re: Federal Judge Upholds Trump’s Hospital Price Transparency Rule

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Beating an arbitrary baseline isn't "cheaper"

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The baseline isn't arbitrary. It's necessary because comparing a plan that doesn't cover maternity, or behavioral health or cancer or other services but somehow has a cap on the payer outlays shouldn't be compared directly to a product that as none of those limitations and is actually insurance. Anyway, if you disagree, take it up with the folks at Brookings.

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Second, you're only comparing ishtty marketplace policies. Policies no one wants. And almost no one buys.

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Well, the subject was premiums in the non-group commercial market so of course, I found an article that compared marketplace products to individual products pre-ACA. incidentally, the non-group market is bigger now than it was pre-ACA, so evidently more people want the shitty marketplace policies than the really shitty can't even call it insurance products that littered the non-group commercial market pre-ACA. Finally, individual policy spend makes up a larger component of hospitals' revenue than they did pre-ACA since people can actually use these products.

Anyhow, my broader point was that what's going on in the marketplace doesn't really impact the group commercial market because they are distinct and one is much much much larger than the other.

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Anyhow, my broader point was that what's going on in the marketplace doesn't really impact the group commercial market because they are distinct and one is much much much larger than the other.

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Lol. I’m going to let roadgator handle this one.

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How often do you use your Homeowners Insurance? It's there for protection in case of a catastrophic loss, not because you are using it a lot.

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Uhh...if you have a mortgage it’s there because your mortgage lender doesn’t want to have to worry about catastrophic losses associated with the house.

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The baseline isn't arbitrary. It's necessary because comparing a plan that doesn't cover maternity, or behavioral health or cancer or other services but somehow has a cap on the payer outlays shouldn't be compared directly to a product that as none of those limitations and is actually insurance.

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So if I “forecast” the the stock market will be 50,000 next week, but it turns out. it’s only 32,000... would you say the market declined 18,000 points?

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Anyway, if you disagree, take it up with the folks at Brookings.

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You (mis)quoted it. But I can understand why you won’t defend it.

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Well, the subject was premiums in the non-group commercial market so of course, I found an article that compared marketplace products to individual products pre-ACA. incidentally, the non-group market is bigger now than it was pre-ACA, so evidently more people want the shitty marketplace policies than the really shitty can't even call it insurance products that littered the non-group commercial market pre-ACA. Finally, individual policy spend makes up a larger component of hospitals' revenue than they did pre-ACA since people can actually use these products

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That’s nice.

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Anyhow, my broader point was that what's going on in the marketplace doesn't really impact the group commercial market because they are distinct and one is much much much larger than the other.

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No your original claim was that premiums had gone down significantly for individual policies.

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So if I “forecast” the the stock market will be 50,000 next week, but it turns out. it’s only 32,000... would you say the market declined 18,000 points?

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You (mis)quoted it. But I can understand why you won’t defend it.

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Let's put up my direct quote from the article again.

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Moreover, ACA marketplace SLS plan premiums are still lower in 2016 than individual market premiums were in 2013, on average, and a full 20 percent below where the Congressional Budget Office (CBO) originally projected they would be when they first estimated the impacts of the ACA in 2009.

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You are focusing on the non-bolded text as opposed to the bolded, though my point was entirely about the bolded text and I have had absolutely nothing at all to say about how actual prices in the non-group market compared with CBO projections. If your argument is that it does make sense to compare actuals to a forecast, I'd disagree with you, but for our purposes today, I'm happy to concede that it's arguable. Now let's shift back to my actual point. Here's another quote from the same article.

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According to our analysis, average premiums for the second-lowest cost silver-level (SLS) marketplace plan in 2014, which serves as a benchmark for ACA subsidies, were between 10 and 21 percent lower than average individual market premiums in 2013, before the ACA, even while providing enrollees with significantly richer coverage and a broader set of benefits. Silver-level ACA plans cover roughly 17 percent more of an enrollee’s health expenses than pre-ACA plans did, on average. In essence, then, consumers received more coverage at a lower price.

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There are a bunch of ways to attack this analysis if you're so inclined. And it seemed like you are very much so inclined. But saying I'm misreading something I'm directly quoting is weak AF. So we are where we were, if you want to make the argument that on an apples to apples basis, plan premium prices in the non-group commercial market have gone up post-ACA, take it up with Brookings, they disagree with you. If you have alternatively literature from a reputable researcher on this question, please do share.

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your original claim was that premiums had gone down significantly for individual policies.

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I'm in about five separate conversations in this thread that is about the new price transparency rule

1. with theunknownknight about the how government-mandated trade secret disclosures in the current price transparency efforts are pretty Marxist and facile (my actual original point)

2. with 808 about the how government-mandated trade secret disclosures in the current price transparency efforts are pretty Marxist and facile (my actual original point revisited)

3. with dafif about (a) why hospitals aren't required to turn over their rates to customers (b) whether or not hospitals can legally charge insured patients different prices than uninsured patients (they can) and (c.) how it is fallacious to blame increases in premiums and deductibles over the last 5 years on the ACA because total healthcare spending and then necessarily premiums and deductibles have been all rising faster than inflation for decades in a fairly linear fashion and how that trajectory has not shifted since 2014 (d.) further, the ACA is concerned primarily with the non-group market which is a small fraction of the overall commercial insurance market which also has seen rising premiums. (e.) also the ACA, according to Brookings, on an apples to apples basis, has reduced individual market policy premiums as compared to the pre-ACA period.
4. with roadgater about the impact of Health Insurance Industry Fee on premiums in the group commercial market
5. with you about 3e.

Which is to say, 3e is hardly my original claim. Also, it's not really even my claim its Brookings'

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d. There is no way this existed pre ACA. There is no way this is justified by simple inflation. There is no way these premiums were lower than in 2013.

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Pre-ACA, the policy you're referencing may not existed. In the individual market pre-ACA, you would have had to attest to your medical history and if you had a pre-existing condition, you probably couldn't get a policy written that covered it. You mentioned earlier about having a procedure a number of times over the years. Well Pre-ACA, you'd have a hard time getting a policy written that covered that procedure. Additionally, all kinds of other stuff would be excluded from most policies on general principle. Those pre-ACA were also subject to lifetime and annual caps on Payers spending, and if you did file a large enough claim, the Payers would look for discrepancies in your attestation in order to get your whole policy cancelled. We used have who teams looking for fraud in that way. The pre-ACA individual market was a jungle.

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Sit back and tell me that a jury is going to allow you to charge $100 for a bandaid to an uninsured person but only .50 for a bcbs insured. It is not going to happen. Further, the hospital will never let it happen.

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I'm not really a lawyer, I suspect as a condition of service in non emergent situation you sign some paperwork agreeing to the bill. I don't know what to tell you, hospitals do win judgments from time to time against patients who don't pay. Usually its not worth the lawyers fees so they let it go, as in your case, seemingly.

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And you're continuing to ignore the obvious. An increase in premiums cannot be called a "decrease" because some forecast was higher.

No amount of word salad will rehabilitate that.

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Let's try this again. Here's the money quote.

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Moreover, ACA marketplace SLS plan premiums are still lower in 2016 than individual market premiums were in 2013, on average

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What forecast? All I've talked about is trend, not forecasts. The quote I pulled and the accompanying chart was created in July of 2016 looking backward in time at figures from 2013-2016. There is nothing forward looking
on this chart. Brookings found that individual market premiums were $4,200 on the low end and $4700 on the high end in 2013 and premiums were less than that in 2014, less than that in 2015, and again less than that in 2016. If you think the trend is incorrect, fine, take that up with Brookings. Still not a forecast.

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Admittedly, I do not know the actual answer to this question, but I always believed that you could get a policy of insurance excluding the pre-existing condition but, after a time, they would then cover.

If mistaken, please let me know.

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Pre-ACA that it was at the discretion of the market. Meaning a policy for someone with pre-existing condition could be created, but there was no mechanism* to force any Payer to offer such a plan, so they might just not write one for you because it'd be a bad risk to do so.


*some states tried with limited success to lean into payers to make them offer plans with what we know call essential benefits.

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I don't have much of a choice since I dropped coverage. . Last year before I cancelled in October, I had paid over $12,000 for an insurance policy I hardly used. (Roughly $275 a week). The only thing that the insurance helped on was the cost of prescriptions. And I found an app that helps with the cost of those

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I found a pharmacy in Texas that charges you the wholesale cost of the drug. You pay a membership fee to be a member.

scriptco.com

This place is a membership pharmacy. Cost is $120 a year. You get your prescriptions at the wholesale cost that the pharmacy gets. No markup. It could be worth checking into if your meds are costing too much. The local Fox reporter did a report on this business and they interviewed people who showed that Scriptco saved them thousands of dollars a year.

I passed this to a relative who has to take maintenance meds. She texted me that she had one prescription that her insurance charged her $40 a month and another was $35 a month. The cost for both drugs from Scriptco was only $24 a month.

After paying the $120 member fee she still saves $492 a year over her insurance copay cost. I imagine uninsured persons would save a ton.