Maybe a conservative can explain, the Repiblicans are going to "repeal" the ACA,

Guille said:
I'm not for Medicare for all but I think it could fill in the gaps. I'm not sure how much of a problem we had to begin with.

This is anecdotal but I wonder how many people will relate. A friend of mine has a loser son, 27 years old and always bitching about not being able to see a doctor. He claims he can't do it, even today with the ACA...until he needed a "glaucoma" diagnosis, then he found the money and a doctor no problem at all.
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Insurance companies figured that 27 year old would do EXACTLY that.

That is why we have the mandate.

Insurance companies can't afford having people jump in when they're sick and then jumping out when they are NOT sick.

Without the mandate, insurance companies have to be hard core about preexisting conditions - requiring long wait periods, identifying problems that the insurance won't cover, refusing to carry people at all, charging huge sums for those who aren't well, charging way more for those nearing retirement (since the risk is higher), dumping those who get sick, etc., etc.

Before the ACA, we saw all of these.

I think the "gap" would become "all those who don't pay insurance" - that is, if you make little enough that you don't have to pay taxes, you would be on Medicare. Medicare would become better, because it would involve too many people for our representatives to ignore.
 
I should have added that this was a source of the great care we have surrounding medical records.

Before the ACA, insurance companies would analyze personal health care information to determine whether they would sell you insurance - and at what price.
 
Guille said:
The subsidy costs more.
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I would need to see a reliable cite to support the idea that subsidies for ACA can be more than the cost of Medicare to tax payers.

After all, subsidies are sized to solve the problem - which is often a small amount, leaving the insured to pay the majority of the cost of the policy.
 
WillReadmore said:
Insurance companies figured that 27 year old would do EXACTLY that.

That is why we have the mandate.
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That's not why we have the mandate. If your reasoning were correct then 26 year old adults would not be able to remain on their parent's policy and the fines wouldn't be substantially less than the cost of a policy. We have a mandate to prevent competition.

WillReadmore said:
Insurance companies can't afford having people jump in when they're sick and then jumping out when they are NOT sick.
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Sure they can, they just might have to get used to lower profit margins.

WillReadmore said:
Without the mandate, insurance companies have to be hard core about preexisting conditions - requiring long wait periods, identifying problems that the insurance won't cover, refusing to carry people at all, charging huge sums for those who aren't well, charging way more for those nearing retirement (since the risk is higher), dumping those who get sick, etc., etc.
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I've got news for you, they're still not that friendly to people with pre-existing conditions.

WillReadmore said:
Before the ACA, we saw all of these.
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And we're still seeing it to some extent.

WillReadmore said:
I think the "gap" would become "all those who don't pay insurance" - that is, if you make little enough that you don't have to pay taxes, you would be on Medicare. Medicare would become better, because it would involve too many people for our representatives to ignore.
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I'd set the line at the poverty level employed or not but that's just me.
 
Guille said:
That's not why we have the mandate. If your reasoning were correct then 26 year old adults would not be able to remain on their parent's policy and the fines wouldn't be substantially less than the cost of a policy. We have a mandate to prevent competition.
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Well, I don't believe that at all.

The reason for 26 year olds to be on their parents coverage has to do with giving kids a start. It's common for them not to be able to pay the full cost of coverage on their own until they have reasonable employment.

The mandate is intended to cause people to buy insurance. It started small and is going up. It would have been seen as highly objectionable if it were any higher at the start, before the ACA had proven itself.

A mandate doesn't prevent competition of any kind. All health insurance is required to be ACA compliant. So, the penalty doesn't give preference to any specific insurer - it only gives preference to having insurance at all.
 
Guille said:
Sure they can, they just might have to get used to lower profit margins.
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No, everyone agreed on this - nobody thought insurance companies could survive having people jump in and out, given the requirements for insurance companies to sell to all those who apply. Dems, Repos, insurance companies - all agreed that a solution was required. And, nobody found another solution.
I've got news for you, they're still not that friendly to people with pre-existing conditions.
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Please cite. I've NEVER been asked ANY questions about my health care status and have purchased individual policies from when the ACA was first available. That includes having switched companies, which I did because my health care corporation cut a provider I like from my network.
And we're still seeing it to some extent.
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I think all the bad behaviors I identified are now not allowed to happen.

Please cite - I'd like to know.
I'd set the line at the poverty level employed or not but that's just me.
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I agree the line could be set wherever we want. I just think it would end up at or even above the line we use for income tax. Those at the poverty line most definitely can not afford what health care coverage costs. And, dumping the central ACA principles (as the GOP has proposed) would make health care substantially MORE expensive for older Americans who are still a long way from the current Medicare age.

So, if we're going to cover any significant percent of our population without subsidies (such as we now do with the ACA) the line for Medicare/Medicaid would have to be substantially higher than the poverty line, I think.
 
WillReadmore said:
Well, I don't believe that at all.

The reason for 26 year olds to be on their parents coverage has to do with giving kids a start. It's common for them not to be able to pay the full cost of coverage on their own until they have reasonable employment.
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26 years old? I could see full-time college students and I'm not talking about middle age dudes going back to school to finish up their degrees but 26 years old? No means testing? I'm not buying this and quite frankly I don't believe you do either.

WillReadmore said:
The mandate is intended to cause people to buy insurance. It started small and is going up. It would have been seen as highly objectionable if it were any higher at the start, before the ACA had proven itself.
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It's going to be highly objectionable whenever it's done, if it's ever done, no matter how many years the ACA has been in effect and...still waiting for the ACA to prove itself :)

WillReadmore said:
A mandate doesn't prevent competition of any kind. All health insurance is required to be ACA compliant. So, the penalty doesn't give preference to any specific insurer - it only gives preference to having insurance at all.
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It does prevent competition because of what comes with it, ACA compliant plans. With no mandate I'm under no obligation to purchase an ACA compliant plan and I could go back to the plan I had before.
 
Guille said:
26 years old? I could see full-time college students and I'm not talking about middle age dudes going back to school to finish up their degrees but 26 years old? No means testing? I'm not buying this and quite frankly I don't believe you do either.



It's going to be highly objectionable whenever it's done, if it's ever done, no matter how many years the ACA has been in effect and...still waiting for the ACA to prove itself :)



It does prevent competition because of what comes with it, ACA compliant plans. With no mandate I'm under no obligation to purchase an ACA compliant plan and I could go back to the plan I had before.
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No.

Your previous plan does not exist, because it was not ACA compliant.

This is an issue of regulation. The ACA defines limits on what health care policies must support.

From there, insurance corporations may compete, but their products must meet ACA regulatory requirements.




The 26 yo thing wasn't intended to apply only to those who go to college. Everyone coming out of high school is in trouble if they have to immediately buy insurance. By covering them under their parents plans they aren't left paying penalties for merely existing as a post high school citizen of America.
 
WillReadmore said:
I would need to see a reliable cite to support the idea that subsidies for ACA can be more than the cost of Medicare to tax payers.

After all, subsidies are sized to solve the problem - which is often a small amount, leaving the insured to pay the majority of the cost of the policy.
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Which I suppose was my original point to Guille re. Medicare for poor, vs subsidies.

Better for Medicare, would be a public option. It would add to Medicare's coffers, and lessen the burden of what is now the highest risk pool in the country.
 
Guille said:
It does prevent competition because of what comes with it, ACA compliant plans. With no mandate I'm under no obligation to purchase an ACA compliant plan and I could go back to the plan I had before.
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The ACA is a little like what we do with auto manufacturers in terms of what policies must cover.

People can't simply build a car and sell it. Automobiles must comply with federal regulation on what cars must have.

Today, we have regulation on every element of cars - floorboards, exhaust, knobs on radios, mirrors, brakes, windshield wipers, roofs, hoods, minimum speed, etc., etc., etc.

Within that regulation, auto manufacturers may compete.

Within ACA regulation, health care insurance corporations may compete.
 
Althea said:
Which I suppose was my original point to Guille re. Medicare for poor, vs subsidies.

Better for Medicare, would be a public option. It would add to Medicare's coffers, and lessen the burden of what is now the highest risk pool in the country.
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I could see that.

As I've said, I'm not dogmatic about the solution. There ARE issues with the ACA (though I may not agree with everyone on what they are, of course).



The PRIMARY thing right now is the STUPENDOUS irresponsibility of killing our health care payment system without having ANY plan even in discussion.


When we moved to the ACA we had the ACA BEFORE we moved to it. The vote in congress was to modify our system - not to KILL our system.

What the GOP is all excited about is absolutely NOT acceptable. They are playing games with the coverage of EVERY American.
 
WillReadmore said:
No.

Your previous plan does not exist, because it was not ACA compliant.

This is an issue of regulation. The ACA defines limits on what health care policies must support.

From there, insurance corporations may compete, but their products must meet ACA regulatory requirements.




The 26 yo thing wasn't intended to apply only to those who go to college. Everyone coming out of high school is in trouble if they have to immediately buy insurance. By covering them under their parents plans they aren't left paying penalties for merely existing as a post high school citizen of America.
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I know the 26 year old thing wasn't intended for college students.

I said the mandate prevents competition and you just made my case better than I did.
 
WillReadmore said:
I could see that.

As I've said, I'm not dogmatic about the solution. There ARE issues with the ACA (though I may not agree with everyone on what they are, of course).



The PRIMARY thing right now is the STUPENDOUS irresponsibility of killing our health care payment system without having ANY plan even in discussion.


When we moved to the ACA we had the ACA BEFORE we moved to it. The vote in congress was to modify our system - not to KILL our system.

What the GOP is all excited about is absolutely NOT acceptable. They are playing games with the coverage of EVERY American.
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I'm fine with a public option as long as there are also private options.
 
Guille said:
I know the 26 year old thing wasn't intended for college students.

I said the mandate prevents competition and you just made my case better than I did.
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Competition is still fully encouraged. It just has to conform to basic coverage requirements.

I'd point out that the requirements in question are wildly supported by Americans as polls consistently show.
 
Guille said:
I'm fine with a public option as long as there are also private options.
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This was part of the original ACA design, but got cut due to the extreme closeness of the congressional vote.

It seems possible to me that having a public option would be a good thing. It could put downward pressure on prices and might be handier as a way of covering those who would otherwise simply be using the ER, without being able to pay - a big problem before the ACA.

Obviously, the GOP is monumentally opposed to this idea.
 
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