tag:blogger.com,1999:blog-8512362.post1555185273190298612..comments2024-03-10T13:59:19.230-04:00Comments on xpostfactoid: What if a public option were added to the ACA marketplace now?Andrew Sprunghttp://www.blogger.com/profile/17601269968798865106noreply@blogger.comBlogger4125tag:blogger.com,1999:blog-8512362.post-73687910066689823322016-09-29T17:44:53.112-04:002016-09-29T17:44:53.112-04:00I have been thinking about basic health plans as a...I have been thinking about basic health plans as a public option.<br />In MN, the basic health plan is backed up by a 2% tax on providers, and a 1% tax on all other health premiums.<br />Without these taxes, the MinnesotaCare basic plan would have no reserves. <br />If we take more people onto the basic plan, I think we would have to raise taxes. The taxes would come in large part from people who have good group coverage and will not benefit from the expansion of the basic plan. This will not be easy.<br /><br />I am puzzled as to how the basic plan can be so good! Let me explain.<br /><br />The average cost of the plan for 105,000 residents in MN is $5,200 a year. Let's call that $400 a month.<br /><br />I think that figure is community rated, but just for the heck of it let's say that we have a 50 year old male paying $400 a month. Assume he is 300% of poverty so he is paying the whole premium<br /><br />With the basic plan he gets a $36 annual deductible, co-pay of $50 for ER visit, $150 per hospital admission.<br /><br />Now let's go the ACA exchanges. With Centene, a carrier that you say pays Medicaid like rates, here is what a 50 year gets in Texas for $400 a month:<br /><br />a $4500 deductible, 20% coinsurance after the deductible, and no drug coverage until he meets the deductible. In other words, pure ACA crap (and I just gave you 2016 rates)<br /><br />Help me out, I am not being sarcastic. I just do not get it.<br /><br />The basic health plans would take over the entire individual market in two weeks!bob.hertzhttps://www.blogger.com/profile/09686373408419885558noreply@blogger.comtag:blogger.com,1999:blog-8512362.post-33443601868923456322016-08-23T21:10:13.555-04:002016-08-23T21:10:13.555-04:00Actually I agree with you Lans. I would like to se...Actually I agree with you Lans. I would like to see:<br /><br />a. risk adjustment, where all losses of insurers are covered<br /><br />b. subsidies based on gold plans<br /><br />c. subsidies at all income levels<br /><br /><br />Do keep in mind that my changes would also cost in the billions -- though not as much as the public option. And my changes would somehow have to overcome fierce Republican opposition.bob.hertzhttps://www.blogger.com/profile/09686373408419885558noreply@blogger.comtag:blogger.com,1999:blog-8512362.post-69690141407432634732016-08-23T18:09:40.700-04:002016-08-23T18:09:40.700-04:00@bob.hertz
"The premium is determined politi...@bob.hertz<br /><br />"The premium is determined politically, not actuarially." This is exactly why I am against a public option !<br /><br />A public options will be subject to intense political pressure, from all relevant interest groups, to keep premiums and deductibles low and expand the benefit package to cover a wide range of health conditions and medications. It will quickly evolve into an expensive unfunded entitlement.<br /><br />I will much rather support an improvement of risk adjustment and reinsurance program for health insurers and a modification of the structure of the subsidy for individuals.<br />Lanshttps://www.blogger.com/profile/09888547524720959796noreply@blogger.comtag:blogger.com,1999:blog-8512362.post-87574685390786521572016-08-20T10:26:59.061-04:002016-08-20T10:26:59.061-04:00A public option will not be cheaper just by paying...A public option will not be cheaper just by paying less to providers, at least not much cheaper.<br />A public option would be cheaper if it uses real tax dollars to hold down premiums, just as Medicare does with its Part B premiums. The taxpayer cost for Part B has gone up from about $85 a month up to $104 per month over the past 5 years, even as total Part B spending has climbed must faster.<br />A public option will be cheaper if it uses real tax dollars to ignore high claims experience. If the public option draws the least healthy enrollees, so what?<br />I speak from some experience. By chance I am acquainted with one of the legislators in MN who introduced our Basic Health Plan 20 years ago. That plan continues to charge about $25-$50 a month to insureds, with modest adjustments for family size. The premium is determined politically, not actuarially.bob.hertzhttps://www.blogger.com/profile/09686373408419885558noreply@blogger.com