The Great ObamaCare Debate, Part 237: Back to Court - Page 501 - Politics and Economics

Because young adults will be cross-subsidizing older adults, they need to enroll in sufficient numbers for that cross-subsidy to be sufficient. In other words, if 7 million people enroll in the new health insurance marketplaces – which is what the Congressional Budget Office has projected – then 40% of them (or 2.8 million) would need to be young adults (assuming a similar proportion enrolled in ACA-compliant plans outside of the marketplaces as well). If 5 million people enroll, then the target for young adults would be 2 million.

If enrollment among young adults falls short, then the total amount of premiums collected by insurers will be less than the total health care expenses of enrollees plus administrative overhead and profit. And, if insurers believe that those enrollment patterns will continue into 2015, then they may raise premiums higher to compensate for the loss.

However, because premiums are still allowed to vary substantially based on age, the financial consequences of lower enrollment among young adults are not as great as conventional wisdom might suggest.

We simulated the effects of two scenario

Quote:

Scenario 2: Young adults age 18-34 enroll at a 50% lower rate than other individuals relative to the potential market. Under this scenario, young adults would represent 25% of enrollees, substantially less than their share of the potential market. It is roughly comparable to what Covered California reported for October and November (the first two months of open enrollment), with 21% of all enrollees who picked a plan in the 18-34 age range. However, this is likely a worst-case scenario, since the expectation is that older and sicker individuals are more likely to buy first and that younger and healthier people will tend to wait until towards the end of the open enrollment period (which concludes March 31, 2014). In fact, our recent survey of people in California who are uninsured found that 58% of young adults said they planned to get coverage in 2014. But, if this more extreme assumption of low enrollment among young adults holds, overall costs in individual market plans would be about 2.4% higher than premium revenues.

05-05-2014 , 02:31 PM

#12502

FlyWf

It's the other way

Join Date: Apr 2004 Posts: 58,097

NHA, you need to be slightly less arrogant. I know you're like, super excited to share with the rest of the class this BREAKING ****ING NEWS that you just learned last week about how the exchanges work, but dude, we know.

That's the ****ing point.

The old, poor, and sick are subsidized by the young, rich, and healthy. What ****ing alternative does ikes want? (remember, he "supports" Obamacare)

Note: This is exactly how it works in group insurance, right now. Like as we speak I am currently subsidizing my boss' health insurance. He makes more money than me! WHAT AN OUTRAGE!

05-05-2014 , 02:33 PM

#12503

schu_22

Carpal \'Tunnel

Join Date: Jan 2012 Posts: 38,519

sigh

05-05-2014 , 02:39 PM

#12504

FlyWf

It's the other way

Join Date: Apr 2004 Posts: 58,097

FFS if you increased the allowable age-related price differential you'd just be redistributing the premium support taxes.

This isn't a sincere problem that ikes has identified and wants to solve, it's some **** he heard that he thinks he can fashion into an anti-ACA talking point because he's furious his dad's money is buying black people health insurance.

05-05-2014 , 03:05 PM

#12505

NHA

banned

Join Date: Apr 2014 Posts: 1,809

it's pretty easy to discern ikes's argument imo... one that the less wealthy, less secure 18-34 shouldn't subsidize the higher salaried 50-62. obviously, he's missing the point that the healthcare costs of those older ones is much higher relative to the salary difference.

it's obvious to me that 28% is too low.

Last edited by NHA; 05-05-2014 at 03:24 PM.

05-05-2014 , 03:25 PM

#12506

The REAL Trolly

old hand

Join Date: Mar 2014 Posts: 1,603

Quote:

Originally Posted by neg3sd

That was a slogan from the fifties. It was the Washington Senators then.

Ya, OK, but you get that it has nothing to do with the point you were making, right?

05-05-2014 , 03:41 PM

#12507

[Phill]

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Join Date: Jun 2004 Posts: 52,717

Quote:

Originally Posted by NHA

Its a really poor argument though. It fundamentally breaks the idea of spreading risk, there is a reason the ACA and insurance in general works this way.

No one is confused that 28% is "too low", btw. When the Republicans stop telling young people to avoid signing up and when the penalties designed to get them to do so kick in for real the figure will rise quickly.

If anything 28% should be higher than expected in year one for obvious reasons I shouldnt need to go into.

05-05-2014 , 03:43 PM

#12508

ikestoys

banned

Join Date: Nov 2006 Posts: 94,424

Quote:

Originally Posted by NHA

But I'm not missing that point. Those subsidies only go to people who actually need them. With the different age-related rules, everyone gets that subsidy, regardless of ability to pay. That's dumb imo.

Hint: Never, ever, ever, reflexively agree with fly itt.

05-05-2014 , 03:48 PM

#12509

ikestoys

banned

Join Date: Nov 2006 Posts: 94,424

Quote:

Originally Posted by [Phill]

.

No one is confused that 28% is "too low"

It's a perfectly reasonable assumption that this post:

Quote:

Originally Posted by grizy

And unlike what GOP is suggesting (some would even say hoping) for, judging by the net changes, a big chunk of the signups are in the 18-34 group

comes from someone who doesn't think that 28% is too low. Sure as hell seems to be what he's saying. The youth sign up numbers are a problem.

05-05-2014 , 03:51 PM

#12510

ikestoys

banned

Join Date: Nov 2006 Posts: 94,424

Quote:

Originally Posted by FlyWf

See guys, fly just knows that I'm an ******* who wants to watch poor people burn. If you start from that assumption, you can always be right in this thread... at least in your head.

Fly, this is a perfect example of why you aren't on my level. You have little advanced understanding of this issue beyond DEMOCRATS GOOD, REPUBLICANS BAD!

Yo schu, remember me laughing at your post earlier? This is exactly why. This is the type of **** I deal with whenever I post itt.

05-05-2014 , 04:35 PM

#12511

FlyWf

It's the other way

Join Date: Apr 2004 Posts: 58,097

Quote:

Originally Posted by NHA

LOOOOOOOOOOOOOOOOOOOOOL

Yeah, definitely, that's actually a really excellent point. Problem identified by ikes. Solutions might be tough to come up with, but here's my stab at it:

What if we had some sort of comprehensive premium subsidy system that helps poor people pay their premium, but phases out as income increase? Would that solve ikes' very sincere concern that he apparently developed just recently? This way rich older people are paying close to full freight, while poor younger and older people get some help getting Affordable Care.

Maybe that do it?

05-05-2014 , 04:42 PM

#12512

ikestoys

banned

Join Date: Nov 2006 Posts: 94,424

Quote:

Originally Posted by FlyWf

Again, no, it wouldn't. The old person's 'full freight' is already cut significantly. Here's an idea, why don't we properly charge people, then use the subsidy system?

05-05-2014 , 04:44 PM

#12513

MrWookie

Don't Call Me Meredith

Join Date: Feb 2005 Posts: 94,159

Quote:

Originally Posted by ikestoys

Again, no, it wouldn't. The old person's 'full freight' is already cut significantly. Here's an idea, why don't we properly charge people, then use the subsidy system?

Yeah,and while we're at it, why don't we just charge people who are already sick more?

05-05-2014 , 04:45 PM

#12514

grizy

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Join Date: Dec 2006 Posts: 20,576

The current age curves are made so even the oldest brackets are profitable. This was intentionally since nobody was all that sure how strong the adverse selection effect was going to be.

It turned out to be not all that bad.

05-05-2014 , 04:45 PM

#12515

ikestoys

banned

Join Date: Nov 2006 Posts: 94,424

Quote:

Originally Posted by MrWookie

Yeah,and while we're at it, why don't we just charge people who are already sick more?

Say what you're trying to say directly here or walk away. I'm 100% right on this.

05-05-2014 , 10:00 PM

#12516

neg3sd

banned

Join Date: Nov 2008 Posts: 3,335

So you guys think the federal govt should completely take over the entire healthcare system. Look how well the govt has run the VA

https://www.google.com/search?q=va+h...sm=93&ie=UTF-8

http://www.azcentral.com/story/opini...ngton/8636909/

One year wait times in Phoenix.

http://en.wikipedia.org/wiki/Walter_...eglect_scandal

Walter Reed Army Medical Center (WRAMC) in Washington, D.C. has had several cases of patient neglect and shoddy living conditions which were reported as early as 2004.

05-05-2014 , 10:14 PM

#12517

Benholio

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Join Date: Jun 2004 Posts: 8,292

Who said the federal government should completely take over the entire healthcare system? That's not a requirement for universal healthcare...

05-05-2014 , 10:18 PM

#12518

NHA

banned

Join Date: Apr 2014 Posts: 1,809

if negs is anything other than a spambot that regurgitates the same talking points, i'll be sorely disappointed

05-05-2014 , 10:18 PM

#12519

ikestoys

banned

Join Date: Nov 2006 Posts: 94,424

Benholio please, 'so you guys think the federal govt should completely take over the entire healthcare system' is an entirely fair characterization of the attitude here.

The VA stuff is obviously far more complicated.

05-05-2014 , 10:23 PM

#12520

Benholio

Carpal \'Tunnel

Join Date: Jun 2004 Posts: 8,292

Quote:

Originally Posted by ikestoys

Did I miss some posts saying that the govt should run the hospitals and doctors offices, etc?

05-05-2014 , 10:24 PM

#12521

ikestoys

banned

Join Date: Nov 2006 Posts: 94,424

If the government takes over in a single payer model and is in charge of everyone, they are running the hospitals and doctors office. They control the money. You're trying to make an absurdly fine semantic point that is meaningless.

05-05-2014 , 10:33 PM

#12522

Benholio

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Join Date: Jun 2004 Posts: 8,292

Quote:

Originally Posted by ikestoys

So the difference between Cuba's healthcare system and Germany's is just semantic?

05-06-2014 , 08:54 AM

#12523

neg3sd

banned

Join Date: Nov 2008 Posts: 3,335

http://www.huffingtonpost.com/2014/0...n_5175942.html

Quote:

In the HBO documentary "Paycheck to Paycheck: The Life and Times of Katrina Gilbert," cameras captured the day-to-day struggles of a single mother of three working as a full-time certified nursing assistant. Thirty-year-old Gilbert fights to support herself and her three children on $9.49 an hour, which amounts to an annual salary of roughly $18,000. After taxes, Gilbert's bi-weekly take-home pay is $730.

In San Francisco CNAs get paid about $20 an hour. Why should people from poor rural areas pay as much for healthcare as wealthy people from urban areas? The USA is much larger than any country on single payer. There isn't a homogeneous cost of living through out the USA. Doctor visits should be cheaper in rural Tennessee than in wealthy metropolitan areas.

05-06-2014 , 08:57 AM

#12524

grizy

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Join Date: Dec 2006 Posts: 20,576

Because it's a lot more expensive, on a per patient basis, to provide rural healthcare.

It's not close at all.

If anything, rural patients should be paying more, a lot more, than urban patients.