ACA - Obamacare Is Working; Over 7.1 Mil PAID in 2014, 9 M More Expected! Rate Increases Lower Than Predicted! [204*18]

NOVEMBER 8, 2013

EUREKA! I GOT INTO THE OBAMACARE WEBSITE! Since Oct 1, 2013, I kept trying to find out the various prices for the various exchange plans available. After about a week, I was able to get to the log-in sign-up screen. It took two more weeks to get an actual user name and password. At about 8:50 PM, Nov 8, 2013, I finally succeeded in breaking through the walls and apply for insurance so that I could find the prices, yeah!

WHAT ARE 2015 RATE CHANGES LOOKING LIKE?

These are close to the final numbers, or in some cases are the final numbers. Notice two things; 1) the more insurers there are, the less increase in premiums there (in a few cases there is a decrease in premiums) showing competition is working; as envisioned and 2) virtually all states have some plans who lowered their rates.

ALABAMA: Alabama saw only an average 3% increase in premiums for 2015. That puts the average Silver Plan premium for a single person at $269/mo, before subsidies. For comparison, the Platinum Plan, which often has no deductibles, has an average premium of $317/mo, before subsidies.

ALASKA: At an average rate of $583/mo, before subsidies, for the Silver Plan, Alaska comes in worst out of the 50 states. The high rate was the result of the worst average increase in the Nation, when compared to 2014, of a whopping 31%! Fortunately for Alaskans, 88% of them will qualify for some sort of subsidy where, in 2014, 61% paid $90/mo or less.

ARIZONA: Average Silver Plan Premium to be $313; Range Change from -25% to +24%; Average change: 4.5%; Number of Insurers: 16; Number of new Plans: 9

JANUARY 22, 2014

I JUST COMPILED THE LATEST INSURANCE EXCHANGE statistics I could locate. Most were current as of Dec 28, 2013, but a few were reports from the first week of Jan 2014. Enrollment has now climbed above the 2 million mark. The ratio, as would be expected, of healthy to unhealthy is not where it needs to be for the program to be a success. I don't expect to be until after tax time when the penalties kick in.

MARCH 11, 2014

THERE ARE JUST 2O DAYS LEFT TO SIGN UP FOR OBAMACARE or face penalties next April 15, 2015. To-date, about 4.3 million people have signed up through the insurance exchanges

MARCH 18, 2014

THE WHITE HOUSE JUST REPORTED the number of sign-ups for Obamacare just passed the 5 million mark. Millions more have signed for expanded Medicaid in those states who saw fit to help their citizens. Also, a significant number of signed up for private insurance but not through the exchanges; these people are generally the ones who don't qualify for subsidies and can find better deals outside the insurance exchanges. Six million now appears a bit more doable.

We are one step closer to a much healthier America.

Continuing

ARKANSAS: Average Silver Plan Premium to be $429; Range Change from -?% to ?%; Average change: -2.0% (includes private option for Medicaid-eligible individuals); Number of Insurers: 4; Number of new Plans: 0

CALIFORNIA: Average Silver Plan Premium to be $388; Range Change from -3% to +28%; Average change: 6.3%; Number of Insurers: 15; Number of new Plans: 4

COLORADO: Average Silver Plan Premium to be $412; Range Change from -22% to +35%; Average change: 2%; Number of Insurers: 15; Number of new Plans: 5

CONNECTICUT: Average Silver Plan Premium to be $393; Range Change from -22% to +9%; Average change: -1.9%; Number of Insurers: 9; Number of new Plans: 4

DELAWARE: Average Silver Plan Premium to be $400; Range Change from -3% to +4%; Average change: 0.7%; Number of Insurers: 2; Number of new Plans: 1

FLORIDA: Average Silver Plan Premium to be $391; Range Change from -12% to +20%; Average change: 5.3%; Number of Insurers: 17; Number of new Plans: 6

GEORGIA: Average Silver Plan Premium to be $402; Range Change from -7% to +18%; Average change: 3.7%; Number of Insurers: 9; Number of new Plans: 5

ILLINOIS: Two new insurers joined the other six to offer a total of 306 individual policy choices and 198 for small groups; that is up from 120 and 45, respectively. No word on rates yet, but expected to have some decreases with the extra competition.

INDIANA: Average Silver Plan Premium to be $457; Range Change from -8% to +24%; Average change: 9.7%; Number of Insurers: 13; Number of new Plans: 9

IOWA: Average Silver Plan Premium to be $357; Range Change from 0% to +19%; Average change: 11%; Number of Insurers: 7; Number of new Plans: 0

KANSAS: Average Silver Plan Premium to be $393; Range Change from +11% to +20%; Average change: 15.5%; Number of Insurers: 6; Number of new Plans: 2

KENTUCKY: Average Silver Plan Premium to be $?; Range Change from -4% to +15%; Average change: 4.6%; Number of Insurers: 9; Number of new Plans: 5

OHIO: Average Silver Plan Premium to be $373; Range Change from ?% to ?%; Average change: 12.1%; Number of Insurers: 6; Number of new Plans: 5

OKLAHOMA: Average Silver Plan Premium to be $357; Range Change from -9% to +20%; Average change: 6.7%; Number of Insurers: 10; Number of new Plans: 1

MAINE: Average Silver Plan Premium to be $408; Range Change from -1% to +2%; Average change: 0.7%; Number of Insurers: 4; Number of new Plans: 1

MARYLAND: Average Silver Plan Premium to be $298; Range Change from -14% to +16%; Average change: 5.9%; Number of Insurers: 8; Number of new Plans: 2

APRIL 1, 2014

NO MORE SIGN UPS TO OBAMACARE ALLOWED until November 2014. Granted, those that got their foot in the door by midnight Eastern Daylight Time, March 31, 2014 can still complete their application and pay up. It is clear that the lower goal of 6 million sign-ups was blasted through as was the original estimate of 7 million. Given the applications from the state exchanges and off-exchange insurers, the probability of exceeding the CBO threshold of 7,000,000 enrollments being met is very high.

The next critical question is, did enough young people sign up? It is these people who insurers are counting on to keep costs down as they service the more sick class of older adults. From the series of conflicting reports and propaganda let out from both sides, it does seem more probable than not that the mix is near what is needed. My main barometer is the lack of worry coming from the insurers themselves.

It is that same lack of public jitters from the insurers that make me think the program is working as designed, even though not in as automated way as they had hoped given the fact the back-end computer systems are still being worked on.

APRIL 18, 2014

PRESIDENT OBAMA ANNOUNCED THAT FEDERAL EXCHANGE SIGN-UPS NOW EXCEED 8,000,000; and the number is expected to grow a bit more. The CBO, however, expects that when the dust settles in a few months, there will be around 6,000,000 people paid into the federal exchange system. Why the drop? Because the CBO expects some not to pay, maybe 15%, let coverage lapse or cycle out of the system by obtaining insurance from another source.

The 8,000,000 number is not the only good news for Obama and the Democrats, there is also:

  • The CBO just reduced its estimate of the overall cost of Obamacare by $104 B between 2015 - 2024
  • Around 35% of enrollees in the federal exchanges were below the age of 35; the White House originally hoped for 40%, but it is much better than the 25% that was being seen in January and is in line with what Massachusetts experienced in their first year.
  • The ACA is still expected, by the CBO, to lower the deficit.
  • Many more insurers are coming off the sidelines and will participate next year
  • The Society of Actuaries predicts premium increases to fall, on average, between 6 - 8.5% rather than the normal 7 - 10%.
  • Enrollment in state and off-exchanges plus under 26ers on parent's plans should total another 5,000,000 enrollees
  • Enrollment in Medicaid increased by 3,000,000
  • Gallup estimated that the rate of uninsured dropped from 18% in the 4th quarter of 2013 to 15.6% by March 31, 2014; it declined even further in those states who participated in the expanded Medicaid program.

Continue

MICHIGAN: Average Silver Plan Premium to be $360; Range Change from -22% to +18%; Average change: 3.6%; Number of Insurers: 19; Number of new Plans: 10

MINNESOTA: Average Silver Plan Premium to be $320; Range Change from -9% to +17%; Average change: 5.7%; Number of Insurers: 5; Number of new Plans: 1

MISSISSIPPI: Average Silver Plan Premium to be $?; Range Change from -25% to +7%; Average change: -9.3%; Number of Insurers: 2; Number of new Plans: 0

NEBRASKA: Average Silver Plan Premium to be $?; Range Change from -3% to +20%; Average change: 9%; Number of Insurers: 4; Number of new Plans: 1

NEVADA: Average Silver Plan Premium to be $?; Range Change from -7% to +24%; Average change: 4.9%; Number of Insurers: 13; Number of new Plans: 1

NEW HAMPSHIRE: The two providers have proposed changes between a 9.8% average increase to an 15.4% increase, the actual increase depending on the plan. [ed: interesting difference between Maine and New Hampshire]

NEW MEXICO: Average Silver Plan Premium to be $?; Range Change from -4% to +9%; Average change: 1.4%; Number of Insurers: 6; Number of new Plans: 1

NEW YORK: New York appears to be an outlier for 2015 so far with only rate increases coming down the pike. The average increase requested is 13% with a new entrant wanting a 28% increase.over 2014 rates.

They didn't get what they wanted, for average Silver Plan Premium is to be $?; Range Change from -15% to +13%; Average change: 0.6%; Number of Insurers: 21; Number of new Plans: 4

NORTH CAROLINA: Average Silver Plan Premium to be $384; Range Change from +9% to +18%; Average change: 11.8%; Number of Insurers: 8; Number of new Plans: 3

OREGON: Average Silver Plan Premium to be $250; Range Change from -20% to +10%; Average change: -2.5%; Number of Insurers: 13; Number of new Plans: 0

PENNSYLVANIA: Average Silver Plan Premium to be $478; Range Change from -6% to +20%; Average change: 10.4%; Number of Insurers: 13; Number of new Plans: 8

RHODE ISLAND: Average Silver Plan Premium to be $305; Range Change from -5% to +5%; Average change: -1.4%; Number of Insurers: 3; Number of new Plans: 1

SOUTH CAROLINA: Average Silver Plan Premium to be $?; Range Change from +10% to +17%; Average change: 13.4%; Number of Insurers: 10; Number of new Plans: 2

SOUTH DAKOTA: Average Silver Plan Premium to be $460; Range Change from 0% to +3%; Average change: 2%; Number of Insurers: 5; Number of new Plans: 2

TENNESSEE: Average Silver Plan Premium to be $360; Range Change from -9% to +17%; Average change: 13.8%; Number of Insurers: 5; Number of new Plans: 1

UTAH: Average Silver Plan Premium to be $?; Range Change from +8% to +19%; Average change: 7.6%; Number of Insurers: 8; Number of new Plans: 3

VERMONT: Average Silver Plan Premium to be $414; Range Change from +8% to +11%; Average change: 9.3%; Number of Insurers: 2; Number of new Plans: 0

VIRGINIA: Average Silver Plan Premium to be $354; Range Change from 2% to +18%; Average change: 10.2%; Number of Insurers: 14; Number of new Plans: 6

WASHINGTON: Average Silver Plan Premium to be $364; Range Change from -3% to +26%; Average change: 5.1%; Number of Insurers: 14; Number of new Plans: 4

WASHINGTON D.C.: Average Silver Plan Premium to be $?; Range Change from -6% to +8%; Average change: 2.3%; Number of Insurers: 4; Number of new Plans: 0

WEST VIRGINIA: Average Silver Plan Premium to be $417; Range Change from 0% to +10%; Average change: 6.7%; Number of Insurers: 7; Number of new Plans: 2

WISCONSIN: Average Silver Plan Premium to be $465; Range Change from -17% to +24%; Average change: 3.8%; Number of Insurers: 17; Number of new Plans: 3


APRIL 24, 2014

THIS SECTION WILL DISCUSS EXCHANGE INSURANCE COSTS. For starters, let me give you a baseline for comparison, which is my company's insurance. We are a small business with a little less than 40 employees, so we don't have to provide insurance; but, we always have, even when we only had three employees. We currently have what would be equivalent to the exchange's 90/10 Platinum Plan.

Our plan, from United Health, costs the company $324 per employee per month and the employee $81/month. We do not cover spouses or family, so those costs the employee between $340 and $440 for a spouse or child; or $761 more per month for the rest of the family, should they choose to purchase them. It provides the following:

Deductible - $250/$750

Co-Pay after deductible - 90% - 10% (70% out of network)

Primary - $25, Specialty - $50

Max Out of Pocket - $2,500/$5,000

The Exchange Plan commonly used for comparison purposes is the Silver Plan, this is the one for which typical premiums are available. Its benefits are:

Deductible - $2,907/$6,078

Co-Pay after deductible - 70%- 30%

Primary - $32, Speciality - $56

Max Out-of-Pocket - $5,730/$11,495

The table below presents typical premiums paid for single and family coverage by state. The variability is caused by several factors but one primary one is how many companies are competing in a given locality; in some places it is as low as one. It appears that will improve next year indicating rates may go down in many areas of the country.

More Headlines

6/5/2014: Gallup Survey (Apr 1, 2014 - May 31, 2014) -

  • Lowest uninsured rate across all (9 out of 10) subgroups since poll started in 2008!
  • Rates among blacks fell by percentage points and Hispanics by 5.6 points.
  • Rates dropped 6 points in households with incomes less than $36,000

6/18/2014:USA Today (Jayne O'Donnell and Kaitlyn Krasselt) -

  • Nearly 70% of consumers who bought subsidized health insurance on the federal exchange for 2014 paid $100 or less in monthly premiums,[ed: so much for unaffordability]
  • ... rate increases that are largely in line with pre-Obamacare years.

7/4/2014: Factcheck.org -

  • A poll by the nonpartisan Kaiser Family Foundation indicates that 57 percent who signed up for private insurance through exchanges had no coverage before.
  • The poll also showed that the majority of those who signed up for individual policies rate their Obamacare-compliant coverage as excellent or good
  • The poll shows as well that those who sighed up believe it is a good value for what they pay for it, and say they are satisfied with various aspects of their plans.

7/21/2014:

  • The D.C. Federal Court of Appeals ruled 2-1 that subsidies obtained from federally run state exchanges violated the ACA
  • The Southern District Court of Appeals in Richmond, VA ruled 3-0 that the subsidies were valid under the law
  • Previously two district court cases challenging this aspect of the law were dismissed and another ruled in favor of Obamacare.
  • The Federal government is appealing the D..C. ruling to the full court. If the D.C. ruling holds, then the next stop is the SUpreme Court. If the challenge fails, it will be appealed to the Supreme Court by the plaintiffs and it is problematic if the Court will hear it given all of the lower courts would be unanimous in finding the subsidies valid.

7/25/2014: ProPublica

  • Since open enrollment closed and the extension ran out at the end of April 2014, more than a million transactions have taken place due to life events
  • This is much higher than expected

9/5/2014: Kaiser Health Foundation

  • "...average premiums will decline slightly next year in 16 major cities for a benchmark Obamacare plan."
  • "... for the second year of marketplace operation. On average, rates will drop 0.8 percent in the areas studied."

12/17/2014: CNN (2015 Season ends Feb 15, 2015)

  • 2.5 million have signed up for 2015 enrollment in the federal exchanges so far. Another 700,000 have signed up in state exchanges
  • Of those, about 48% are new enrollees, the rest are renewing or changing existing policies. (For those who signed up in 2014 and do nothing, they will be automatically re-enrolled)
  • A report released Tuesday from Avalere Health, an advisory firm, estimates exchange enrollment will total 10.5 million people by the end of next year.
  • Some 6.7 million people were enrolled in Obamacare plans in 2014, while some 8.7 million more people are enrolled in Medicaid as of August than were last year. (This includes people who are newly eligible under Obamacare, as well as people who were qualified but hadn't enrolled.)

2/7/2015: CNN (2015 Season ends Feb 15, 2015)

  • CBO now estimating that 16.2 million people will sign up to Obamacare by 2/15/2015. Of those, they expect 14.2 million will end up paying and 13.5 million will still be with the program by the end of 2015.
  • HHS estimates those numbers to be 10.0 M, 9.1 M, and 8.6 M, respectively.
  • An independent estimate gives 12.5 M, 11.0 M, and 10.5 M, respectively.

Did The Republicans Get It Right or Wrong

HERE IS WHAT REPUBLICANS, aka CONSERVATIVES HAVE said about Obamacare:

1. Obamacare won’t really cover any new people!

- About 9.5 million people gained coverage that didn't have it before, it met expectations.

2. The coverage provided by Obamacare will be worse!

- About 59% of those covered believe they are better off and about 25% saw no change.

3. People will hate the Obamacare plans!

- About 43% are Very Satisfied and another 35% are Somewhat Satisfied.

4. People signing up won’t even use the coverage!

- About 60% who signed up have used it and another 6% haven't had their plan go into effect yet.

5. Obamacare will cause long lines and wait times, nobody will be able to get appointments!

- About 41% get an appointment within one week, another 25% within two weeks.

So, what do you think?

TYPICAL FEDERAL EXCHANGE SILVER PLAN PREMIUMS

INDIVIDUAL RATES
STATES (order: low to high)
FAMILY PLANS
$161 - $189
TN, AZ, KS, OK, NM, PA, ID, IL, IA
$584 - $683
$201 - $209
TX, MI, UT, NE,MT, AL
$656 (UT), $727 - $757
$212 - $223
OH, FL, WV, MO,VA, GA, SC
$768 - $809
$232 - $249
ND, SD, DE, NH, WI, NC, AR, LA
$841 - $902
$260 - $342
NJ, IN, ME, MS, AK, WY
$943 - $1,237

OBAMACARE APPROVAL RATING

 
7/7/14
4/28/14
3/31/14
12/8/13
12/10/12
ABOUT RIGHT
41.3%
41.9%
40.4%
37.4%
42.2%
TOO LIBERAL or NOT LIBERAL ENOUGH
53.5%
51.7%
53.4%
57.0%
47.4%
 
 
 
 
 
 
Source

MANY STATE INSURANCE EXCHANGE POOL RATES ARE LOWER THAN EXPECTED!

YES, THAT IS RIGHT! The premium rates for the "Silver" plan, 2nd in a 4-tier structure, are being published by various states now, California being the latest, are coming in close to or lower than comparable small-business plans but with generally much better coverage. This, of course, is counter to what most pundits were predicting and unbelievable (like the 2012 election results) to those on the Right.

There are four plans in the State pool system, Bronze, Silver, Gold, and Platinum, just as there are in the company plans they mimic. The federal government uses the Silver plan as the benchmark for determining qualification to any subsidies that might be available. All states must implement these plans by October 1 (or have the Federal government do it for them) and people can begin signing up then. The insurance becomes effective January 1, 2014.

CNN Money on-line has an article entitled, Obamacare premiums in California lower than predicted, By Tami Luhby @Luhby May 23, 2013: 5:06 PM ET; the link is provided until it disappears. In it, you will find such statements as:

  • "Health insurers in California will charge an average of $304 a month for the cheapest silver-level plan in state-based exchanges next year ..." (I pay about $410 for my small business plan with United Health Care who did not participate in the California exchange program. My benefits are better than the Silver level, however.)
  • "Subsidies will be based on the cost of silver-level plans and will be available to those earning up to 400% of the poverty line -- roughly $45,000 for an individual or $92,000 for a family of four."
  • ...Several estimates, including some focusing on the California market, have predicted that premium rates in the individual market would soar because more older, sicker folks would enter the exchange..." [in fact], "...the agency noted that the rates for individuals will be between 29% lower and 2% higher than the average premium for small employers ..."
  • "The least expensive silver plan for a 21-year-old could cost $216 a month, but those earning only 150% of the poverty line (or $17,235 annually) may pay only $44 after receiving federal subsidies"
  • Oregon and Washington recently posted their rates, as well. They were also lower than some had expected.
  • JULY 2013: New York is now following suit. As reported in the NY Times on July 18, 2013, individual insurance rates are set to FALL an average of 50% come Jan 1, 2014!! In New York City, where individual insurance premiums now run $1000/mo, with the exchanges they will be able to be had at $308/mo; even lower when you include subsidies some people may qualify for.

Also, the claim has been made that these are empty policies ... not true. As a minimum they must cover:

  • Pediatric services (including oral and vision care)
  • Preventive/wellness services and chronic disease management
  • Ambulatory (“walk in”) patient services
  • Rehab and habilitative services/devices
  • Emergency services
  • Mental health and substance use disorder services (including behavioral health treatment)
  • Hospitalization
  • Maternity/newborn care
  • Prescription drugs
  • Lab services

Most, I understand, cover more than the minimum. Further, in another article, it seems the Bronze plan is like a traditional 60/40 plan; the Silver, a 70/30 plan; the Gold, an 80/20 plan, and the Platinum, a 90/10 plan (the one my company chose instead of taking a rate reduction two years ago; we had an 80/20 plan.)

I expect sometime next year, the poll numbers on Obamacare to reverse and become very positive for, as they say, the proof is in the pudding, and the pudding in now being made.

JUNE 5, 2013

THE LATEST CNN/ORC NATIONAL SURVEY once again, as it has for three years, shows that a majority of Americans want some sort of Obamacare-type health coverage. In the poll, 35% DO NOT support Obamacare, 16% think Obamacare doesn't go far enough and needs to be stronger, and 46% DO support Obamacare.

As expected, Conservatives once again falsely parade around the 46% result rather than the more correct 35% Against or 60% For national healthcare coverage; but then, that is what politicians do, isn't it, it just happens to be Conservatives this time.

AUGUST 20, 2013

USA TODAY TODAY REPORTED the results of a survey of all 50 states regarding their estimates of how many people they expect to join their Obamacare insurance exchanges; 19 have replied so far. CBO estimates that for the Exchange Program to be economically viable, more than seven million people need to join. With the 19 respondents, the total is 8.5 million so far; with 31 states left to chime in!! This isn't particularly good news for the conservatives who want to keep many Americans uninsured.

OCTOBER 5, 2013: NOW THAT THE EXCHANGES ARE OPEN (and not working very well, at the moment), it is turning out most of the State programs are coming in much less expensive than earlier predicted. The expected glitches did indeed occur; somewhere volume related, some were not. The volume related problem was the 3 - 5 minute wait to get to a log-in screen on the Florida, one of the States who abrogated their responsibilities to the Federal gov't, One of the system glitches was the merry-go-round I got on for a few days trying to get passed the security question screen. Yesterday, that problem was solved and I was able to get log-in credentials. Then today I tried to sign my wife up (I am on Medicare) and was stopped by volume again; I will try again later.

OCTOBER 10, 2013: THE STATE EXCHANGES appear to be working, but there are only 13 States responsible enough to do it on their own, the remainder chose to go on welfare and let the Federal government take care of it for them; States like Texas, Florida, and Alaska. In any case, the private contractors the Federal government hired to build the system for them weren't up to the task, as their proponents on the Right guarantee us with their rhetoric that the private sector is always better than the government. What they provided the People was glitchy at best and still doesn't work 10 days later, so the People aren't getting what they paid the private sector to build for them. I know they will get it figured out shortly, and I really don't blame them for they were handed an impossible task when so many States failed in their responsibilities.

In any case, I started scouring the Internet looking for reliable reports of how many people have actually applied for Obamacare. At the moment, it is not many and only in a few States who choose to report it, like 5 in Iowa. Anyway, you can find the running total at the top.

NOW I CAN ASK

DID YOU SIGN UP FOR INSURANCE USING THE EXCHANGES IN 2014? IF SO, DID YOU LIKE WHAT YOU GOT?

See results without voting

CURIOUS MINDS WANT TO KNOW WHAT YOU THINK

NOW THAT SEVERAL YEARS OF IMPLEMENTATION OF OBAMACARE HAVE GONE BY, HAS YOUR OPINION CHANGED?

See results without voting

It is interesting to note, and may be a deflator to the Republican anti-Obamacare message, that a March 2014 Wall Street Journal/NBC News poll shows the following among registered voters::

  • More likely to vote Democratic because they support Obamacare - 48%
  • More likely to vote Republican because they oppose Obamacare - 47%
  • Other or Not Sure - 5%

Of the Democratic 48%, 33% feel strongly and of the Republican's 47%, 35% feel strongly that way. What is more, after the March 31 deadline has passed and all of the hoopla has died down from not making the 7 million target enrollment number has died down, There will be between 5 - 7 million votes from people who do not want to lose their insurance against the Republicans who would like see them lose their regular coverage and millions more who would lose their Medicaid coverage..

OBAMACARE IS BEGINNING TO PAY FOR ITSELF

THE ACTUARIES FOR THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS), an organization responsible for providing independent analyses, forecasts, and statistics regarding the past, present, and future costs of Medicare and Medicaid released several reports reviewing the success or failure of Obamacare. One such report, released Dec 2012, is titled, Report to Congress, Fraud Prevention System, First Implementation Year, 2012. The report lays out what the actuaries found in terms of this programs initial roll-out. In bullet form, it was determined that in its first year (2010) it:

  • Met and exceeded legislative requirements and timeline
  • Implemented the FPS nationwide, better coordinating fraud-fighting efforts across program integrity contractors’ jurisdictions
  • Developed complex and sophisticated FPS models as a result of nationwide implementation, strong stakeholder partnerships, and a rigorous governance process
  • Achieved a positive return on investment (ROI), saving an estimated $3 for every $1 spent in the first year
  • Prevented or identified an estimated $115.4 million in payments
  • Generated leads for 536 new investigations by CMS’s program integrity contractors and augmented information for 511 pre-existing investigations their 2nd Annual Report.

In mid-2012, CMS released another report titled The Affordable Care Act: Lowering Medicare Costs by Improving Care which described how Obamacare will now save $200 billion by 2016 in Medicare Trust Fund costs and $208 billion by 2020 in costs to Medicare recipients. The $200 billion breaks down like this:

ACTUAL AND PROJECTED SAVINGS FOR THE MEDICARE TRUST FUND

HEALTH CARE REFORMS FROM THE AFFORDABLE CARE ACT
AMOUNT 2010 - 2016 ($ billion)
COMMENTS
Reducing excessive Medicare payments to private insurers who operate in Medicare Advantage
$68
 
Reforming provider payments, including improved productivity
$85
 
Improving patient safety through the Partnership for Patients
$10
Through 2013
Cracking down on fraud and abuse in the Medicare system, and getting the best value for Medicare beneficiaries and taxpayers for durable medical equipment
$8
 
Additional provisions, including the net effect of expanded benefits, lowered payments for hospital acquired conditions, readmissions reductions, and adjustment to premium subsidies
$41
 

The same report estimates that $208 billion has been or will be saved, through 2020, in costs to Medicare recipients; primarily from lower premiums and out-of-pocket costs.

NOVEMBER 17, 2013

WITH ONLY TWO WEEKS TO GO before the administration's self-imposed deadline of Nov 30, the Obamacare website seems to be continuing to work. As I mentioned at the top, the breakthrough appeared to have occurred around Nov 8, when I got to the enrollment stage without a hitch; I didn't actually enroll because neither my wife or myself need to, but I was able to view the plan prices for Florida. In any case, it has not gone unnoticed by me at least, that news reports of people having problems accessing the Obamacare website have fallen way off; they have now been replaced by news of the low enrollment numbers because of the previous problems.

According to President Barack Obama's website adviser Jeffrey Zients, the site, the one for the 36 states who decided to try to defeat Obamacare by not setting up their own websites, is about to process 17,000 enrollments per hour now. Apparently the triage of Obamacare produced 250 fixes that needed to be in place prior to the new deadline; Zients said only 50 were left to implement. Currently, they are making significant upgrades to capacity, e.g., a bunch of new computer servers, in anticipation of a rush during the first two weeks of December in order for enrollments to be effective on Jan 1, 2014.

Looking through several sources, 129,813 people have actually enrolled (not just filled out an application) so far. Only 6,870,187 left to go.

IT'S AMAZING WHAT A COUPLE OF DAYS MAKE

NOVEMBER 20, 2013: AS REPORTED BY Matthew Yglesias of Slate Magazine that it is not Obamacare that is the problem for low enrollment, but the IT issues!. He found the following among the States who manage their own working websites:

  • "... California — which enrolled about 31,000 people in health plans last month — nearly doubled that in the first two weeks of this month..."
  • ",,, Connecticut and Kentucky, are outpacing their enrollment estimates,..."
  • "... Minnesota, enrollment in the second half of October ran at triple the rate of the first half, ..."
  • "... Washington state is also on track to easily exceed its October enrollment figure, ..."
  • ' ... But where the IT is on track, the enrollments are on track...."

Interesting!


NOVEMBER 30, 2013

THE OFFICIAL COUNT IS OUT FOR OBAMACARE in October and November. The Table below presents some selected numbers.

STATISTC
STATE-RUN ACA
FEDERALLY-RUN ACA
TOTALS
Total Website Visitors
10,678,534
28,412,628
39,091,218
Total Call Center Calls
1,752,767
3,495,276
5,248,043
Number of People Who Selected a Plan
227,478
137,204
364,682
Potential Enrollees Who Are Eligible
554,397 1
1,388,204
1,942,601

Another 803,077 people are eligible for Medicaid or SNAP programs. Ignoring, for the moment, the dismal start-up, Obamacare has been enrolling almost 6,000 per day or, at this rate, 2,100.000 annually ... a far cry from the 7,000,000 HHS says it needs. However, numbers can be deceiving for the 6,000 is based on the assumption that the rate of increase in signups is flat; zero acceleration. In fact. however, sign-ups are increasing at some accelerating rate, implying a much higher enrollment at the end of the year as opposed to what the linear model shows..

3/7/14; Roughly 4,3 million have signed up through February 2014 with, the industry estimates, 85% of them being paid up. While the number of young adults is increasing it isn't up to snuff yet. What apparently is, however, are those buying health insurance through the private, non-exchange market, While far fewer, maybe a million, they are a younger crowd and count toward what is projected is the minimum number of young adults needed for profitability.

© 2013 My Esoteric

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Comments 44 comments

Mitch Alan profile image

Mitch Alan 3 years ago from South Jersey

The cost factor, which I still believe will go up after the initial launch and implementation, for both the reasons of simple economics and the influx of amnesty granted illegals, but also because costs are being kept down by a shell game, smoke and mirrors temporary government subsidy. This is a hoax of epic proportions, as seen by a government (regardless of party) that is well versed in such hoaxes. No federally mandated program, run by the federal government exists with the confiscatory taxes it they run on...and non is run properly. Further more, how can you support a program run by the federal government that FORCES it's citizens to purchase a product or service simply for being alive? Without a misquoting of "common good", how is Obamacare justified in light of the enumerated powers listed in the Constitution and the 10th Amendment?


My Esoteric profile image

My Esoteric 3 years ago from Keystone Heights, FL Author

Only time will tell if Obamacare actually works more or less as advertised. As to supporting the idea, I don't see Obamacare any different than Social Security or Medicare, both of which "force" citizens to buy insurance of one sort or another, whether they want it or not. When you cut through all of the vitriol and hyperbole regarding those latter two programs, the taxes paid into those programs have the effect of being premiums you paid for an annuity or an insurance program.

The fact that those premiums are mandated by law, doesn't change their character, they're purpose is still the same.

The enumerated powers and 10th Amendment have been debated before they became law. Virtually every President, every Congress, every Supreme Court, and every political party has argued for both a liberal and strict interpretation, probably within any given 12-month period of time; it only depends on the issue.

Conservatives throw the 10th Amendments out the window when it comes to gays having the right to marry. Liberals invoke it when Conservatives want to make a national ban on product liability cases. Go figure.


Mitch Alan profile image

Mitch Alan 3 years ago from South Jersey

I'm against all forced commerce, whether it be Obamacare or Social Security. The government should not be in the business of business.

As to the gay "rights" issue when it comes to marriage, I have written a hub on that very topic. As a TRUE Conservative and not merely a Republican (they are not the same), I believe that the government should not be in marriage game at all, especially as it has been since the turn of the last century.

I am consistent in my application of the 10th Amendment, enumerated powers, etc. Regardless of party in power. And, simply because something has been disregarded by the majority of both parties, does not make it right or accurate to the original text.


My Esoteric profile image

My Esoteric 3 years ago from Keystone Heights, FL Author

Thanks for the comment @Fundraising. I might add, it will also brighten the day for those who weren't allowed to have insurance by the insurance company to be able to buy insurance now

Thanks for your comments as well, Mitch. Yes, you have definitely been consistent, for sure, and I applaud you for that. The problem is, of course, and will keep you and me busy for years to come, is that the founders purposely kept the original text ambiguous and they did it for several reasons. One was to get the Constitution passed to begin with, but another, and James Madison made this very clear in his notes on the Constitutional Convention, was to allow the Constitution to be reinterpreted as society changed; he knew this had to be in order to keep the other promise of the Constitution ... to have a perpetual Union. Thomas Jefferson felt the same way as did John Adams, they knew that for the Nation to survive, the Constitution could not be immutable.


SOBF profile image

SOBF 3 years ago from New York, NY

Excellent hub Esoteric - I often wonder what world the nay say-or's are living. The talk about increased insurance cost as though it has remained flat over the past 10 years (up 131%). They pretend that insurance companies actually care about policy holders, while they drop them at every chance, a act that many times leads to their death. They constantly complain about the tax cost of funding government assisted health insurance , while covering the cost of the multitude of uninsured today.

They complain about constitutional rights being stripped away and how we are ignoring the desires of our founding fathers. The following is a quote off the Jefferson Memorial, in Washington DC.

"I am not an advocate for frequent changes in laws and constitutions, but laws and institutions must go hand in hand with the progress of the human mind. As that becomes more developed, more enlightened, as new discoveries are made, new truths discovered and manners and opinions change, with the change of circumstances, institutions must advance also to keep pace with the times. We might as well require a man to wear still the coat which fitted him when a boy as civilized society to remain ever under the regimen of their barbarous ancestors."

Your point....has been made.


My Esoteric profile image

My Esoteric 3 years ago from Keystone Heights, FL Author

Thank you for your thoughts @SOBF, I had forgotten about that quote. I just drove up to the D.C. area for some business. I was going to take the opportunity to drop by the Pentagon, I use to work there, and take in the 9/11 memorial. They hadn't quite finished it by the time I moved down to FL, and they kept it well hidden while building it. Now, I think I will swing by the Jefferson Memorial while I am at it.


My Esoteric profile image

My Esoteric 3 years ago from Keystone Heights, FL Author

Then how come, @Fundraising, a new employee of mine now has a $40,000 hospital bill (which is getting bigger by the week) because her husband needed emergency surgery before our insurance plan kicked in for her? That doesn't sound free to me.

Further, none of those 40 million uninsured, or what ever the number is, that will now have access to insurance were on Medicaid; by definition Medicaid is insurance.

Also, those who do get "free" emergency care by skipping out on their bill, may get by, but you didn't ... I hope you enjoyed helping to pay for their medical bills through your higher taxes and insurance premiums (assuming you have insurance yourself.)


ZipperConstantine profile image

ZipperConstantine 3 years ago from United States

It was announced this morning on the news that Unions are now very worried about Obama Care.


HSchneider 3 years ago from Parsippany, New Jersey

Great Hub, My Esoteric. Next year the major cost saving changes will be implemented along with the healthcare exchanges. Then we will truly see how ell this works. It will certainly be a fairer system.


fundraising cards profile image

fundraising cards 3 years ago from Englewood, Florida

LOL :-) Yes as a small employer I purchase my own Insurance. I keep it JUST IN CASE there is something UNEXPECTED .. I pay the first $10,000 and then the Insurance company pays remainder. By doing this it keeps the premiums reasonable .... I could pay to have doctor co-pays of medicine Co-pays or physicals and all sort of stuff... But I know those will happen so I budget for them... can not insure the expected

As far as "a new employee of mine now has a $40,000 hospital bill (which is getting bigger by the week) because her husband needed emergency surgery before our insurance plan kicked in for her?" Shame they chose not to purchase health insurance.... there are very very few circumstances where, a person being uninsurable is based on things that are not Covered by insurance reg. If he had prior coverage, he could have chosen to keep cobra ins or mini cobra (depending on state and company size) if that coverage was going to be exhausted, private health insurance can be purchased on a guaranteed basis, within 63 days of Cobra running out.... the most common reasons for not having continuous coverage:

1. I am healthy why would I waste my money on insurance - For reasons like above.

2. It cost too much/ I can't afford it / I am not working - None of these are caused by the health care system (in an ideal world without government waste or corporate greed, health care costs remain relatively even per person) - those are Economic excuses/reasons

3. Choice/priority/poor planning - Self indulged poor health

But for whatever reason a semi reasonable person will end up paying for health coverage, either by paying for Health insurance, or by making a payment plan after a health event.

BTW I am a pretty compassionate person and my family has helped other families (children) (3 that I can remember within the last year) in need on an individual basis, but that was by choice in circumstances that aligned with our values.


Mitch Alan profile image

Mitch Alan 3 years ago from South Jersey

Eso, The ultimate goal of Obamacare is a single payer system, which is never good for the people as a whole. Obamacare is part of a Cloward & Piven approach to collapse the current system and then "reluctantly" have the government come in a take it over. Remember C.S. Lewis' quote, "Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. It would be better to live under robber barons than under omnipotent moral busybodies. The robber baron's cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience." This is the hallmark of our modern political system...and with the majority of both parties.


Dave 3 years ago

I was an expat living abroad when Obama care got passed, and am just now (2013) getting ready to return to the States. From the beginning it looked like a plan that had serious potential, but suffers from being "rushed through" and is too unclear. This article helps some, however, I still don't see any basic, simple definitions that help me know what to expect.

So, probably in a year or two, if I remember this article, I will be returning to let you know how I feel.

The potential is there, but we'll see if the execution is there.

P.S.-- I'd feel a lot better if our politicians were getting on this plan with us, then, at least, I'd know they themselves truly trusted it.


My Esoteric profile image

My Esoteric 3 years ago from Keystone Heights, FL Author

Dave, I appreciate having your point of view, it is an interesting take. I have a hub on "What has Obama Done in 4 years ..." (the number keeps increasing) where I have more detail about what Obamacare is supposed to do and think touched on other aspects in another hub.

It took a full year, and multiple revision to accommodate Conservative objections, to get this version through, but over 40 years in the making, with the last serious push being under Clinton. It is my understanding that Congress isn't actually "exempt" from Obamacare, they are covered by the Federal insurance program from which part of Obamacare appears to be patterned, the exchange pools; this is what I belonged to until I hit 65 this year and switched to Medicare. To put it another way, Congress is covered by an employer's insurance plan.

The biggest thing that remains unclear about Obamacare is if Congress has the ... gonads ... to pass the requisite laws that are needed to achieve maximum savings; they never have in the past, so I am not holding my breath.

Thanks for reading this hub.


JON EWALL profile image

JON EWALL 3 years ago from usa

My Esoteric

''The biggest thing that remains unclear about Obamacare'' July 2, 2013

Obamacare's employer mandate delayed a year

http://www.cbsnews.com/8301-18563_162-57592075/oba... 2/11/13

The Real Cost of Obamacare

http://moneymorning.com/2013/02/11/the-real-cost-o... 2/11/13 2/8/13

The 7 Biggest Obamacare Lies

http://moneymorning.com/2013/02/08/the-7-biggest-o...

the biggest Obamacare promises were Obamacare lies

6/23/12 Obamacare It’s a TAX

Supporters Slow to Grasp Health Law’s Legal Risks

http://www.nytimes.com/2012/06/24/us/past-denials-...

The only part of the law is that it is a TAX, the rest of the law is UNCONSTITUTIONAL.3/13/13 obamacare

Insurers warn of overhaul-induced sticker shock

http://bigstory.ap.org/article/insurers-warn-overh...

3/22/13 Obamacare

How Will the New Health Law Affect Your Premiums?

http://blogs.wsj.com/corporate-intelligence/2013/0...

one needs to get by the mainstream media and whitehouse.gov distortions


My Esoteric profile image

My Esoteric 3 years ago from Keystone Heights, FL Author

Jon, and other readers, know that:

1) more than 95% of companies with more than 50 employees already provide health insurance, so all of the hoop-la about billions of people being laid-off because of Obamacare will be from those less than 5% who aren't responsible enough to provide insurance in the first place.

2) Because the vast majority of uninsured workers are from companies with 25 or fewer people, Obamacare offers a subsidy to the businesses to provide such insurance, even though there will be no requirement that they actually provide it.

3) The first "Moneymorning" article regarding insurance cost is debunked by http://www.factcheck.org/2013/03/obamacare-to-cost... Actually, the IRS used a hypothetical average for a family of five, so divide by 5 and what do you get, $4,000 per person per year which is less than what I pay for the insurance I provide my employees. There is a term used in logic to describe your, and Moneymorning's, misinterpretation of facts, Jon, it is called "overwhelming exception fallacy"

3) The principal logical fallacy used in the next Monday Morning article is called "Cherry Picking"

4) The New York Times article, while true, appears to be non sequitur, I am not sure what this piece has to do with this hub.

5) The "sky-is-falling" report in the AP piece is from the "America's Health Insurance Providers" (AHIP) an insurance industry-funded trade group. The article then provides counter arguments at the end of the piece.

6) The Wall Street Journal article is actually pretty good, it basically says some premiums may go up, and others down.


JON EWALL profile image

JON EWALL 3 years ago from usa

other readers,

MAY I ADD more information not tainted by different sources.

Republican bill to annul Obamacare exchanges

http://www.cbsnews.com/8301-250_162-57591646/sen-p...

Ryan and Van Hollen Debate Medicare Proposals 6/3/11http://www.youtube.com/watch?v=o_SHUELJci4

Reid: Obamacare could be "train wreck" without more money

http://thehill.com/homenews/senate/297333-reid-say...

It's time to get out of the bubble and get in the real world.


My Esoteric profile image

My Esoteric 3 years ago from Keystone Heights, FL Author

Real world Jon? Do you really think the Republican bill to deny 30 million people access to insurance is going anywhere?

Yes, Reid said that, he also said in the same article, which you failed to mention, that "Reid warned the federal government is not spending enough money to implement the law because of "Republican opposition" to ObamaCare." So, if I understand Reid's comment correctly, it is the "Conservatives who are driving up Obamacare costs", using the kind of logic you use. I would assume you agree with that, Jon, don't you; that it is the Conservatives who are the culprit?


JON EWALL profile image

JON EWALL 3 years ago from usa

My Esoteric

''30 million people access to insurance '' hOW MANY WILL BE SUBSIDIZED BY TAXPAYERS ( GOVERNMENT)5/1/13 Train Wreck Ahead

http://www.creators.com/opinion/john-stossel/train...

details of President Obama's Affordable Care Act

Obamacare – Anatomy of Government Fraud

http://hubpages.com/politics/Obamacare-Anatomy-of-...

March 23, 2010 President Barack Obama is applauded after signing the health care bill

http://www.foxnews.com/politics/2012/04/09/study-c...

ObamaCare increases deficit, knocking down president's vow CASED CLOSE


JON EWALL profile image

JON EWALL 3 years ago from usa

My Esoteric

''the Conservatives who are the culprit?'' OBAMCARE IS 100% OWED BY THE DEMOCRATS.Allow me to bring you back to earth.11/03/09

AMERICA WAKE UP TO NATIONAL HEALTHCARE

http://hubpages.com/politics/AMERICA-WAKE-UP-TO-NA... Congress Votes

Majority Leader Pelosi released a draft of the so called public option Healthcare Bill

POTUS says ‘’ TRUST ME ‘’ CREDIBILITY


My Esoteric profile image

My Esoteric 3 years ago from Keystone Heights, FL Author

30 Million Gaining Access to Insurance: Jon, wouldn't the better question be

1) "How many are currently being subsidized by the taxpayers through higher taxes and insurance premiums because they have no access other than the emergency room?"

2) "Is it possible the taxpayer supported subsidy will be offset by lower health costs because these 30 million people will now be able to live healthier lives rather than depend on very expensive taxpayer paid for emergency treatment for an illness much worse than it otherwise might have been?"

Increasing the deficit - Now that may ultimately happen if Congress refuses, or is not allowed to by the Conservatives, to do its job and passing the laws needed by Obamacare, but currently, Obamacare has and is reducing the cost of Medicare by $20 billion a year and is saving Medicare recipients another $20.8 billion a year. Why is that, Jon?

Obamacare 100% owned by Democrats - Yes it is, Jon, I was simply pointing out your misuse of logic by telling only part of the story, you missed the part where Senate Majority Reid, while saying "train wreck" the part you did mention, also said the "train wreck" was being caused by active Conservative opposition to Obamacare, the part you neglected to let your readers know.


JON EWALL profile image

JON EWALL 3 years ago from usa

My Esoteric

'' Obamacare 100% owned by Democrats - Yes it is''WITH DUE RESPECT,Obamacare was passed by a super majority Congress by DEMOCRAT Senators and DEMOCRAT Congressmen/ women without reading or debating the bill in both houses.Their actions alone should tell you that Democracy was not in action.I can recall when one of the leaders of the House REPLY WHEN QUESTIONS WERE ASKED. His reply was '' we can do that because we won and we have the majority to do so''.Another said '' we need to pass the bill to find out what's in it''.That's not the way legislation gets passed, the Constitution was ignored all the way to the Presidency.

American Government Less you forget

1) Legislative2) Executive3) Judicial

intent behind the system is to PRESERVE stability and the rule of law.

http://hubpages.com/politics/American-Government-1...

THE OATH OF OFFICE:

"I do solemnly swear (or affirm) that I will faithfully execute the office of President of the United States, and will to the best of my ability, preserve, protect, and defend the Constitution of the United States.


My Esoteric profile image

My Esoteric 3 years ago from Keystone Heights, FL Author

Jon, Conservatives have made great hey about Congressmen not reading the entire final bill. They, and you, say this as if every Representative of each Party read the final form of every bill that comes to a vote. Well, this may be a surprise to you then, rarely do members of either Party read the entire final bill before voting on it; there is physically not enough time in their lives to do so.

Also, explain to me, if you can, why I, and not you, knew all of the important points that were in the final bill at least a month before it was passed? Why is it I was able to write about its contents? Am I prescient? I think not, I simply followed the news about what the bill was going to contain. The fact that Conservatives chose not to read what information was available to the general public, let alone Congress itself, is not the Democrats fault is it; it is theirs entirely.

Did they rush to put the final touches on the bill in the end before they lost their super-majority, yes they did; and that is the Democrats fault because they didn't need to, they had had plenty of time which they pissed away bickering among themselves. Did any informed Democrat not know all of the important features of the bill, I seriously doubt it, that is what they have staffs for. But, I will admit, even the Democrats can elect a dunderhead or two who might have kept themselves in the dark as apparently all of the Conservatives did.


JON EWALL profile image

JON EWALL 3 years ago from usa

My Esoteric

POTUS pushed the bill in both houses '' we need to get it done ''. GENERAL RULES AND PROCEDUES OF CONGRESS REGARDING LEGISLATION WAS NOT FOLLOWED.Shamefully Democrat members on Congress ignored the will of their constituents and voted for the party and the President's wishes.Obamacare – Anatomy of Government Fraud

http://lionsdenmedia.hubpages.com/hub/Obamacare-I can only tell you, you missed a lot of information by not reading the many links I furnised your hub.With due respect,I MUST TELL YOU that your ignorance at times outshines your intelligence sorry to say.

For your information the bill was not written by members of Congress, Obama TRANSPARENCY was nowhere in sight as promised.2/27/10 HOW DID BARAK OBAMA CLOSE THE HEALTHCARE SUMMIT?

http://hubpages.com/politics/BARAKOBAMAHEALTHCARES...

President gave notice to the Republicans and the American people that he will move forward to pass a Healthcare bill with or without their votes or approval.

CASE CLOSED


My Esoteric profile image

My Esoteric 3 years ago from Keystone Heights, FL Author

You know as well as I do Jon, that the polls had Americans in favor of comprehensive health care reform until the Conservative propaganda machine ratcheted up like it was WW II all over again. Given how much you read, you also know that the next layer down of almost every poll ever taken had those opposed to comprehensive health care of any kind in the 35 - 40% range, making them a MINORITY of Americans who opposed any form of what turned out to be Obamacare. Roughly the same number of Americans supported Obamacare in the form being proposed . It was the other 20 - 30% who didn't think that Obamacare went FAR ENOUGH and therefore opposed the current proposed law making it look like Americans were against the idea of Obamacare; you know that to be true, you just don't share it and advertise only the misleading headline.

I haven't missed the point that you still haven't answered my question as to why I knew the fundamental ingredients of the final bill and you didn't.

Are you suggesting President Obama wrote the legislation and slipped under Pelosi and Reid's door when they weren't looking? Or, is it just possible it was written, like most legislation is, by the staffs of those members assigned to the committees responsible for such legislation, committees the Conservatives chose to boycott.


JON EWALL profile image

JON EWALL 3 years ago from usa

My Esoteric

Unions, the reliable Democratic supporters, split from president on ObamaCare

http://www.foxnews.com/politics/2013/05/25/unions-...

union leaders say the roughly 20 million people covered by the plans will likely have higher premiums because the Affordable Care

Another Surprise!


My Esoteric profile image

My Esoteric 3 years ago from Keystone Heights, FL Author

The Truth about the "Cadillac" insurance excise tax:

- For comparison purposes, the plan I offer my employees costs me about $4800 per person per year, they pay 20% of that. It provides for a $500 deductible, $25 co-pay on visits and tests, and a 90%/10% split everything else. (I was able to take advantage of a 10% decrease in premiums two years ago and offer a better plan.) The coverage is approximately the same as my personal Medicare and Tricare coverage

- The threshold for the 40% tax is $10,200 for a single and $27, 500 for family. That means if the premiums are $11,200 for a single person, the tax will be $400 or $33/mo

- The threshold goes up for retirees and those in dangerous jobs.

- Less than 19% of insured workers will be effected

- According to the Kaiser Foundation, economists think that many employers, as they adjust their premiums downward, will pass the savings on in the form of higher wages.

- The purpose of the tax is to 1) generate income for awhile and 2) encourage employers and employees to be more responsible in using health care services

- Other Obamacare provisions are expected to lower the costs of premiums, thereby taking some companies below the threshold.


fundraising cards profile image

fundraising cards 3 years ago from Englewood, Florida

@ My Esoteric - One thing that I believe is being missed is, the rates and amounts you are writing about are "Group Rates". Group rates are at an tremendously increased rate as compared to individual rates. BECAUSE they are already covering the unhealthy through guaranteed issue, (the #1 reason for obama care) I could be 500 lbs, an alcoholic, drug addict and had a heart attach today, and start working for you tomorrow, in 60 to 90 days I would have full health coverage.... the rates are 2 to 3 times individual rates because you have to cover the unhealthy.

Since most of the uninsured are only going to be eligible for individual care, it is going to increase the individual rates, to a point where people who are currently being responsible and paying for their own insurance, will no longer be able to afford it. In the end it will cost most people more premium as the entire individual class will be treated as one group.

Universal coverage can work ... but it requires one thing that, that is not included in Obama Care (it is in medicare) .. It require 100% participation and/or Open enrollment.


JON EWALL profile image

JON EWALL 3 years ago from usa

My Esoteric

Another Day, Another Slew Of Bad News For Obamacare

http://lonelyconservative.com/2013/05/another-day-...

Health insurance premiums could rise by as much as 40 percent as a result of President Obama’s healthcare law, according to a new study

case closed


My Esoteric profile image

My Esoteric 3 years ago from Keystone Heights, FL Author

Thanks for the comment, @fundraising, I hope more join us. Did you mean "decreased" as opposed to "increased" when you wrote " Group rates are at an tremendously increased rate as compared to individual rates" If you meant "decreased" then there is no question that belonging to a group is more cost effective than going it alone. But, if you actually meant "increased", I am not sure you are correct, for my cost for group insurance for my employees is around $400 per individual, but I know others who have their own personal insurance have a hard time finding equal coverage for less than $700.

Also, I think you will find Obamacare does require all to have health insurance, that was one of the results from the Supreme Court decision; if one chose not to have insurance then you pay a penalty (Roberts called it a tax) to help cover their insurance costs when they finally do use the health care system.

Also, also uninsured individuals can join pools, they are called exchanges which each state must set up.


My Esoteric profile image

My Esoteric 3 years ago from Keystone Heights, FL Author

@Jon, how come you don't report that rates for individuals will fall 29%. You can find that figure in this hub which came from http://money.cnn.com/2013/05/23/news/economy/calif...


JON EWALL profile image

JON EWALL 3 years ago from usa

My Esoteric

Obamacare is a one shoe fits all attempt to control all of the nations heathcare industry. Who do you believe the funds to pay , subsidies, comes from?

Even if underlying premiums rise, many people will see their own costs fall because of the HELP they'll get from subsidies, GOVERNMENT,taxpayer funding, Milliman said.

Read more: http://thehill.com/blogs/healthwatch/health-insura...


fundraising cards profile image

fundraising cards 3 years ago from Englewood, Florida

@My Esoteric - as a Florida insurance agent for 15 years, I can assure you that A HEALTHY person who looks to purchase the same coverage on an individual basis will pay less than 50% the cost of group coverage (for the same coverage). The ONLY Upside to Group coverage is the guaranteed coverage (if you have had continuous coverage)....

OH and good luck getting in the individual pool, if can get coverage in the pool it is at a rate 3 to 4 times normal rates.

BTW a healthy family of 4 or 5 with parents in their early forties can get GREAT individual coverage for their entire family for $500 to $700

The ONLY Upside to OC is the guarantee issue ... Prices and quality will be less. Biggest flaw is that you don't have to pay for coverage any more Until something big happens ... Get diagnosed with cancer. .. go get a policy then... you can not be turned down .. Now insurance agents and Lawyers will be ambulance chasers :-)


My Esoteric profile image

My Esoteric 3 years ago from Keystone Heights, FL Author

@fundraising, if what you say is true, what is California talking about with the exchange pools and the prices they anticipate on charging for anybody who wants to sign up?

Give me the names of those insurance companies, if you would, I have several friends who would like to lower there monthly bills considerably. The best I could find for a family of 4 with the parents healthy and in their 30s was a little less than $727/month (ours would be $1166 if the family paid the full freight). That was with a $2000 family deductible (ours is $750), a $35 co-pay (ours is $20 for regular, $50 for specialized), and a 30% co-insurance (ours is 10%). Don't know about you, but I like our plan better (the actual cost to our family would be about $842 since we pick up 80% of the employee's insurance premium; the plan is from United Health Care, btw)


fundraising cards profile image

fundraising cards 3 years ago from Englewood, Florida

@My Esoteric, From my username, you can likely tell that I am not active in insurance at the moment.... in mid 2007 the industry "died" while everyone was waiting for their free insurance card.

As for your friends ... you can send them right to your agent and have them get golden rule individual insurance (united healthcare) ... Unfortunately you will not know what may keep your friends from getting the best rates.. as they may not tell you about their health issues, and your agent better not! But items like HBP can increase rates by 40% same as smoking and the Height/weight rates that can make a person self-conscious about their physique :-)

As for the coverage you offer and pay for... that is fine for people who do not have any budget (congratulations on your success) Just an FYI The 30% co-insurance or 10% co-insurance ... is for show the more important numbers associated with those numbers are the MOOP (maximum out of pocket) with everything else the same a 90/10 to 10k is roughly the same as a 70/30 to 3.5k as for co-insurance they are both about $1,000 OOP (not the same as MOOP as MOOP includes deductibles and hospital, docter, drug, Mental health and child well care co-pays)

The greater the value a plan is perceived the more you can charge per dollar spent and the more your agent loves you (BTW your agent LOOOOOOOOVES you, just not enough to take the time and energy to explain how you can same money) .

A simplified formula for figuring out the value of a plan is to compare two items on an annualized basis. (PS No charge for the savings :-) lets use the info you provided as an example (this is total costs, not what portion anyone pays)

1166 x 12 = $13,992 This amount is paid year in and year out whether it is used or not. the family would probably average another 500 a year in co-pays and such ... and over a 7 year period would like max their plan out 1 time (A hospital visit lasting more than 3 hours) so about $3000 extra that year for a 7 year total of about $104,444.00 (of course that is not including any premium increases)

Take the same family and have them get a 100% golden rule plan with a high family deductible of $5800 with no silly co-pays (there are some tax advantages at that amount) and charge them about $350 a month.

$350 x 12 = $4200 a year plus lets say that they go prescription and dr. crazy and total another $2000 a year (remember this is a healthy family and these go towards the deductible) and lets say that this family is really accident-prone and instead of the 1 time in the hospital in 7 years (like above) they max out the plan 7 times in 7 years (never happen) for a total of $40,600 the 7 year total would be

$91,000 for an absolutely worst cast scenario savings of $13,000 ... in a fairer more realistic scenario the high deductible plan would have a total medical cost of $62,200 saving about $40,000 or just under $7000 a year.

Is your agent screwing you or just lazy or stupid? (not to be argumentative :-)

I only explain that to give you an idea how little of an idea you actually have of insurance costs ... Trust an agent who read every detail of each 50 page policy from front to back and worked in the best interest of the insured.

Insurance is supposed to be to insure the unexpected, not the expected expenses like annual check ups, birth control, vitamins, exercise, the occasional cold or flu or ear infection ..... I can assure you you will pay for those items regardless so why give all that money to an insurance company so they can pay people to administer it for you?

But worst yet.... you know that the government will add to the list of expected items and ad and add and add... next "we" pay for weight loss clinics and gym memberships and AA meetings and condoms and birth control and abortion and on and on and on .... things that are not insurable by the very definition of the word insurance.

In 97 Florida enacted Mini hippa .. all insurance plans had to comply ...... Before that children 2-18 could be insured for $25 to $40 each per month after plan it went to about $80 per month per child, The reason? All plans had to pay for well child coverage (10 visits of 15 years) without any co-pay of deductible (and a few other things were added as well) it increased the cost of a family of 4 by $800 per year ... PLUS OVer half the insurance companies Left the state of florida so there was less competition (thanks Charlie Crist, who was the insurance commissioner at that time.... in government when someone does a bad job promote them). Government is bad for insurance.

Sorry know nothing about California insurance pools only know that California has the highest insurance rates in the United State.


fundraising cards profile image

fundraising cards 3 years ago from Englewood, Florida

@My Esoteric Sorry forgot to finish it

Since you are saving about $9800 a year on insurance , Let your employe know that is maximum POSSIBLE yearly heathcare cost COULD be increasing by about $3500 for any year that your family has a bad health year ... so that you the big bad employer can save a substantial amount of money ... For that reason and to be "fair" you are going pay $5000 a year into his 401k (you keep the other 5k if you want). If he maxes out his medical expenses every year... he will still be a little further ahead... if he is prudent and does not run to the dr for every little sniffle he will likely be substantially further ahead (ooooops we just made him accountable shame on us:-)

Of course you can give him all of the savings if you would like

Bet he respects you for showing that you trust him with his own health and healthcare costs.


My Esoteric profile image

My Esoteric 3 years ago from Keystone Heights, FL Author

Definitely have to mull over your numbers. Question, are there any studies to determine if the general health of children improved after the change, I would suppose that would be the purpose, to reduce childhood health problems.

Also, do have any probabilities regarding how many people in the population fit into your health scenario.

BTW, if MOOP is the lifetime max, then ours is a million or more.


fundraising cards profile image

fundraising cards 3 years ago from Englewood, Florida

@My Esoteric

"Question, are there any studies to determine if the general health of children improved after the change"

OMG ---- REALLY :-) Perhaps we should add on a few million dollar study and increase the premium another $5 per kid ... and even more kids would then go uninsured because of cost increases. FYI Well child care (is included in your employees current Florida policy, you can read exactly what is covers , as your company has the master policy) which includes immunization shots can be gain for anywhere from free to $25 per visit at most county health clinics (regardless of income) (for a total of $250 of child's lifetime and if you go to your doctor to have the visits even at 100 a visit you are looking at a lifetime total of $1000 ... so glad the responsible insure had an increase of $16,000 over 15 years per child to have those visits covered at 100% (I do need to point out the "mini HIPPA" is a term used to call a Florida change that had many many different aspects that were designed to mimic the national HIPPA Law This child clause was a very very small sliver of that law. You may recognize HIPPA (governing companies with over 50 employees) because the biggest parts of it are about patient privacy and continuation of coverage for people leaving big companies.

"Also, do have any probabilities regarding how many people in the population fit into your health scenario."

What probabilities? There are no probabilities in the numbers I gave you. I gave you the numbers for the very worst possible scenario, a family that hits their deductible and maxed out their out of pocket expenses every single year for 7 years in a row. You could say that was every family in the world and every single one of them would save money.

1 million is your lifetime maximum, this refers to the maximum the INSURANCE COMPANY will pay over your lifetime ( 1 million is the lowest offered by any company. It cost about $3 to $5 a month to insure the 1million to 5 million)

MOOP is YOUR annual Maximum out of pocket expenses ... this includes ONLY your deductible and co-insurance amount per family. It is a bit of a deceptive term because in addition you must add any doctor, hospital, prescription, chyropractic and mental health co-pays. Realistically this should also include premiums so people can compare their entire health care costs.

The main point I am trying to make is this, most people do not truly understand insurance. This is not their fault, why spend the time and energy to learn it to that level? It would be like knowing every single accounting law and loop hole, when all you care about is installing sprinkler systems... That is why we pay insurance agents, and accounting firms and lawyers and physicians and require that they are licensed, so that we trust in what they say and do ... we don't have to know it. Look at yourself, your obviously smart and successful to a level more than most... But be honest when it comes to insurance I am writing way over your head and you are reading each paragraph 2 or 3 times in order to be able to follow it at all. Again not your fault, if you took the time and energy to learned everything yourself you would not be as successful as you are.

I guarantee that most of the people who penned this law do not understand it, and likely 90% of the population does not understand it. What we have left is a very very small sliver of people who understand the intricacies of insurance, in war you divide then conquer. The same is happening here, first divide by demonizing insurance, then people with no understanding can try to implement some pie in the sky plan.

How about this, next we can demonize accountants and we can just have a single national accounting system, so that businesses can run more economically and sell us products cheaper (that is the only thing the average person cares about)... we could call it the IRS sure some might call that communism or socialism, but I could get a product 10% cheaper initially, even if the increase prices later in order to save ourselves.

Politicians are taking advantage of the "I don't give a Crap about anyone but me." attitude that is running ramped in the US....


My Esoteric profile image

My Esoteric 3 years ago from Keystone Heights, FL Author

Oh OK, my MOOP is $3500.

I absolutely buy in to your point that most people do not understand insurance and that is because it is very complicated. And, I agree that is why we have insurance agents who pay homage to three masters, their employer, their commission, and their professional ethics to deliver the best policy for the buyer's situation. Often, that third master doesn't receive the attention it should.

Another truism is that most people don't like option in most things in life, if they did, they would be spending their whole life analyzing them rather than living their life. The biggest "option" most people fail to do is budget their income and expenses and that is the one which could be the difference between an OK life, a good life, or a great life. That is my biggest resistance to high deductible plans where the insured must 1) budget for uncovered medical bills and then 2) fund it.

I find that those on the Right generally believe all people are capable of doing those things and should do them if they try a little bit; and if they don't, too bad, they should have known better so suffer the consequences and share your costs of those consequences with the rest of society.

Those on the Left, not too far Left mind you, are a bit more practical and try to build in the known faults in the human condition into their public policy, thereby cutting the "total" cost to society. It's a long-term proposition, you understand.

As to accounting, the profession does strive toward a single accounting system, it is called GAAP, Generally Accepted Accounting Principals; all public companies must follow them. Private companies may do what they want, but if they stray too far, they may find it difficult to get loans based on their financial statements. If you are a financial institution, because of the special requirements in that industry, they have another system, I forget the name; it is similar to GAAP in most respects but is somewhat stricter in accountability.

Absolutely agree with your last statement.


bradmaster from orange county ca 2 years ago

My Esoteric

Where are the 32 million new people that Obamacare was created for.

Many of the people that you list, already had insurance but their health insurance plan didn't meet the ACA staandard, so they were forced into a new insurance plan.

Getting health insurance doesn't mean getting quality health care. The insurance companies still practice medicine without a license by denying certain treatments.

The level of competent medical care in this country is mediocre at best. The quality of doctors, nurses, and medical care persons run the gamut from place to place.

A friend of mine had to go clear up to the state of Washington to find a doctor that could operate successfully on a hip condition for his young adult daughter. What is pathetic about that is in the hundred or so radially miles from Orange Country Ca is about 12 million people and large medical institutions with high reputations, yet they didn't have the skill needed to help my friend.

Adding tens of millions of more patients into the system is not going to improve quality, it is only logical to suspect it will have a negative effect on the quality.

Medicare has almost fifty years of experience and during its span, it has been the place where easy money for the medical professional can literally count on. Now, all of a sudden we are going to stifle the fraud, I don't think so.

The federal government cannot go bankrupt, but that doesn't mean that they can't fail. They fail all the time.

Thanks


bradmaster from orange county ca 2 years ago

My Esoteric

Now president Obama wants to include tens of millions of illegal aliens into the ACA as well as amnesty.

There are already millions of Amercian Citizens that can't afford the ACA, yet the president wants to add non citizens to an already fragile healthcare system.

Adding tens of millions of people to the heatlhcare insurance does nothing to improve or even keep up with the costs and services of healthcare.

Where is the funding for all of this wild gesture by the president going to come from. Unless the constitution has chaged congress still is in charge of the money.

This is an irresponsible act by the president.

It does nothing to improve or benefit the three hundred million Americans, and it is unequal protection for all those immigrants that are going through the legal immigration process. And most of them will be denied entry to the US.

Once again, I have to ask what is the benefit of being a US citizen when anyone can be given the same treatment without citizenship.

President Obama didn't even try to work with the new congress, and this matter was not urgent that he had to take unilateral action.

This is more like the act of a spiteful child, than a US president..

So what are you going to say about him when he vetoes all the Republican created bills?

Sofor the next two years, it is going to be Obama that is going to gridlock congress.

Why can't the voters admit that they made a huge mistake in electing and reelecting Obama as president.

He didn't do any better as a Senator, as he spent his last two years as senator campaigning for the presidency.

Yes, there were dozens of others doing the same thing, and they and the rest of that congress didn't do their job, and that is partially why we had the economic meltdown.

When you have some time to answer this comment, I will be very interested in reading it.Thanks

bradmasterOC.


Mercel 22 months ago

cares one way or the other if he actually reads what he puts out. Being actrcaue and telling the truth is not really all that important to them. Having been a Republican delegate in the past, I still get all his campaign mailers sent to me and without exception they are loaded with disingenuous BS. The latest one for instance says It's Utah's time to lead meaning if we re-elect Borin Orrin Utah will somehow lead the nation. Never mind that he has been there for thirty some odd years and we have never been the nation's leaders in anything yet except maybe the birthrate and the percentages of idiots we send to congress.


My Esoteric profile image

My Esoteric 22 months ago from Keystone Heights, FL Author

BMOC - "Obama wants to include tens of millions of illegal aliens into the ACA as well as amnesty."

ME - First, most of the (actually) 5 million undocumented aliens pay taxes already into all but the State and Federal income tax systems ... Now they will pay income taxes as well.

Second, because most of these long-term undocumented aliens pay taxes already, that means they work, generally at jobs white Americans won't touch.

Fourth, PBO wouldn't have had to do this if the Right-wing in the House had simply done their job; everybody else did, you know, the Senate and the D's in the House.

Third, the Right-wing Daily Caller, the first search that popped up, says these 5 million ARE NOT eligible for ACA. This is unfortunate because, since they work, most are probably in reasonably good health which will lower insurance premiums.


JON EWALL profile image

JON EWALL 22 months ago from usa

Healthcare reform http://hubpages.com/politics/GOVERNMENTHEALTREFORM... … Healthcare Summit http://hubpages.com/politics/BARAKOBAMAHEALTHCARES... … Obama Health Reform http://hubpages.com/politics/ObamaHealthReformInsu...

11/10/14 Obamacare architect’s stunning candid remarks about the ‘ stupidity ‘ of voters http://www.washingtonexaminer.com/full-video-obama...

Obamacare fraud of the century ?


My Esoteric profile image

My Esoteric 22 months ago from Keystone Heights, FL Author

OBAMACARE - the best thing since Social Security, Medicare, and sliced bread.

The 11/10/14 comment was 1) taken somewhat out of context, 2) apologized for, and 3) retracted during House testimony

Why do Conservatives want millions to lose the health care coverage they have waited decades to become eligible for or could now afford?

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