Affordable Care Act Scene 2 - Insurance Premiums

Parent Cafe
4941

<p>Lerkin,</p>

<p>Hmmm…my bronze plan’s premiums are more expensive, and the bronze plan has a higher deductible than the platinum plan.</p>

<p>The network issue is real. The limited networks in many areas can lead to higher costs.</p>

<p>Do the demographics skew younger in Minn? I thought younger people want out of there. It is toooooo cold. </p>

<p>I think the 1:3 rule overstates the financial burden of young people. (the job market is a big, big issue). 80 percent of uninsured young people qualify for subsidies. Millions of young people have already stayed on their parents plans. Obviously…some people are affected negatively…</p>

<p>We are comparing rack rates with the 1:3 rule when 80 percent of uninsured young people do not have to pay rack rates. Who pays rack rates? Ok…sometimes…I do. I dont always make the best financial decision even though that is my field. :)</p>

<p>If it turns out I am wrong…And I had the authority, I would adjust the numbers. :)</p>

<p>How many major insurance companies do you have in Minn?</p>

<p>We will see what happens…</p>

<p><a href=“http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2013/Aug/1701_Collins_covering_young_adults_tracking_brief_final_v4.pdf[/url]”>http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2013/Aug/1701_Collins_covering_young_adults_tracking_brief_final_v4.pdf&lt;/a&gt;&lt;/p&gt;

4942

<p>Southbel…good luck. Has there been any talk about pricing?</p>

4943

<p>dstark, I opened your link in post #4930 and saw the video about sex workers (an euphemism if I ever saw one) touting ACA and how the law would benefit them. Of all the arguments defending ACA on this thread, I found this one the most convincing. :)</p>

4944

<p>Do the reported enrollment numbers include the 5 million subscribers whose policies were cancelled? If so, it doesn’t seem like one can assess much about how enrollment is going until we get past that 5 million number.</p>

4945

<p>GP, :)…</p>

<p>You dont really want to wait until after nov 30. Are you going to call Anthem soon? </p>

<p>Does BS have a better local network?</p>

<p>Oh yeah… You want that cancelled plan. Nevermind. :)</p>

4946

<p>

No. I suspect there will be a pretty big cost increase. Right now, I’m okay with that.</p>

4947

<p>Southbel…and the network are the same? </p>

<p>Right now…without a deal…it looks like Sutter is out of Anthem Blue Cross’s network…uncancelled plans or not. Sutter is a big hospital chain where I live.</p>

4948

<p>

That’s the word. Same networks, same policies, but no word on increased cost. That’s the huge issue I had with the ACA plans. Two major hospital systems here- Roper (private) and MUSC. Only one non-exchange ACA plan had just Roper. Crazy. Over 90% of doctors are in one of the two physician partner networks.</p>

4949

<p>

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<p>I haven’t seen a thorough analysis of this, but a few points:</p>

<ol>
<li><p>Rates in Minnesota aren’t uniformly low. They’re extremely low in the Twin Cities where the bulk of the state’s residents and medical providers are, and where many insurers are competing for market share. Most analyses say this is a simple function of supply and demand, and old-fashioned healthy competition. In southeastern Minnesota where pretty much all health care goes through a single provider, the Mayo Clinic, and where only one insurer is offering policies on the exchange, rates are roughly 2 to 3 times the Twin Cities rate. Healthy competition = low cost, no competition = high cost.</p></li>
<li><p>Rates are also much higher in neighboring Wisconsin, despite a similar population, demographics, economy, etc. Some western Wisconsin counties are part of the Twin Cities metro area, but rates in the Wisconsin counties are roughly 2 to 3 times higher than in neighboring Minnesota counties (rates in some other parts of Wisconsin are somewhat more moderate, but on a statewide average basis Wisconsin rates are still significantly higher than Minnesota’s). That makes for a particularly interesting comparison. I’ve seen several explanations for this:</p></li>
</ol>

<p>a. Minnesota decided to continue its high-risk pool, at least as an interim measure; Wisconsin is terminating its high-risk pool immediately. That means many of the highest-need, highest-cost individuals are being thrown onto the exchange in Wisconsin, while in Minnesota most of those in the high-risk pool are expected to stay in the high-risk pool and off the exchange. Insurance rates in each state reflect insurers’ expectations as to how many of those high-cost unhealthy people they’ll need to pick up on the exchange. If Minnesota eventually terminates its high-risk pool, rates in Minnesota will rise. </p>

<p>b. Minnesota already covers a lot of low-income people (above the Medicaid-eligible level) through a state program known as MinnesotaCare; that program is continuing, and most of those people will stay in MinnesotaCare. Because of its expansive high-risk pool and MinnesotaCare, Minnesota has a much smaller pool of uninsured, unhealthy, low-income people going onto the exchange. That means in Minnesota insurers are competing for a generally healthier and somewhat wealthier customer base on the exchange, and the competitive rates reflect that.</p>

<p>c. Minnesota already had one of the lowest rates of uninsured in the nation, around 9% (compared to 16% nationally), and state officials estimate that 60% of the uninsured will qualify either for Medicaid or MinnesotaCare. State officials are aggressively recruiting uninsured Medicaid- or MinnesotaCare-eligible residents to sign up for those programs through the exchange or elsewhere. Again, that means the risk pool of those buying private insurance through the exchange is very different than that in many other states.</p>

<p><a href=“http://www.usatoday.com/story/news/nation/2013/11/09/comparing-health-care-law-minnesota-wisconsin/3465247/[/url]”>http://www.usatoday.com/story/news/nation/2013/11/09/comparing-health-care-law-minnesota-wisconsin/3465247/&lt;/a&gt;&lt;/p&gt;

4950

<p>Yeah…if we can expand on what is happening in NH…and I have a feeling we can…looks like hospitals are cutting deals with insurance companies. Hospitals offer lower rates but they want more bodies…so other hospitals are cut out. </p>

<p>I doubt very much that Blue Cross is doing this in just one state…NH.</p>

4951

<p>Bclintonk, Interesting.</p>

<p>How many major health insurance companies are there in Minn?</p>

<p>Why would anybody want to stay in the high risk pool in Minn they didnt have to?</p>

<p>I looked at the high risk pool in Cal. The rates were higher than regular plans. There were annual caps that wouldnt cover a major operation. There was a waiting list to join. :)</p>

4952

<p>dstark, I have until Dec 6 to elect to keep my current plan until March 31. I am also waiting to hear what’s going to happen with the so-called fix. So I am going to be patient until I have all the information.</p>

<p>If I had to choose an ACA plan right now, I would go with Anthem over BS. The Anthem network is better than BS in my region, although I am waiting for Anthem to install a provider search tool on their website.</p>

4953

<p>We may have to end up signing up in Dec. That could be a nightmare.</p>

4954

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<p>I think it is 6.</p>

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<p>According to this article it is access to the doctors:</p>

<p>[Minnesota’s</a> high-risk insurance pool to close - TwinCities.com](<a href=“Minnesota’s high-risk insurance pool to close – Twin Cities”>Minnesota’s high-risk insurance pool to close – Twin Cities)</p>

<p>Also according to this article, after high risk pools close at the end of 2014, it should have a positive effect on exchanges:</p>

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<p>(MCHA is a non-profit through which high risk coverage can be bought).</p>

4955

<p>Interesting that Minnesota has not cancelled their high risk pool. I thought most states did.</p>

4956

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<p>Minnesota’s high-risk pool is the oldest, largest, most generous, and most expensive in the nation. It offers pretty comprehensive health care coverage, and it limits annual out-of-pocket costs to $5,960 for an individual or $11,900 for a family. Premium rates are capped at 125% of the standard rate for private health insurance; the program is heavily subsidized by taxes on health insurers and occasional infusions of state general fund subsidies. </p>

<p>Ultimately I suppose it will be cheaper for some people now in the high-risk pool to go onto the exchange; at least their premiums will be lower, though I’m not sure what it means once you net out deductibles and out-of-pocket limits. Mainly, though, people in the high-risk pool who are now getting good care from familiar providers just want to stay where they are, and don’t want to risk being unable to see their regular doctors as the result of switching to an insurance policy purchased on the exchange.</p>

<p>I understand Minnesota plans to phase out its high-risk pool at the end of 2014, but an appeals process will allow currently enrolled persons to seek continuation of their coverage if they can show their access to medical providers and medications would be diminished in the private market.</p>

4957

<p>DStark, if there is any possibility that you will sign up via the exchange (Covered Cal) – then set up an account now. You don’t have to enter the detail info - just set up user name/password. </p>

<p>I have found the Covered Cal site to run pretty smoothly, but navigation is somewhat confusing and it is regularly down for maintenance in off-peak hours. </p>

<p>I’m just suggesting this as a potential time saver down the line. Of course, if you are absolutely, positively, 100% sure that you will never qualify for a tax credit or subsidy, then just buy straight from the company. With Blue Shield it doesn’t make a difference: their exchange plans are identical to their direct plans – but Kaiser & Anthem have some variations that might be attractive. Kaiser has a Silver level HSA compatible plan ($1500 deductible) --that could be a very nice option for someone with moderate health costs, given the tax benefits of an HSA. Definitely if I was in a higher income bracket (outside the edge of subsidy eligibility) I’d look at that.</p>

4958

<p>Bclintonk and lerkin, thanks. I find that info very interesting.
It is also interesting that rates rise dramatically in areas of lower population. </p>

<p>Calmom, thanks.
If you dont know the answer, to this question. Np. I will find out.
Can I sign my kid up on or off an exchange and drop him mid year? With these sign up periods, I dont know anymore.</p>

4959

<p>Heard on the radio while out in the car, so no link.</p>

<p>The news from the hearings is that the portion of the website that processes payments for the insurance hasn’t been built yet!</p>

4960

<p>likely due to the roll-out fiasco, but viewpoints have changed on healthcare responsibility:</p>

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<p>[Majority</a> in U.S. Say Healthcare Not Gov’t Responsibility](<a href=“Majority in U.S. Say Healthcare Not Gov't Responsibility”>Majority in U.S. Say Healthcare Not Gov't Responsibility)</p>