The requirement for continuous coverage was weakened by the end of the individual mandate. It’s cheaper to just pay the 30% extra for a year when you get sick instead of paying the fine.
We’re talking about the individual market here. You can’t be ‘fired’ from that. If you lose coverage under the ACA, it’s because you didn’t pay your premiums. Presumably, that will be true in the individual market for whatever comes next, as well. I don’t know what you mean by “D” and “S.”
As for the employer market, COBRA will still exist. The price increase can shock people, but they can keep that coverage for 18 months.
AshLee Strong (@AshLeeStrong) (national press secretary for Paul Ryan): “While we’re setting the record straight: AHCA was posted online a month ago, went through 4 committees, & has been scored by CBO – twice.”
It was on display in the bottom of a locked filing cabinet stuck in a disused lavatory with a sign on the door saying Beware of the Leopard.
Heh, I made that same exact joke elsewhere when they were all scrambling to “find” the draft.
Edit: also, she’s specifically referring to CBO scores for previous versions of Ryancare.
Look, we already scored it jeeze!
(And it looked horrible then, but lets not mention that)
And we used to be the #1 state for education when I was in high school (or so our teachers told us, every week).
Yes, because having your premiums jump 4-5x WHILE YOUR ****ING UNEMPLOYED is very helpful.
Is health care a right? It is a good question. I think both society and individuals have an obligation to help those less fortunate than ourselves. That’s a fundamental part of the country’s Judeo-Christian heritage and not only is this almost universally believed outside of a few libertarians. It is also practiced by a very high percentage of America.
So for example, we provide free public education K-12 education for all, and even non-citizens kids. (Not to mention providing citizenship to anybody born here.). We also believe that everyone in America should get food. Between government programs food stamps, and the plethora of charity programs, while food insecurity is a problem, hunger in America looks nothing like it does in South Sudan. America’s poor are obese.
But we seem to draw the line at shelter, there isn’t a lot of support for providing the poor with housing, and even Section 8 vouchers are unpopular and not just among conservatives.
I think there is a huge difference between supporting providing life- saving care to everyone regardless of income, to thinking that everyone is entitled to the best care regardless of income. And it is even a bigger leap to believe that best way of providing health care, is for the federal government to get in the business of paying for health insurance.
In my mind health care and health insurance or really separate entity, and that fact that Oregon study showed that primary benefit of providing poor people with health insurance (i.e. Medicaid) was mental well-being reinforces that.
TL:DR. We should provide basic health care to everyone but not advanced, but it is not a function of the Federal government.
So no one ever switches between markets then? Once you’re in one you’ll never cross seems unrealistic. COBRA is prohibitively expensive for more than a short period of time.
Demand / Supply. Insurance for all mostly addresses one side.
See, that’s a premise that, while I don’t agree with it, I can engage with. We can have an actual debate over whether we agree or disagree on this.
But we’re not getting this sort of discussion at all. Not from the people who can make decisions, at least.
Yeah, the price of COBRA is essentially prohibitive to almost anyone. It’s not a real solution, once folks realize the price.
I know it is sad, that isn’t happening. I held out a glimmer of hope that if Hillary was elected, two policy wonks like her and Ryan could actually understand each others views and reach a working compromise.
Ryan, has been Peter principled, chair of the budget committee was the ideal job for him. So imagine even he has given up on making any real changes to health care. This is just making tax reform easier.
It’s helpful if you have saved some money. I know that from personal experience. And yeah… the first time, it was an eye-opener to realize just how much my employer had been subsidizing my insurance (it went from $83 a month to $600).
I don’t understand what you mean by switching markets. Why can’t you? Are you positing that continuous coverage requirements will limit you to the same insurance company or the same geography? They don’t and won’t, as far as I know. In any case, I was just trying to point out that, if you buy on the individual market, you can’t lose your coverage due to getting fired.
Let’s just back-up for a minute here. I said part of the problem with the pre-existing condition issues we had previously was the break in coverage clause, which was included with many if not most employer plans. Then I showed a scenario where it’s not a moral hazard that caused the break in coverage or waiting to be sick before seeking coverage, but a scenario that can happen to a lot of people that suddenly leaves someone without coverage. Your response to that is we’re talking about the individual market, not the employer market. Then I point out, yeah… people can shift markets… so still a problem. You’re acting like losing a job and jumping into COBRA is no problem except it is hugely expensive, especially for someone who lost a job. Jumping into a individual market after you’ve lost a job… still not that simple, and if at any time you are without coverage while you’re making these transitions, the pre-existing problem can crop up. That’s it.
Pre-existing conditions was NOT only a problem for the individual market. It was a problem for BOTH markets.
Nesrie has a very good point. Our current economy–which is not just structure, but psychology, too–is based on certain premises, one of which is job = healthcare. Another, though, is consumers = prosperity. Consumption depends on disposable income. The definition of disposable has been culturally shifted from “everything left after obligations, savings, and contingency planning” to “everything I have after the mandatory bills, up to and including my credit limit.” One can argue, with some correctness, that this is kind of wonky, but I think it’s too much to expect people to ignore the constant bombardment of messages, from the politicians (“buy American!”), the advertisers (if you don’t buy, your’re a loser!"), and the popular culture (“see us, we’re a normal family! If you’re normal, you’ll have the same sort of stuff!”). So most middle class families end up being fine, as long as the breadwinner(s) is/are employed.
What happens when, as it inevitably does, someone loses a job? It’s one thing to have to cut back on cable; it’s another to have to cut back on health care. And guess what? By turning health care into just another commodity, we put it in just the exact same category as cable, or a new iPad. No wonder people are fucked.
Right, and that should change. All the more so since more and more jobs simply don’t offer healthcare (a trend that started before Obama’s election).
I understand this – everyone in my small company, including me, buys on the individual market. I absolutely rely on the health of that market. Therefore, it has to make sense for insurers to participate in it. Part of that is not allowing people to game the system, waiting until they are sick to buy insurance. The current ACA makes that easy. It shouldn’t.
For people in the group market, they have two options to retain continuous coverage, COBRA or an ACA plan (losing your insurance is a qualifying event). Nobody should experience an involuntary lapse of coverage for 63+ days unless they’re out of money. And nothing will help the destitute other than single-payer, which is not on the current menu of possibilities.
It might be in 2020. I hope so – I favor single-payer healthcare. I’ll vote based on that preference if the opportunity arises. In the meantime, though, I’d like the private market for individual insurance to remain viable. Because this isn’t theoretical for me.
Massive changes with the healthcare system of a country is not theoretical for anyone. The the individual market does certainly affects providers who also serve the employer market. The employer market will respond to what the individual market does. And of course, anyone who says Medicare for all… probably hasn’t studied what Medicare doesn’t cover as closely as they think they have, especially in a world where private insurance has largely eliminated maximums but Medicare has Part A and Part B exhaust (these are not permanent exhaust but you can certainly exhaust your benefits for a time, of course you can use up reserve days too).
You are very correct about Medicare, and Medicaid. Having spent the last decade or so with elder care issues involving Medicare, Medicaid, and Social Security, I can definitely say the entire system is, to use a technical term, fucked six ways to Sunday.