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Response to snappyturtle (Reply #1)

Wed Dec 5, 2012, 09:14 PM

11. Yes. It could be an insurance company that already had overhead costs that exceeded the ACA

MLR mandate of 15% and it probably was already used to operating with that high overhead for a long time, so changing in order to meet the 85:15, services : overhead, ratio mandated by the ACA Medical Loss Ratio at the same premium dollar amount, is quite a bit more difficult for them, so they raised the premium amount in order to cover expenses that they were previously covering with a higher percentage of the premium dollar and, thus, a lower percentage spent on services, which the ACA will no longer allow. This could well be one of those companies that may eventually be absorbed by other more efficient companies as competition increases within the ACA mandated insurance exchanges. They'll either get their premium amounts down and covering comparable services, while meeting the 85:15 standard, or they will go away.

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Response to Tennessee Gal (Original post)

Wed Dec 5, 2012, 08:39 PM

2. The insurance company was likely going to do this anyway, using Obamacare as cover. IF this is true

That is the other thing. I would like the FB poster to prove his allegation.

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Response to Tennessee Gal (Original post)

Wed Dec 5, 2012, 08:43 PM

3. It would have gone up more without the reform. They should be thankful

but just are not bright enough to know it.

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Response to Tennessee Gal (Original post)

Wed Dec 5, 2012, 08:48 PM

4. increase may not be from ACA

http://www.whitehouse.gov/sites/default/files/uploads/careact.pdf


"80/20 Rule: The health insurance companies of 76 million Americans now have to meet the 80/20 rule, or Medical Loss Ratio, where they must spend at least 80 cents of your premium dollar on your health care or improvements to care. If they fail to meet this standard, they must provide a rebate to their customers.


Reviewing premium increases: For the first time ever in every State, insurance companies must publicly justify any rate increase of 10 percent or more. And the new law gives States new resources to review and block these premium hikes. Already, more than $154 million in grants have gone to States to assist them in implementing or improving their rate review activities..."

http://www.healthcare.gov/law/resources/index.html

Q. Will my insurance premium go up?

A. The Congressional Budget Office estimates that private health insurance premiums will increase by 5.7 percent each year, on average, from 2012 until 2022. But premiums would be getting more expensive with or without the Affordable Care Act. The budget office has estimated that, relative to what would happen in the absence of the law, premiums in the individual insurance market will be a little higher, employer-sponsored insurance premiums for big companies will be a little lower and employer-sponsored insurance premiums for small companies will stay about the same.

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Response to Tennessee Gal (Original post)

Wed Dec 5, 2012, 08:48 PM

5. It has been said that the inflation rate for medical insurance premiums reflects real inflation.

Like, if the inflation rate in the economy at large were 10%, your health insurance provider may bump it up 10% next year, but you'd only get a 2% cost of living increase from your non-unionized employer. Food prices have gone up faster than people's wages. It's been since the 1990s that a fair loaf of wheat bread could be had for a dollar. If my wages kept up with the price of food, my wages probably would've been 50% higher today than they actually are.

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Response to Tennessee Gal (Original post)

Wed Dec 5, 2012, 08:52 PM

6. Yes ...

The appropriate, but fruitless response to his FB Page, would be (after asking him to post the letter to his FB Page, because you don't believe it exists) ... "ObamaCare had nothing to do with your employer's decision to purchase a plan that increased your premiums and your out of pocket costs (while reducing his/her contribution). If you don't believe me, ask your employer to provide you documentation of his/her contribution this year versus last year. He/she will probably fire you for questioning his/her veracity; but that'll tell you something else about your employer."

This tactic won't stop him from passing on the lie; but it'll stop him from posting it on his facebook page.

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Response to 1StrongBlackMan (Reply #6)

Wed Dec 5, 2012, 09:10 PM

9. Most Employers Shift More Cost To Employees Routinely

Obamacare may have something to with this change though but the FB poster needs to understand there are also tremendous improvements too such as unlimited preventive care, no lifetime maximums and coverage for dependents to age 26, Typically employees see a combination of plan design features such as raises in the deductible and maximum out of pocket amounts coupled with an increase in the employee contribution to be in the plan. These actions are normally based on the projections provided by their actuaries on what the medical trend will be for the next year. Some generous employees are willing to absorb some of this increase or all of it to keep the plan design and costs to the employee unchanged. The company I worked for raised contributions last year but it was the first such increase in 4 or 5 years. By the way, health care trends are flat this year and are projected to rise only 5% or so next year. Companies who have delayed implementing any of the improvements of HCR will see bigger increases though. I'm fortunate enough to have an employer that implemented all of the improvements early so the only thing we will see changed in 2013 is the 100% benefit for contraception and the cost associated with that change is very low. Some companies waited because they really believed Obamacare would be repealed. There was a "grandfathered" provision that allowed companies to wait until 2014 to make mandated changes and many companies took advantage of that provision. That was a risky approach in my opinion since if Obama had lost there is a possibility that repubs would have tried to repeal some or all of it even though they said they would keep most of the "good stuff" that people like but you can never trust the bastards.

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Response to Indykatie (Reply #9)

Thu Dec 6, 2012, 09:58 AM

12. While, it is true ...

Employers routinely shift more healthcare insurance costs to their employees; but these shifts are NOT BECAUSE OF ObamaCare, as this FB Poster's employee has indicated.

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Response to Tennessee Gal (Original post)

Wed Dec 5, 2012, 08:56 PM

7. Good responses. Thanks everyone. nt

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Response to Tennessee Gal (Original post)

Wed Dec 5, 2012, 09:06 PM

8. Just because it went up doesn't mean that the increase was due to Obamacare. Insurance

companies are in control of their own businesses.

If they raised premiums in order to cover costs with the ACA prescribed Medical Loss Ratio, 85% on care : 15% for overhead, whose fault is it that they were apparently already in need of more than that 15% before the ACA MLR mandate? Whose fault is it that they were apparently already operating at less than 85% spent on health care services, before the ACA MLR raised that to 85%? So that, now that they have to live with that 15% limit on their costs per dollar of premium and they can't spend less than 85% on health care services, they have to raise premiums to cover their pre-existing greater than 15% overhead costs.

Some insurance company's premium dollars were running as high as 30-35% overhead before the ACA, do Ben and she, think that is a good deal for their money? Compare that 30-35% to Medicare overhead at 4-5% and you have some idea of how bad business practices must be in the company that Ben and she are buying their insurance from and other such companies who have top-heavy organizations and in-efficient business processes supported by our premium dollars, that is, supported and subtracted from the services that we pay our premium dollars for.

When the ACA insurance exchange is constructed in her state, she can compare health care services covered relative to premiums charged by other companies and surmise how well other companies are run and thus they are able to provide more service per dollar than the company she is dealing with which apparently needs more of her premium dollar to pay fat salaries and expense accounts in their overhead, instead of covering services for the insureds. When Ben and she see the difference between who they are dealing with and what's out there in the "free market", they can tell their employer that the insurance s/he is offering will not do. The employer can go get a better deal (from a company in which overhead is not so high), or they can stay with the expensive company they've been dealing with and Ben and she can take their premium dollars into the ACA mandated insurance exchange and find a better deal at a better fit with their health care needs.

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Response to Tennessee Gal (Original post)

Wed Dec 5, 2012, 09:13 PM

10. Now every RW employer can up their employees health insurance fees and blame Obama.

Not Big Pharm. Not runaway healthcare administrative costs.

ObamaCare.

Classic RW profiteering while blaming the Left.

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