^
I have a friend who doesn't closely follow politics but dislikes aca because where he works, everyone's healthcare costs went up because his employer had to cover more people, who happened to be older, and they spread these costs around.

When asked what should sick people do, without healthcare, he says they should just go to the hospital, they'll get treated anyway. Part of his basis for this is that he had an in law die of cancer with more that $100k in bills that basically evaporated (from his perspective). And this belief is common, with even republican congress people telling voters we don't need healthcare reform because we have emergency rooms.

I think if we had a clearer idea of how hospitals are funded and had an understanding of what actually happens to the medical costs of the deceased, we would have a better dialog on aca. It's obvious most people don't want to let sick people die because they can't pay, but too many people are under the impression that the system had been working, because poor people were getting care.

12/31/2014 11:08:03 AM

Quote :

"Anyone with half a brain would stop reading right fucking here. This is the mental (infant) gymnastics that you're contorting yourself into to draw a distinction between what is compelled and what isn't? You're taking the next two NEEDS on the top of the American list after food and health and trying to say they are optional in our society? Get the fuck outta here with this tripe."

That's your problem, you must only have half a brain. Literally millions of people in the US don't pay homeowner's insurance, yet you are saying it is compulsory. I see estimates as high as 30% or more of households that don't even own the unit in which they live, yet you are arguing that every single household in the US must pay homeowner's insurance. Likewise, literally millions of people in the US don't pay car insurance, because they don't own a car and instead take mass transit everywhere. Yet, you are claiming that every single person in the US is clearly compelled to purchase it. Meanwhile, you ignored the other strong points I made, probably because you only have half a brain and had reached your reading limit for the day.

Quote :

"And what does the state pay for the privilege of eminent domain power to build those roads? Citizens have rights to use of collective resources like this."

Are citizens not able to walk on those roads? Are they not able to ride bikes? Are they not able to purchase a moped? Are they unable to use public transportation? There are numerous clear and obvious ways that people can avoid paying car insurance and still make use of the roads, so I think your point rings pretty hollow.

12/31/2014 8:06:23 PM

There are many roads you can't walk on and can't ride a bike on. These are also arguably the most important roads. But that's an argument for another day, which I'm pretty sure I've had here at least once already. Particularly, I don't want to get too wrapped up in the libertarian angle of that pickle because my own conclusion is essentially that it doesn't work. Transit is always collectivized so there's no point in working out the details of true liberty in the system. The can of worms that opens up is a fundamentally non-objective wealth distribution system. In this case, it's not "redistribution" but "distribution", because the value created by the transit system can not be had without its socialization. There's no way to ever call it fair. A transportation system with objective fairness can not even be created theoretically.

Quote :

"It's obvious most people don't want to let sick people die because they can't pay"

Most? Sure. But if you asked the questions in a leading way, starting from the topic of who pays for it, I'm less convinced. I suspect you might even get a reluctant majority who will accept some preventable deaths when faced with a healthcare budgetary crisis and whatnot.

A majority might vote to have their cake and eat it too in a flagrantly self-contradictory way. I don't doubt that for a second.

1/1/2015 10:49:53 PM

I am curious. Does anyone here not accept that there must be some limit to the amount society should be made to pay to keep someone alive?

I accept the distinction of a billionaire spending their own money. But the ACA eliminated maximums from health insurance, which seemed down-right absurd to me. My old insurance which was banned by the ACA had a lifetime maximum limit of $1.2 million, which to me seemed like plenty. If $1.2 million won't keep me alive then society should let me die. My new ACA approved insurance has a lifetime limit of $infinity, which seems absurd in every possible sense to me.

1/4/2015 11:28:58 PM

It would be easy to hit a 1.2 mil limit with a major and/or rare illness. So...what would you suggest they be?

[Edited on January 5, 2015 at 10:40 AM. Reason : I hate phone typing]

1/5/2015 10:39:35 AM

$1.2M is not sufficient for any kind of major chronic illness. I'm not even talking about major intervention or major surgeries to sustain someone at the end of life, but a chronic condition that lots of people manage and live with will eat up $1.2M before they are even that old.

1/5/2015 12:12:15 PM

The original ACA had a provision that would have helped reduce end of life costs through counseling on things like hospice care and the like, but Sarah Palin called it a "death panel" and enough mouth-breathers believed it to make Democrats cave and remove it.

Lifetime maximums seem more death panel-ly to me.

[Edited on January 5, 2015 at 4:38 PM. Reason : And yeah $1.2m is way too low. That was shitty insurance.]

1/5/2015 4:29:55 PM

I get some corp ins from Coventry soon, wifes new job ftw!

1/5/2015 11:03:22 PM

Well this is extremely relevant:

http://thedailyshow.cc.com/videos/kqwpe9/exclusive---steven-brill-extended-interview-pt--1

On the Daily Show, Steven Brill hashes basically the same arguments that I've been bemoaning in this thread. Mainly, the prices are too damn high. In his view (and I agree), the bill did so little to address price control that it's practically nothing.

Interestingly, Stewart argues that health care spending went down in 2014 (it didn't), and it was the exact same argument we had here a few pages ago. The rate of increase was slightly less than the year before. That's all. Spending is still increasing faster than inflation, faster than GDP growth, too fast period.

If he was better prepared for that argument, he might have noted the aging population of baby boomers should be increasing costs as a demographic factor. It still doesn't change the bottom line.

In fact, nothing changes the bottom line. Simply taken as a fraction of GDP, health care spending is increasing at an unsustainable rate. Even if you had full access to the checkbook of the nation (ACA does not have this ability), it would be unworkable.

On the first page, I noted that hospitals will deploy more front line workers in place of doctors, responding to the bill's price pressures. It was tremendously naive of me to think there was much hope in such measures. As Steven Brill argued, the big giant sponges that are soaking up all the additional resources that go into the system are the "nonprofit" hospitals, medical device makers, drug companies, and other corporate interests with their hand in the cookie jar (although this may no longer include insurance companies to a large extent). Shuffling around the health care workers isn't going to change the picture. Doctors are not the reason that our system is broken, or at least their direct labor costs aren't. Their prescription decisions and general conflicts of interests might be.

The guy even made the exact same argument I did about the higher co-pays and prices. Patients simply don't negotiate or shop around for prices in the world we live in. Good on the ACA for bringing more price transparency, but it clearly didn't do enough. Medical billing is still broken beyond recognition. No patient is engaging in negotiations. It was a fantasy that this was a valid cost control measure. When offices universally put their prices up publicly then we might be able to count the effect. Even if we added this modest restraint, it would pale in comparison to the giant suck of resources that gives no better health outcome.

He also mentioned that someone making $5-20k per year in Texas might be forced to buy health insurance with no subsidies while a guy making $80k per year would have subsidies. Either way, the point I've made many times is that we don't have genuine socialization of the costs in any way. Cadillac plans are a drop in the bucket. We've mandated that the costs of health care will be paid by premiums, and we've protected the system from any obligation to major reform. There's only one mathematical consequence, and that is that the bill will be borne by the middle class.

This is terrible. I hesitate to say that the ACA is on-balance bad, but I think it's bad in the larger picture because it locks out any other options we had for radical reform. All our problems will get worse and we will repeat the same fucking fights sometime around the end of this decade.

1/12/2015 10:50:31 PM

Don't worry, bro. The point of ACA was to break the system so badly that people would be screaming for single-payer. You'll get it soon enough.

1/13/2015 12:39:27 AM

Quote :

"Medical billing is still broken beyond recognition. No patient is engaging in negotiations. It was a fantasy that this was a valid cost control measure. When offices universally put their prices up publicly then we might be able to count the effect. Even if we added this modest restraint, it would pale in comparison to the giant suck of resources that gives no better health outcome."

You may have already seen this, but BCBSNC has an online tool to look up prices for treatments in your area now:
http://www.bcbsnc.com/content/providersearch/treatments/index.htm#/

The results were predictably insane, with as much as $50k difference in some procedures between hospitals just a few counties over (note they also combine all related bills for a procedure and only report an average to increase the insanity)
http://www.charlotteobserver.com/2015/01/11/5440156/blue-cross-payment-disparities.html#.VLUn7FK2flw

The point being, you're right. Unwinding the byzantine medical billing system seems impossible at this point.

1/13/2015 9:24:39 AM

^ This is clearly a step forward. We couldn't even have a conversation about those monstrosities before because we didn't even know about them.

But that's just a first step. I hope that the data releases will get us to deal with cost control sooner rather than later. But that's just a hope. The bit about "foot in the door" to get single payer is just a meme. I don't remotely believe it'll happen.

1/13/2015 2:07:32 PM

^the best suggestion I've heard from the release of all those prices is that some of the hospitals on the really high end of a procedure will start to moderate their prices so that they are atleast ballpark with the other providers, try to mitigate some of the questioning.

[Edited on January 13, 2015 at 5:37 PM. Reason : remains to be seen though]

1/13/2015 5:37:34 PM

^^ It's not a matter of it being a "foot in the door." No one is going to use the ACA bill, itself, as a lead-in or a plan for single-payer. Instead, the ACA was meant to deal the death-blow to the existing model, by making changes so detrimental to it as to render it completely non-functional. You may think our healthcare system sucked before the ACA, but the ACA was meant to make it worse. It allows the Democrats to say, with a shit-eating grin, that "the free market clearly doesn't work," even though they removed any and all elements of an actual free market from the system, and then they can move to single-payer because people will be clamoring for something, ANYTHING, different.

1/13/2015 10:57:33 PM

The marketplace is telling someone I know who is unemployed they have to pay $400 a month because they make too much, wtf.

1/14/2015 12:53:02 AM

Quote :

"some of the hospitals on the really high end of a procedure will start to moderate their prices so that they are atleast ballpark with the other providers, try to mitigate some of the questioning."

Right, and I think that this begins to tell a story about what is very likely to happen. You'll see some pressure on both ends of the price spectrum as providers and payers (the professionals) say "wait, why am I getting this price?"

That in itself can be a cost control measure. But before we drive too deep into it, we must recognize that it is imperfect. In the Charlotte Observer link, people kept raving about how unexpected this was, and this had a heavy implication that BCBS was under no obligation to produce this level of data. Other regions and parts of the market might stay opaque.

Putting that aside, hit "play" and see how this story goes. Maybe we could see an equalization of prices where providers start to converge on an actual market price for procedures. Costs could still grow out of control. We could still get consistent but high prices.

Businesses right now are throwing shit against the wall to see what sticks. Hell, the ACA itself is widely touted to do this, trying different things in different areas. I've heard that many times, and I don't pretend to understand it, so of course I'm skeptical. It could help to learn lessons in localized areas about what brings costs down and then replicate that over the rest of the nation.

Transparency should be a force for good, and the more transparency you get, the closer you are to a free market. Even if the needed changes are structural, a playing field to shop around for procedures might ultimately lead to less expensive MRI scans and machines. Obviously the cynics like burro would claim that we now have a less free market thanks to the ACA. Maybe that's the critical distinction here. We might not even be able to answer that question. The bill defers a lot to rule making on various regulatory levels. I think we likely have space to make things worse or better.

1/14/2015 11:37:47 AM

I don't think it's even debatable that we have a less free market thanks to ACA... But whatever.

1/14/2015 11:37:41 PM

1/15/2015 7:12:40 PM

Alternate data point (though roughly the same final number):

http://www.gallup.com/poll/179774/cost-barrier-americans-medical-care.aspx

1/15/2015 11:20:49 PM

So the government filed it's brief in Halbig v King, http://sblog.s3.amazonaws.com/wp-content/uploads/2015/01/14-114-Respondents-Brief.pdf. Nothing too novel here, just the same points presented in clear legalize. I did like this particular section as it strikes right at the heart of plaintiff's interpretation of the words "by the State",

Quote :

"5. The phrase “established by the State under Section 18031” serves to identify the Exchange in a particular State, not to exclude a federally facilitated Exchange. Petitioners contend (Br. 20, 27-28) that the government’s interpretation renders the phrase “established by the State under Section 18031” superfluous. They are mistaken. As the use of that phrase in Section 36B and throughout the Act demonstrates, it serves to identify the Exchange in a particular State. Its presence or absence in the Act’s provisions reflects style and grammar—not a substantive limitation on the type of Exchange at issue. An Exchange is a state-specific marketplace, and Section 36B(b)(2)(A) uses the phrase “Exchange established by the State under [Section 18031]” because it is referring to the Exchange in the specific State mentioned earlier in the same sentence: The formula for tax credits depends on the cost of one or more insurance plans “offered in the individual market within a State * * * which were enrolled in through an Exchange established by the State under [Section 18031].” 26 U.S.C. 36B(b)(2)(A) (emphasis added); see 26 U.S.C. 36B©(2)(A) (cross-referencing Section 36B(b)(2)(A)). In like manner, the other references to an “Exchange established by the State” in the relevant Titles of the Act refer to the Exchange in a specific State, typically one identified elsewhere in the same provision. In contrast, when a provision of Section 36B addressing Exchanges does not refer to the Exchange in an earlier-referenced State, the phrase “established by the State under [Section 18031]” is omitted. 26 U.S.C. 36B(d)(3), (e)(3) and (f)(3). That phrase is also missing from numerous other provisions of the Act addressing the tax credits and subsidies available through Exchanges. See, e.g., 29 U.S.C. 218b(a)(2); 42 U.S.C. 18032(e)(2), 18033(a)(6)(A), 18051(d)(3)(A)(i), 18052(a)(3), 18071(b)(1), (d)(1) and (e)(3), 18082. All of those provisions concern tax credits and the accompanying subsidies, and on petitioners’ reading they should apply only to an “Exchange established by a State under Section 18031.” Yet none of them contain that limitation—they refer to credits and subsidies available through “Exchanges,” and some of them actually use other formulations that even petitioners concede (Br. 13) “clearly encompass HHS Exchanges.” See 42 U.S.C. 18051(d)(3)(A)(i), 18052(a)(3). It strains credulity to insist, as petitioners must, that Congress limited tax credits to States that establish Exchanges for themselves by including the modifier “established by the State under [Section 18031]” in two subclauses of Section 36B, yet omitted that purportedly crucial limiting language from all of the Act’s myriad other references to the credits and subsidies available on Exchanges. That pattern raises no such difficulty if—as the text of the relevant provisions makes clear—the modifier serves not to exclude federally-facilitated Exchanges, but merely to refer to the Exchange in a particular State identified elsewhere in the same provision."

In other words, the plaintiff's argument,



[Edited on January 24, 2015 at 10:22 AM. Reason : :]

1/24/2015 10:18:05 AM

Damn, they are really reaching at this point. And you think it's a strong argument.

1/24/2015 10:55:11 AM

Yeah, they are reaching. Let's just recap really quick exactly what King et. al want us to believe,

-that the writers of the law intended to coerce States into setting up their own Exchanges by making the availability of federal tax credits contingent on it

-that they buried this bomb in a section describing how tax credits are calculated, not in any of the relevant sections on tax credit eligibility

-that it was never debated, argued against, talked about by pundits in the media, on or off the record, at any time before, during, or after the passage of the law (until these asshole brought it up).

-that the administration, despite a section in the law on "State flexibility" pertaining to Exchanges (where a surrogate (HHS) is given the authority to Establish "such Exchange" in the event a state does not) were shocked that some States would still abstain.

-upon this discovery, they implemented an illegal rule which provided the tax credits anyway

This doesn't even go into tortured legislative history we're supposed to believe, the myriad inconsistencies created by the reading, or how the entire mechanism by the which the law intends to provide UHC falls apart through their reading. But it's enough for anyone capable of coherent thought (ie. not aaronburro) to realize the entire argument is bullshit. Remember, if the Plaintiff's reading is correct, then the entire law becomes a giant subsidy from states that hate Obama to ones that like him. That's what the Plaintiffs want us to believe Congress passed, without a single peep of protest from the opposition.



[Edited on January 24, 2015 at 11:57 AM. Reason : :]

1/24/2015 11:53:38 AM

Quote :

"that the writers of the law intended to coerce States into setting up their own Exchanges by making the availability of federal tax credits contingent on it"

What a crazy idea. That's exactly what was stated was the purpose! Did you forget Gruber? It seems Obama and his buddies did, at the exact moment that he became inconvenient, too.

Quote :

"that they buried this bomb in a section describing how tax credits are calculated, not in any of the relevant sections on tax credit eligibility"

Really? The section that actually states which plans are qualified for the tax credit is not the section that states eligibility? What are you smoking?

Quote :

"that it was never debated, argued against, talked about by pundits in the media, on or off the record, at any time before, during, or after the passage of the law (until these asshole brought it up). "

Other than the fact that it was. I mean, Gruber isn't a pundit, he didn't talk about it at all, other than the three videos we have where he is explicitly saying exactly what is being argued by the plaintiffs. Riiiiiiiiight.

Quote :

"that the administration, despite a section in the law on "State flexibility" pertaining to Exchanges (where a surrogate (HHS) is given the authority to Establish "such Exchange" in the event a state does not) were shocked that some States would still abstain."

Irrelevant. They were surprised states would reject the Medicaid expansion, but states did.

Quote :

"upon this discovery, they implemented an illegal rule which provided the tax credits anyway"

After we ignore the fact that the FIRST rule they implemented was the exact opposite, until they realized that lots of states wouldn't go along with it. Well, shit.

Quote :

"This doesn't even go into tortured legislative history we're supposed to believe"

Which doesn't exist. It's plainly obvious, and is extremely evident in the legislative history, where the specific issue was debated, and actual language which would have explicitly allowed tax credits for federally-established-exchanges was dropped. Moreover, some in the House even complained that the State-specific language was included in the Senate's bill... http://www.forbes.com/sites/michaelcannon/2014/08/07/halbig-critics-struggle-with-the-acas-legislative-history/

Quote :

"the myriad inconsistencies created by the reading"

That don't exist, unless we go cross-eyed with stupidity.

Quote :

"or how the entire mechanism by the which the law intends to provide UHC falls apart through their reading"

Irrelevant. Sloppy law-writing doesn't change the fact of what the law is. If you write 2+2=5, then you must calculate 2+2=5, or correct it, which Congress didn't do, even though it had the votes to do so.

1/24/2015 10:58:32 PM

I think the real sad part is that aaronburro is a true believer in this case, he's not even playing along with the act like McConnell or other members of Congress. He actually thinks this is a legitimate legal argument! Thank god law school is expensive and hard to get into.

Hey, why don't you tell us more about your grand prediction of Obamacare destroying the health care industry. When was that supposed to happen by the way? Before or after it became a runaway success? Fucking retard.

1/25/2015 7:39:03 AM

http://www.dailymail.co.uk/news/article-2927348/Obamacare-program-costs-50-000-American-gets-health-insurance-says-bombshell-budget-report.html

Congrats - for every person that gets this insurance, it costs us more than the average American salary.

1/27/2015 11:51:27 AM

... for 10 years, before offsetting taxes, penalties, and fees

[Edited on January 27, 2015 at 11:58 AM. Reason : but what do you expect from this, it's all about protecting the insurance companies]

1/27/2015 11:55:35 AM

I'm sure in that time frame you would've settled down, had a kid or two, and actually worry about these kinds of pricetags when your kids come of age and start having to pay off this debt.

1/27/2015 12:02:45 PM

to put that cost in context, isn't it significantly less than the per-capita expense of Iraq/Afghanistan?

1/27/2015 12:06:33 PM

republican state officials involved with the ACA and state exchanges say burro is completely full of shit

http://www.washingtonpost.com/blogs/plum-line/wp/2015/01/27/republican-state-officials-cast-doubts-on-anti-obamacare-lawsuit/?hpid=z3

1/27/2015 12:15:33 PM

^^I'm sure it is, but I've never argued against the fact that those wars are costing the crap out of us. Just saying, it isn't like we need more expenses.

1/27/2015 12:42:27 PM

healthcare is the kind of thing we should be spending money on though. we can argue if this is the best way to accomplish that (it's not), but as a cause this is the kind of thing that public money should be spent on.

1/27/2015 12:58:49 PM

I wonder how much cheaper it would have been if they didn't have to keep hiring lawyers to defend it in court.

By the way, smallest budget deficit since before the recession, it's really hard to argue Obamacare is costing us too much.

[Edited on January 28, 2015 at 9:03 AM. Reason : :]

1/28/2015 8:57:59 AM

shrike is the kind of god damn retard that reads entire powerpoint slides aloud to a room

1/28/2015 9:33:27 AM

Here's some real wasteful spending related to Obamacare,

Quote :

"For taxpayers, the previously calculated cost for each vote to overturn all or some of the ACA was set at approximately $1.45 million per vote, according to numbers from the Congressional Research Service and CBSNews.com. Based on those numbers, Congress will have spent approximately $87 million in symbolic votes that either die in the U.S. Senate or will not be signed by President Barack Obama since 2010. The upcoming bill is also likely to either be filibustered in the Senate or get vetoed by President Obama."

1/29/2015 8:41:12 AM

https://www.youtube.com/watch?v=FHkxVXB37EU

2/5/2015 6:39:16 PM

This is what the actual chief architect (not a made up one like Gruber) of this lawsuit actually believes (or wants us to) about Obamacare's legislative history,

Quote :

"Brian Beutler ? @brianbeutler @jadler1969 @mfcannon many? or every single Republican (sans the three absent ones)... Michael F. Cannon @mfcannon Follow I'm happy saying every single R was clueless. So were *most* Ds & CBO. So was I. So were you. @brianbeutler @jadler1969 11:53 AM - 23 Jan 2015 "

So in order to believe in this case, you also have to believe that the legislative language being considered was covertly inserted by a small group of Democrats, who for some reason thought it would be a good idea to restrict tax credits on federal exchanges. I honestly feel sorry for anyone who's ever defended this garbage.

[Edited on February 6, 2015 at 1:57 PM. Reason : :]

2/6/2015 1:55:59 PM

haha, aaronburro's posts in this thread are hilarious

6/26/2015 2:37:44 PM

Quote :

"I don't think it's even debatable that we have a less free market thanks to ACA... But whatever. "

Isn't this part of the goal? There shouldn't be a profit motive to deny people healthcare o.O.

6/26/2015 3:34:54 PM

It's still a shitty law and it still doesn't provide healthcare.

First preference would be nothing at all like this law, but if we must have socialized medicine, let's just have socialized medicine and go to a single payer system. That would be massively preferable to this mish-mash of a system we have now.

6/27/2015 11:17:49 AM

Unrelated, but I want to make a quick point about the myth of "Romneycare". All Romney ever supported was an expansion of catastrophic health insurance. Basically every other facet of the law, including the individual mandate, was written and passed by the overwhelmingly liberal Democrat MA state legislature over veto attempts by Romney. It's been politically advantageous for both sides to pretend Romney played a critical role in it's passage, but it's just not true. MA's healthcare law and Obamacare is and always has been a wholly Democratic creation, and they should all be damn proud of it.

[Edited on June 27, 2015 at 4:07 PM. Reason : .]

6/27/2015 4:02:04 PM

Good article about rate increases.

http://www.cnbc.com/id/102811143

and before you start with how conservative/right leaning CNBC is, I just want to point out that this was a NY Times article.

7/6/2015 1:50:20 PM

^ What strikes you as problematic there? Seems like sick people got insurance, and the insurance worked like it was designed to. People can switch plans to minimize the effect of rising premiums, at the cost of possibly having a different doctor pool, but this is how insurance works-- that's how a market for care providers/insurers operates.

Sick people will always use more than they pay in, they always have, and healthier people have always paid for them by getting less out than they put in. IF you want to lower premiums, this money has to come from somewhere.

Repealing ACA won't fix this problem. You either have to give the insurance companies more money, make people healthier, and/or lower procedure costs.

7/6/2015 2:04:36 PM

i'm not very excited about a 25% premium increase, i already had to absorb my premium almost doubling

7/6/2015 2:06:52 PM

The only thing problematic is that this was entirely predictable and yet sold as something that wouldn't happen.

Also, the fact is that this is a huge wealth transfer from the young and financially vulnerable to the old and financially stable.

Pretty sure there will be an increase in the number of people choosing to pay the penaltax this year.

7/6/2015 2:14:22 PM

^^ you shouldn't be, no one should...

^ So what should be done about it?

7/6/2015 2:48:23 PM

Yawn, this again? They've predicted massive rate increases every year since the ACA was passed and it hasn't happened yet. At least this time they are throwing out realistic numbers instead of the triple digit fantasies they were peddling in years past. With that said, here's a few things you might of missed if you just skimmed the article for the headline figures,

- the study that article was based on also says this,

Quote :

"Premium changes for 2016 will vary substantially across areas and across insurers within a given region. At this time, with complete premium information only available in 10 states plus DC, and still awaiting final reviews by state regulators, it is too soon to draw conclusions about the premiums nationally. As a result of the ACA’s rate review provision, data has become public on rate increases over 10 percent, with some insurers requesting average increases well into the double digits. However, the patterns in these 10 states and DC, where more complete information is available, suggest that the premiums for the two lowest-cost silver plans – where the bulk of enrollees tend to migrate – are not necessarily increasing, and where they are increasing, the growth has generally been moderate."

-most of the states mentioned, with a few exceptions, are the usual suspects run by GOP governors/legislators who've refused to expand Medicaid, build their own Exchange, and generally done everything in their power to obstruct implementation of the law. This is not a coincidence.

-as moron mentioned, rate increases due to sick/poor people finally being insured and able to see a doctor were inevitable, and are exactly why the federal subsidies were so important. Without them health insurance may have once again become unaffordable for those folks.

-let's not forget that on a national level, average premiums have increased less rapidly since the ACA was passed then ever before, along with the total cost of healthcare.

7/6/2015 3:00:28 PM

Quote :

"^^ you shouldn't be, no one should..."

but the burden has been shifted downwards to the middle class by capping rates for old people, old people should pay a lot more than the ACA allows them to? I have to underwrite the insurance of people who benefited from stronger social programs than i get and who have more wealth than i have, why should i be happy about that?

7/6/2015 3:22:35 PM

It's also kind of suspect that after an era of insurance companies raking in multi-billion dollar profits, they are now whining about single year deficits in the hundreds of millions. Where did all those billions go? Oh yeah, straight to the pockets of their executives and shareholders.

7/6/2015 3:40:44 PM

Where exactly do you think profits typically do go or should go?

Get ready for more mergers and less choice. It's really the only way they have to reduce their fixed costs now that they have to spend a certain % of premiums on healthcare expenditures. Hundred million dollar losses are not sustainable in any industry and certainly not one in which operating margins have been mandated.

The amalgam that ACA created is destined for failure unless significant changes are made. Something like changing the age based caps and/or mandating that people with certain pre-existing conditions must enroll in a medicare/medicaid plan would be a start.

Ultimately we're headed towards single payer, IMO. But until then everyone under the age of 45 is going to continue to get it good and hard.

7/6/2015 3:57:30 PM

It's almost like healing the sick should have never been a for-profit enterprise to begin with, like we've said all along.

7/6/2015 4:09:59 PM