Friday, November 15, 2013

Five things ACA supporters are just learning (Part II of III)

… that ACA opponents knew from the beginning.  That’s why we were ACA opponents in the first place (duh).

See the full article here.  

Continued from Part I – 

“2. Many people will lose their current insurance.”

You don’t say.

Supporters of the ACA accurately state that technically there’s nothing in the ACA that forces insurance companies to take your plan away from you.  It’s the big, bad insurance company’s fault that you can’t keep your plan.

Yes, the big, bad insurance companies are doing exactly what anyone who paid attention in Econ 101 said they would do – change in response to the new regulatory environment.  With the new “minimum essential coverage” guidelines, all these plans are being legislated out of existence.

If I could just digress a moment to discuss these theoretical “junk” plans.  It’s the new talking point that everyone is getting a better plan.  This is just straight-up not true.  Story after story abound *cough* about people having to pay an exorbitantly higher amount for the same or fewer benefits.

Now, that being said, here is an area where I am actually with the ACA supporters – ACA opponents are complaining everywhere that because of the way different types of people are now lumped together, men are having to pay for maternity care, breast cancer, and a host of other female-specific conditions.  They’re not complaining so much that women have to pay for male-specific conditions, so I guess that’s not as big of an issue to them.  /eyeroll.

Listen here kids – if men’s and women’s premiums are all lumped together to pay for BOTH male-specific and female-specific conditions (setting aside maternity care for a second), on balance it’s a wash, unless there’s some huge difference in how common certain conditions are.  Which I don’t think there is; if you can find something to prove me wrong, please do.

Now – returning to maternity care – how do women get pregnant?  What’s that you say?  Because a man voluntarily had sex with her?  Awesome.  Guess why I don’t care that men are griping about having to pay for maternity care?  Show me a man who’s a virgin – he’s the ONLY one with a legitimate complaint in this department. 

“3. You don’t have to buy through the exchanges.”

Now this one right here isn’t technically about the ACA.  This item has more to do with the lack of general knowledge about open market insurance options.  And that makes sense - if most people are getting subsidized premiums through their employer, they have no need to go anywhere else.  It wasn’t until I switched jobs and decided not to pay $2000 a month to insure my family that I investigated my open market options.

The purpose the exchanges serve is a guaranteed place where anyone could buy insurance.  But since no one is likely to get on the exchanges for quite some time, and also since many of the big carriers are opting out of the exchange, I don’t think it’s going to be very effective.

But while we’re on the subject, it’s bullshit that the only way to get an insurance subsidy is to buy through the exchange.  Why can’t I buy a policy on the open market and then claim a deduction on my 1040?  Would that have been so bad?

Also, why are premiums paid through my employer deducted straight from my W-2 wages (thus lowering my AGI), while premiums paid myself are deducted elsewhere on the form and do not lower my AGI?  My AGI is used as a base to calculate the allowability and amount of several different deductions, so buying insurance myself (as opposed to through my employer) is essentially a penalty.

If it were up to me, I would scrap the insurance-through-employer model.  I would also scrap the insurance-pays-for-everything model.  I would make health insurance more like auto insurance.  You buy it on the open market, decide who you want on your policy (self, kids, grandma, down-on-her-luck friend, neighbors, parents, ANYONE), decide what your catastrophic illness deductible is (with the understanding that regular doctor visits are out-of-pocket*), and your price is adjusted accordingly. 

*One thing to remember with health insurance – if you have a high deductible plan and go to the doctor before you hit your deductible, look at your bill.  Your bill will show gross charges, “plan discounts” or some such, and the amount you owe.  Even though you’re paying out-of-pocket, you’re still not paying 100% of charges.  Whenever I’ve gone to the doctor with my high deductible plan, my actually out-of-pocket cost has actually been pretty darn good.

To be continued …

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