Not sure what you think liberals are predicting other than a generally successful rollout but here's what I expect to happen:

- 30m additional people covered
- Subsidy cost in line with estimates
- health care inflation somewhere in the 4-7% range
- Overall satisfaction with the health care system as measured by Kaiser Family Foundation modestly up

What's 25% of that?

Well you certainly throw a bunch of factoids against the wall from a supposed position of authority but last time you applied your expert analysis to a subject in this thread you asserted that California would spend north of a billion dollars annually on Exchange Navigators and then disappeared when I offered to bet you on a number that was less than 20% of the number you came up with.

Shall we set a line on the number of things I will find in your post to correct?

Oh and still waiting on your response to my generous offer on the Navigator bet.

lol @ disappearing. I hadn't checked this thread in a while and CA released the rates so I decided to drop in and see if it had been mentioned yet. CA stated they wanted 20,000 navigators. I stated that an average lowl-level government employee is pulling in ~$50k/year in salary and benefits and that $50k x 20k employees is $1 billion. If CA can find 20k of these navigators to work for $59 per enrollment with no base salary or benefits, well then that's fantastic since all of those navigators won't make jack s-hit. That would mean with 20k navigators they would need to each be making only $10k/year for the state to spend "only" $200M annually.

What's also interesting with these new rates is that most people between 300-400% of FPL will not get any subsidy since the plans do not cost more than 9.5% of income. A single person at 300% of FPL makes $34,470 so if the silver plan costs less than $272/month there will be no subsidy.

Hey, yeah perfectly reasonable, just take a number and then multiply it by another number that you pull out of the air, ez game. Except when the number you come up with is so outrageous that anyone with an ounce of common sense would say to themselves "Wow, that's a really big number and doesn't really seem possible, what am I missing?"

Anyway, I'm happy to set the line at $200M for whatever you want to bet with escrow, no brainer right?

I don't think CA will have the 20k navigators that they want to hire, so I don't think they will pay out $200M either. $1B is a theoretical number based on the employment numbers that were suggested by the state itself. My guess is they will only be able to hire navigators as part-time employees during open enrollment periods and cut back on the number of them outside of open-enrollment periods. I'd still love to see the people they can find that are willing to work for $59 per enrollment with no base salary or benefits. While navigators IMO are a huge waste of money, will have no clue what they're doing and offer lots of bad advice, they are a pretty small issue in the grand scheme of Obamacare. More important is the cost to consumers such as myself - self-employed, over 400% FPL, and young and healthy. Currently I pay around $90/month for health insurance with a $3k annual OOP maximum and HSA compatibility which I max out every year. What are the odds I will be able to get a similar policy for anywhere near $90/mo next year?

So I have this right, if my plan is $180/month with a $2500 deductible, I'm looking at shelling out ~$4500 in a year before my insurance company starts paying 80%?

In the macro sense, I mean.

Yeah, but I think there are also out of pocket maximums in the $6500 range.

I'm skeptical that those are the real rates available. If you go to Blue Shield of CA for example, rates are basically double what HealthNet is saying, and much more in line with the exchange rates. Same goes for Anthem Blue Cross.

Anyone familiar with CA know what HealthNet is doing? If they were really that far below the market no one would buy anywhere else. My guess is that they're either HEAVILY underwritten, or the "quote" they give you is nothing like what you'd actually pay.

Are you making this up? It says no such thing in the brochure about no BlueCard access (which is only relevant for the blues plans anyway). Even so, so what? If you move, get a new insurance plan in the new state. If you're traveling, emergency care is always paid with in-network benefits anyway. Individuals don't need nationwide coverage. Large employers do, and that's the selling point of the BlueCard program.

This last part makes no sense. Other than for large employers, what exactly is the benefit of these nationwide networks in your head? Are poor people traveling all over and needing non-emergency care when they do? And lol at the differences in coverage increasing. The status quo is that the rich have coverage and the poor have NO COVERAGE AT ALL.

Thanks Justin, I figured this was the bottom line of his factoid salad of a post and hadn't gotten had a chance to do the research yet. Another assumption that I would question is his representation of Plans that are comparable to Silver plans.

BTW it's also interesting that he managed to make several posts on the Navigator discussion trying to defend his position which after being challenged on his initial BS, he now says he doesn't think will happen. So be prepared for a few iterations where you call him out after which he unceremoniously disappears.

A couple of things on your post. Personal attacks on my intelligence level are probably not only uncalled for but likely to be inaccurate. I realize it is a common practice to attempt to demean people on internet forums, but it seems a bit seedy to me. It's also interesting that an opinion different from yours causes such an emotional response from you. I wonder why that is.

Also responding with snarky questions to make your point is a sophomoric way to make you argument and I prefer not to discuss these issues on that level, so I'll just leave your post for what it is and I suppose people will make what ever they want of it.

You would do well to remember that arrogance does not equate to truth. The great thing about this discussion is that we will have our answers shortly. The not so good thing is no matter how it turns out the "losing team" will have a spin to explain their failures. Now that is where your bravado might help you.

When I tried to sign up for individual insurance through one of those aggregators in CA a few yew years ago - they wanted a credit card before giving you a final quote. Umm no.

Another plan that did give a decent quote but had a very cleverly placed checked box that said - we reserve the right to raise your rate if certain conditions are met blah blah.

The whole thing felt very scammy. I ended up going with Kaiser and was mostly satisfied.

Saw a couple days ago that the City of Chicago was dropping health insurance subsidies for retirees. While of course the primary incentive was to save money, one reason cited was that with the ACA, those retirees now had more options for health care and no longer had to rely on the City.

That could apply to the private sector as well: a business's employees would be less pissed off about losing their employer coverage if they can go to the exchanges. Thus the business has less incentive to provide coverage.

That incentive only exists if the penalty is cheaper than providing minimum coverage. The penalty is $2k per employee and is not deductible, so for a for profit entity the penalty is really like $3k per employee.

Private employers will all find it less expensive to offer minimum coverage (remember, you only have to offer individuals) than to pay an effective $3k per employee penalty. Only government entities, which provide sickeningly rich benefits and are not for profit, have the incentive you describe. And if they do dump people on the exchange it is a net positive in terms of cost to the government - it will just be the federal government eating a portion of the cost of a good plan as opposed to the state government eating all of the cost of a Cadillac plan.

I simply posted the lowest quotes for plans with lower OOP maximums than the Silver plans available on the exchange. Starting in 2014, those plans will no longer exist.

Plenty of companies are "far below market" in various states. In Virginia, Anthem BCBS is priced 20-40% lower than every other company in almost all demographics, and often 50-60% lower for people ages 50+.


One of my buddies is the one of the top Anthem agents in CA and has contacts with the higher-ups in the company. He told me there is only one plan they will offer called Prudent Buyer PPO that will include national BlueCard access. From what he has been told that plan will only be available outside the exchange so anyone that is subsidy-eligible can't get it unless they want to pay full price.

The Covered CA brochure says Anthem has 300 hospitals and 30k physicians. Anthem's own brochure shows they have 370 hospitals and 82k physicians (see page 3 under "network discounts") - http://docs.anthem.com/wellpoint/doc...r=CABR10003SPR

So obviously the exchange PPO plans have a significantly smaller network of doctors than the regular plans do, and that does not even factor in the national BlueCard access.

I have hundreds of clients and almost all of them opt for PPO plans with national networks, usually BCBS plans because they have the largest national network. Local/regional networks can severely limit the options when you have a chronic disease or need a specialized surgical procedure or treatment, and having to go out-of-network for that type of treatment is cost-prohibitive to most people.

The poor have Medicaid, it is the middle-class that gets squeezed in the existing health insurance market and they are still the ones getting squeezed in the post-2014 market. You can lol @ the cost difference all you want, but for family plans you are talking hundreds of dollars per month difference in premiums which is an expense that most people can't afford. My brother, his wife, and their newborn baby currently pay $273/month for an HSA plan with BCBS that has a $5k deductible and 100% coverage thereafter. Their cost in 2014 is going to be at least double that price for a family plan and probably closer to triple that price since they will not qualify for a subsidy.

Let's see what the family rates are for the major carriers like BC/BS/HealthNet/Kaiser and we can compare those to the existing plans too. I find it interesting that most people buying on the individual market are families, yet they did not release a single family rate in their marketing presentation.

I may have more to say if I have time tomorrow, but there's no such thing as a family rate anymore. Each person in the family gets a rate based on age and area and the rates all get added up. The only exception is if you have more than 3 kids on the plan only the first three are used to calculate premium.

Seriously though when you said "focused on the silver plan", that was spin. That was your attempt at bravado or whatever.

Great, so for a family silver plan you can figure it will cost $600/mo at a minimum and more like $1000+/mo for most families. $45 primary care copays, $65 specialist copays, $25 generic Rx copay, probably $50-100 brand name copays, plus a $12k+ annual out-of-pocket maximum. Sounds pretty affordable to me.

That rating system for families is also state-dependent, not every state will operate that way even if CA does.

No that part is federal law (the family rating)

Law might be the wrong term, but it's in the federal regulations.

Can you show me where? Have not seen that mentioned by any of the insurance companies I sell for. Seems like something that would be left up to each states DOI.

http://www.gpo.gov/fdsys/pkg/FR-2013...2013-04335.pdf

Page 5.

Looks like there's an exception for states with pure community rating if the state chooses.

lol okay. All the issues on the table and that's all you got?

Interesting, had not seen that before. That's how Anthem prices their policies now, but did not receive notice from any insurance companies that price differently that this will be the case. For example, CareFirst BCBS currently charges premiums the same way group policies do (individual, individual + spouse, individual + children, family) so looks like they will have to change their entire premium structure. A family of 5 is going to get absolutely crushed with premium increases. Even using the CA rates that have been posted which are supposedly so "affordable", a family of 5 would be looking at over $1000/month just for a silver plan.

I have no idea what you mean by "all the issues". You don't understand what the law does, your post was talking point soup full of handwaving.

I think the single most illustrative post you've made this is one, in response to goofball saying ACA not increasing premiums

Like goofball's post is just his opinion and frizbeedog is being gracious and civil or some ****. It either increased the premiums or it didn't. That's a fact. That's like, the central fact we are debating. goofball isn't entitled to believe that unless it's true.

Dude, none of us here are your mom. We don't need to nod thoughtfully when you post uninformed nonsense and congratulate you like you're "entitled" to believe whatever. Not the way it works.

Little kids cost $200/mon to insure too ?