Affordable Care Act Scene 3 - Insurance Premiums 2015

deleted to make way for a better x-post.

Okay…to good to resist

http://www.nytimes.com/2015/01/06/us/health-care-fixes-backed-by-harvards-experts-now-roil-its-faculty.html?_r=0

But wait…no no no…we didn’t mean this is good for US…it’s good for THEM…we just like to theorize on paper and advise higher ups…all of whom of course would never every actually have to deal with the reality of our ‘advice’. This is sooooooooooo unfair…!!!


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Who is the “we” you are talking about, dietz? The Harvard faculty members who are quoted as not wanting to have to pay $250 deductibles (oh goodness gracious, how could anyone afford that!) are not the same Harvard faculty members who advised on the ACA.

I can assure you that when the Obama administration looked for health care economists to design a health care plan, they didn’t consult the world’s leading authority on classical Latin.

Well, we could have polled the these bright lights as to their level of support, CF…

… but that was then, this is now:

She sounds so like the average, shell-shocked, “what?, I’m going to have to pay for all this? Me?” whiner that you might think she’s really a auto plant worker in Georgia.

Too funny.

You would think these very smart Harvard people would have seen this coming, like the rest of us stupid people did a few years ago.

Somehow I’m having trouble getting excited about $250 deductibles and $20 office copays. They apparently have been living in la la land for quite some time.

Read more closely, catahoula. Did you notice that Dr. Alan Garber supports the Harvard changes?

So the classics professor and the historian of modern France say they don’t want to pay more for their health care. So what? The auto plant worker doesn’t want to pay more either, and neither does anyone else. Everybody wants to pay less for more. So what?

Wouldn’t have include that bit if he hadn’t, fang. It’d be pretty disappointing, what with his clear paper trail of support, if he turned out to be as big a hypocrite as the faculty - leadership evidently counts for something at Harvard, even if the little cogs think it tastes like castor oil.

You aren’t maintaining that every one of the Harvard whiners weren’t previously fervent supporters… are you?

I have no idea whether they were previously supporters, and neither do you. This seems to me to be an ordinary dispute between employer and employees about benefits. Yawn.

True, about what we know but it’s hardly an ordinary benefits dispute. Nope, we have the cream of the academic class bitterly fighting changes that were intrinsic to ACA working.

Didn’t get to Harvard but I believe this might be termed ‘foreshadowing’.

They might also support a minimum wage that does not mean they want Harvard to pay them that. They had a great benefit they want to keep or to receive an offset gain in some other area of their compensation package. That does not mean they are wrong to support a program that could provide thousands a chance at health care coverage.

Really, since the first thread on ACA some have been saying: don’t just go looking for headlines that, only at first glance, seem to support your feelings. Gotta look a little further, to be informed.

I don’t think I can link Rachel Maddow’s page, but look for the comments by Steve Benen. Jan 6.

“They might also support a minimum wage that does not mean they want Harvard to pay them that.”

Right, they just think they are smart enough to figure out what’s best for everyone else. Sometimes, they are wrong, though probably because they are somewhat out of touch with everyone else and really believe everyone else is stupid. What a mess.

The Harvard Corporation reducing benefits to employees is hardly intrinsic to ACA working. The ACA would work just as well if Harvard continued the generous health plan.

This is just employees and employers squabbling about benefits. The Harvard professors do, however, seem ignorant about most people’s insurance coverage. Whining about a $250 deductible? $250? Oh come on, get a grip.

That’s (perhaps) true. But – and I have no idea of what the costs are – the Cadillac tax which kicks in later might have an impact today. If the Harvard plan is so rich, for example, that the tax is a foregone conclusion in 2018, the Corporation might want to start reducing plan expenses today so its ee’s don’t take a big hit later. But that’s all my speculation, no of which is covered in the article.

(Yes, of course, H is clearly rich enough to pay the Cadillac tax and continue premium benefits, but it would probably be a publicity nightmare. The optics would look bad to Joe Six-Pack.)

Just registered on the health care website,and will receive a good tax credit, due to recent layoff, I anticipate a fairly low income for 2015. even with the tax credit, I am surprised at the rates, and am considering an HMO with UHG.

I am concerned about the risks of an HMO, (have had a PPO last few years through employer) and primary concern is being out of town and having need for care. I was told the HMO must pay for true emergencies out of state, at the in network rate, but am still not sure this is a smart idea. How has that worked for others?

thanks!

Here’s the H 2015 plan, sorry if someone already linked it. You can see costs, as well. http://hr.harvard.edu/files/humanresources/files/2015healthplanratechart_facultyandnon-unionstaff.pdf

myturnnow https://www.healthcare.gov/health-care-law-protections/doctor-choice-emergency-room-access/
“Access to out-of-network emergency room services: Insurance plans can’t require higher copayments or coinsurance if you get emergency care from an out-of-network hospital. They also can’t require you to get prior approval before getting emergency room services from a provider or hospital outside your plan’s network.”

Check not just emergency care out of network, but also the urgent care, think of minor, non emergency department things, but which still require a visit- bladder infection, new high blood pressure, minor injury etc. Also, check what happens with something serious where you go to the ED and are admitted, that admitted care after a cardiac event or MVA would no longer be emergent care.

If you are eligible for subsidies and your income is less than 250% FPL, you would be eligible for reduced deductibles and co-pays, be sure to review the silver plans for that.

This may be an issue that unites left and right. The right thinks the Harvard professors are whining hypocrites because they (allegedly) favor Obamacare but don’t like these changes, and the left thinks the Harvard professors are whining elitists for complaining about a wonderful health plan that most people could only dream about. But everybody thinks they’re whiners.

" that admitted care after a cardiac event or MVA would no longer be emergent care." Gotta read your policy’s fine print- or call the insurer and ask.

This is from United Healthcare. Same wording should be find-able for others:

If the enrollee is admitted to the hospital through the emergency room, the entire encounter is considered an inpatient admission (i.e., including the services rendered in the emergency room), and therefore only the inpatient benefits/copay apply. The fact that the enrollee entered the hospital for admission through the emergency room (versus the admissions door) does not change the benefit for the inpatient admission (i.e., only the inpatient benefit applies). If this emergency admission is at a non-network facility, network benefits will be applied. UnitedHealthcare may elect to transfer the enrollee to a network facility as soon as medically appropriate. If the enrollee chooses to stay at the non-network facility after the date that it is determined a transfer is medically appropriate, non-network benefits will be applied for the remainder of the inpatient stay.