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Thomas L. Bakos
I would suggest that we have all been on the Healthcare.com website trying to enroll for the past two weeks and have had no time to participate in surveys. Of course, given we are all part of a 50 year reunion, that can't be the case since we are all on Medicare and don't have to worry about the impact of the ACA on our lives - unless, of course, it starts affecting Medicare.
But, maybe, it is precisely the fact that we are less affected by the ACA that we have little concern about expressing an opinion on it.
With 40+ years work experience as an actuary pricing life and health insurance products, it is hard for me to understand how, when coverages not routinely included in health insuarance coverages are mandated (essential benefits), the risk selection process cannot exclude or charge higher premiums to individual applicants who are already sick (pre-existing conditions) when they apply for coverage, and benefit limits to control claim costs are not allowed (no annual/lifetime limits) that premiums will go down!
Certainly, one may think all of those changes are a good thing, but the effect on premiums will be to increase them. Nothing in those changes points to reduced claim costs. The government position is that, for many, the "out-of-pocket cost" will be lower - because of the subsidies available to lower income people. However, the actual premium cost is still going to be higher - it's just that somebody else is funding the subsidies - the "somebody else", of course, is the tax payer or the healthy lives forced into the system by the mandate they participate.
Since pre-existing conditions are excluded as a reason to decline coverage (in fact, insurers must take all applicants under the ACA - Obamacare) and, given the high deductibles which are part of almost every plan even near to "affordability", the least expensive health insurance route to take is: Don't enroll. Pay thre penalty, if the IRS insistes or search for one of the many ways to get an exemption (one way is, if the cost of health insurance exceeds 8% of income - which is very likely to be the case for many who do not qualify for a subsidy). Then, if you do get sick, enroll during the next open enrollment period since you must be accepted under the pre-existing conditions provision.
Clearly, the above creates some individual risk since there is likely to be a gap between sickness and insurance coverage for some. But, the alternative is Obamacare premium costs of $12,000 - 16,000 per family with deductibles around $12,000 per year. And, that is the cost this year. It is likely to increase since close to 100% of individuals already sick will enroll while many or most of the healthy lives necessary to make the Obamacare system work probably won't - they either can't afford the premium cost (with no subsidy) or can't see paying so much for health care they don't reasonably anticipate actually using. For example, the last time I was in a hospital as a patient was when I was junior at Glenbard East and I ran into Dave Smith's head and broke my collar bone.- over 50 years ago. I've had health insurance coverage over the past 50 years but rarely, if ever, used it.
Obama waived the employer mandate for one year because he forsaw another 93,000,000 people with employer subsidized health insurance being dumped into the Obamacare market this year, if he didn't. But that is only delayed and, unless major changes are made, will happen by this time next year.
The Obamacare system was built to fail - if it ever gets started. I don't know if that was intentional or not. But failure is coming.
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