<p>“Your first sentence is incorrect, and your strategy will not work”
-As some posts pointed out, it will in some (expensive) situations that involve conditions that can wait. I do not see why not. BTW, I personally do not care, I have 3 coverages for at least now. I care more about care accessability than coverage. I see that it simply will not be available for the very old, very sick and very young, I mean the groups that needs it the most.</p>
<p>The comparison of auto to health insurance was made to show how people will dodge the requirements. Eventhough we drive by choice, many people, some 30% in California have no auto insurance. They get around the rules. And why not? They are judgment proof if they do have a car accident. </p>
<p>The same will happen with ACA. I just saw some of the Covered California rates for the Silver Plan for those who will get federal subsidies. Someone making 17,000 per year will pay $600 a year for health insurance. The co-pays are very small. Still for that person $600 is a lot of money. And if you’re one of the young who think they will never get sick, why pay? At that income level the penalty, if it’s even collected is smaller. And if and when you do get sick, if you have no assets for the collection agencies to go after, you are not worth their time. </p>
<p>I’m not saying it’s right, or it’s moral, it’s certainly not responsible, but it is what many, many people will do.</p>
<p>I agree, people on $17k / year in CA out of all places, will not buy med. insurance, I do not know how they can rent a simple dwelling on this income, forget insurance…Frankly, many will not consider living in CA at all because of the cost of living</p>
<p>TatinG, you are correct that this risk exists. One factor that may serve to mitigate it to some degree is the “mom factor”. For example, I have a niece who is 27 and her job does not offer benefits. She is young and healthy, and doesn’t make much money. </p>
<p>She said she would pay the penalty rather than buy the insurance. Then her mom told her she would NOT refuse to buy health insurance. After all, which of us would allow our kids to not get care they need, if we can. My SIL told her D that she wasn’t just buying insurance for her health, but to protect the entire family’s assets. Anyone could develop a health issue, and my SIL said she didn’t want to go homeless just because her D didn’t want to pay a pittance to buy health insurance. So my niece will have insurance, regardless of who actually pays for it. The mom factor may not be a majority response, but it’s out there.</p>
<p>I am wondering about MediCaid, we all hear that it is difficult to find a doctor who accepts MediCaid. If a person is currently insured and has a PCP, in 2014 the person finds themselves on MediCaid, will that doctor be obligated to keep them as a patient? Where are all these new MediCaid patients going to find providers?</p>
<p>hayden, Bingo! I feel the same way as your SIL. It’s all about our asset protection. We could never let one of our children not receive potentially life-saving, yet expensive, treatment just because they didn’t have coverage. D agrees, so this won’t be a battle for us.</p>
<p>We also plan to be sure our kids are always covered by insurance, even if we pay for it out of our pockets.</p>
<p>“It will be the same with this law too.”</p>
<p>You’re describing the current system. Under the current law, your hypothetical freeloader doesn’t even have to pay a penalty, and if he does try to buy insurance, he’s likely going to be put off by high rates and preexisting-condition exclusions.</p>
<p>The law IMPROVES this situation by changing the calculus a little bit: he has to pay some kind of penalty for freeloading, in most areas basic plans are more affordable than they are without the exchange, and he can’t be excluded because of his HS basketball injury. Plus, there’s a big national push underway to remind him that insurance is a smart idea if he cares about his physical and financial future. As other posters have noted, his mom may be thinking about this now where she wasn’t before. He’s more likely to buy insurance now than without the law.</p>
<p>So I agree that the law doesn’t do enough to prevent freeloading – it ought to have a mandate with teeth, where you pay the cost of the insurance on your tax bill if you refuse to buy it. But it’s a step in the right direction.</p>
<p>“It will be the same with this law too.”</p>
<p>Yes, some will choose to pay the penalty, but if we use Massachusetts as an example since health insurance has been required for several years now - most have purchased insurance. I heard the figure is 99% now have health ins. in that state. </p>
<p>The biggest problem I see, in terms of getting people to sign up, is in the states which aren’t expanding medicaid, and making navigators and any information about how to get health insurance in those states, against the law (Missouri and Florida, for eg.)</p>
<p>The mom factor may work for the CC demographic, but for most lower income people, mom and dad have no assets either. </p>
<p>Eventually, I think, health insurance premiums will be deducted from pay just like Social Security and taxes.</p>
<p>TatinG, from your mouth to God’s ears.</p>
<p>
The ACA requires that employer insurance include dependent coverage, although that mandate does not necessarily include coverage of a spouse. But basically, an employee’s children will be covered. </p>
<p>That does not mean that the employer has to subsidize the dependent coverage, however. It is very possible that a person may end up paying more to cover her children on the employer’s plan that she would if she could buy policies for them on the exchange.</p>
<p>Another thought about the medal levels and choosing your plan. The notes say that bronze and silver would be HMO based, gold PPO based. Thus far, I have not see anything offering me an opportunity to verify provider availability when choosing plans. With a 2013 plan, you can go to the company website and run provider availability searches based on the plan, but so far, I have not seen that option.</p>
<p>somemom, re your Medicaid question – I think that with the expansion of Medicaid, there will also be more providers willing to accept it. It probably depends on the specific provider and area. It simply may become more cost-effective for some providers when a higher proportion of their patients are getting Medicaid.</p>
<p>Then again, there will also be a growing pool of patients who have insurance through the exchange providers — and plenty of doctors who already have closed their practices to new patients simply because they have more patients than they can handle.</p>
<p>“The ACA requires that employer insurance include dependent coverage, although that mandate does not necessarily include coverage of a spouse. But basically, an employee’s children will be covered.”</p>
<p>I think the company in question is really small (less than 50). I suspect they are not required to cover anyone. </p>
<p>This thread is going too fast but I am thinking this is tied to the new born baby question?</p>
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<p>This is my concern. (See several posts back.) I think the HMO plans will only offer a subset of the current provider lists. I’ve seen articles to this effect. So it’s important to know if your current docs are on their list or not.
In principle, this is to be expected. As it is now, the cheaper plans are HMOs, where the providers have agreed to take a specific amount of compensation, and where hospitals agree to keep costs down. But if you are accustomed to premium care with a university teaching hospital, I doubt you’ll find it on the Bronze or Silver plan. That’s a perk the PPO, Gold plans will offer, I believe.
Let’s hope this is more transparent come Oct. 1st.</p>
<p>At least the ACA will enable the ability of SOMEONE to purchase insurance if there is a desire to do so without HUGE expense. Even for folks we know with low income, many would buy coverage if they could and premiums weren’t sky high and excluding their Pre-existing conditions, including asthma.</p>
<p>
Yes. Except that if her employer pays for her now, and has to offer it to the baby, but doesn’t have to pay for it, the employee has a choice whether to pay for the baby through her employer, or both go to the exchange. She can’t continue to have her employer pay hers and buy insurance for just the baby through the exchange.</p>
<p>I know this because I called our insurance agent to ask.</p>
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<p>I don’t see how you come to this conclusion. The very old have Medicare. The very sick will not be exempted from insurance, as many of them are now. And of course, there will still be emergency care for emergencies. And the very young? They are being better taken care of than ever, being able to stay on their parent’s policies until 26. And the get a very cheap catastrophic policy until they’re 30. Who are these very old, sick and young you’re speaking of?<br>
The new law protects and includes more people. But it’s going to cost some people more money for more comprehensive care that they wouldn’t have purchased otherwise.</p>
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<p>That’s not at all true in my state – so I am not sure what “notes” you are referring to.</p>
<p>Here are the basic choices in my region:</p>
<p>Bronze: 5 insurers total, 8 plans
3 HMO plans with 2 insurers
5 PPO plans with 3 insurers (1 HSA eligible plan)</p>
<p>Kaiser, Anthem, and BS each offer 2 bronze plans – the difference in their bronze plans are in the breakdown between deductible and co-pay amounts. So basically it’s a choice between a $4500 deductible + 40% copay vs. paying a slightly higher premium for a $5000 deductible + 30% copay. (Keep in mind that the annual out of pocket max is the same for all plans except Platinum)</p>
<p>Silver: Same 5 insurers, 5 plans
2 HMO – 3 PPO</p>
<p>As I understand it, I do think that the new PPO for my insurer will have a smaller overall network than the PPO I now have (which is being discontinued).</p>