Covered California 13 Individual Health Plans

[Yagents]

Subsidies are based on the second lowest cost silver plan.

If a couple carriers in each state come in with low balled premium numbers for the silver plan (staged players?), it will effect everyone's subsidy DOLLAR amount, and make all of the other plans more expensive to purchase for the consumer.

On the other hand, it will be good for the taxpayer

 

[timsip]

No one cares about rich peoples tax bills...

What will be on TV is the stories of those who could never qualify or afford health insurance that now have coverage.

They have to be able to afford that coverage to get it. Even with subsidies, many low income earners won't be able to cut enough out of their grocery budget to cover their portion. The the republicans don't gather up enough of this market segment to tell the story, they are too stupid to get elected.

 

[ctg]

What's to stop the low income earners from opting for the penalty...I mean tax, and not purchasing coverage? If they have an emergency, they have to be provided care. If they get sick, they wait until the next election period to get coverage. They flake on paying their bill and the provider is on the hook driving up costs even more.

 

[TXINSURANCE]

They have to be able to afford that coverage to get it. Even with subsidies, many low income earners won't be able to cut enough out of their grocery budget to cover their portion. The the republicans don't gather up enough of this market segment to tell the story, they are too stupid to get elected.

Subsidies are EXTREMELY rich even with the rising rates in some areas and some age bands. I do understand your point, if someone is paying $0 now to squeeze $50 out of them will be hard as the latest Iphone or Galaxy S4 plans do not come cheap!

 

[ctg]

...as the latest Iphone or Galaxy S4 plans do not come cheap!

They didn't get the free Obamaphone?

 

[Sam]

Subsidies are based on the second lowest cost silver plan.

If a couple carriers in each state come in with low balled premium numbers for the silver plan (staged players?), it will effect everyone's subsidy DOLLAR amount, and make all of the other plans more expensive to purchase for the consumer.

On the other hand, it will be good for the taxpayer

Bill, this is a really important point. There can be two small regional HMO's with a tiny networks that wind up being the Silver plan that subsidies are based on, even though no one in the most populous areas can even access the plans.

 

[Ann H]

Medicare is free right now, and a lot of people who are eligible for it don't enroll. Since there often is a retroactive enrollment privilege for those who are eligible, many hospitals have a department that enrolls those folks when they come to the hospital for care.

 

[VolAgent]

Bill, this is a really important point. There can be two small regional HMO's with a tiny networks that wind up being the Silver plan that subsidies are based on, even though no one in the most populous areas can even access the plans.

Is there any type of qualifier on the subsidy? It would be illogical to base the subsidy on a plan you couldn't get because you lived in the wrong area. Not that the government is logical, but hopefully that issue is addressed.

 

[Ann H]

Is there any type of qualifier on the subsidy? It would be illogical to base the subsidy on a plan you couldn't get because you lived in the wrong area. Not that the government is logical, but hopefully that issue is addressed.

The subsidy is based on the 2nd lowest cost Silver plan in the residence location of the primary insured. There are rules for how many Providers must be within x number of miles from the policyholder.

Nonetheless, some of these low-bidder Co-op or MAPD insurers can really skew the subsidy calculation. And, since those low-bidder insurers have a target market of the very heavily subsidized business, they will be focused on the Silver plan. That is because those at 250% of FPL or lower who want CSR (cost sharing reduction) subsidies must take the Silver plan. Hence, the Silver plan gets unrealistically low premiums, resulting in lower subsidies for everyone.

 

[Tennesseehorn]

Not only the public, but the people who run these exchanges think that if the individual family plan premiums are close to what a group plan charges, it's a good thing.

Here's a guy in charge of a California Consumer Advocacy group who is pleased with the state's exchange premiums...

"“Health insurance isn’t cheap but this seems to provide individuals and families the group rate that large employers get,” said Anthony Wright, the executive director of Health Access California, a state consumer advocacy coalition."

Source: http://www.nytimes.com/2013/05/24/b...ce-on-health-policies-under-new-law.html?_r=0

Obviously, Mr. Wright has never purchased his own individual health plan before. The vast majority of Americans mistakenly believe that Group plans have lower premiums. Many of my Individual Family Plan small business-owner clients wanted a small group policy until I showed them the thousands of annual dollars they'd save by insuring the 2 or 3 families individually.

-ac

If people want to REALLY see what a group health premium looks like just look at any COBRA statement and that will give you a dose of reality. Most of ones I have seen are north of $1,000 for a family of 3-4.