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Author Topic: Obamacare and the $7,000 a month family premium  (Read 2331 times)
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WhiskeyGirl
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« on: December 16, 2009, 08:33:38 AM »

New Jersey seems to have a lot of experience with community rating, pre-existing conditions, and private health insurance.

What can be learned from the New Jersey experience?

They have a handy chart available on the internet.

http://www.state.nj.us/dobi/division_insurance/ihcseh/ihcratepage_sp.pdf

Depending on benefits, the premiums for families can be just over a thousand to over ten thousand a month.

Quote
In 1992, the New Jersey Legislature created two programs to guarantee access to health coverage for individuals and small employers, regardless of health status, age, claims history, or any other risk factor.

The Individual Health Coverage Program ("IHC") and the Small Employer Health Benefits Program ("SEH") have reformed the individual and small employer (employers with 2-50 employees) health insurance markets.
 

The IHC Program has been fully operational, as a standardized, open-enrolled, community rated market, since August 1, 1993. Individual coverage is available to anyone who is a resident of New Jersey and does not have access to employer-based group insurance or Medicare.

The SEH Program went into effect on January 1, 1994, with the sale of standardized, open-enrolled, modified community rated plans. Small employers (those with 2-50 full-time employees) may choose to purchase standardized health benefits plans, offered by all carriers, or, under certain conditions, they may purchase or renew pre-reform ("non-standard") plans.


http://www.state.nj.us/dobi/division_insurance/ihcseh/

Also from the site -

Quote
Portability and Pre-existing Conditions:
Generally, all conditions are covered by a standard plan as of the effective date, if an applicant's prior health coverage has not lapsed. An individual applicant without prior coverage may have to wait for up to one year for coverage of a pre-existing condition. In the small employer market, a pre-existing condition waiting period of up to six months may be imposed only on groups of two to five eligible emeployees that have no prior coverage. None may be imposed on groups of six to 50 eligible emeployees.


Minimum Loss Ratio:
Rates carriers charge for coverage are not subject to approval prior to use. However, a carrier participating in the IHC or SEH Program is required to pay out 75 cents in benefits for every dollar received in premiums (the result is referred to as the "loss ratio"). As of 2009, the required loss ratio is 80% in both the IHC and SEH markets. If this minimum loss ratio is not met, the carrier must refund some portion of the premium to the policyholder.

Sounds like Obamacare, but there are pre-esisting  coverage clauses for those without prior coverage - possibly those who wait until they are sick before getting coverage...I need surgery, I better buy some insurance...

It looks like the $4,000 monthly premium for families is already here...

(I wonder how many families in New Jersey take the $10,000 a month insurance program?  Or, how many policies does that insurance company sell in New Jersey?)
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All my posts are just my humble opinions.  Please take with a grain of salt.  Smile

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they'll end up in your family anyway...
WhiskeyGirl
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« Reply #1 on: December 16, 2009, 08:42:53 AM »

"The Health-Insurance Market Is Not Free"

(I would say "the health insurance company does not have a money machine like Obama")

Quote
In an effort to protect themselves, insurance companies would prefer to then charge more to the person who waited until he became sick to buy insurance. However, some people cannot afford these higher payments, so the government has imposed price controls.

There are also "community ratings," which require insurance companies to charge the same amount to all members of a pool. Maine, Massachusetts, New York, New Jersey, North Dakota, Oregon, Vermont, and Washington are the most severe. These "community rating" laws effectively force insurance companies to finance people with preexisting conditions, and as a result they vastly increase the premiums for healthy people.

Sounds like Obamacare...in any version.  Someone has to finance the folks that wait until the last minute.

Quote
Another aspect that keeps insurance prices high is government-mandated coverage. The policies vary, but in some states, people who don't drink alcohol must purchase coverage for alcoholism, nonsmokers must purchase coverage for antismoking programs, non–drug users must purchase coverage for drug-abuse treatment, etc. Some states require consumers to purchase 50 or more types of mandated coverage. Special-interest groups are mainly behind these acts of legislation, which come from people in certain fields who want to expand the market for their services.

Make a treatment, build a treatment center and mandate coverage.  No need to cut off feet or take out toncils...

Quote
...Were it easy for new health-insurance companies to enter into the market, surely we would be seeing a vast increase in them as a response to the record profits of the past few years. On the contrary, the number of health insurance companies has been on a consistent decline because of regulations and barriers to entry.

read more here - http://mises.org/story/3727
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All my posts are just my humble opinions.  Please take with a grain of salt.  Smile

It doesn't do any good to hate anyone,
they'll end up in your family anyway...
WhiskeyGirl
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« Reply #2 on: December 16, 2009, 08:52:10 AM »

Quote
"Guaranteed Issue" forces every insurance company to sell health insurance to every applicant regardless of age, health history, lifestyle, or risk factors. 

In theory, this appears sound. If health insurance companies can't "just say no" to high-risk applicants, no one will be left without access to coverage.

Unfortunately, the law of unintended consequences trumps this logic. Under Guaranteed Issue mandates, "access to coverage" becomes "access to higher premiums."

In New Jersey and Massachusetts, unlike in California, laws were passed to force every insurance carrier to sell plans to every individual applicant. Individual insurance premiums in New Jersey and Massachusetts are three times higher than those in California.

Washington State tried Guaranteed Issue. With no way to mitigate risk, insurance carriers in the state suffered severe financial losses related to high-risk patients. They then exited the individual market; no individual health insurance plans were accessible to Washington residents at any price.

Obamacare in any form seems to point to higher premiums for responsible people, and a free ride for those that are irresponsible.

Quote
In mandate-heavy states, consumers are denied the option of buying low-cost, basic health insurance plans to cover major illness or injury. They cannot choose to save money by paying out of pocket for ten-dollar pneumococcus pneumonia vaccines and ninety-dollar mammograms, thereby reserving health insurance for significant expenses. 

In those states, insurance is not insurance at all -- it is expensive, prepaid health care.

When Hummers and Ferraris are the only vehicles sold, people on Toyota budgets can't afford transportation.

a good article here - http://www.americanthinker.com/2009/12/senates_solution_consumer_choi.html

What's wrong with an affordable, no frills, no bells and whistles plan?

If you want a hummer you should be able to buy it.  However, everyone should not have the fruit of their labor stolen so you can ride in excess.

jmho
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All my posts are just my humble opinions.  Please take with a grain of salt.  Smile

It doesn't do any good to hate anyone,
they'll end up in your family anyway...
Nut44x4
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RIP Grumpy Cat :( I will miss you.


« Reply #3 on: December 21, 2009, 03:24:38 PM »

Happy Holidays 

Senior Health Care Solution

So you're a senior citizen and the government says no health care for you, what do you do?

Our plan gives anyone 65 years or older a gun and 4 bullets.  Your are allowed to shoot 2 senators and 2 representatives.  Of Course, this means you will be sent to prison where you will get 3 meals a day, a roof over your head, and all the health care you need!  New teeth, no problem.  Need glasses, great.  New hip, knees, kidney, lungs, heart?  All covered.

And who will be paying for all of this?  The same government that just told you that you are too  old for health care.  Plus, because you are a prisoner, you don't have to pay any income taxes anymore. 

IS THIS A GREAT COUNTRY OR WHAT?!
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