GP, my post on page 307 in response to busdriver & mini’s posts was referring to Washington state, where my son lives. Though not nearly as bad as it was in NY, where my d. lives. (Fortunately my daughter has had consistent employer coverage since graduating college, but we did not know that during her spring semester, so I tried to price plans to replace her California policy. I was paying roughly $150/month for a high deductible plan in Calif. and would have had to pay $650+ to replace it; she was eligible for continued coverage in Calif. as long as she remained a full time student, but not after she graduated.)</p>
The rate sheet from my old Blue Shield plan shows that the premium for a couple would have been more than double the premium for a single person alone. So merely paying a per-person premium is a savings. (I have no idea why, maybe they had actuarial data to back it up). The per-person approach will probably also be a savings for very small (1 child) families and for very large ones, but perhaps work the other way for families with 2-4 kids, because of the way rates were previously set for family coverage.</p>
Maybe they mean they can’t raise them beyond the 9.8% rate increase they already have planned for January 1? Perhaps there is a limit in California to how often a insurance company can seek a rate increase (I don’t know, I haven’t checked- but it would make sense – I’ve never had rate changes more frequently than once a year as far as I can remember)</p>
<p>“That Washington bug (which only affected 8000 people) sounds like a run-of-the-mill bug. It’s bad, but they found it quickly, it’s so simple to fix and it sounds like it has been fixed. If that’s the only problem the Washington exchange has, they’re doing fine.”</p>
<p>How many people more than 8,000 even signed up? I believe that is a very large percentage of the total enrolled. They are finding out they aren’t getting subsidies, or less of a subsidy than they were told…several weeks after the fact. I’d imagine many of those will want, or will try to get their old plans back. Maybe that is doing fine compared to other sites, but that would seem like a pretty big deal to me if I was counting on it.</p>
<p>This is why individual health insurance needed a change.</p>
<p>"730,000 Californians who buy private insurance on the individual market through Anthem saw an average 17.5 percent increase. But some are getting hit with as much as a 26 percent jump.</p>
<p>Consumer Watchdog says this is third or fourth rate hike in two years
from an insurer whose parent company made $2.7 billion in profits last year."</p>
<p>This kind of stuff was happening for a decade…</p>
<p>“Meanwhile, the refugee who lives with us can now risk getting a job!”</p>
<p>That’s wonderful that he will now be able to work. He is lucky that you are helping him, you really do put your money where your mouth is. I thought you were saying how well it is working in WA, and I am pretty disgusted at how it isn’t. Initially, when we had one of the few sites that were working well, I thought, of course! We have so many smart tech people around here, we do things right, well of course. Then with all the mistakes…I guess we’re just like everyone else. So much for tech snobbery.</p>
<p>Doesn’t matter. The bug was a mistake in units (months instead of years), only affected 8000 people, and was trivial to fix. The percentage of applicants affected is irrelevant; what matters is the absolute number, which is not very big.</p>
<p>OK, I guess I’ve just been the beneficiary of internal policies or practices at Blue Shield. I think the only time I’ve seen more than one rate increase in a year is when I’ve had a birthday bumping me up into the next 5-year age bracket… I do think those age-bumps went into effect immediately, even though my insurance renewal period was set for a different month. But they weren’t technically rate “hikes” because I would just be charged whatever the published rate was for that age, from the same schedule as my previous rate. (Blue Shield always did include a copy of the current rate schedule for my policy and region with the policy, so that part was easy enough to check)</p>
<p>Re the months vs. years for subsidy calculation: as I have posted, that is how Covered California is set up to calculate ALL subsidies-- so I have a hard time seeing how it is disastrous. Again, I think they are prioritizing screening for Medicaid-- it is pretty obvious to me that Medicaid expansion is a huge part of what makes ACA work, and I am happy to be living in a state that understands that. </p>
<p>Most people at lower income ranges do not have wildly fluctuating incomes, and I think those who do are probably aware that the entering a single month’s income is not going to be accurate.</p>
<p>Calmom, the issue was that in Washington, someone would report a monthly income, and it would be treated as yearly income. So people were treated as having 1/12 the income they actually had, which made them appear eligible for subsidies when they were not.</p>
<p>Calmom, what kind of rate increases did you receive over the years? </p>
<p>Mine was double digits. To be fair, because we age…the cost increases would run close to double digits. However, the increases were higher than high single digits.</p>
<p>Bruce B was an advocate for universal healthcare. </p>
<p>The individual market in Cal has about 2 million people. If I remember correctly, 5 million are uninsured. Some of those are probably illegal immigrants. </p>
<p>A rate increase that covers 730,000 people effects quite a bit of the insurance market.</p>
<p>“Busdriver, you are essentially gloating: you work for a company that has a self-funded, top-of-the-line insurance plan. Ha, ha. You get super wonderful insurance and your company doesn’t pay all that much to provide it, or charge you anything.”</p>
<p>No, not at all. I’m typically sarcastic, but definitely not gloating about this. My point is that it still doesn’t seem reasonable that an employer can offer better insurance to their employees at less than half the price, compared to the Obamacare option. In this case, it seems to me that a big problem is very low competition, so the insurers can jack up the rates like crazy. </p>
<p>“You apparently don’t know much about what it has been like buying insurance on the individual market in the past. I do. The point isn’t to try to compare what is available under ACA to top-of-the-line employer benefits – it’s insurance, it is keyed to a risk pool. Mini is saying the premium levels are better than what was available in Washington before.”</p>
<p>I realize how difficult it is, but perhaps mini can show us where he got his data that ACA plans are now better and cheaper in virtually every case. Is that, perhaps, because every case where people have signed up, it is for Medicaid or large subsidies? If so, of course it’s better and cheaper if it’s free or highly subsidized! It doesn’t mean the policies are cheaper, it just means that the people signing up for it aren’t paying the exorbitant rates the insurance companies are charging. The data I saw on Forbes, said that insurance after ACA in WA will go up from 21%-44%, depending upon your demographic. So better and cheaper isn’t accurately describing the insurance market in WA.</p>
<p>“Doesn’t matter. The bug was a mistake in units (months instead of years), only affected 8000 people, and was trivial to fix. The percentage of applicants affected is irrelevant; what matters is the absolute number, which is not very big.”</p>
<p>I realize you’re talking in computer speak…easy problem to fix. I was talking in success of the website, ie, if you mess it up for most of the enrollees, you’re really screwed up. Now those people that thought that everything was set may have to go back to the search for insurance. Here we were bragging about what a great job we were doing in WA, when really, they blew it for most people. Maybe an easy fix, but a little late to figure this out.</p>
<p>Dstark – I posted before about my annual increases – I’m not going to dig up the numbers again, but I think it averaged to about 12-15% per year. Hard to get a handle on because whenever the hike was too big, I usually would switch to a higher deductible plan.</p>
Your employer is self-insured-- that cuts down on administrative costs – and the numbers you quoted are for one year only. Because your company is self-insured, it reports the actual amount of its out-of-pocket medical expense for the previous years – it is quite possible that amount fluctuates significantly from one year to the next. Finally, an employer risk pool would trend toward somewhat healthier people than than the overall individual market risk pool, because by definition within each insured family unit, there is at least one person healthy enough to maintain full-time or nearly full-time employment. I’m sure that your company has generous sick pay and leave policies as well, but most people with serious, long-term chronic, disabling diseases would lose their jobs sooner or later. </p>
<p>I’m not saying that we wouldn’t save money if we could cut the insurance companies out of the loop for the individual market as well, through a public, single payer option – obviously that probably would save money (assuming that the public, single payer entity could hire competent people to build their computer system) - but that wasn’t realistic from a political perspective. </p>
<p>But it just is not realistic to compare the numbers to what your employer pays- it’s simply too small a sample to draw any true conclusions from.</p>
<p>Yes, busdriver. I think that is an important distinction. The policies are not less expensive. They are subsidized in a variety of ways. But this does not make them less expensive. </p>
<p>This is why I don’t understand the highly restricted networks. Seems that if the insurance companies are getting their increases, which they are, they ought to not also try to squeeze the doctors. </p>
<p>To me this is a massive failure in the new system. People paying higher premiums for less access.</p>
<p>There are 4600 posts here and this is just part 2. I am 57. It is hard to memorize the posts. :)</p>
<p>One thing that probably should be said over and over is if a person qualifies for subsidies…they should look at silver plans. The premium maybe higher but the overall costs may be lower. This I do remember you saying calmom.</p>
<p>calmom, you and anyone else can explain it to me all day…but logically it seems to me that a large part of the difference for self insured vs insurance company insured is gouging, pure and simple. Even before ACA health plans were offered, I was checking family insurance plans online, and I was surprised that they didn’t cost as much as I’d expected. They appear much higher now. Though I don’t know if I was looking at the exact same plans.</p>