Don’t just let them expire. Force a vote specifically to identify the party that is raising our of pocket healthcare costs for 20 million potential voters.
DEEEEETTTTRRROIIITTT on
wasn’t the whole point of the subsidy to end the benefit cliff?
hypsignathus on
I believe in the power of markets, but can we all just agree that healthcare is a shit market and we should stop pretending there is much–if any–consumer choice?
mwheele86 on
I’ll be honest, I’ve done a lot of 180s on policies that I supported 10 years ago after seeing their implementation. ACA is one of them (I’m self employed and buy on the market place).
ACA suffers from the same incentive problem as cost plus contracts. Profit % is capped for insurance companies, so how do grow your EBITDA? Pay more for services. Even better, buy up providers so one unit is paying another unit.
There is a ban on physician owned hospitals, that limits new competition, the medical records regs are so onerous that Epic has basically a monopoly on EMR services and charges insane prices (they lobbied during the ACA drafting).
The plans now are abhorrent for the value you get. I’m more sold on everyone getting HSAs, and just a public option for a high risk pool but also wiping out tons of these regulations. All things the GOP pushed for at the time.
The one thing I do think they should keep is some sort of baseline standard of what is included in plans offered so people can’t be rug pulled, but the ACA has completely obfuscated any direct consumer relationship between doctor and patient and created tons of opportunities for middlemen to make lots of money off of that dynamic.
gburgwardt on
> In March 2021, at the height of the pandemic, the American Rescue Plan temporarily extended premium subsidy eligibility to those with incomes above 400% of the federal poverty level, allowing people at any income level to receive subsidies originally intended for those with modest means. In August 2022, the Inflation Reduction Act extended those subsidies through December 2025.
>Letting the subsidies go away merely restores the original ObamaCare premium-support structure. That preserves access to subsidies for low-income populations, who already comprise 93% of the 24 million who get health insurance through the ObamaCare exchanges. The expiration will affect roughly 1.6 million current enrollees. These are the people with incomes above 400% of the federal poverty level who have been receiving subsidies that cap their premium contributions at 8.5% of income. A family of four in Arizona making $600,000, a married couple in West Virginia making $580,000, and a single individual in Vermont making $180,000 all qualify for subsidies.
TheSandwichMan2 on
Awful, dogshit-tier take. There are two ways to provide universal insurance to everyone irrespective of their ability to pay – either single payer coverage or subsidized private insurance (aka the ACA PTC system). The latter is the more free market option. It will almost always produce higher overall expenditures than a single payer system because patients really value their healthcare in a free market!
If you want to introduce an incentive to pick cheaper plans, let excess PTCs left over after paying for a premium be put into a patient’s HSA. That would introduce an incentive to pick less expensive plans without gutting affordability for poorer and middle class families that actually need it. Additionally, you could add a federal public option, which is particularly useful for controlling costs in markets with few insurers/little competition. Don’t jack up costs for poor families, that is barbaric and doesn’t solve the problem.
mackattacknj83 on
Only if we combine this with some deregulation on what services must be provided by actual doctors as opposed to other medical professionals.
7 Comments
Don’t just let them expire. Force a vote specifically to identify the party that is raising our of pocket healthcare costs for 20 million potential voters.
wasn’t the whole point of the subsidy to end the benefit cliff?
I believe in the power of markets, but can we all just agree that healthcare is a shit market and we should stop pretending there is much–if any–consumer choice?
I’ll be honest, I’ve done a lot of 180s on policies that I supported 10 years ago after seeing their implementation. ACA is one of them (I’m self employed and buy on the market place).
ACA suffers from the same incentive problem as cost plus contracts. Profit % is capped for insurance companies, so how do grow your EBITDA? Pay more for services. Even better, buy up providers so one unit is paying another unit.
There is a ban on physician owned hospitals, that limits new competition, the medical records regs are so onerous that Epic has basically a monopoly on EMR services and charges insane prices (they lobbied during the ACA drafting).
The plans now are abhorrent for the value you get. I’m more sold on everyone getting HSAs, and just a public option for a high risk pool but also wiping out tons of these regulations. All things the GOP pushed for at the time.
The one thing I do think they should keep is some sort of baseline standard of what is included in plans offered so people can’t be rug pulled, but the ACA has completely obfuscated any direct consumer relationship between doctor and patient and created tons of opportunities for middlemen to make lots of money off of that dynamic.
> In March 2021, at the height of the pandemic, the American Rescue Plan temporarily extended premium subsidy eligibility to those with incomes above 400% of the federal poverty level, allowing people at any income level to receive subsidies originally intended for those with modest means. In August 2022, the Inflation Reduction Act extended those subsidies through December 2025.
>Letting the subsidies go away merely restores the original ObamaCare premium-support structure. That preserves access to subsidies for low-income populations, who already comprise 93% of the 24 million who get health insurance through the ObamaCare exchanges. The expiration will affect roughly 1.6 million current enrollees. These are the people with incomes above 400% of the federal poverty level who have been receiving subsidies that cap their premium contributions at 8.5% of income. A family of four in Arizona making $600,000, a married couple in West Virginia making $580,000, and a single individual in Vermont making $180,000 all qualify for subsidies.
Awful, dogshit-tier take. There are two ways to provide universal insurance to everyone irrespective of their ability to pay – either single payer coverage or subsidized private insurance (aka the ACA PTC system). The latter is the more free market option. It will almost always produce higher overall expenditures than a single payer system because patients really value their healthcare in a free market!
If you want to introduce an incentive to pick cheaper plans, let excess PTCs left over after paying for a premium be put into a patient’s HSA. That would introduce an incentive to pick less expensive plans without gutting affordability for poorer and middle class families that actually need it. Additionally, you could add a federal public option, which is particularly useful for controlling costs in markets with few insurers/little competition. Don’t jack up costs for poor families, that is barbaric and doesn’t solve the problem.
Only if we combine this with some deregulation on what services must be provided by actual doctors as opposed to other medical professionals.