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It was announce yesterday that Health Insurance Premiums in Ohio are going up 88%. If Golf is still selling health insurance policies looks like big paydays are ahead for him.
Posted by easyed598
Actually this is from a Forbes magazine article that appeared on Monday. However if you read the article. the 88% is a highest estimate and does not apply to most people. Here is a link to the article:
There are a lot of things that one must understand first. Ohio Insurance Commissioner Mary Taylor is also the Lt Governor and has no prior experience in the insurance business. She is an elected official and has a political axe to grind. She is also an accountant by trade. Normally the insurance commissioner is appointed by the governor and usually has extensive experience in the insurance industry so they have some idea of the industry they are supposed to regulate. Mary Taylor is a politician who has opposed the ACA from the get go.
Another thing is that many existing policies sold on the individual market are limited benefit policies that offer skimpy coverage. They are sold mostly on the basis of price so their appeal is high for those who have to get insured through the individual market. One commonly sold limited benefit policy has a lifetime cap of $250,000 and an annual cap of $50,000. A serious illness would expose someone insured under that policy to large madical bills that could bankrupt them. Other policies have scheduled benefits soch as another commonly sold policy that pays a maximum of $200 per day for hospital confinement and has a surgical schedule that maxes out at $5000 for open heart surgery (when the surgeon's charge is closer to $20,000). Another commonly purchased individual policy only pays benefits if the person is confined to an hospital overnight and does not cover any outpatient services. Others have annual deductibles of $10,000 (which is not permitted under the ACA).
Of course those type of policies are much less costly, but they are nothing but junk health insurance. They leave the person wide open to exposure to large medical expenses if they have a serious illness or injury.
The largest increase in health insurance premiums under the ACA would be among young adults since the ACA requires that premiums for the oldest age group be no more than three times the premiums for the youngest age group. So you might say that the young are subsidizing the old. Also premiums are unisex rated so there is no difference between premiums for men and women.
Also maternity benefits have to be included in all policies offered through the exchanges and be covered as any other illness. Presently normall maternity expenses are excluded unless the person insured purchases a rider for that benefit. Maternity riders are very expensive and do not offer full coverage. In more than 36 years in the insurance business, I have never sold an individual health insurance policy with a maternity benefit. Complications of pregnancy are covered and that includes an involuntary c- section. But if a woman has had one previous c-section, she is often rejected for coverage completely and is uninsurable.
Another thing that is not stated in this article is that the greatest difference in premiums will be among younger adults, but young adults up to age 26 can now be covered on their parent's group health insurance plan. Many young adults have already taken advantage of that already. Plus younger adults are most likely to be eligible for a premium subsidy since their earnings are often not as much as older adults. People with incomes less than 400% of the federal poverty level ($32,400 per year for a single adult) will be eligible for a premium subsidy. That subsidy works so that the cost of a basic level "bronze" plan through the exchanges will cost that person no more than 8% of their federal adjusted gross income. So in the example given on this thread, a young adult earning $30,000 a year would pay no more than $200 per month for health insurance no mater what the actual premium for that policy would might be. This premium subsidy would limit the amount anyone would have to actually pay for their health insurance that is purchased through the exchanges regardless of what the actual premium might be for the health insurance.
This headline is a perfect example of the scare mongering that the Republicans are trying to do to undermine the implementation of the ACA. While on the surface some health insurance premiums may increase 88% over previous rates for some groups, it ignores some key facts and hides the actual truth. For someone like the Ohio Insurance Commissioner who is in charge of regulating the insurance industry in Ohio to say something like this is sheer irresponsibility and pure politics. Mary Taylor is unfit to be the Ohio insurance commissioner and should resign that position. Ohio needs a professional in the position of insurance commissioner who understands the insurance industry, not an elected official with a political axe to grind with no insurance experience.