re: TrumpCare fines will cost young healthy Americans more than Obamacare

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Doesn't sound like a mandate to me.

The company doesn't even have to do it if they don't want to.

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This mechanism is designed to serve the same purpose, it is the stick to juxtapose the carrots of subsidies.

It is meant to encourage coverage, because in order for insurance to be affordable you need plenty of healthy people paying into the pool.

The problem is there is no guarantee this will have the same intended effect. Which is to be a mandate without actually being a mandate.

As is, a number of economists I have read predict it could very well have the opposite effect. Where young or healthy people will just wait til they get sick, pay a one time 12 month penalty and be done with it. ultimately making the pools less healthy and more expensive. Or more stay out of the individual market entirely. Which coupled with less generous subsidies that aren't tied to income or the price of plans in an area, could heavily exacerbate the problems we are already seeing in the exchange markets.

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As is, a number of economists I have read predict it could very well have the opposite effect. Where young or healthy people will just wait til they get sick, pay a one time 12 month penalty and be done with it. ultimately making the pools less healthy and more expensive. Or more stay out of the individual market entirely. Which coupled with less generous subsidies that aren't tied to income or the price of plans in an area, could heavily exacerbate the problems we are already seeing in the exchange markets.

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It would probably be better to have condition specific copays that disappear over time. That way, there is no coercion but you can still protect individuals from being locked out of insurance and protect risk pools from people who game the system.

You'll also need to scale back all of the "essential" coverage requirements that are making it impossible for young, healthy people to afford a decent plan.

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It would probably be better to have condition specific copays that disappear over time. That way, there is no coercion but you can still protect individuals from being locked out of insurance and protect risk pools from people who game the system.

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Wouldn't that require removing the regulations on discriminating against pre-existing conditions? Which opens up a whole new can of worms if we go back to that?

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Wouldn't that require removing the regulations on discriminating against pre-existing conditions? Which opens up a whole new can of worms if we go back to that?

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You can still have guaranteed issue and portability.

All that would prevent is people waiting until they're sick before they enroll. Maintain coverage and your condition can't be considered preexisting. A short lapse and you have only a minimal reduction in benefits. Go years without signing up, and you pay extra for your claims for the next few years.

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It's mandatory when you say get it or pay a fine.

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so, under the proposed plan, what fine do you pay for not buying insurance?

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so, under the proposed plan, what fine do you pay for not buying insurance?

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I think the economic argument would be you pay a deferred penalty when/if you decide to purchase insurance.

Instead of a continuous penalty you must pay every year, you instead are only subject to a 1 year penalty the year you decide to purchase insurance, a penalty paid directly to the insurer.

That last part is also why some think that mechanism may not pass the reconciliation parliamentarian, since it is not directly addressing federal spending. And would be a major blow to the legislation being able to function properly. Since it would cut the biggest provision that tries to deal with the adverse selection problem.

That's all fine and dandy until shite goes sideways. I have always carried insurance and really only go to the doctor twice a year. Once for checkup and once to the lady doctor. Then one day during a checkup cancer was discovered. No terrible symptoms, no warning, I've never smoked, slim, eat healthy etc. During same year husband who never goes to the doctor except for a yearly checkup needed emergency surgery to remove his gallbladder. shite happens. Being uninsured is irresponsible. I know I didn't have the 200k my insurance paid out last year for both of us saved. God knows how much we'd owe if I had needed chemo and radiation and had no insurance.