ACA: Coverage Implications for Immigrants

[rahul412]

Well, ethics for one.

Hospitals can't just turn away people just because they don't have health insurance.

That's correct, I agree. Then why doesn't govt pay for them just like tax benefits for low income families.

[rahul412]

by law, hospitals can not turn away an uninsured in need of emergency care...so an uninsured is gonna end up a burden to other tax payers..

A person is uninsured means he doesn't have money to buy an insurance, which means he should get some help from govt. Am I wrong??

[rahul412]

In addition to contributing to the common good. Buying health insurance is also about being responsible and fair to others who pay taxes.

Here's another question? My wife and I don't have children and time has gone by quickly with time spent at universities and our careers we may not have kids. However we do pay taxes so that other children can go to public schools. So should I not be complaining?

Every kid will go to school whether their parents pay the taxes or not.

But coming to hospitals, they treat patients differently based on what type of insurance they have.

 

A person with insurance will be billed thousands of dollars ( of course that is paid by the insurance comp) for a minor surgery, a person without insurance will be billed few hundreds of dollars for the same surgery. And I saw this happening recently.

[JoeF]

That's correct, I agree. Then why doesn't govt pay for them just like tax benefits for low income families.

It still comes from the tax payer. The government receives taxes and pays stuff from that.

[cap-gap]

A person with insurance will be billed thousands of dollars ( of course that is paid by the insurance comp) for a minor surgery, a person without insurance will be billed few hundreds of dollars for the same surgery. And I saw this happening recently.

 

hospital is a whole different beast compared to a simple doctor visit..it costs several millions to set up one and to run one..so they need to recover the expenses from somebody, that happens to be insured people...

 

if you think that is unfair to the insured people,then you got ur answer..ACA is trying to make everbody pitch in..

 

The penalties imposed by ACA on uninsured takes the indivudal's economic status in to consideration and are very considerate(not much in other words)...

 

may be it will teach some responsibility to the current genrn..At the food pantry I volunteered, the young kids of a woman waiting in line weere wearing expensive sneakers than mine..I am sure they can afford health insurance instead of those jordan sneakers..

[cap-gap]

Years ago, remember that I am older than dirt , people had health care - better than now or what is likely to be in the future.

 

Health care has been converted from an honorable service to a profitable coporate concept..

 

Not sure whether it survived..there was a proposal in the ACA to put a ceiling on the profits of insurance companies, meant to limit the greedy denials of legitimate claims..

[rahul412]

The penalties imposed by ACA on uninsured takes the indivudal's economic status in to consideration and are very considerate(not much in other words)...

 

So what do they gain by penalizing??why are you forcing a person to buy an insurance??

[rahul412]

It still comes from the tax payer. The government receives taxes and pays stuff from that.

well that's what this ACA is doing indirectly.

[t75]

Many people choose not to have health insurance.

[Desi Dude]

Rather than arguing, why don't we look at the facts and real stories.

 

Who here has actually applied for ACA? Can you provide details of what you got, premium, deductible etc?

 

Then we can talk about the pros and cons.

 

Also if you have NOT applied for ACA, please don't sing praises (like Democrats have been doing for 3yrs) and please don't criticize (like Republicans have been doing for 3yrs).

[rahul412]

Rather than arguing, why don't we look at the facts and real stories.

I gave you a real incident where the doctor and insurance company took advantage of an insured guy.

[JoeF]

Rather than arguing, why don't we look at the facts and real stories.

 

Who here has actually applied for ACA? Can you provide details of what you got, premium, deductible etc?

 

Then we can talk about the pros and cons.

 

Also if you have NOT applied for ACA, please don't sing praises (like Democrats have been doing for 3yrs) and please don't criticize (like Republicans have been doing for 3yrs).

I have insurance from my employer, of course. So, no need at all to use ACA.

And quite frankly, I would not work for an employer who doesn't provide health insurance benefits.

[cap-gap]

 

And quite frankly, I would not work for an employer who doesn't provide health insurance benefits.

that is just wrong to drive the workforce in to the iron grip of big corps, just because of one essential benefit..

 

insurance companies refuse to offer group policies to small firms or enthusiastic start-ups and people working for these small firms make no less contribution to that of people working at big firms..

[JoeF]

that is just wrong to drive the workforce in to the iron grip of big corps, just because of one essential benefit..

 

insurance companies refuse to offer group policies to small firms or enthusiastic start-ups and people working for these small firms make no less contribution to that of people working at big firms..

Well, I work for a startup, and my employer offers group insurance...

And healthcare is big business, if you like it or not. It's that way all over the world. We also "force" drivers into the grip of big corps, with car insurance...

[Desi Dude]

Till now we have not heard anything positive about the ACA, from someone who has signed up or someone who knows someone who has signed up.

 

All the people talking are those who have their political ideologies blinding them from the facts. Please keep your biased opinions to yourself. You don't have to defend ACA just coz you vote Democrat.

[cap-gap]

Well, I work for a startup, and my employer offers group insurance...

 

 

I did too few years back, the happiest,most productive environment, compared to the current fortune 100, ENR top 3 firm..

 

at that small firm, employer reimbursed premiums went from $400 to $1900 (may be due to some claims)..same story when switched to other plans, they came with more restrictions..

 

employer had to shop almost every quarter for new plans..some people switched to spousal plans..the ones with out that option quit and moved to bigger firms..

 

may be ur CA state has more control on insurance companies or ur group has not yet hit a pot hole..but I have seen the same scenario in my state with several small firms..

[rahul412]

Well, I work for a startup, and my employer offers group insurance...

And healthcare is big business, if you like it or not. It's that way all over the world. We also "force" drivers into the grip of big corps, with car insurance...

And with this ACA, it's health care industry which is getting benefited not the AMERICANS.

[JoeF]

And with this ACA, it's health care industry which is getting benefited not the AMERICANS.

Hmm, no. Americans are the ones who benefit.

For example, before, healthcare companies could deny coverage for pre-existing conditions. Not anymore. That's a direct benefit for Americans.

[rahul412]

Hmm, no. Americans are the ones who benefit.

For example, before, healthcare companies could deny coverage for pre-existing conditions. Not anymore. That's a direct benefit for Americans.

These people are paying new premium(more than the current premium) under this act. And under this act, more people will be buying the insurance so more premiums to the insurance companies.

 

Of course their are new benefits for the people, but that is very less when compared to the health insurance industry benefits under this ACA. People should get more benefits, not the industry.

[maverick41]

These people are paying new premium(more than the current premium) under this act. And under this act, more people will be buying the insurance so more premiums to the insurance companies.

 

Of course their are new benefits for the people, but that is very less when compared to the health insurance industry benefits under this ACA. People should get more benefits, not the industry.

 

 

You really think ACA is going to benefit the industry? If ACA was that good for industry , then why did the industry and their lobbyists try their best to derail ACA before it became law.

 

Here is why the industry tried to block ACA:

• companies can no longer exclude people with pre-existing conditions, and children will be allowed on their parents’ policies until age 26
• the medical loss ratio provision states that 80% of an insurance premium must go to actual paying of coverage and only 20% may be used for overhead, marketing and profit. 

Many insurance companies spend a substantial portion of consumers’ premium dollars on administrative costs and profits, including executive salaries, overhead, and marketing. The Affordable Care Act requires health insurance issuers to submit data on the proportion of premium revenues spent on clinical services and quality improvement, also known as the Medical Loss Ratio (MLR). It also requires them to issue rebates to enrollees if this percentage does not meet minimum standards. MLR requires insurance companies to spend at least 80% or 85% of premium dollars on medical care, with the review provisions imposing tighter limits on health insurance rate increases. If they fail to meet these standards, the insurance companies will be required to provide a rebate to their customers starting in 2012.

(Source CMS) 

 

The only good news for insurance companies---the young and healthy demographic that were previously uninsured will now buy insurance, balancing out the good risk and the bad risk for insurance companies. 

[maverick41]

Yes there maybe the growing pains of ACA and it may not be the silver bullet that solves all of America's health care problems but this initial roll out of version 1.0 has already created an impact with:

1) With a focus on prevention and wellness rather then just the reactive/treatment aspect, ACA ensures more free preventive services (counselling, shots, screening). ACA also provides financial incentives for providers who encure preventive services

 

2) expanded coverage for Medicaid

 

3) coverage of pre-existing conditions

 

4) Having children be on their parent's insurance plans till the age of 26

 

5) 80% of an insurance premium must go towards actual paying of coverage

 

6) Adoption of electronic health records  

 

Something had to be done. According to a Bloomberg study on healthcare efficiency:

• The U.S. ranks 46th
• The U.S. ranks 2nd in health care cost per capita ($8,608), only to be outspent by Switzerland ($9,121) -- which, for the record, boasts a top-10 health care system in terms of efficiency.
• U.S. is 1st in terms of health care cost relative to GDP, with 17.2 percent of the country's wealth spent on medical care for every American.

In other words, the rich and developed nation of the US  spends more of its money on health care while getting less than almost every other nation in return.

(Source: Bloomberg, HuffPost)

[JoeF]

These people are paying new premium(more than the current premium) under this act. And under this act, more people will be buying the insurance so more premiums to the insurance companies.

 

Of course their are new benefits for the people, but that is very less when compared to the health insurance industry benefits under this ACA. People should get more benefits, not the industry.

No, these people can get insurance with the ACA, they didn't have insurance before.

[JoeF]

In other words, the rich and developed nation of the US  spends more of its money on health care while getting less than almost every other nation in return.

Yup. That's one of the major issues. The countries with mandatory healthcare insurance are all doing better than the US.

The current issue with the website is pretty much the usual issue with the government contracting out these things. The contracts are based on political considerations, not competence of the bidders. Pretty much all major government software development efforts have huge budget overruns or fail outright. The previous one I remember was a new air traffic control system.

[rahul412]

No, these people can get insurance with the ACA, they didn't have insurance before.

which means they are BUYING the insurance from companies, so more money to the industry. And moreover congress has raised new taxes under this law.

 

I am not against this reform, but the way it's been written makes me to say this. Bottom-line, money is indirectly going out of your pocket into the hands of corporates.

 

People say you get more benefits, but think practically you won't get more benefits without paying more money.

[JoeF]

which means they are BUYING the insurance from companies, so more money to the industry.

They are also getting something in return. In particular people who couldn't get health insurance before.

For example people with chronic diseases. These people save big time.