The Gaming Den

Can somebody break down what the ACA really means as far as out-of-pocket cost of my group health plan?

Assuming we in the Dallas/Ft. Worth area actually ever get to see it implemented.

Game On,
fbmf

fbmf wrote:Can somebody break down what the ACA really means as far as out-of-pocket cost of my group health plan?

Assuming we in the Dallas/Ft. Worth area actually ever get to see it implemented.

Game On,
fbmf

You already have one? OK:

• Your plan will supposedly not be allowed to drop you if you get sick. They may or may not be able to find a loophole around that, but it is at least harder for them to cancel your plan if you get an expensive chronic disease.
• Your plan's host company will have a cap on the amount of money they are allowed to keep as profit or spend on "administration" which is lower than what they do right now. So the plan would have to spend more money on providing care or lower premiums to you.

And that's basically it. Most of the act is aimed at people who don't have or can't get insurance.

-Username17

what about the cadillac plan surcharge? And the penalty if you're plan doesn't cover certain things. I see republicans complaining about how they're gonna have to get a plan that covered gynecological visits.. even though they don't need any.

given that most people get insurance through work, and everyone basically gets the same plan (maybe a choice of 2) I'd be surprised if their plans didn't already cover such things, and if they don't.. they really ought to. There's basically not a single 'men only' industry these days.. except maybe chipendale

Depends on where you work. If you have a strong union behind you, or if you work for a large company with tens of thousands of employees, your insurance plan may remain largely unchanged. There's been a trend over the past few years of higher premiums and crappier coverage, and that may continue to an extent. It depends on how the healthy uninsured people react. If they decide to pay the tax, then everyone else's premiums will increase to offset the burden of the really sick people who will now be able to buy insurace from their hospital beds.

You said to assume the Dallas/Ft. Worth area. So there's probably not a strong union, unless you work for the Federal government or something like that. Teacher's unions, electrical worker's unions, labor unions in Texas don't have a whole lot of power, generally speaking. I could be wrong, but that is the stereotype of unions in Texas. If it is the AFLCIO or UAW, they'd probably have sent out a newsletter or something about the impact to you, so I am going to assume that is not the case since you're asking here.

If you work for a small business, there is a better than average chance that they're going to stop covering you and pay the fine instead. This also depends on the industry. If it is highly competitive with tight profit margins, then you can probably kiss your employer-provided insurance goodbye. If the goods and services you offer are in high demand and profits are high, then your boss will probably continue to cover you. Or, if you offer an in-demand skillset that is hard to replace, then he'll probably continue coverage. If he's a greedy, racist, white guy who hates Obama, then he'll probably drop coverage out of spite. Whatever the case, I think premiums are going to go up and coverage is going to decline. It has already started happening.

Stock price of insurance companies over the past few weeks paints a pretty dismal picture. A quick look at stock prices for Aetna, BC/BS, Humana, and a few other big names shows 5-12% drop in the value of their stock. The nosedive began June 28th, the day the Supreme Court decided the fate of ObamaCare. Is that short-term over-reaction by the stock market to the judgement rendered by SCOTUS?

If the market is predicting the future, then insurance companies are in for a rough time ahead. The value of their stock over the past few weeks tells me that insurance companies' costs are going to rise, and their profits are going to fall. Hopefully the lobbyists in Washington and various state capitals won't be able to bribe convince lawmakers to create a bunch of loopholes allowing insurance companies pass on their costs on to us, and keep huge profits for themselves. Those loopholes may not exist currently, and that's reflected by the drop in stock prices.

Course, the Stock Market is usually an indication of loonacy and crazy. The stock market goes down when good things happen, and it goes up when horrible things are happening to people. Wars, famines, the stock market loves misery.

The market predicts nothing. It merely reacts to manipulation.

Drops in insurance stock are nothing more than people selling off their shares in response to right-wing propaganda. When quarterly earnings continue to stay wildly high as they always have been, the price will rebound.

Or not. Stock prices are extremely subject to perception, so it's possible that Republican propaganda will keep insurance stock prices depressed for several years as they keep trying to push their agenda of stripping healthcare from everyone.

Aetna's stock went up by 6.5% in one day back in March when the Supreme Court made it clear that they were unlikely to strike down the individual mandate and leave the rest of the act in place (the worst possible outcome for insurance companies).

http://tcftakingnote.typepad.com/.a/6a0 ... 970c-800wi

By June 28th, it had already lost all of that extra value and more. Aetna was trading at nearly 50 on March 30th, by the day of the Supreme Court ruling it was down to less than 41. Today it's trading at a bit under 38. Clearly: things that don't have fuck all to do with the Supreme Court rulings figure much larger in the stock prices of Aetna than do the Supreme Court Rulings, at least in the long run.

The sky is not falling on insurance companies. Or if it is, it has something to do with the 18% of stock value that Aetna lost completely independent of the ACA's constitutionally or lack thereof, and not the 7% of stock value it has lost since the ruling - even if that 7% drop was entirely attributable to the ACA (which I doubt, since Aetna's stock was already falling).

-Username17

Considering that there is a penalty for not buying insurance if you can afford it, I think the insurance companies are going to be seeing record profits with the number of people who will be opting into insurance plans.

This should easily offset the hit they are going to take from not being allowed to drop you when you get sick or being able to refuse to cover you if you have a pre-existing condition.

Conventional wisdom is that the stock prices would be rising if the insurance companies are headed for a massive windfall. All the drama swirling 'round the decision and the upcoming election may be delaying the market's reaction to the news. The market may be expecting the uninsured to pay the penalty tax, since it will probably be cheaper than insurance.

Some investors think that the added burden of really, really sick people who never wanted insurance before but can now sign up for it from their hospital beds will put a major hurt on insurers. From a numbers standpoint, it doesn't make sense for healthy people who do not want insurance to now buy it. They'll just pay the fine. Then taxpayers will have to bail out the insurance companies, like we did the banks and car companies after the government over-reached its Constitutional authority and screwed them up.

npc310 wrote:Some investors think that the added burden of really, really sick people who never wanted insurance before but can now sign up for it from their hospital beds will put a major hurt on insurers. From a numbers standpoint, it doesn't make sense for healthy people who do not want insurance to now buy it.

I don't understand how these two sentences can go together.

Maj wrote:

npc310 wrote:Some investors think that the added burden of really, really sick people who never wanted insurance before but can now sign up for it from their hospital beds will put a major hurt on insurers. From a numbers standpoint, it doesn't make sense for healthy people who do not want insurance to now buy it.

I don't understand how these two sentences can go together.

It's a version of the free rider problem. If health insurance companies can't turn away clients who have preexisting conditions, then many people won't get insurance until they have pre-existing conditions.

Oh. OK. Thanks!

and they'll pay the penalty
Now if only the god-damn Republicans wouldn't neuter the penalty.

npc310 wrote:Conventional wisdom is that the stock prices would be rising if the insurance companies are headed for a massive windfall. All the drama swirling 'round the decision and the upcoming election may be delaying the market's reaction to the news. The market may be expecting the uninsured to pay the penalty tax, since it will probably be cheaper than insurance.

The beauty of the market is that it acts in defiance of conventional wisdom pretty consistently. (See Facebook IPO, mortgage-backed securities and real estate investment pre-2008, etc.)

We are living the age of high-speed trading where automated supercomputers make millions of trades per second and flash crashes appear for no reason. Prices don't mean dick.

Insurance companies already operate on an amazing amount of fat, often only paying out 50-60% of what they take in. Once they are forced to pay out 80% of every dollar they take in, their rates will fall proportionately and you'll see the rise of insurance packages that are at least slightly below the penalty rates.

To maintain the obscene levels of profits that they are used to, they have to start operating in volume. This means offering policies to the young people who don't get sick often at cut-rate prices below the penalty level.

It is common for doctors to have to submit claims three or four times before they get paid. Insurers may loosen up in that regard a little bit, too.

Back to the OPs question, no, we can't tell you what is going to happen to your group healthcare plan. With Texas opting-out of ObamaCare, insurers may use Texans to recoup the money they'll be losing elsewhere. There I go again, off on wild conjecture. Bottom line is, we'll have to see it implemented. The plan is too large with far too many regulations for any of us to understand. A team of insurance lawyers, accountants, doctors, and judges would be required to make sense of it.