How Would You Modify the ACA?

[somarco]

If you want to learn more about AV you should take a few minutes to read these blogposts by one of my co-bloggers.

InsureBlog: Biggest Loser?

InsureBlog: Why "You Can't Keep Your Current Insurance"

InsureBlog: If You Like Your Obamacare Plan Don’t Count on Keeping It

 

[RayNY]

I've explained AV as "A government created formula that attempts to predict how much of your normal health expense is covered by the plan, for an average person. A plan with a 70% AV, called Silver, for instance, is expected to cover 70% of the medical expenses for an average person in an average year. It's not a "coinsurance" split, nor is it a guarantee, simply an estimate of the average."

The AV isn't going anywhere, it's honestly the only real method I've seen for comparing the "value" of two plans without breaking into individual usage comparisons.

Of course, individual usage comparisons are where professionals like us excel. Quite a few high-use clients realized how much cheaper it was to be on a non-standard Gold (with unlimited free PCP visits) than a lower priced standard gold with 1 free visit, based upon their usage. The clients who need medication are obviously better off on a plan with no RX deductible, but those who both need medication and extensive care actually may benefit by the combined deductible on some plans.

No metal label or math formula is going to replace what our knowledge, skill, and foresight can do for a client. We think of things our clients would never consider, whether you realize it or not.

 

[somarco]

For others, you might want to click the links above for some eye-opening info about just how foolish the AV metal tiers are, especially which plans meet the narrow definition of acceptable and which do not.

 

[timsip]

I've explained AV as "A government created formula that attempts to predict how much of your normal health expense is covered by the plan, for an average person. A plan with a 70% AV, called Silver, for instance, is expected to cover 70% of the medical expenses for an average person in an average year. It's not a "coinsurance" split, nor is it a guarantee, simply an estimate of the average."

And for the average consumer, you just spoke over their head by about a mile. That is my point exactly. There isn't an easy way to explain it. Sure they will nod their head and say 'Uh-huh' when you ask if that makes sense to them. In their head they were just trying to figure out if this week's 'Big Bang Theory' is set to record on their DVR.

 

[rugerred]

I think they should design the plans more like life insurance or med supps. Why should a 60 pay for maternity coverage. Here is your base plan and what riders do you need with that?

The family glitch needs to go completely.

Move the enrollment period to coincide with tax season.

Embrace agents and bring them more into the circle.

Sent from my Samsung Galaxy

 

[timsip]

I think they should design the plans more like life insurance or med supps. Why should a 60 pay for maternity coverage. Here is your base plan and what riders do you need with that?

There ya go! This is so very true!

 

[Yagents]

That's not in the spirit of socializing maternity

 

[rugerred]

That's not in the spirit of socializing maternity

I am against socialized anything. Dean in WI had it set up that way before obamacare. You had to check to add prescription and maternity coverage.

Sent from my Samsung Galaxy

 

[lionsrr51]

I know this may be bring on some "repeal it" posts, but as it stands today, ACA is here for a little while in it's present form. Since AEP is over, curious what others think will be beneficial modifications to the ACA to make it work better that it did. Here are a couple of mine:

- you can choose to opt out of Medicaid and choose a subsidized plan from the start.
- potential eligible Medicaid enrollees would first be enrolled in ACA plan, then once approved could drop it for Medicaid.

There was never a need to establish the ACA! This was one man's ego and a bunch of sheep following behind!
We already had the vehicles in place to take care of the supposed 15% that were uninsured or didn't have the proper coverage for pre-existing conditions!
They were the CHIPs that existed in every state! The plans could have been embellished to provide some of the caveats that now exist in the ACA and that 15% could have been afforded coverage along the same guidelines.
The CHIPs would have been further subsidized as we are with the ACA plans now. As for the other supposed 85% covered under either existing group lans or their individual plans, they could have indefinitely kept the plan of their choice! Instead, again, due to one man's penchant to build a baseless legacy, the entire country is now saddled with the crippling burden of a plan and system that is on a course for failure within the next 5 years or less! Numbers don't lie! Only politicians do!!!!
This wasn't rocket science and until the politicians got involved, it could have handled on a state to state basis! Corruption at its best! All on the backs of the people of the US, while the politicians exempt themselves from the laws of the land!

 

[barbpci]

Medicare and Medicaid work - open it up to everyone and make it a payroll deduction, like FICA. The insurance companies can sell Medicare supplements to enhance the program. Everyone who could not afford a supplement would still have basic coverage. With everyone contributing to the pool the desired younger group included would offset the older group and everyone would benefit in sharing the cost. There would also be more leverage in getting the pharmaceutical companies to a more reasonable profit margin - no company is worth a 400% profit on the backs of sick people.