Unvarnished Truths is a blog depicting my attempts to write about things I make, and about things that interest me. Sometimes I may try to explain why this is so, or why something was built a certain way as opposed to another, but usually I am not successful. I think about the best that readers can hope for is to be mildly entertained.
Obamacare
Posted 27th December 2015 at 10:37 AM by Harry
In an effort to provide useful information about health insurance in response to Auntie Pam's post, I asked an agent to explain some of the points she brought up:
I can say, that while it hasn't been overly successful it hasn't been a failure. About 70% of my clients have saved @30% on premium. About 30% are paying more than they were...but their plans are better.
During Open Enrollment Period (11/01-3/31) no one can be denied coverage & pre-existing conditions don't exist. Outside of OEP, it is impossible to buy individual medical insurance unless certain Life Events occur such as marriage, divorce, birth, losing a group plan, and others.
As to anyone losing their homes or bankruptcy it is unlikely that their medical plan was at fault, since the maximum any one person would owe for coverage during any year is the annual premium+$6,850(plan maximum out of pocket). Not cheap, but certainly workable for most people.
There is also a percentage who choose to spend money on personal interests rather than insurance, health, home, or life.
However, it is the non-medical expenses (lost wages, maybe home modifications, extra childcare, etc) that cause...and have always caused... financial catastrophe. You might have a couple weeks sick pay but that doesn't last and it doesn't usually pay for the time you lose to care for a sick spouse or kids. This is true for employees covered under group plans as well as the individual plans.
Then too, a lot of people chose to pay the tax penalty rather than buy the Obamacare plans. They were "offended" by being forced into government plans. Then if they got sick, because they are outside of OEP, they couldn't buy a plan so all the medical expenses are their responsibility. So that somehow transforms into being the fault of the insurance.
As to employers not being able to afford coverage for employees, some do, some don't... I can't see any difference after ACA. Although that will change. In the next couple of years all employers will be required to provide plans for employees (dependents can buy individual plans). However, the rules haven't been revealed yet by the Feds.
In summary, I personally don't like many portions of the plans. But no plan works for everyone and these plans actually work pretty good. The ACA will evolve over the next several years just as Medicare did before it.
However it isn't going away no matter who gets elected. By 2017 it'll have been around for 3 years. Roughly 70% of those who bought it pay less than before. They won't vote to get rid of it.
I can say, that while it hasn't been overly successful it hasn't been a failure. About 70% of my clients have saved @30% on premium. About 30% are paying more than they were...but their plans are better.
During Open Enrollment Period (11/01-3/31) no one can be denied coverage & pre-existing conditions don't exist. Outside of OEP, it is impossible to buy individual medical insurance unless certain Life Events occur such as marriage, divorce, birth, losing a group plan, and others.
As to anyone losing their homes or bankruptcy it is unlikely that their medical plan was at fault, since the maximum any one person would owe for coverage during any year is the annual premium+$6,850(plan maximum out of pocket). Not cheap, but certainly workable for most people.
There is also a percentage who choose to spend money on personal interests rather than insurance, health, home, or life.
However, it is the non-medical expenses (lost wages, maybe home modifications, extra childcare, etc) that cause...and have always caused... financial catastrophe. You might have a couple weeks sick pay but that doesn't last and it doesn't usually pay for the time you lose to care for a sick spouse or kids. This is true for employees covered under group plans as well as the individual plans.
Then too, a lot of people chose to pay the tax penalty rather than buy the Obamacare plans. They were "offended" by being forced into government plans. Then if they got sick, because they are outside of OEP, they couldn't buy a plan so all the medical expenses are their responsibility. So that somehow transforms into being the fault of the insurance.
As to employers not being able to afford coverage for employees, some do, some don't... I can't see any difference after ACA. Although that will change. In the next couple of years all employers will be required to provide plans for employees (dependents can buy individual plans). However, the rules haven't been revealed yet by the Feds.
In summary, I personally don't like many portions of the plans. But no plan works for everyone and these plans actually work pretty good. The ACA will evolve over the next several years just as Medicare did before it.
However it isn't going away no matter who gets elected. By 2017 it'll have been around for 3 years. Roughly 70% of those who bought it pay less than before. They won't vote to get rid of it.
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