ACA/Obamacare: What Does a Replacement Plan for Obamacare Plan Look Like?

"We believe the American health care system is desperately in need of reform. The Affordable Care Act has failed to achieve its goal of affordable, universal coverage. Instead it has forced people, especially those in middle-income households, to choose from insurance plans with deductibles that are unreasonably high and provider networks that are too narrow to adequately help many afflicted with serious health problems.

The following proposals would vastly improve coverage by making health insurance affordable for all and by ensuring access to reliable medical care. They are incorporated in bicameral legislation introduced in the House and the Senate by Rep. Pete Sessions and Sen. Bill Cassidy and in the Patient Freedom Act, sponsored by Sen. Cassidy". - Replacing Obamacare and Insuring the Uninsured, The Independent Institute, 02/13/2017

Some highlights are:

(1) uniform tax credit for people buying their own health insurance coverage,

(2) tax credit can be used toward coverage in the individual market or the credit is transferable to an employer willing to purchase group health insurance for the individual,

(3) portability between individual and group health insurance coverage,

(4) integrate Medicaid and private insurance for seamless coverage,

(5) remove incentives for dumpling plans onto the individual market via “health status risk adjustments”,

(6) removal of mandate and the use of Medicare type penalty rates (higher premiums) for those not signing up for coverage when first eligible.

Note: At the link below one can download the “Executive Summary”.

http://www.independent.org/publications/article.asp?id=8994


Note (B): A more detailed discussion appears at this link:

http://www.independent.org/newsroom/article.asp?id=8979

U.S. Healthcare Delivery System: We Have Met Canada and We are Them

“Americans like to think that our health care system is very different from “socialized medicine” in Canada. In fact, the two health care systems are far more similar than they are different. In Canada, when people go to the doctor the visit is free. In America, it’s almost free.

On the average, every time Americans spend a dollar at a doctor’s office only 10 cents is coming out of our own pockets. The rest is paid by an employer, an insurance company or government. Like the Canadians, we do not primarily pay for health care with money. We pay with time.

According to a Merritt Hawkins survey:
The average wait time to see a primary care doctor in the United States is almost three weeks.
In Boston (where we are told there was universal coverage even before there was Obamacare), the average wait is more than two months.

Compare that with how long you have to wait to get your cellphone repaired.

Waiting in the US is becoming more like waiting in Canada and in some cases it can be worse.” - What Everyone Should Know About Rationing By Waiting, Forbes, 11/09/2015

Link the entire article appears below:

http://www.forbes.com/sites/johngoodman/2015/11/09/what-everyone-should-know-about-rationing-by-waiting/

ACA/Obamacare: Employer Work-Around and Other Avoidance Techniques

“Take Advantage of Imperfections in the Minimum Value Calculator. In addition to being affordable, health insurance must meet a “minimum actuarial value” test. For self-insured companies, this means that the benefits can differ from the essential health benefits included in a standard plan, but the employer plan has to cover at least 60 percent of expected costs under a standard plan.

One official way to do that is to get a passing score on the Department of Health and Human Services’ “minimum-value” calculator, an online tool. And here is a surprise: an employer can actually meet this test without including hospitalization! (See the discussion at Kaiser Health News.) At the site, the visitor is invited to check boxes indicating whether certain benefits are included in the employer plan. In addition to hospitalization, mental health care, imaging (MRI and CT scans) ER visits and specialist services are other items that do not have to be included to meet the government’s test.



Pay the Fine. Employers can drop health insurance coverage altogether (or never provide it in the first place) and pay a fine equal to $2,000 per employee. That’s a stiff price to pay, but it’s less than the cost of health insurance. If the employer chooses this option, the employees will be eligible for subsidized insurance in the exchange.


By the way, this is a win-win choice. Economic theory tells us that the $2,000 fine will ultimately be paid by the employees – in the form of lower wages or reduced non-health care benefits. But most low-wage employees will get a subsidy that is worth much more than that and they will have generous health insurance to boot." - What Can Employers Do To Reduce The Cost Of Obamacare?, Forbes, 09/16/2014


Link to the entire article appears below:
http://www.forbes.com/sites/johngoodman/2014/09/16/what-can-employers-do-to-reduce-the-cost-of-obamacare-2/



　


　

　
　

John Goodman Discusses ‘Insurance Death Spirals’ in Relation to Obamacare

Obamacare Exchanges Offer Medicaid-Type Provider Networks? Glorified Medicaid?

“Think of an insurance plan as having three main components: (1) a premium, (2) a list of covered benefits and (3) a network of doctors, hospitals and other providers. Under the Affordable Care Act, there is very strict regulation of benefits—right down to free contraceptives, questionable mammograms and non-cost-effective preventive procedures. At the same time health plans have been given enormous freedom to set their own (community rated) premiums and choose their own networks. They are using that freedom in yet another way to attract the healthy and avoid the sick.

In the ObamaCare exchanges, the insurers apparently believe that only sick people (who plan to spend a lot of health care dollars) pay close attention to networks. Healthy people tend to buy on price. Thus, by keeping fees so low that only a minority of physicians will agree to treat the patients, some insurers are able to quote very low premiums. They are banking on attracting the healthy and they may even have the good luck to scare away the sick.

Community rating is what makes this strategy work. In the ObamaCare exchanges, if I am healthy why wouldn’t I buy on price? If I later develop cancer, I’ll move to a plan that has the best cancer care. If I develop heart disease, I’ll enter a plan with the best heart doctors. And these new plans will be prohibited from charging me more than the premium paid by a healthy enrollee. (See a more comprehensive analysis.)

As a result, we are getting a race to the bottom on access—with private plans in the exchanges looking increasingly like Medicaid, just as they do in Massachusetts.

The Obama administration doesn’t seem to be bothered by this development. In fact they have been touting the fact that the premiums have been lower than expected, even though the reason is that the networks are narrower and skimpier than expected.

Think how different this is from what we were promised. During the 2008 election, every serious candidate for the Democratic presidential nomination repeated the “universal coverage” mantra repeatedly—and on the left “universal coverage” means universal access to care. No candidate even hinted that access to providers might not be any better than it is under Medicaid. - Obamacare’s Insurance Exchanges Will Foster a Race to the Healthcare Bottom, John C. Goodman, The Independent Institute, 10/03/2013

Link to the entire article appears below:

http://www.independent.org/newsroom/article.asp?id=4739
 



Updated 11/14/2013:

Think ObamaCare Is Bad Now? It Gets Worse Next Year, investors.com, 11/12/2013

http://news.investors.com/ibd-editorials-on-the-right/111213-678930-millions-with-coverage-at-work-to-lose-their-insurance.htm

 

ObamaCare: risk pools for pre-existing conditions

"We now know how many people have the problem most often cited as the reason for last years’ health overhaul legislation. Answer: 8,000." - John Goodman
Apparently the mantra of ObamaCare, those nasty pre-existing conditions, that dearth for the American public, has attracted 8,000 people into risk pools. The same risk pools that were projected by Medicare's chief actuary to be populated by 375,000 people by year end 2010 have attracted 8,000 out of 310,000,000 Americans. Please take a moment and visit Mr. Goodman's blog for a very insightful post entitled Health Problem Quantified:

http://healthblog.ncpa.org/health-problem-quantified/?utm_source=newsletter&utm_medium=email&utm_campaign=HA#more-17097