<p>"More insurance companies would mean they would have to compete to sell their products to employers. In order to compete, they would need to lower the premiums, Felgar pointed out.</p>
<p>“Anthem has never talked to Frisbie, and still won’t talk about it,” he continued. “So how does a monopoly operate without getting bids from providers? It doesn’t add up. I told Anthem I would accept the same terms as Wentworth-Douglass Hospital. Lisa Guertin (NH president of Anthem) wouldn’t do it. The way this has been implemented is totally unlike anything I have ever seen in this state — no due process, no
public hearings, limiting patient choice — and the insurance commissioner signed off on it.”</p>
<p>The Concord Monitor, covering a meeting between Guertin and state senators in September, reported that the CEO said Anthem sought to reduce the cost of its plans by reducing the number of participating
providers, with participating hospitals accepting lower reimbursement rates to gain patient volume in a narrow network."</p>
<p>The Anthem/Sutter issues are old news – that is, they started well ahead of implementation of ACA. I’m not a fan of Anthem – I’m in an area primarily served by a Sutter-affiliate – but Sutter is a for-profit operation that also has not been consumer-friendly in its pricing practices. </p>
<p>I mean, the bottom line is that health care costs $$$. As far as I can tell, everyone wants to have the care, and they want to have their choice of care… but nobody wants to have to pay for it.</p>
<p>Maybe we need a very different model of health care delivery and payment, but we don’t have that. We have a market based, private insurer model and within that model we need a mechanism to get insurance for everyone.</p>
<p>I wear multiple hats (have a full time job and help my H run his business from the finance side of the things). So, what I discovered, while helping my husband, is exactly what you are writing about: for many the only affordable health care is a free health care, regardless of their income.</p>
<p>I told this story more than once. We had a guy who made around 70K in Midwest, which is pretty good here. He was not married, but had a girlfriend sharing household expenses. He was not buying insurance through us because he “could not afford it”.</p>
<p>He got drunk one night and fell in the bath tub. He broke a bone really bad. He called us to enroll in health insurance, literally from the hospital bed (after the surgery). He then was very upset that he got 14K bill from the hospital, because, after all, he was now enrolled into health insurance. The insurance actually did not start until next month, but I guess this is a minor detail for him.</p>
<p>I know the Sutter issue has nothing to do with ACA. Does decrease the network though if the parties dont come to terms.</p>
<p>The NH story is interesting. Lower costs from hospitals in exchange for monopoly powers. (I may be slightly exaggerating with the key word slightly). Then after the deal between Blue Cross and a hospital…another hospital states they would meet those terms. </p>
<p>I think NH is a mess. How is the above good for patients? There is a good chance Blue Cross could have gotten the same deal from a few more hospitals. This puts hospitals that are shut out at financial risk.</p>
<p>I was only saying about the taxes to compare it with unneeded insurance people might pay for. We pay about 2-3% in home value each year and it only gets locked in after people hit 65 or something but otherwise keeps changing in value. But theoretically, if I stick around after 3 years, I am supporting the school district with no return at all. The richer ones who send their kids to private schools (I have a neighbor whose kids have never entered a public school) are subsidizing the schools big time without ever making use.</p>
<p>Emily, I am sure you understood that the cost for maternity care coverage is very spread out and that individual premiums shouldn’t increase so much due to it. When we cover maternity care we are convering very small population. Let’s assume every one of us, male, female, age 27 through 65, has two kids and we cover maternity as long as we have health insurance for about 40 years. Out of those 40 years we use maternity care for about 2 years, 1 year for each kid. If we spread the cost over 40 years, each year we are paying about 5% of the cost. About half the population are male baring no babies and help lower the cost to 2.5%. That’s the maiximum cost of maternity care when spread out. If the average cost of have a child is $10,000, we should expect about $250 a year. It doesn’t explain the noticable jump in premium.</p>
<p>I attribute the noticeable jump in premiums to a) removal of lifetime cap; b) inability to price risk; c) inability to kick of people from insurance when they get sick and therefore d) expected increase of sick people buying insurance, thus making the entire risk pool more expensive. </p>
<p>Remember, before ACA most of the people on individual health insurance market were relatively healthy, hence lower insurance premiums.</p>
<p>Right now it is too early to say how things are going to end up with ACA . There are a few stories that state that things are improving. Signups are increasing. I read today that signups are expected to increase exponentially after Thanksgiving until Dec 15. </p>
<p>I can see why people would like to sign up before that time period…if they are able. :)</p>
<p>Talking about subsidies… The signups so far are low and the signups for those that qualify for subsidies are lower. </p>
<p>And the only way to get there is ensuring profits for the health care industry? Of course there’s nothing wrong with the profits in itself. It is an issue, however, if profits are provided by change in rules/laws rather than earned.</p>
<p>The ACA rebate checks are part of a provision in the health care law that requires insurance companies to use 80 percent of collected premiums on medical services. If they don’t, they have to send rebates to policyholders for the difference. </p>
<p>20% is not profits. It includes operating and administrative costs. I don’t know how much the profits would be, but not nearly close to 20%.</p>
<p>There are other ways to control profits, such as increasing competition. But since health insurances cannot be sold across state lines, it is a no-go. Meanwhile, if people are so opposed to profits, they should see if they have access to non-profits.</p>
<p>Lerkin, we might be comparing apples and oranges. I dont think the link I provided includes medicaid. Oregon has signed up 70,000 people for medicaid for example.</p>
<p>I like your link. I wonder what makes Minn able to offer the cheapest plans?</p>
<p>This was interesting too.</p>
<p>“Altogether, about 60 percent of the estimated 500,000 uninsured people in Minnesota qualify either for Medicaid or MinnesotaCare, the state program for people slightly above the poverty line who can afford to pay nominal premiums.”</p>
<p>It seems to me that people who are eligible for something for free or virtually free are going to be in more of a hurry to sign up than people who are going to have to pay out-of-pocket. My current insurance has premiums due on the first of the month – I could pay those premiums 3 weeks in advance but I don’t. I pay the day they are due (I use auto-pay and a credit card to make it all work – of course because I use a credit card, I actually pay later, when the credit card comes due.)</p>
<p>I’d think that the significant numbers are going to be the December enrollments, which will pick up all people who are certain that they want insurance and need coverage as of January 1.</p>
<p>There will still be people who don’t think they “need” insurance who will wait until the end of March to sign up, and that’s probably where a good chunk of the younger demographic will be.</p>
<p>I cannot understand that either. I posted before, that I thought it was too good to be true. I have two and half possible reasons:</p>
<ol>
<li><p>I have heard on the radio (sorry no link) that MN also has highest deductibles in the nation. </p></li>
<li><p>It has something to do with very limited networks (and reimbursement rates)</p></li>
</ol>
<p>Out of curiosity I priced health insurance for my family of 4 on the exchange (platinum):
$3000 deductible, 100% plan. The cost per year is $9600.</p>
<p>Compare it to my employer plan:
$3000 deductible, 80/20 plan ($16000 per year out of pocket maximum). The number from my W2 for 2012 is a little less than $14K. This number does not include 3 months when my H was on a different insurance plan. It is basically the same plan I am going to get next year, but at higher premium to me (I don’t know yet what overall premium is going to be).</p>
<p>As you can see I get worse plan for a higher rate (shared by my employer and me).</p>
<p>However, my employer plan network is so much better than the exchange network. In fact the networks are so narrow, that alone would be a reason for me to avoid exchange. And this is why I will try to keep the non-exchange plan for my H’s business employees for as long as it is possible. </p>
<p>3) I think MNsure promised insurance companies a huge influx of previously uninsured young guys who will subsidize everyone else rates through 1:3 rule. They probably used some statistics and run some models that told them that MN has this large untapped population of healthy young people without insurance as compared to MN sick population.</p>
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<p>Got it. I also have read somewhere that because in MN the rates are so low, many people who sign up for private plans and expected to get subsidies and tax credits do not qualify for them. I don’t have a link right now.</p>
<p>Here in South Carolina, our insurance commissioner is giving the insurance companies until December 2nd to decide whether or not they will allow cancelled policies to be extended. They are not placing any restrictions on policies being extended.</p>
<p>My insurance company has stated they will extend the policies but is still analyzing everything before sending notice to customers.</p>
<p>There were 150,000 cancellation notices sent out in South Carolina. The Dec 2 deadline is cutting it close but I am hoping for good news and I’ll be able to keep my policy.</p>
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