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Healthcare Question re: Preexisting Conditions
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Date: July 3rd, 2012 1:36 PM Author: sadistic razzle hell So, my understanding is that, once all the provisions of the ACA are in effect, insurers will not be able to deny coverage based on a preexisting condition.
However, will they still be able to set prices based on preexisting conditions? Like, if you get cancer and then try to get insurance, can they say "sure we'll cover you, but your premiums are going to be $10,000/month"?
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Date: July 3rd, 2012 1:37 PM Author: spruce adventurous location reading party No, they are given a discretionary pricing band but it's very limited. A ban of price discrimination means you can't price based on individual risk factors, pre-existing conditions being one such (very material) risk factor. (http://www.autoadmit.com/thread.php?thread_id=1985469&forum_id=2#21008843) |
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Date: July 3rd, 2012 1:41 PM Author: Mentally impaired degenerate I'm happy about this, even though I know premiums will be much higher for everyone as a result. (http://www.autoadmit.com/thread.php?thread_id=1985469&forum_id=2#21008866) |
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Date: July 3rd, 2012 1:44 PM Author: Spectacular internet-worthy circlehead address Why? You want to see the insurance market collapse? (http://www.autoadmit.com/thread.php?thread_id=1985469&forum_id=2#21008881) |
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Date: July 3rd, 2012 1:47 PM Author: sadistic razzle hell So, I'm wondering what this will come down to in practice.
In other words, what is the difference in premium amount that you're risking by not carrying insurance? If you're perfectly healthy, it seems like the only reason to carry insurance is to avoid (a) the risk of getting emergency-pwned before you can sign up for insurance, or (b) the risk of having to pay at the high-end of the premium band of you get a dreaded disease and need to sign up for insurance.
Depending on the difference between the no-insurance penalty and your healthy premiumn, and the cost of high-end premiums, it may or may not be a risk people are willing to take. |
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Date: July 3rd, 2012 1:50 PM Author: Cerebral carnelian business firm volcanic crater the high-end band can only be 3x the low end, right? Which gives you a quant for b). (http://www.autoadmit.com/thread.php?thread_id=1985469&forum_id=2#21008924) |
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Date: July 3rd, 2012 1:51 PM Author: spruce adventurous location reading party as i understand it, they will be phasing the 3:1 ratio out. (http://www.autoadmit.com/thread.php?thread_id=1985469&forum_id=2#21008932) |
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Date: July 3rd, 2012 1:52 PM Author: Cerebral carnelian business firm volcanic crater what will the price discrim ceiling be then? (http://www.autoadmit.com/thread.php?thread_id=1985469&forum_id=2#21008942) |
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Date: July 3rd, 2012 2:08 PM Author: spruce adventurous location reading party you're right in that 2704 has the de jure 3:1 max ceiling, but from what i understand there are other provisions which i'm going to look into later off work that work in conjunction with IRS 223 that limit the amount of out-of-pocket and which can be unilaterally amended each year without congressional approval. This is the means to effectively cap and phase out the de facto ceiling. (http://www.autoadmit.com/thread.php?thread_id=1985469&forum_id=2#21009036) |
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Date: July 3rd, 2012 1:51 PM Author: spruce adventurous location reading party exactly. (b) will be very limited, so it's not the high of a risk, especially considering at that point the cost of the underlying health care you seek will likely far outweigh the premium. (a) is a concern and is really the only enforcement mechanism (making sign-up strenuous and not apply retroactively) left that will keep people from opting out until the last minute, in which case the insurance system will eventually collapse. (http://www.autoadmit.com/thread.php?thread_id=1985469&forum_id=2#21008927) |