I had to check this three times before I believed it.
A word separate .. I had believed that while this act was extremely inadvisable the republicans were inflexibly exaggerating it's 'horror', and that it was a political football, especially since at 2700 pages of law, and 10k pages of regulations, NO ONE HAD READ A DAMN THING. In fact as I found out yesterday when the numbers and plans actually came out, the reality is incomprehensibly WORSE than anything I had imagined.
Anything I had imagined.
Cruz, Paul et al are right to a TEE.
When you are being paranoid, the chances are that you are not paranoid enough.
In so far as my individual premium is concerned there is NO QUESTION about these numbers.
The second link tells you how to calculate your final premium based on ‘factors’ (i.e. BLACK BOX formula)
Monthly Premium =( Base Rate* Plan Factor*Area Factor*Age Factor*Tobacco Factor)
First this, for the BEST individual plan here in Maine ($1300/month) you get a yearly $500 deductible, and $750 out of pocket max, $15 Dr co pay and $10 Rx. Nice, but expensive. Before this there were 4 companies offering a total of 9 plans.
We now have 2 offering 3, Bronze, Silver and Gold.
The out of pocket max is three times previous.
My BASE premium is $1027. My plan factor is 1.27. My age factor is 2.952, and my Area factor is 0.9487
Final Premium is = $1027*1.27*0.9487*2.952*(NO TOBACCO FACTOR)
Final Premium per month = $3652.75
GULP.
That’s the side the Insurance companies receive.
Is there any doubt WHY govt supplied subsidies are REQUIRED for a family earning up to $92k. Where is that coming from?
And I have not even talked about how HORRIBLE the Bronze plan is … you have to PAY OUT your entire deductible before anything is paid for. And that’s $6k.
Now I have NO MEDICAL INSURANCE because costs here are $900-$1300/month. AND there are previous condition exclusions which make it all impossible. Therefore I had actually THOUGHT there was a chance this might make sense.
Now to the subsidy side … we will max out at the stated 9.5% of income and therefore MASSIVE subsidies to the insurance companies will have to be sent from Uncle Sam. According to the latest figures I have seen there are 8.7 million people just like me, retired 62-65, no health insurance. That’s about 25-30% of the uninsured population. Let’s say the avg subsidy given the plan factors above will be $3,400/month.
8,700,000*$3,400 = $29,580,000,000
PER MONTH
For just ONE SLICE of the population. Buy stock in Anthem, Aetna, Cigna and Oxford. WHAT A WINDFALL!
I will be better off FOR A WHILE. Selfishly. I’ve had two heart attacks so my wife and kids will be happy. But we are all taking hemlock.
Me too.
Just one thing.
We are heading for a day, WHILE I AM ALIVE
that there will be NOTHING FOR ANYONE
THERE WILL BE NOTHING FOR ANYONE
How long can the unsustainable be sustained?
Just sayin’
Please check my math?
6 comments:
Paging Mr. Cloward and Mrs. Piven:
The build-in self-destrcution of this plan,
is it a bug or a feature?
If the tobacco factor is zero, then we shouldn't pay anything at all, right?
If only...
BTW, according to Bill Clinton, if you or your spouse works for an entity that offers health insurance, and you don't use it, YOU GET NOTHING. Making that premium, the actual premium.
Confused yet?
Wait till you talk to a 'navigator'
"For just ONE SLICE of the population. Buy stock in Anthem, Aetna, Cigna and Oxford. WHAT A WINDFALL!"
NO! WRONG!! the exact opposite! The premium is based on the sum of the actuarial components and the biggest risk for the company is that the entire pool has no cap. The company's liability is totally open-ended. Statistically, an unusual number of multi-million dollar outlier claims will throw the entire pool into a big loss.
Which is WHY, the personal out of pocket caps for individual policies are now delayed for at least one year.
NO OUT OF POCKET CAP
BTW, at 36-3800 per month, my yearly premium would be about $43-45k.
For a VERY serious heart attack, 3 days in icu, 3 stents and a week hospital stay, the bill was $55k.
I think we almost have self pay, except other people are 'self paying' it via subsidies.
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