<p>Has anyone determined which of the essential benefits are truly driving up the cost of insurance? </p>
<p>Is the lifting of a lifetime cap the benefit most responsible for increased cost? If so I believe that is a necessary trade off because in my opinion many people really had insurance with little true value if their insurance had a low lifetime cap.</p>
<p>Large employers have risk pools that are much less healthy than the private pool used to be. Remember, they cover all employees, even for example cancer survivors, heart patients and asthmatics, and they also cover employees’ families.</p>
<p>The new rule that’s driving up health premiums is community rating, the risk pool, where the insurance companies can’t deny insurance to anyone. It’s much cheaper to provide health insurance if you don’t have to insure sick people.</p>
<p>In order to get employer coverage you need to be able to work and thus be relatively healthy (I am ignoring dependents and Cobra here). It used to be that private market consisted mostly of healthy people, now we are adding high risk people who could not get insurance before, hence skyrocketing prices. It’s really not that surprising.</p>
<p>Tom1944, There was a study. I think removing the lifetime cap costs around $40 per person a year.</p>
<p>“you can keep your doctor”
I am keeping my doctor. In fact, all my docs.</p>
<p>Agree with Calmom, not the fault of the law itself.
If Anthem changed your provider access, Anthem changed it.<br>
GP, you are a moving target. No one is denying you Cedars. They are saying, your choice, we won’t pay per the in-network scheme. You choose.</p>
<p>Community rating, perhaps. But I’ll say it again: as approved by your state.</p>
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<p>ALL of the essential benefits raise the cost of premiums. A few percent here and a few percent there, and all of a sudden, we’re talking real money. :)</p>
<p>(paraphrasing the late Senator Dirksen)</p>
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<p>I don’t follow this comment. Community rating is a federal law now.</p>
<p>Ok…they raise premiums. Do they raise overall costs?</p>
<p>I reas that paying for prevention doesnt pay off. But… Does paying for the ten essential benefits pay off with lower overall costs? That is a different question with maybe a different answer.</p>
<p>dstark- $40 seems a small price to pay for insurance that will actual cover you if you have serious medical bills. So is anyone against the lifting of the cap?</p>
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<p>Negaive. Published research shows that in the short-term, prevention does not lower costs. Some of the essential benefits might – might – lower costs in the long-term, but that is not what the '14 & '15 premiums are based on.</p>
<p>(edited to post the link so I don’t get chastised again. Research also available on the New England Journal of Medicine’s site.)</p>
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<p><a href=“http://www.cbo.gov/sites/default/files/cbofiles/ftpdocs/104xx/doc10492/08-07-prevention.pdf[/url]”>http://www.cbo.gov/sites/default/files/cbofiles/ftpdocs/104xx/doc10492/08-07-prevention.pdf</a></p>
<p>Can we list the essential benefits now added-
No cap
free birth control
pregnancy
no preexisting exclusions</p>
<p>what are the others?</p>
<p>Looks like this message needs to be repeated every couple of pages since the discussion veers off into political arena.</p>
<p>This is not a thread to fix, improve, change, update, modify, or nullify ACA.</p>
<p>I suspect that to the extent that any premiums are going up, it may be a reflection on the uncertainty of who they’re insuring, rather than any one benefit. </p>
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But why should you? For every one employee, you may be bringing in multiple dependents with pre-existing conditions. </p>
<p>The insurers have the same uncertainty everyone else has: they don’t know right now who they’re underwriting so I think they’re pricing for a risky pool. The key will be where the costs go once the pool stabilizes over time.</p>
<p>Free vaccinations, free screening tests like mammograms and colonoscopies. Your insurance probably already covered those, but they were probably subject to copays and coinsurance.</p>
<p>I agree with hayden. I would not be shocked to find out insurers overestimated their potential costs to cover everyone and that going forward the premiums may come in lower.</p>
<p>Hayden, </p>
<p>Statistically speaking, number of healthy dependents should greatly outnumber unhealthy ones. So, my argument still stands.</p>
<p>You can only stay on Cobra for 18 months. It used to be that if you got sick most likely you could only keep your private insurance for 12 months. The numbers are comparable. As soon you got sick you were promptly kicked out from both insurance markets, unless you were lucky enough to be someone’s dependent.</p>
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<p>We can be sure it’s a risky-er pool. Unless insurance underwriters are complete incompetents-- and they’re not-- the people who applied for insurance and were denied are costlier than the people who applied for insurance and were accepted. And we know that the rejected people want insurance, so we can safely assume that they will buy it now that they can.</p>
<p>Bluebayou, I appreciate the link. </p>
<p>I am not going to comment further. :)</p>
<p>dstark, just so you know what I am up to - today I have traded emails with the Chief Operating Officer of Anthem. He is assigning a knowledgeable Anthem official to call me with definitive answers. If you have any other questions besides the ones we have discussed, let me know.</p>