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<p>How is it “unfair”?</p>
<p>I understand that it not fun. No one wants to have to pay out more money, whether it is for insurance, increased rent, food costs, taxes, whatever. </p>
<p>But my idea of “fair”, ideally, is “equal.” So, “we all pay the same amount” seems to me to be the epitome of fairness.</p>
<p>But we all in this case is just the people who were buying their own insurance. It is not really we all at all. Remember, the vast majority is still unaffected.</p>
<p>It’s an unfair deal because it is asking a very few people in the population to pay more and not those getting employer coverage. We are basically being pooled with a particularly unhealthy group of individuals in a way which is not right, imho. I do not see this as “fair” by any stretch of the imagination. Use your critical thinking skills, not your political bias.</p>
<p>It should be spread across the entire population and it will be, I imagine, soon enough. At some point in time everyone will be in the same pools, not these segregated pools. The big great thing is supposed to be able to be free of the tyranny of being stuck in a job because you can’t afford the health insurance etc… This won’t last.</p>
<p>Yesterday Iglooo was unable to produce any data demonstrating that the new private insurance pools were any less healthy than the employer insurance pools. Are you able to produce any data today, or are you still repeating the same claim that nobody was able to back up yesterday?</p>
<p>^^I don’t know, poetgrl. The unions will scream bloody murder, and if premiums go up too much for employers, they will dump the policies. Imagine the outrage then. I suspect a small group of you will have to continue to take care of the rest. Scream louder, buy lobbyists. It’s the only way.</p>
<p>As far as statistics, does it really matter, cf? People know whose premiums are going straight up.</p>
<p>CF and Calmom, I was asked a question and I answered it. </p>
<p>Here is the post count up to me. I think you guys have had more than enough of a say:</p>
<p>Who Posted?
Total Posts: 6,710
User Name Posts
dstark 726
Goldenpooch 719
calmom 705
Cardinal Fang 694
texaspg 313
emilybee 264
busdriver11 263
poetgrl 232
TatinG</p>
<p>But keep in mind that employer premiums have historically been higher than individual market premiums – the full amount tend to be hidden from the individual because of employer subsidies – so if you are talking about which group pays more you have to factor in the full cost of employer premiums.</p>
<p>^^more importantly, large employers tend to be self-funded. They don’t purchase insurance (premiums) for their employees. Its the small employers that purchase insurance if they want to cover their ee’s.</p>
<p>Depending on risk profile, employers with as few as 300 employees can self-fund. (Our broker says that employers with <200 ee’s are seriously considering ASO plans.)</p>
<p>Look, here’s the deal. The uninsurables and the seriously ill can’t even work most of the time, certainly not at the capacity which offers great health insurance.</p>
<p>I will go back on employer health insurance, I imagine, soon enough. I certainly have it available to me should I choose it. Given that we have been given the old policy for one more year, which does not pool us with those who use massive amounts of care and cannot work, I will stick with it.</p>
<p>However, don’t try to tell me that this isn’t what has happened. I can do the math.</p>
<p>Also, we’ve been over the employer subsidies bit on this thread about a hundred times. Honestly, it’s not new information or new to the thread, nor does it have anything to do with MY insurance, which is what I was asked about.</p>
<p>Carry on.</p>
<p>Did we resolve the “massive amounts of care” issue? Did I blink?</p>
<p>Here are statistics on the uninsured:
[Key</a> Facts about the Uninsured Population | The Henry J. Kaiser Family Foundation](<a href=“http://kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/]Key”>Key Facts about the Uninsured Population | KFF)
[Overview</a> of the Uninsured in the United States: A Summary of the 2012 Current Population Survey Report](<a href=“http://aspe.hhs.gov/health/reports/2012/uninsuredintheus/ib.shtml]Overview”>Overview of the Uninsured in the United States: A Summary of the 2012 Current Population Survey Report | ASPE)</p>
<p>The majority are in families making between 100% and 400% of poverty.
The majority have at least one full time worker in the family.
The majority are between 19 and 44.
The majority say that they are not insured because of costs. </p>
<p>So it looks like the majority of people going on to the exchange are going to be young, working adults (and possibly their families). I’d wager a guess that those with chronic conditions are going to be on Medicaid and not on the exchange.</p>
<p>ETA: Various sources seem to indicate 1 in 7 to 1 in 8 are denied due to pre-existing conditions in any given year. Could this be skewed by people who don’t bother applying? Yes. I will not link because they’re mostly political and/or blog sources. I’m still looking for a reputable source that I can link.</p>
<p>LF… :).</p>
<p>Bluebayou, Similar policies. Which are more expensive? Those in the individual market or those in the large employer market?</p>
<p>LF. I just came on to say that dotgov is apparently working in our state. I was asked a question and answered. I’m not reading this thread anymore or posting on it except for this. </p>
<p>In other words, I have not been reading along to keep up with the loop of California responses, nor will I be after this. </p>
<p>I would suggest, however, that it be relabeled as a few Californians discuss the ACA. The thread title is rather misleading at this point.</p>
<p>Thanks! I needed that laugh about now. LOL!</p>
<p>Well, this I think is the best I can find: </p>
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</p>
<p>[Millions</a> Previously Denied Insurance Coverage Because Of Health Problems Look To Online Marketplaces - Kaiser Health News](<a href=“http://www.kaiserhealthnews.org/stories/2013/october/01/preexisting-condition-consumers-insurance-obamacare-marketplaces.aspx]Millions”>Millions Previously Denied Insurance Coverage Because Of Health Problems Look To Online Marketplaces - KFF Health News) Click on the highlighted “pre-existing health conditions” in the article. </p>
<p>Best I could find. I don’t really care about the data or what it says or doesn’t say but since people seem to not want to provide any statistics on the matter, I figured I’d give it a shot.</p>
<p>Nice find, Romani. The actual report about pre-existing conditions is here:</p>
<p><a href=“http://www.gao.gov/assets/590/589618.pdf[/url]”>http://www.gao.gov/assets/590/589618.pdf</a></p>
<p>Lots of uncertainty. People with employer insurance report higher rates of pre-existing conditions than uninsured people or people with private insurance, but why? Is it because they are sicker, or because they know that they have certain conditions because they are able to get regular health care?</p>
<p>I think it’s important to keep in mind that a “pre-existing condition” is not the same as a chronic condition or current illness. </p>
<p>The term pre-existing condition refers to a determination that health insurers made based on past health history, as part of the process of assessing risk of future medical expenses. </p>
<p>So that term includes people who are currently ill or have high current medical expenses, but it also includes people who have no significant current medical needs (or expenses), but have some past diagnosis that simply means that they are at greater risk of needing future treatment. </p>
<p>So a person with a pre-existing condition is simply a person with a known risk factor that increases the odds of future medical expenses.</p>
<p>A person without any pre-existing condition is someone with unknown risks of incurring future medical expenses. </p>
<p>I think this is important because it changes the math. Yes, there were people with known, chronic conditions who were excluded from being insured in the past, but ACA is also going to bring an influx of new people who simply happen to be a riskier investment from the insurance point of view. </p>
<p>Also, I think that a large proportion of the sickest people with the most expensive chronic conditions may already be covered, primarily through Medicaid or Medicare, but also via employer coverage – because their need for treatment would pretty much require that they find some sort of coverage. Either they exhaust all their assets to pay for their dialysis or chemotherapy or whatever expense they have, and get to the point where they are sick enough and poor enough to qualify for SSI and Medicaid; or they have an employed spouse or parent who didn’t dare quit his job for fear of losing insurance. </p>
<p>I think the people with pre-existing conditions who went without insurance are likely to be people with less immediate needs. Some of them may have deferred treatment for a number of years, such as recommended surgery – and may rush to get that as soon as they can get a policy – but many may be people who were essentially stigmatized by something in their medical history that has little impact on their current medical needs. </p>
<p>Of course bringing all these people into the individual insurance market will change the profile of the risk pool, but I don’t know that it will have the high level impact that people fear. And again, the very sickest are likely to qualify for Medicaid, particularly in the expansion states-- in a sense, the new system even provides something of an incentive to qualify for Medicaid because of the elimination of means testing. It’s hard to sustain employment while seriously ill – and unemployed people, for the most part, are going to be Medicaid-qualifiers.</p>
<p>I don’t think it’s so easy (or justified) to line up those who disagree with someone’s “own eyes” and blanket label them Obamacare defenders. As if there’s one’s own accurate perception on one side and fault on the other. Cheating husbands? What impression is that supposed to leave? </p>
<p>I see it as more explaining aspects of it or pulling up references that clarify, correcting some impressions or assumptions (some wild ones,) etc. In some cases, trying to rein in unsupported pronouncements. Most of us are trying to figure it out, see how it applies to us, where it may serve us and where it may fall short of perfect. For us. It’s very YMMV. </p>
<p>We’re going to see how this works- going forward into 2014, we’ll learn more about how our plan choices suit us, how they work if we need medical attention and how this rolls out in states and for the country. Then, we’ll have both a more personal and a wider view. We’ll have experienced it.</p>
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<p>I agree that this is the intended case, which is why I never felt the employer mandate should have been delayed. Whether they like it or not, even the self-insured companies will be contributing to the system via the surcharge that is so controversial, and according to a pal in the industry, has hr folks screaming and crying at brokers :)</p>
<p>Historically, the pooling in employer insurance has been a formula of age and usage, except in emp ins that was already part of a larger pool, such as BCBS in Michigan. </p>
<p>In our small example, the young and old when pooled caused premiums that happened to match almost exactly what similar coverage would now cost on the exchange (without subsidy.)</p>
<p>I suspect the reason the true cost of employer ins as paid together by employee and employer has perhaps in some cases been higher than some of the historic rates in the individual market is more a function of actuary assessment instead of pooling and streamlined (eg loopholes and caps, gaps) in coverage – hence the wild variation. Leveling the playing field in this case meant that those policies now reflect more closely what an employer pool looks like to some extent, because now its pooled and the primary premium variable is age.</p>
<p>So I’m unclear why anyone is taking exception to poet girl’s analysis. I’m pretty sure its in line with both the intent of the legislation and the mechanics of rating :)</p>
<p>Ultimately, whether the presently uninsured will cost more or will cost less overall will not necessarily cause a sea-change of differential in individual vs employer insurance premiums, in part because the number is too small to move the average, and in part due to the variations of the uninsured pool, which would likely average out at the end of the day.</p>
<p>What will make a difference in premiums is an age imbalance in our society 
So for those of us middling folks, its actually likely a good thing that our younguns have been a mandated into the pool ;)</p>
<p>^Excellent post. Refreshing to hear a cool reasoned argument. </p>
<p>About the young taking up for the old, if you look at the wealth distribution, you’d think we shouldn’t ask young people take up more burden. I hope the health care doesn’t become yet another way of skewing the wealth.</p>
<p>About having three months grace period, I don’t see why anyone would pay all 12 month premiums. If they don’t expect they will get sick during the last three months, they could stop after the 9th payment. They are still insured. If they get sick during that time, they can catch up on payments. It will be interesting how it works out.</p>