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Volmarias posted:I remember a while back people talking about groups to help people sign up for the exchanges. A friend of mine has his father in law living with him. He's a green card permanent resident, but also 70, so apparently whenever they look for insurance for him they get shown "lol medicare" as soon as they put in the age. Why does he not qualify for medicare? I was under the impression it was also available to legal residents, not just citizens.
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Jan 18, 2016 19:21
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Reik posted:Why does he not qualify for medicare? I was under the impression it was also available to legal residents, not just citizens. Only if you've worked for 10 years but if you've been here for 5 years you can buy Medicare coverage. Yes it is dumb but there is always a bit of a panic about immigrants coming to the US to free ride on our benefits.
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Jan 18, 2016 20:00
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Discendo Vox posted:A plan that would seem remotely aimed at winning the primary or the election would be sufficient. Did you fall through a time warp in 2009 and land in this thread? That sort of cowardice running away from progressive, populist values has lost the Democratic Party every major election outside the White House for the last 5 years.
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Jan 18, 2016 20:11
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Typical Pubbie posted:Did you fall through a time warp in 2009 and land in this thread? That sort of cowardice running away from progressive, populist values has lost the Democratic Party every major election outside the White House for the last 5 years. quite a qualification to throw in there while discussing the presidential race
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Jan 18, 2016 20:21
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That's because winning the White House shouldn't be a problem for the Democratic Party no matter who they run. It's the down ticket and mid-term elections that matter. "We need to improve the ACA, not fight a new battle" is just the sort of wishy-washy, empty rhetoric trying to appeal to moderates that has gotten the Democrats absolutely no where. The Republicans will never work with Hillary to improve the ACA. They'll never work with Bernie to pass Medicare-for-All. Neither plane is more politically viable than the other as long as the Republicans control congress.
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Jan 18, 2016 20:32
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Bernie's plan isn't viable if Democrats control congress. No D rep in a swing district is going to vote for an income tax increase, because few voters in a swing district would vote for a president that would advocate tax increase.
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Jan 18, 2016 20:35
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You do realize that taxes have been raised before in this country?
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Jan 18, 2016 20:41
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Look at all this non-PPACA discussion in the PPACA thread.
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Jan 18, 2016 20:57
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Has anyone run into an exchange requesting/demanding documentation to verify income to qualify for reduced premiums? I'm in a weird gray area because I'm leaving my full-time job for self-employment and I don't really have a way of proving consistent income yet, but I would still like to pay lower monthly premiums rather than get a tax credit at the end of the year if possible. They want some kind of documentation within 90 days or they could boot me off the insurance entirely (!). I called the Washington State health plan customer service line, and they basically said they have no idea how I can do it, but they referred me to local insurance broker guy who might know how to provide the information to the state. I called the broker and he said he'd never heard of a request for income verification at the beginning of the application period. He assumed that it would just be reconciled on the tax return at the end of the year, which is how I thought it worked, too. I guess it's a new thing due to federal requirements trying to weed out people improperly claiming lower income? Anyone have an idea how to navigate this?
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Jan 18, 2016 23:37
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My fiancee was in that situation. Before the subsidy was approved they demanded proof of income because her AGI last year was too high for the subsidy. We couldn't meet their demands because she went from full time to self employed contract work and that is so up and down you can't really prove income like they want you to. After a bit of back and forth over "yes I know this contract says I made X but that's a one time thing spread over several months not a weekly paycheck" the end result is that she is going to be getting a nice tax refund this year  I bet that a local agent or ACA Navigator is going to be your best bet. Maybe a different agent has dealt with proving income for subsidies before?
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Jan 19, 2016 01:52
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Just a blank shot- anyone here on the new Harken Health PPO plans in Chicago / Atlanta here? Enrolled recently wondering if any experiences 2c on them
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Jan 19, 2016 04:43
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Look at all these people who have no idea how Risk Adjustment works and probably shouldn't have any pull in the health insurance industry: https://www.washingtonpost.com/nati...d124_story.html My favorite by far: quote:Departures have already begun. A decades-old South Florida HMO, Preferred Medical Plan, had the lowest premiums in Dade County for 2014 and received a risk-adjustment bill of $97 million. “You have to scratch your head,” said its president, Albert Arca. Good thing the president of the company doesn't understand that premiums have no direct affect on the direction of risk adjustment payments/receipts, and by having the lowest premium they were probably attracting the healthiest consumers in the market, which would explain why they were a risk adjustment payer.
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Jan 19, 2016 23:03
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Reik posted:Look at all these people who have no idea how Risk Adjustment works and probably shouldn't have any pull in the health insurance industry: They know how it works, they just can potentially make a lot of money by telling a newspaper they don't and hoping it becomes a political issue.
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Jan 20, 2016 00:18
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Shifty Pony posted:Only if you've worked for 10 years but if you've been here for 5 years you can buy Medicare coverage. Yes it is dumb but there is always a bit of a panic about immigrants coming to the US to free ride on our benefits. Yes, this. He's only come over in the last year or so, and is effectively retired and a stay-at-home grandpa for his grandchild. So, he's basically fallen through a coverage hole? Is there any sort of professional he could talk to about this?
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Jan 20, 2016 19:40
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I think there are companies (or agents) who specialize in green card insurance plans. You'll get a lot further talking to a human than trying online because most of the online systems will just kick you out if you put in a high age. Maybe try calling the various insurance companies if you don't have a local agent who deals with that?
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Jan 20, 2016 20:13
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evilweasel posted:They know how it works, they just can potentially make a lot of money by telling a newspaper they don't and hoping it becomes a political issue. What's he trying to accomplish, getting the ACA repealed?
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Jan 21, 2016 03:19
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PerniciousKnid posted:What's he trying to accomplish, getting the ACA repealed? Maybe get risk adjustment effectively removed or some kind of executive pressure to weaken it, work towards an increasingly paper law to re-entrench older practices, something like that
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Jan 21, 2016 03:27
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Jacobin posted:Maybe get risk adjustment effectively removed or some kind of executive pressure to weaken it, work towards an increasingly paper law to re-entrench older practices, something like that But risk adjustment is a critical piece of the law, it's hard to imagine a politician willing to remove it who doesn't already want to repeal the whole law.
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Jan 21, 2016 15:32
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PerniciousKnid posted:But risk adjustment is a critical piece of the law, it's hard to imagine a politician willing to remove it who doesn't already want to repeal the whole law. One of the main goals of the exchange was to increase competition in the retail market. Lots of small insurers are not doing well and they're blaming risk corridor and risk adjustment. Because ACA supporters want more carriers on the exchanges, they might get tricked in to doing something stupid to risk adjustment like putting in a transfer cap amount based on percent of premiums/revenue/claims/whatever. It'll come back to bite them later because small carriers probably benefit the most from risk adjustment because they can't eat a bad year like the large carriers can. They only reason they're paying out is if they had a healthier than average population according to the HHS risk score submissions. If they weren't under priced like the rest of the market they would have had plenty of money left over to cover the transfers.
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Jan 21, 2016 17:03
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What I could kinda see happening is payment deferrals above some amount, to spread out the pain.
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Jan 22, 2016 04:15
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PerniciousKnid posted:What I could kinda see happening is payment deferrals above some amount, to spread out the pain. The idea behind risk adjustment is for there to be no financial incentive to take in healthy members over sick members. There's already a large cash flow incentive because of how long it takes between the claims incurred and the transfers, spreading out the transfers would only magnify this incentive. By definition and in practice risk adjustment is a zero sum game, it's really just up to the insurance provider to do their due diligence in pricing and reporting.
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Jan 22, 2016 16:08
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Well, is there a flaw in that companies are effectively paying claims based on other company's experience rather than their own? It seems like it would be hard for small companies to perform due diligence in pricing when they don't have complete information. Flaw is of course subject to the timing of corridors and filings and so on, which I know nothing about.
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Jan 22, 2016 18:00
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PerniciousKnid posted:Well, is there a flaw in that companies are effectively paying claims based on other company's experience rather than their own? It seems like it would be hard for small companies to perform due diligence in pricing when they don't have complete information. Flaw is of course subject to the timing of corridors and filings and so on, which I know nothing about. I'm not sure what you mean there. It is difficult to price without market specific experience, it's what every carrier on the exchanges did for 2014 and 2015, but that is true for every carrier entering a any market regardless of their cap size. It would probably be in the best interest of smaller companies to hire an actuarial consultant the first year or two until they have credible experience to use for their pricing. Also, risk adjustment wouldn't have more or less of an impact on a carrier entering a new market. You can only use claims from that year in order to show the risk of your population, so you can't use a cancer diagnosis from 2014 to prove that same person has cancer in 2015 for purposes of risk adjustment.
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Jan 22, 2016 20:01
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What I mean is that credible experience isn't sufficient. Until you know what the experience of the whole market is doing, you don't know what claims+adjustment you owe. So you have to sit on a pile of cash while you wait to get an idea of your obligations. You can make a guess based on your experience, but you don't know if others are doing better or worse.
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Jan 22, 2016 20:57
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PerniciousKnid posted:What I mean is that credible experience isn't sufficient. Until you know what the experience of the whole market is doing, you don't know what claims+adjustment you owe. So you have to sit on a pile of cash while you wait to get an idea of your obligations. You can make a guess based on your experience, but you don't know if others are doing better or worse. There are methods to estimate the market just using your experience and/or census data. That's why they keep us actuaries around.
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Jan 22, 2016 21:08
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Hillary Clinton lost her poo poo last night and said she now supports Universal Health Care, so I guess we'll find out this week whatever that plan is
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Feb 2, 2016 14:42
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EugeneJ posted:Hillary Clinton lost her poo poo last night and said she now supports Universal Health Care, so I guess we'll find out this week whatever that plan is Look forward to the website going bare bones support staff after the next open enrollment no matter who wins.
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Feb 2, 2016 15:09
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Check out the Twitter comments if you want to see absolutely everyone calling her out for flip-flopping: https://twitter.com/HillaryClinton/status/694377539364593665
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Feb 2, 2016 15:11
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EugeneJ posted:Check out the Twitter comments if you want to see absolutely everyone calling her out for flip-flopping: Mostly because they're idiots who don't understand that UHC doesn't mean single payer.
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Feb 2, 2016 16:55
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Kalman posted:Mostly because they're idiots who don't understand that UHC doesn't mean single payer. Unfortunately idiots elect the president.
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Feb 2, 2016 21:11
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Any reason why HSAS are only available for high deductible plans? Why shouldn't I get a tax break for v saving money to convert my out of pocket costs of I have a low deductible?
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Feb 3, 2016 17:13
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Armyman25 posted:Any reason why HSAS are only available for high deductible plans? Why shouldn't I get a tax break for v saving money to convert my out of pocket costs of I have a low deductible? HSA's were created specifically to help people pay for their high deductibles
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Feb 3, 2016 19:12
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http://talkingpointsmemo.com/dc/obamacare-insurers-complaints-threatsquote:“In general, insurers are looking to exercise more control over how insurers market [coverage] and how consumers buy it,” Levitt said.
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Feb 4, 2016 13:57
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Armyman25 posted:Any reason why HSAS are only available for high deductible plans? Why shouldn't I get a tax break for v saving money to convert my out of pocket costs of I have a low deductible? They wanted to reduce moral hazard and overinsurance in the health insurance market, so they introduced MSAs (1996) and HSAs (2003) as an incentive for people to choose higher deductible plans. Also, as a minor reason they wanted to prevent people from "double dipping" - getting tax advantages for a rich health plan and also for getting permanent tax advantages for HSA savings.
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Feb 4, 2016 14:31
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Armyman25 posted:Any reason why HSAS are only available for high deductible plans? Why shouldn't I get a tax break for v saving money to convert my out of pocket costs of I have a low deductible? You can use a FSA but your employer has to offer it. They have downsides of course including being use or lose for the employee and being 100% prefunded and thus a risk for an employer if the employee doesn't stay at the job for the full year to pay it back.
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Feb 4, 2016 14:39
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Armyman25 posted:Any reason why HSAS are only available for high deductible plans? Why shouldn't I get a tax break for v saving money to convert my out of pocket costs of I have a low deductible? If it makes you feel better a "high" deductible right now is like $1,300. https://www.irs.gov/pub/irs-drop/rp-15-30.pdf
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Feb 4, 2016 17:15
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CMS snuck in another special enrollment period last Friday after everyone stopped paying attention at work: https://www.regtap.info/uploads/library/ENR_FTR_SEP_Guidance_020516_5CR_020516.pdf Lets reward people who didn't file taxes in 2014 with subsidies paid for with federal taxes. I can't wait until the stupid elections are over and whomever is in office doesn't have to worry about whether PPACA is popular or not.
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Feb 9, 2016 18:46
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Does anyone know if it's possible for me to contact someone and have a face-to-face consultation about choosing a plan on the exchange outside of the enrollment period? Like, is that somebody's job somewhere and I just pay them for advice? I'm roughly in Boston if that helps.
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Feb 25, 2016 19:15
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Jack Gladney posted:Does anyone know if it's possible for me to contact someone and have a face-to-face consultation about choosing a plan on the exchange outside of the enrollment period? Like, is that somebody's job somewhere and I just pay them for advice? I'm roughly in Boston if that helps. https://betterhealthconnector.com/enrollment-assisters This is your best bet. Since MA has their own website everything would be done through the Better Health Connector.
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Feb 25, 2016 19:53
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BexGu posted:https://betterhealthconnector.com/enrollment-assisters Thank you!
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Feb 26, 2016 00:25
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