Anyone sign up with Obamacare yet?

[Danger]

I hate Papa John and will never patronize his business because of his hypocrisy in this matter. He loudly announced that he would have to lay off hundreds of employees due to cost if Obamacare was enacted, then a couple of weeks later bragged that he was giving away 2 million free pizzas for Superbowl weekend.

 

[Medicol]

http://www.papajohns.com/index.html

Yes, one of the problems of the First World is it has a lot of such people who always create "fake gravities".

 

[edward]

Here is a good cost calculator from the Kaiser Foundation that gives people a starting point.

http://kff.org/interactive/subsidy-calculator/

 

[mheslep]

As it was, and probably still is, some are still forced to go without.

The insured rate in the US has hovered around 84% to 88% for decades. As of the first part of this year the insured rate was 86%.

 

[Locrian]

Concerning network size,

For 2014, there were lots of large, extended network plans on the exchange. I don’t think I ever looked at a region and didn’t find a broad-network choice available.

However, nobody bought them. The exchange emphasizes price, and did a very poor job of informing the consumer around network size, resulting in people mostly purchasing the cheapest plans.

So, I think it is not true that exchange plans (or ACA plans, however you want to put it) have narrower networks. It is, however, true that many (most?) plans purchased on the exchange have narrower networks.

 

[Locrian]

As for provider reimbursement,

I see no evidence whatsoever that the .60 cents on the “private” dollar listed earlier in this thread is accurate. As far as I can tell, it’s a number from an article that quotes another article, which is merely listing a very specific instance for one insurer in one state.

I look at unit costs almost every day, and I can tell you that ACA plans at multiple large insurers are paying much more than Medicare for almost all services. However, this varies by type of service, provider and insurer. I have no doubt that there are specific CPT codes for particular insurers that are bringing in low dollars, but it would be spectacularly wrong to extrapolate that. Providers make up for Medicare’s low payment by overcharging commercial plans, and they’re very good at it.

On the other hand, the problems providers are having with bad debt are very real. Thankfully, provider networks are mostly locked in for 2015-2016, but suffice it to say there are going to be some very intense negotiations going on over the next few years.

 

[Locrian]

Just a thout to keep in mind,

A great deal was made of the price of 2014 ACA policies. The same is true for the price of 2015 ACA policies, which were compared to 2014 policies.

Which is silly, because in many instances these estimates were shots in the dark. They were sometimes good shots in the dark, but the target is very small.

When 2015 rates were set, actuaries had, at most, three months of claims with no runout, and the vast majority of membership had signed up days before, with no claims data to study.

Keep in mind that central to the ACA is risk adjustment – I would actually place it as more important than the exchanges, more important than the mandate, and possibly more important than guaranteed issue. The edge servers were supposed to be online and working in 3rd quarter 2013, but weren’t functioning properly the same time a year later. Actuaries, for both 2014 and 2015, were having to price policies assuming a risk adjustment system that was ill-defined and of questionable functionality.

2015 rates weren’t interesting, and you should glean absolutely nothing from them.

2016 rates are another matter entirely.

 

[edward]

Rates will always go up as long as the cost of health care keeps going up.

To help pay for ACA Medicare payments to providers is going down and at the same time providers are charging more. I have Medicare plus a supplemental policy that costs me $250 per month. My supplemental policy pays for everything that Medicare doesn't pick up right down to the last dime.

Today I called to make an appointment with my orthopedic surgeon to schedule an appointment to get another synvisc injection in my knee. The receptionist told me that the Dr. has dropped all Medicare patients because reimbursement for Medicare patients is dropping.

The irony here is that the supplemental policy would still pay for what Medicare doesn't, but the Doc will never know how much Medicare doesn't cover because he no longer sees Medicare patients. <(@^^@)>

I am in pain and sol. This might have been a good post for the First World Problems thread.