tag:blogger.com,1999:blog-8512362.post5409145476966163380..comments2024-03-10T13:59:19.230-04:00Comments on xpostfactoid: New Jersey can sabotage-proof its ACA marketplace next week Andrew Sprunghttp://www.blogger.com/profile/17601269968798865106noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-8512362.post-88669547604917958992018-04-07T09:33:14.054-04:002018-04-07T09:33:14.054-04:00Good points......
I think we are near (or past!) t...Good points......<br />I think we are near (or past!) the point where the private insurance industry cannot provide affordable comprehensive products for persons over 50 or 55.<br /><br />Funny, we had a national response to that when the age was 65.<br />Tom Bodenheimer had a piece in Health Affairs about expanding Medicare downwards in age. This might be the long range national solution.<br />bob.hertzhttps://www.blogger.com/profile/09686373408419885558noreply@blogger.comtag:blogger.com,1999:blog-8512362.post-35825613730081428282018-04-07T07:41:12.322-04:002018-04-07T07:41:12.322-04:00Bob, I don't mean to suggest that arresting an...Bob, I don't mean to suggest that arresting and partially reversing the steep premium hikes of the last two years is a sufficient solution. It's just what's possible on a state level now, particularly in NJ which is in dire financial condition. To stave off the premium hikes expected as a result of the mandate repeal, and possibly peel back premiums up to 10% via reinsurance, would be a major win. Also, you're citing worst case. For older buyers just over the subsidy line, insurance is unaffordable. For a lot of people over 400% FPL, it's an outsized but manageable burden. Finally, modest improvements would improve the risk pool and so might bolster competition in the state, which would benefit subsidy-eligible people.Andrew Sprunghttps://www.blogger.com/profile/17601269968798865106noreply@blogger.comtag:blogger.com,1999:blog-8512362.post-50203046683061455992018-04-07T07:19:49.503-04:002018-04-07T07:19:49.503-04:00Thanks for your thoughtful comments, and for your ...Thanks for your thoughtful comments, and for your persistent good efforts in the public sphere.<br /><br />You conclude that "individual mandates plus reinsurance will lead to more affordable coverage."<br /><br />I will give that a kind of weak 'maybe.' Let me be more specific:<br /><br />today a 55 year old making $50,000 a year in Princeton NJ is facing premiums of $700 a month for really awful coverage -- $5000 deductible, and then doctor visits and generic drugs covered at just 50% after the deductible. (see Health Sherpa for details)<br /><br />If he makes $50,000 a year, which is not rich in NJ, then his after tax income will be about $3000 a month. $700 a month for health insurance is about 23% of his real income.<br /><br />So far I have said nothing new. My question is this:<br /><br />will a mandate and reinsurance get his premium for decent coverage down to $300 a month, which is ten per cent of his real income?<br /><br />They won't. To me the only answer is to extend the ACA subsidies to all income.<br /><br />Your solutions though meaning well are what I call aspirational solutions....they hope to lead insurance companies to charge lower premiums. My solution (more subsidies) kind of gives up on trying to nudge insurance companies into lower premiums. I would let them charge what they have to and then subsidize the buyers.<br /><br />Finally let me thank you for supporting the Out of Network bill. New York and California have led the way, but other states and NJ are catching up. Why this has to move sluggishly from state to state is for conservatives the majesty of our federalist system...but to me it is just stupid delaying.<br />bob.hertzhttps://www.blogger.com/profile/09686373408419885558noreply@blogger.com