What's the use of employer sponsored coverage?

Amarante

Thu, Jun 02 2016, 1:25 pm

Orchid wrote:

(So are you in agreement that the federal government has issued mandates under PPACA? You seemed to be arguing that point in your first post).

But in any case, your entire post is besides the point. Forcing companies to not decline anybody on the basis of pre-existing conditions can be the greatest thing since sliced bread. But it is a fact that it will drive up the cost.

See again my example with car insurance. If the govt comes down and forbids car insurance companies from "discriminating" rates between men and women, prices will go up.

Those who obtained insurance through their employer always were able to get coverage regardless of pre existing conditions.

The ability to obtain coverage despite pre existing coverage is literally a life saver for many people.

During the Great Recession many middle aged people lost their good jobs and had th double whammy of not being able to obtain insurance.

For what it's worth, New York State always had a law that prevented insurers from charging more for people based on age. With Obamacare, there is the ability to charge three times the rate of youngest people. By the way, premiums for young people under Obakacare is pretty low and makes sense for most young people who generally don't see a doctor often but who might have a catastrophic accident or get cancer and need expensive care and then they are not going to be wiped out with medical debt AND the public isn't going to have o pick up the cos for non insure people.

MagentaYenta

Thu, Jun 02 2016, 1:25 pm

Orchid wrote:

Obamacare has issued hundreds of pages of mandates that insurance companies must follow. They might be wonderful, amazing, fantastic and the advent of mashiach, BUT THEY WILL RAISE COSTS.

I have had the benefit of employer provided health insurance my entire working life, there wasn't a single year that premiums were not raised. How much ins. premiums can be raised is based on your states regulatory agency.

little_mage

Thu, Jun 02 2016, 2:49 pm

amother wrote:

I don't work in the insurance industry and have been out of HR for many years already. I don't have a clue what all the mandates are and what the impact is.

I simply stated that 1. Insurance costs were already rising rapidly before Obama was a blip on the radar, and 2. at least in my state, once a year, employees with pre-existing conditions were able to get onto the company health care policy. So having employees with serious medical issues drive up rates for the whole company is not something new. The end. I do not favor Obama or Obamacare, but the above is true regardless.

Employees with pre-existing conditions were able to get insurance. The problem was if you didn't have a job, but had preexisting conditions, you wouldn't be able to. My father lost his job in 2001; my mother had gone to free-lancing a year before that. My father is in okay health, but he's got some generalized problems-slightly overweight, genetic tendency to high blood pressure. I was only in high school, so my parents didn't share the details, but I do seem to recall that he had trouble getting health insurance because of those preexisting conditions. That's who the ACA helped in that regard.

amother

Ivory

Thu, Jun 02 2016, 4:31 pm

amother wrote:

1. Insurance costs were already rising rapidly before Obama was a blip on the radar

So true. It was a HUGE concern in the 2000s. For two years running no raises were allowed at my job, even for merit, because our health insurance cost so much to the company already and was skyrocketing. Our raises were the company continuing to pay those premiums and not pass them on to employees.

simcha2

Thu, Jun 02 2016, 5:00 pm

One of the reasons employee health care plans have become "worse" (higher deductibles etc) is because of the so-called Cadillac tax. Companies that were offering premium plans (no deductibles, good coverage) etc got hit with a huge tax burden under obamacare, they therefore changed the plans they offered.

I personally support the ACA in many respects (more people covered, end of pre existing coverage etc), but our personal health care costs have gone up literally thousands of dollars because of the introduction of deductibles and prescription costs).

Last edited by simcha2 on Thu, Jun 02 2016, 5:06 pm; edited 1 time in total

MagentaYenta

Thu, Jun 02 2016, 5:02 pm

little_mage wrote:

I'm going to speak to the bolded. For many decades (depending on your state) insurance was available to private payers and via employee ins. programs for those with pre existing conditions. Depending on your state and the ins. company your pre existing conditions would not be covered but other conditions not pre existing would be covered. Some ins. companies had waiting periods for when they would cover a pre existing condition, most times these waiting periods were for years. This is merely meant to be a point of clarification. Other insurance carriers could and did exclude insuring anyone with a pre existing condition. This varied based on carrier.

Notsobusy

Thu, Jun 02 2016, 5:47 pm

amother wrote:

Regarding the benefits package - I know. It's just frustrating...

But A - my employer is very proud of himself that he offers coverage and often talks about it as if it makes him a better person, (so that's fake gratitude to him) and B - if I'm thankfully not living in poverty, and not eligible for Medicaid, that's a big deal and I should be grateful, its just hard needing to shell out hundreds/thousands for things that others get for free...

Maybe try to reframe it by comparing yourself to the millions of people who are not eligible for Medicaid and don't have employee sponsored health insurance. We get to cover the huge premiums, huge copays and huge deductibles all on our own. That might make you feel better.

little_mage

Thu, Jun 02 2016, 8:17 pm

MagentaYenta wrote:

Fair enough. By the time I actually had to get insurance on my own (in 2010) the ACA was pretty much on the horizon. So I have experience with the ACA, but not so much with conditions before that.

amother

Natural

Fri, Jun 03 2016, 9:16 am

glutenless wrote:

True enough.

nylon

Fri, Jun 03 2016, 11:59 am

The preexisting conditions changes under ACA were for INDIVIDUAL plans.

HIPAA already required group plans to cover all employees even with preexisting conditions since 1996 (there were specific rules about continuous coverage and exclusion for certain conditions but it was meant to make it possible to switch jobs without losing insurance). And pregnancy was required to be covered in group plans since the 1970s.

So the ACA isn't responsible for rises in group plans due to those changes. It did place additional mandates on group plans such as an out of pocket cap that included ALL costs (but this had relatively little impact since plans cap coinsurance and very few people have thousands of dollars in copays), no cost sharing for preventative care including contraception, and some other mandated benefits. But group insurance had already been more comprehensive than individual plans so the ACA mandates affected them less. The Cadillac tax also affected some plans.

Overall, cost inflation and a desire to deal with it by cutting benefits is the bigger culprit.

Also while Medicaid may be more comprehensive, it has the poorest choice of doctors.