Slowly but surely, President Biden is repairing the U.S. health-care system, reversing Trump-era sabotage and ensuring millions more Americans get access to affordable coverage.
The latest of these efforts came on Friday, in a little-noticed but significant decision to protect Americans from junk health insurance.
In 2017, Congress repeatedly tried and failed to repeal the Affordable Care Act. To casual observers, it might have looked like the end of the Republican fight to kill this lifesaving, inequality-fighting, newly popular law. It wasn’t. Over the next few years, President Donald Trump found new ways to sabotage the health-care system and its protections for the most vulnerable Americans.
Among the most insidious of these backdoor repeal measures: expanding “short-term, limited duration” health plans — i.e., attempting to trick Americans into plans that looked cheap but basically covered nothing.
Short-term plans are theoretically intended as brief, stopgap coverage — say, to tide over a new college grad whose job doesn’t start until the fall.
They’re relatively unregulated; they don’t have to cover minimum care benefits guaranteed by Obamacare and other major legislation, for example. A 2018 analysis found that most don’t cover maternity services, substance-abuse care or prescription drugs.
These plans can also deny coverage for care of preexisting conditions, even if the preexisting condition in question hadn’t yet been diagnosed at the time the person enrolled.
People often don’t realize they’ve bought a worthless product until it’s too late — when they get hit by a bus, say, or are diagnosed with a brain tumor.
Such loopholes might seem like no big deal until you find yourself falling through one. The Trump administration made sure more people did by allowing these allegedly short-term plans to last as long as 364 days, rather than the three-month max that had been in place, and to be renewed for up to three years.
This made them look a whole lot like regular plans. Plus, because short-term plans are mega-profitable for insurers, brokers can get much larger commissions for steering hapless customers into them. So, many did.
Exactly how many were lured by this policy change is unclear; the data is lousy, precisely because these products are so unregulated. A recent estimate from the Urban Institute ballparked the number of people enrolled in individual plans that are noncompliant with Obamacare protections at 2.5 million.
The proliferation of short-term junk plans affects even consumers who don’t get duped by them. That’s because these cheaper plans disproportionately siphon healthier (i.e., lower-cost) people out of the broader individual insurance marketplaces. People who have chronic conditions or otherwise know they will need more substantial coverage are more likely to stay in the regular marketplace pool, driving premiums there ever higher.
Last week, however, the Biden administration announced a rollback of this Trump-era expansion of short-term health plans.
In a proposed rule, Biden officials said those already in these skimpy Trump-blessed plans can continue in them, if they so choose. (“There were some hard lessons learned from the ‘if you like your plan you can keep it’ blowback a decade ago,” surmises Georgetown University health scholar Sabrina Corlette.) But going forward, any new “short-term, limited duration” plans would need to be truly short-term (up to three months) and truly limited-duration (renewed for up to one additional month only).
Critically, short-term plans must also provide clearer language about what care they do and don’t cover, and under what circumstances. People who choose to buy junk must know upfront that they’re buying junk.
The White House has marketed this rule as part of “Bidenomics,” though it might be more easily understood as simply pro-consumer. It also dovetails nicely with other actions the administration has taken to expand access to coverage, including outreach to encourage eligible Americans to enroll in marketplace plans and patching the so-called family glitch (a regulatory accident that had blocked a lot of families from accessing subsidized health coverage).
Most important, through last summer’s Inflation Reduction Act, Biden extended the enhanced premium tax credits available for plans on the individual marketplace.
This has meant that millions more Americans can get solid health-care coverage that not only is affordable but also, in many cases, has an out-of-pocket premium of zero dollars. And unlike with those junk insurance plans, the low price tag here isn’t a red flag; these plans actually do provide comprehensive coverage, including for people with preexisting conditions.
It’s not a bait-and-switch. It’s a real subsidy — and one that will likely drive down premiums overall, on average, by drawing more healthy people into the broader marketplace risk pool.
Our health-care system is still kludgy. It still allows too many Americans to fall through the cracks. But small unsung fixes such as this are achievements worth celebrating.
Since I have a Washington Post subscription I try and share the body for the community since it is behind a paywall.
Thank you!
Democracy dies behind a paywall. Thank you.
Doing God’s work
Another way to achieve this is to share an archived link, like this: https://archive.md/ZbSKJ
Not every post is published, though most are.
You can archive links yourself that aren’t published in the archive yet here
The only entity that should be paying for healthcare is the government. And if you don’t think your taxes should go to keeping other people healthy, you don’t understand how diseases work. They don’t care how rich or poor you are.
And if you don’t think your taxes should go to keeping other people healthy
Kind of funny that the people who are against their tax dollars paying for other people’s healthcare are ok with their insurance premiums paying for other people’s healthcare. It really shows that it’s all about partisanship and propaganda more than anything.
Healthy people make a healthy society. That in turn makes a healthy, stronger country. Very simple to understand. This is why the United States will never do the right thing. Just like gun control.
Not quite like gun control, but I get what you’re saying.
Tell the protestors in Iran about the value of gun control, lol.
I think you’re conflating “gun control” with “taking away all the guns.” No reasonable person is advocating for taking away all the guns, so it’s not a reasonable assumption that “gun control” equals “take away all the guns.”
Good point. I think a lot of “gun control” advocates’ end goal is to take away all guns.
If that’s the conspiracy theory you want to subscribe to, I can’t stop you I guess.
But it needs a massive overhaul, as in public healthcare. What Obama did was not enough.
You can thank fuckheads like Joe Lieberman for kneecapping it.
I’ll celebrate when we have universal healthcare, until then it’s just bs to me.
The perfect is the enemy of the good. We are not going straight to universal health care. That’s just not happening.
We can take steps towards it though, until we eventually get they’re.
Every other country has it. It can’t be that hard to implement.
But consider the cultural inertia, silly. You’re being very idealistic (and I’m from outside the US, and even I can see how divided the united states are)
I, too, will celebrate when we have universal healthcare, until then it’s a way for my sister to have good, routine follow-up care for her unexpected cancer diagnosis and for me to be able to purchase comprehensive healthcare on the open market, as I’m an independent contractor and don’t work for a corporation with leverage to get private insurance.
That said, there’s a surgical procedure which would enhance my quality of life significantly and greatly reduce my level of discomfort, but my insurance, and it’s good insurance, refuses to pay for it. I don’t have $25,000 to spend out of pocket, so I’m pretty fucked.
That perspective changes quickly when you or a loved one rely on it. I was able to get free medical care with Missouri paying for it thanks to the ACA.
The corporate propaganda blitz during the so-called “healthcare debate” was insane. Democrats wanted to do a lot more, but the people who make tons of money screwing everyone over were, of course, very upset about it and managed to manipulate public opinion effectively. Crap like “government death panels!” was taken seriously, as if there aren’t already corporate death panels and this huge bureaucracy that fights with you and your doctors about what care to provide. There was a large block of people who had decent healthcare and didn’t gaf about anyone else or understand how even if they’re “satisfied with their plan”, it could be improved. Crazy that people actual support a system where you can lose your house and go bankrupt for one serious medical incident.
Listen to this podcast
Frame Canada: Wendell Potter spent decades scaring Americans. About Canada. He worked for the health insurance industry, and he knew that if Americans understood Canadian-style health care, they might… like it. So he helped deploy an industry playbook for protecting the health insurance agency. https://www.npr.org/2020/10/19/925354134/frame-canada
Most of those democrats no doubt also accepted ‘donations’ from those same companies.
Michael Moore’s movie Sicko showed a video of all these politicians and he put the amount of healthcare lobbying money over each of their heads.
Hillary Clinton also accepted lobbying money from healthcare companies, and her team tried to talk Moore out of mentioning it.
Maybe splitting hairs, but: what Congress did while Obama was President wasn’t enough. Obama didn’t get everything he wanted for the ACA.
Isn’t all privatized healthcare junk healthcare? I mean, it’s tied to an employer, you pay for coverage and depending on your plan, you still have to pay thousands of dollars before it really kicks in and then they still won’t cover 100%, and insurance can still deny your surgery or procedure, and meds are still expensive as hell.
I got into a debate with a vet about socialized healthcare and I told him the military is a form of socialism with socialized healthcare. They get free meals if they eat at the dfac. Vets and dependents get free healthcare and basically free meds. It’s all paid for by the military, which gets money from the government. They still have insurance, but it basically covers everything, even at civilian hospitals. Sure, you have to sign on and possibly go to war, but if/when you come back, you don’t have to worry about healthcare.
It’s definitely possible to do, since the US is the only first world country to not have it. We just refuse to do it because we care more about corporations than people.
It’s still crap but beats not having an insurance.
I’ve always said if you don’t go to college you should be required to do a two year stint in the military. You can take a non-combat role, they will teach you professionalism and a trade, get access to the GI bill and Tricare, etc.
It could be a good safety net for people.
That sounds like a good way to get a lot of people who aren’t very bright into the military and their standards are already low enough.
The military already specifically targets low education regions for recruitment
The only way to repair the US healthcare system is to ban the for-profit, rapaciace, mafia middle men that are private insurance companies and replace it with a single payer system. Anything less than that is not repairing anything, it’s just prolonging the broken system.
Guys, if you are actually poor apply for Medicaid*. Don’t wait for something bad to happen to you or for ACA or a new bill or whatever. Just apply. Even if you don’t think you’re eligible apply anyways. You’d be surprised.
It covers a shit ton of stuff, including meds. Eye, dental, hospital visits, primary Dr. All covered.
Do you mean Medicaid? Medicare is just for seniors.
Yeah and I think Medicaid actually is a much more simple plan because there was no donut hole or supplemental offerings. People on Medicare tend to still have way higher liability for prescription drug coverage.
Which is silly, they have privatized Medicare so much that it’s ridiculously complicated. And servicing government contracts for Medicaid and Medicare have become a huge growth area which is why HMOs supported Medicaid expansion.
What we should do is simplify Medicare to make it more like Medicaid in terms of no deductibles, no donut hole, but then just eliminate the age bracket. Automatically opt everybody in…
Preferably that would be the end of it but if you absolutely had to have like a German type system if someone wanted to opt out they would have to demonstrate their ability to afford private care but that’s a much less efficient way. But it’s still better than the US model.
I mean literally we could make a map of the 35 OECD Nations and throw a dart at it and wherever it lands it would be a better system than what the US has.
Yeah, I mix them up all the time
Basically if you live in an expansion state you’re eligible if you make less than 128% of the poverty level. Which is about $16,000 a year for a single adult. If you don’t live in an expansion state your mileage may vary. There was a buffer during the covid emergency stage where states were a little more generous like Texas than they would otherwise have been.
But Texas in particular at one point kicked you off Medicaid if you made even like 6K a year. They were only supporting people that made less than 25% of the FPL. Certainly not 128%. I think all but 16 states at least now extend to that
The real disgusting thing is those faith based services.
Basically there’s a loophole in the ACA where religions can offer “health ministries” that do not have to abide by any real rules. They rely on leveraging people’s faith and using misinformation to get them on a plan that screws you if you’re really sick.
Progress is still progress, even if it’s just slow incremental work to move back to pre-Trump norms.
2016 was the turning point of me being a stupid and proud “Non-voter” to being a loud and proud voter. If I have to thank Trump for anything, it’s for showing me how stupid our society is and we need to do everything we can to undo the damages he has wrought.
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remember kids. If you want better programs then you need to vote for them at the local and state level. This applies pressure on the fed to follow suit. Individual states have an incredible amount of power in our government, imagine what they can do when they’re all pushing for the same thing
The worst part is that the swindle changes the market. Since you’re paying for air, guess everything else has to get more expensive.
Free market my ass.
I have always been wanting to ask: here in Pakistan we have government hospitals. Sure the supply is skimpy and the patients are too many but it’s totally free. Why doesn’t America have something like that?
Pure greed. :-(
Too corporate and not very keen on helping people ig. They have the funds that they are wasting anyway but nope
There’s a few public hospitals and there is a law that mandates if you show up in emergency room they have to provide you with emergency care, although they can bill you for it. Medical debt is the leading cause of bankruptcy in the United States. It’s basically not existent in the rest of the industrial planet. And even then it’s just emergency care, doesn’t cover follow-ups, doesn’t cover any referrals… but that is essentially the insurer of last resort is an emergency room.
People that make less than 128% of the poverty level are eligible for Medicaid. Some people are stuck trying to stay below the poverty level literally so they don’t lose their health care. In United States you’re better off making 16K a year if you have serious health expenses then you would be making 25k a year.
People over 65 are eligible for Medicare. Everyone else has either no insurance or employee based insurance which is terrible for obvious reasons. That jobs are incredibly temporary. It also is a huge point of leverage for workers that want better conditions but can’t afford to quit or they could lose their health care.
But yes it is very lame and peculiar that the United States is basically the only major industrialized nation that doesn’t have some kind of centralized universal health care plan where everyone is automatically opted in.
It’s disgusting, and it’s also grossly inefficient with a third of our cost going to paperwork and we spend 20% of our GDMP on health care when the average OECD nation spends about 10% and covers everybody.
Wow, you guys really need to sort your medical out. What’s shameful is that what you’re telling me sound like problems that everyone would be aware of increasing their demand to be fixed but nothing has been happening, or as I understand it if something good does happen then shitty people like Trump mess it up.
Unfortunately half of our voters are morons who enable this because they can be guided by republican lawmakers into prioritizing bs issues instead
Totally. They sabotage people’s needs but people still vote for them cuz “Trump has a plan.”
When’s he planning on undoing the sabotage done by Ben Nelson and Joe Lieberman?
The problem is even at the peak of its efficacy Obamacare left 25 million uninsured and $100 million underinsured. And it does literally nothing to curb the rate of cost increases.
The United States needs to join the rest of the OECD and have some kind of centralized single risk pool / single-payer plan . The most simple would be something like Taiwan or the UK or Canada but if they mirrored the French or German system which is a little more complicated but still ultimately adheres to a singular risk pool where everyone has automatically opted into… It would result in universal coverage, and could stop the cost from increasing.
The US spends an average of about 90% of its GDP on health care come out every other OECD nation covers everybody at between 8 - 12% of their GDP
I think it’s worth noting that the primary reason why the ACA left so many people uninsured is because it allowed States to decline the Medicare expansion, and most of the GOP controlled States did. That should never have been possible; single payer/Medicare for all is the only real solution.
The original plan had single payer. But that was sabotaged in the first bill.
Not single payer, a public option. Basically the government would be one of the insurers you could pick, theoretically offering a baseline service that would keep the others ‘more honest’ (until Republicans get in power and sabotage it).
I never understood what stopped a group of people to get together and create a non profit insurer that competes with the for profit ones though. In the current US political climate that’s preferable over a government run option.
Stupid Democrats ruining things, trying to give everyone healthcare JUST when Trump was ready to reveal his amazing plan that he promised in 2016!
Holy shit, I lean pretty solid left, but damn this is some propaganda. I’ll start by saying that I truly believe that our country should provide universal healthcare, but the ACA ain’t it. I work in health insurance and the ACA plans have significantly more problems than any “junk” plans out there. Here’s a few examples from personal experience:
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Inaccurate provider directory - ACA carriers may show a doctor/hospital as in network during the open enrollment period, then 3 or 4 months later when the person goes to use the plan they find out the directory was wrong. At that point, since we’re outside of the open enrollment period they are basically screwed and have to pay out of pocket to continue to use their preferred facilities.
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Customer service - good luck getting someone from any ACA carrier on the phone. Any time there is an issue it’s a jerk around fest getting someone that has any ability to help whatsoever. On top of that, you’re going to have to go through 3-4 individuals that are clearly English as a Second Language before they transfer you up the chain to someone that can actually understand your problem and assist in any meaningful way.
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Network - Good luck trying to get coverage if you’re traveling out of state and have an accident or get sick and need to see a doctor. What if you want to travel across the country to go to the best doctor for your condition. You just flat out can’t use it, they won’t take it.
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Network part 2 - The vast majority of plans are either HMO or EPO. Let’s say you’re on an HMO and have a health condition where you need to see a specialist regularly. You need to go to your primary care for a referral EVERY SINGLE TIME you need to go to that specialist. With EPO’s you can skip that referral step, but good luck getting an appointment in any sort of reasonable timeframe. It usually takes 3-6 months to get in for your first visit, and then another 1-2 months to get an appointment every time you need to see that specialist.
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Network part 3 - None of the top facilities accept any ACA plans. Say you get cancer and want to go to the Cleveland Clinic as they are the best at what they do. Flat out can’t go there, they don’t take it. This goes for Cleveland Clinic, Mercy, Baptist, DiMaggio, etc.
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Dropping coverage - Carriers will drop your coverage out of nowhere with no explanation or notice they are doing so. The individual only finds out when they go to use the policy, and they’d better hope that they’re not trying to use it for anything serious cuz the carrier/marketplace will do absolutely nothing to help you.
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Step Therapy - Let’s say you take an expensive specialty medication that is the only thing that provides any relief from your health condition. Well, every single time the calendar flips to a new year you have to go through Step Therapy. That means that you have to try a generic medication and prove it doesn’t work. Then more than likely a second generic medication. Then you have to try a brand medication and prove it doesn’t work. Then more than likely a second brand medication. Then you can maybe get your specialty drug, but only if it’s on the carrier formulary.
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Insolvency - Each of the past two years there has been an ACA carrier that has gone belly up. Last year it was Bright Health, this year it’s Friday Health. Imagine picking a plan, going through the hoops of finding a doctor that actually takes it, meeting some or all of your deductible, and then the carrier disappears mid year. You’ve just lost all of the money you’ve contributed towards your deductible and have to start the entire process over again of finding a new plan. Yeesh. I didn’t know it was possible for any insurance company to go out of business, but 2 years in a row it’s happened.
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Unnecessary Coverage - Does a 60 year old woman really need maternity? Does someone that’s never been to nor ever intends to go to a psych need mental health coverage? Does someone that has never taken a drug or drank alcohol in their life need substance abuse coverage? Those are rhetorical questions, but the answer is an overwhelming no. Yet they have to pay to have that as part of their plans even if they’ll never use it.
There’s a lot more that I could list but these are the major ones that come to mind right off the bat.
The only issues I’ve ever had with Short Term plans is people lying on an application and not disclosing they have a Pre-ex. Other than that, no issues whatsoever. They offer better coverage, better pricing, better networks, better customer service, pay claims faster. The pre-ex thing is literally the only downside.
Look, our health insurance system is fucking terrible across the board, whether it’s ACA or anything else or there. Healthy people that want a nationwide PPO with lower premiums and access to the best facilities in the country should be able to purchase those plans. No, the plans do not cover pre-existing conditions. No, they do not have all of the Minimum Essential Coverages. But if someone does not have a pre-ex, and doesn’t need the MEC’s, why should they be forced to pay more for worse coverage. Removing choice is not the way to fix our system.
And what happened to personal responsibility? If someone ends up with a “junk” plan that means that they did not do their research, did not ask the right questions when being sold a policy, did not read their policy documents, etc. All it takes is a quick google search to find out what you’re buying, and for something as important as health insurance, where is the responsibility of the individual to do their own research?
I’ll tell you right now, the people that are on short term plans generally love them, and the people on ACA plans generally hate them. This is just going to push people to even shittier fixed indemnity or cost share plans which are the worst things out there.
The real reason this is happening is that only the sick and low income individuals are on ACA plans. The carriers need more healthy people and those healthy people want better coverage, which Short Term plan offer. Let’s make the ACA better instead of making our options worse.
Edit: Typos and clarification
Edit: did the person who took the time to quote my comment, for which I replied to every one of their points delete their comment killing the thread of my response? Wow, glad I took the time to refute their objections. I guess adding the exchange was too much text for one comment so here’s a gallery of the screenshots: https://imgur.com/gallery/Ons2spb
Dropping coverage - Carriers will drop your coverage out of nowhere
Under the ACA that is not allowed. But they can drop you if you have short term junk insurance.
the people on ACA plans generally hate them.
I was on for 2 years and it was pretty good. They had the best drug plan ever. Most drugs cost me $0. Even ones that normally cost $100+ in other plans.
The real reason this is happening is that only the sick and low income individuals are on ACA plans.
Bullshit. Anyone who (1) is not in an employer plan and (2) does not want junk insurance with bad coverage has these plans and is very glad to have them.
Well, every single time the calendar flips to a new year you have to go through Step Therapy.
This does not happen unless you choose a different insurance. Same as employer insurance or your junk insurance.
Does a 60 year old woman really need maternity?
A 60 year old woman never pays for “maternity”. Plans price their premium by age. They know a 60 year woman won’t need maternity, but will need a lot of other expensive coverage a 30 year old probably won’t. Therefore, the 60 year old woman is charged a ridiculous rate.
Insolvency
Less likely for ACA
Customer service
I had great customer service on ACA.
You listed 9 things and only 1 out of 9 (network coverage) was a real issue specific to ACA. And that is just because the plans are new.
Let’s make the ACA better
Well sure. Subsidies should be increased etc. Better yet, Medicare for All.
Upvote for answering and refuting, that’s the best way to learn and understand the reality of shit. It’s late and I will be back in the am with a reply
Here’s the reply edit:
As a baseline for all of my answers, I’ve been in the health insurance business for over 5 years in which time I’ve assisted over 3,500 individuals with their health insurance needs. I consider myself an expert in the topic and every response is based on personal experience.
Dropping coverage - Carriers will drop your coverage out of nowhere
Under the ACA that is not allowed. But they can drop you if you have short term junk insurance.
I field at least one call a week from someone that has gone to use their policy with an ACA carrier to find out that the policy has been terminated. The most common reasons are legitimate; failure to make premium payment or failure to submit required documentation. However, in most (not all) instances the carrier fails to notify the individual that there is an issue so they have no idea their coverage has been terminated.
There have also been an overwhelming number of occasions that the coverage has been terminated and there is no explicable reason why it has happened. You are correct that the ACA cannot legally “drop” coverage, but it happens all the time. I have never once seen a Short Term policy terminated for any illegitimate or unknown reason, and if terminated, the client and the agent are always notified of the termination. This is just simply not the case when it comes to ACA, it always seems to be a surprise.
the people on ACA plans generally hate them.
I was on for 2 years and it was pretty good. They had the best drug plan ever. Most drugs cost me $0. Even ones that normally cost $100+ in other plans.
It’s great that you’ve had a good experience, and a lot of people do. I’m not suggesting the ACA is terrible, just that there are a number of issues that get completely glossed over when shitting on the other options out there. Forcing people into one specific type of plan without recognizing the faults to those plans is disingenuous at best.
In regards to the medication you are referring to, of course it worked as advertised, it’s pretty inexpensive in the grand scheme of things. If you look back at my comment regarding prescriptions, I’m referring to specialty drugs that have retail prices in the thousands of dollar range. The type of drugs that are required for individuals to survive.
The real reason this is happening is that only the sick and low income individuals are on ACA plans.
Bullshit. Anyone who (1) is not in an employer plan and (2) does not want junk insurance with bad coverage has these plans and is very glad to have them.
Bad coverage is a subjective term. As previously stated, my experience is that the people with what you would consider “junk insurance” prefer them pretty heavily to the options available through the ACA. The whole point is choice, and removing the option for individuals to go outside of the ACA is eliminating that choice.
To expand on my prior comment about sick and low income individuals, I guess you just have to take my word that the majority of the individuals that I work with only go to the ACA if they are not healthy enough to qualify for underwritten health insurance policies, or if they get a huge subsidy making the premium lower than it would be otherwise.
Well, every single time the calendar flips to a new year you have to go through Step Therapy.
This does not happen unless you choose a different insurance. Same as employer insurance or your junk insurance.
Again, the step therapy refers to very expensive medications, and yes the ACA insurance carriers make you go through that process each and every year. They flat out do not want to pay for the drugs and this is their way of attempting to get you to use something less expensive.
Does a 60 year old woman really need maternity?
A 60 year old woman never pays for “maternity”. Plans price their premium by age. They know a 60 year woman won’t need maternity, but will need a lot of other expensive coverage a 30 year old probably won’t. Therefore, the 60 year old woman is charged a ridiculous rate.
The whole point of my comment is to state that going through the ACA does not provide the ability to customize coverage to reduce cost. Again, eliminating choice.
Insolvency
Less likely for ACA
Well, it’s happened each of the past 2 years, so I guess it is pretty likely. In my career in the business I’ve literally never seen a private insurer go insolvent, but I’ve seen at least a half a dozen ACA carriers disappear. Some of them have been smaller, regional carriers, but Bright Health and Friday Health were nationwide carriers that went insolvent.
Customer service
I had great customer service on ACA.
That’s great and I’m glad you were able to get assistance. That’s not the case for most people.
You listed 9 things and only 1 out of 9 (network coverage) was a real issue specific to ACA.
Obviously I didn’t just pull these issues out of thin air. You are basing your answers on your own personal experience for 1 person (or maybe 1 family). I’ve got experience with 3,500 individuals and every issue or concern they’ve ever had, and for me it remains 9/9. The quite literal only downside to Short Term Insurance is the denial of coverage for pre-existing conditions. That’s it. One issue. And people with pre-existing conditions should not be on those types of plans.
And that is just because the plans are new.
Not sure what you mean by this. The ACA has been around since 2010 meaning this year’s open enrollment will be the 14th on record. The plans are not new by any stretch of the imagination. They’ve also gotten considerably worse over time with higher deductibles, higher copays, higher max out of pockets, more limited networks, etc.
I’m not saying that Short Term Insurance, what you consider “junk plans” is the best option for everyone out there. It’s just not anywhere near as bad as the Biden administration is making it out to be. Give people the option, let them decide what they think is the best fit for their situation and budget.
Downvote, because it’s not just that I disagree with pretty much every point, but any time someone restore to victim blaming
If someone ends up with a “junk” plan that means that they did not do their research
It’s one thing to do research and weigh options to determine the best out of multiple reasonable choices, but not whether you’re getting ripped off or not. Are we really ok with health insurance being similar to email from a “Nigerian Prince”?
It’s victim blaming to suggest someone should make an informed decision when it comes to something as important as their healthcare?
I’m copying from another one of my comments
The tools exist. Google.com, brochures, carrier websites, policy documents, member portals, physical packets snail mailed to their house. There are multiple ways to look into the things that are being offered to you, and multiple ways to review the policy after the fact. My favorite type of prospect is someone that has done their research, knows what they want, needs me to answer a few basic questions, and assist them in submitting an application.
I’ve never offered a client a policy that was not a good fit for them. It screws them over and makes my job harder. Agents have to be licensed to offer policies, with a 20 hours continuing education course every 24 months, annual ACA compliance certifications, $1 million error and omission insurance. There are also very accessible avenues to report bad actors, and complaints are taken very seriously by the department of insurance. I wish the police had as much scrutiny to to wear a badge as health agents have to carry a license. Nobody is in this career to fuck people over, it’s too easy to lose your license and your livelihood.
The whole issue of “junk plans” is completely overblown. I said it in a previous comment, this change isn’t to protect consumers, it’s to eliminate the ability for healthy people to go with anything other than employer or ACA coverage (which both happen to be offered by the same carriers btw). The marketplace carriers NEED healthy people to start buying plans, otherwise the whole thing is going to fall apart. There’s just currently way too many claims in proportion to the total number of insured. The carriers cannot survive this much longer.
Sure, a ton of the Obamacare plans are straight up awful or a waste of money, but the Medicaid expansion was really good (for the states that accepted it). The singular portal for applying for Medicaid is also a vast improvement, simplifying things for patients in general. As you said, the health insurance system is terrible across the board, ACA plan or not; the only real way to change that is to have a public option at minimum.
Yeah, the title “Biden is quietly reversing…” etc feels like Biden’s playing whackamole while someone is literally dying of a heart attack next to him. But the ACA did more than just establish the ACA Marketplace.
a ton of the Obamacare plans are straight up awful or a waste of money,
All ACA plans have the same basic coverage. That’s how the law works. That is one of the great advantages, is that you don’t have too closely study the fine print, cross your fingers, and pray to Moluch that you will get the things covered that you need. The main difference is deductable and premium cost.
I mean, I think deductibles and premium costs matter a lot, don’t you? A lot of people don’t really understand those things, and it can be a shock to find you have to pay a $2000 deductible before any kind of insurance kicks in.
So what is the solution? Scrap ACA entirely, modify it, improve it, something else? I feel like a public option that is reasonably priced to compete with private insurers and providers is a more actionable option. Disclaimer though, I fully admit I don’t understand healthcare or insurance AT ALL and I only skimmed your post, sorry.
Scrap it entirely and do what the rest of the civilized world does and provide universal healthcare with the ability to supplement with private insurance. That’ll put me basically out of a job, but that’s what needs to be done.
My true solution would be the government offering everyone a social safety net for catastrophic events, something like a $20,000 cap on medical bills lifetime, and then pay cash for everything else. That way doctors and hospitals will actually have to compete for our business, true free market, where the quality of service will increase while out of pocket costs decrease. The only area of healthcare where this has happened is with elective services (lasik, tits & ass, lipo, etc) because the doctors are competing for your business. For people with health conditions have them apply for Medicaid.
That way doctors and hospitals will actually have to compete for our business, true free market, where the quality of service will increase while out of pocket costs decrease.
European chiming in here, which explains my totally communist/socialist viewpoint, I call bullshit. There is no healthcare ‘market’. When a person falls ill, they have no time/energy to seek out the highest quality/most cost-effective hospital or healthcare professionals. They turn to the one that is closest by and specialised in their ailment.
Just like there are no markets for housing, energy, water, public transport and all the other public services that just require deep public investments. These services do not need to make a profit, precisely because profit seeking takes away the investment capacity. This seems to be so hard to understand for folks in the US, I guess the decades long propaganda has taken its toll.
And yes, if one needs a lipo or a breast implant… For sure, that’s a market. As these are completely unnecessary, demand based services.
When a person falls ill, they have no time/energy to seek out the highest quality/most cost-effective hospital or healthcare professionals. They turn to the one that is closest by and specialised in their ailment.
I’m not referring to issues that require immediate attention. Of course if you need to get something taken care of right away you can utilize the public health insurance to get that taken care of.
In addition, with the type of system I suggest, there wouldn’t be a need to “price shop” as the market would drive prices down and determine a standardized cost of service. If you get sick and go to a doctor and get charged some price that is above market standard, you’re sure to remember that and go to a different facility the next time around.
These services do not need to make a profit, precisely because profit seeking takes away the investment capacity.
I am of the firm opinion that health insurance carriers should be not-for-profit companies. That also goes for hospitals and other types of health facilities. I definitely agree with you on this.
The left needs to pool some money together and create a new insurer. Create a network of doctors that’ll work below market rate (but not obscenely so), and make sure the organisation is eligible for debt forgiveness under the PSLF.
Only prescribe generic medicines, focus on preventative medicine and diet as much as possible, do all the stuff government run systems do elsewhere.
I love how absolutely tone deaf and American this take is.
we shouldn't give people the tools to help prevent issues, instead we should blame them when they make decisions based on information that _wasnt_ provided to themThe tools exist. Google.com, brochures, carrier websites, policy documents, member portals, physical packets snail mailed to their house. There are multiple ways to look into the things that are being offered to you, and multiple ways to review the policy after the fact. My favorite type of prospect is someone that has done their research, knows what they want, needs me to answer a few basic questions, and assist them in submitting an application.
I’ve never offered a client a policy that was not a good fit for them. It screws them over and makes my job harder. Agents have to be licensed to offer policies, with a 20 hours continuing education course every 24 months, annual ACA compliance certifications, $1 million error and omission insurance. There are also very accessible avenues to report bad actors, and complaints are taken very seriously by the department of insurance. I wish the police had as much scrutiny to to wear a badge as health agents have to carry a license. Nobody is in this career to fuck people over, it’s too easy to lose your license and your livelihood.
The whole issue of “junk plans” is completely overblown. I said it in a previous comment, this change isn’t to protect consumers, it’s to eliminate the ability for healthy people to go with anything other than employer or ACA coverage (which both happen to be offered by the same carriers btw). The marketplace carriers NEED healthy people to start buying plans, otherwise the whole thing is going to fall apart. There’s just currently way too many claims in proportion to the total number of insured. The carriers cannot survive this much longer.
Wow, thank you so much for taking the time to write all this. I am not familiar with the inner workings of the ACA and this is very insightful. Same as you, I’m all for universal healthcare, but not at the expense of the patients. What a time to be alive.
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