Searching for the young invisibles

The latest enrolment figures are not terrible, but not great either

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I can understand why baby boomers, the sick, the old, the government, insurers and the healthcare providers want young, healthy people to buy a product they likely won't use so as to subsidize a group of people who use (and charge) far more then can be afforded, or paid for, to support an industry designed to be extremely profitable.
But, I haven't heard of any logical reason why the young healthy types should be motivated to buy in. The lack of incentive is so great the law had to insert a penalty should they not buy a private, for profit product.
Where is the penalty/fine for old people not buying multivitamins, prostate exams, renewing drivers licenses and a gym pass? Those would go a long way to ensuring a healthier population.
Where is the penalty of not getting vaccinated?
Is this not a push by greying baby boomers who fear that they created a system (that worked quite well for them when they were young) that will collapse under their weight now, when they need it most?
They didn't pay (or regulate) to create a sustainable system and, now that they need it, but, can't afford it, the time has come to push the cost of a functional healthcare system onto another generation (again.)
I see a lot of logic and self interest on the part of the stakeholders who didn't pay enough to support their own needs but, basically no incentive for me to buy insurance.
Instead, I am forced to buy a product from a for profit company so that I can subsidise the healthcare of a generation that neither planned for the inevitable or paid the full cost of the services they demanded.
Either have a public system funded by tax revenue and use the coercive power of government to force down costs (especially in corporate gouging, lawsuits and pharmaceutical costs) or have a private system that I am free to join or not join.
ACA is a failure on too many fronts and I will likely not enroll and try to avoid the fine.
A sustainable insurance system needs charge enough to pay for the costs they promise to cover. I pay a premium today so that there is money in the coffers when I need care, not so that the cohort before me can underpay, use the government to force their costs on me, use my premiums to get their care, then leave me with a bankrupt system that I will have bail out again.
I hate to sound jaded but, this is just another example of the Me Generation consuming resources then they pay for and then using their voting power to ensure they never have to pay the full cost.
The solutions to the healthcare problems are myriad but, don't include forcing healthy people to buy products they don't need.
Hey, my university was real expensive. I can't really afford it. I think everyone in the country should sign up for the same classes I take then the price would go down (but, only if you actually don't attend the classes you paid for.) What's that? You don't need the class? Well, the school can only make money if everyone buys the class (but, only people without the credits go) so you have to buy the class or pay a penalty! That's fair isn't it, you don't want we going without the class do you!
The solution is to fix the problems that result in Americans paying much higher per capita costs then the rest of the world. We have to get away from the Cadillac healthcare model, away from corruption, and toward a system that, over the long term, becomes sustainable and where people, over their lifetimes, put in enough to cover their own costs. Any other system will fail as soon as soon as demographics change.
In the mean time the boomers should just accept that they are going to receive the services they paid for and it ain't the Cadillac version they were promised.
ACA does not go near far enough to control costs (the real problem) and is essentially 'progressive' window dressing that does little to fix any problems except ask (force) the kids to pay.
Please, inform me why I should pay (too much) for a product I won't likely use so that a group that demanded too much and paid too little can get away scott free.


Disclaimer: I voted for Obama.

Here's what the Affordable Care Act has achieved: the service industry is slashing hours for millions of workers so that the magic 32 hour mark is avoided and huge increases in health insurance costs can be dodged. People like me have seen their premiums double, their co-payments double, their deductibles double, and their actual covered services decreased.

Meanwhile no downward pressure on costs (which continue to rise inexorably) has occurred because there is no linkage between lifestyle choices and costs. I eat a very clean diet, run twice a week (20 miles total) and hit the gym for strenuous exercise every day yet my monthly premium is identical to my neighbor who is obese and never, ever passes up a cheeseburger, fries & shake. In other words, I'm subsidizing the costs he imposes on the system.

Difficult to call Obamacare a success, really... In fact, it's difficult to find anything whatsoever to say in its favor. It is an unmitigated policy disaster of the very worst sort imaginable. If the Republicans weren't irredeemably "the Party of Stupid" it would have sunk the Democrats without trace. As it is, Obamacare may linger on for a few more years, exacting a terrible toll on the economy and doing nothing at all to ease the nation's health crisis.

Simone Crady

Why can't it be more like auto insurance? Private market.. easy to get quotes. I can go online and get a $25/month auto quote from an independent site like Insurance Panda, but when it comes to health insurance, I use the government's SCAM website and have to pay out the eyeballs. WOW


‘First, how many of the new enrollees were previously uninsured? …the health department has yet to give its own figure.’

In the words of a senior official ‘That's not a data point we are really collecting in any sort of systematic way’ Most independent surveys estimate about 20% with the highest I’ve seen at 27%. Avik Roy over at Forbes estimates that less than 1 million previously uninsured will gain coverage through the exchange. For a country that supposedly had 45 million uninsured, counting Medicaid sign ups (due to the law’s expansion) and ignoring any people who have lost their insurance, Obamacare is helping less than 10% of the uninsured gain coverage…

‘Second, how many of the new enrollees are sick? Obamacare bars insurers from asking applicants about their health. This means that sick people can no longer be denied coverage.’

As mentioned, the law forbids insurers from asking this question, but the reasoning for the law is somewhat absurd because even if the insurers know that the applicant is sick they still can’t deny coverage… Of course now this rate can only be identified through claim rates. In other words, we’ll only know after the fact if the risk pool is skewed heavily towards the sick. Further, even if the average is only slightly worse than the general populace on the whole, some individual insurers might be heavily skewed towards the sick bankrupting certain insurance lines due to incorrect actuarial assumptions because the insurers were lawfully forbidden from understanding the risk of the pool.

This leads to the third question: are insurers enrolling enough young people to keep premiums down next year? Obamacare relies on fees from young, healthy people to offset insurers’ cost of covering the ill.

Hmm, this one was answered for us, about 25% of current enrollees are in the ‘young’ demographic. Obamacare’s actuarial tables estimated that the pool would need about 40% of the ‘young’ in order to avoid rate increases… So the answer is no.

One question that wasn’t asked, ‘How many people have actually paid their premium?’ Most studies show about 80%, and who wants to estimate how many of the unpaid are the young demographic?


It seems odd to me that a program that caused over four million people to lose their healthcare (roughly the entire population of Ireland)and raised the cost of practically every aspect of healthcare (my Medicare-Advantage plan premiums increased over $2000.00 per year)to the rest of us is considered a success no matter how you spin it.

Perrodin in reply to CA-Oxonian

But if you get hit by a car while running, you may end up in a wheelchair for the rest of your life, and then your obese neighbor will be subsidizing you.
(In the past ten years, my son had had surgery twice for sports-related injuries. I am twice is age and I see the doctor on the average once a year, just for minor problems.)


The ultimate irony seems to be that those who are most hostile to ACA are old white people who are either collecting or close to collecting Medicare.


Not that anyone pays attention to these comments except for other people that comment. Obama's comment about young people thinking they are invincible is incorrect at least with my children's. One has a job that he is able to pay for insurance with. One is in college and still looking for a job. One has a job but no insurance is offered (most of that is because of Obama care, I know of companies dropping their employees or giving less hours so they do not have to pay insurance because they are getting penalized for not having Obama care even though they had their own insurance). The one that doesn't have insurance through her job is a single mom that is trying to survive on her own and any extra money coming out of her pocket would be a huge issue. Obama wants her to take food off her table (that is going to happen). My husband and I, like this year he has been laid off since November, how do you justify paying for insurance when that happens. When we had insurance we barely went through our 500 ded. (it was through union so we didn't pay a monthly fee). Now the insurance is 518 a month with a 2000 deductible. We couldn't afford to pay the 518 and pay the copays they are asking and the deductible. We couldn't afford to go to the doctor but have to pay insurance. If America is being forced to get insurance then Obama needs to come up with a way to make our jobs better!! People that have been unemployed for more then 6 months, the one's that have ran out of their unemployment money, they are not counted on the percentage of the unemployed people, they are off the books. Going from making a $20/hr job to making a 7.50/hr job is not replacing your income it is getting you off the unemployment percentage. America is not getting any better we are still spiraling down and now we are being forced to pay more money out for insurance when we can use that to put food on the table, gas in the cars to get to work or find work, or even the grocery store. When you are government they are given insurance and not the Obama care and they don't lose it after they leave office. Why do they care what is happening in the world. They aren't in it!!


The released figures do not subtract those who signed up but had not paid. When all is said and done it seems as if the new figures will be at least 10% lower than the gross figures reported.


Question: How do you fix a broken health care system?
ACA answer: You force more people into it without otherwise changing a thing.

guest-seonnij in reply to Ted W14

You've missed something important, Ted W14. Before you go around calling people "not too adept," perhaps you should ask where Simone Crady lives. Insurance rates are determined by your age, zip code, and tobacco-use status. In my area, yes, 28 year olds can find more reasonable insurance. In more expensive areas, no.

guest-seoojnm in reply to Dave6457niner

Not paying more in the first place? Not true at all. My payment for a health plan is more than $150/month more than what I was paying and my deductible went from $2k to $5k. I'm being forced to pay for coverage I don't need. And wait until this all hits our income taxes.
And do you really think that someone who isn't making a whole lot of money or is in this country illegally is going to care about a tax penalty? Typical democrat brainwashed mentality. Take from those who earn what they get in this world and give it to those who expect it to be given to them.

Ted W14 in reply to Simone Crady

Um, I just looked and there are 24 plans under $300 a month for a 28 year old. Here's one:
BCBSHP Silver DirectAccess w/HSA by Anthem Blue Cross and Blue Shield Silver HMO $264 a month.
Or Catastrophic for $128.
It took me 35 minutes to enroll, you must be not too adept.

Ted W14 in reply to guest-seonnij

Okay, find the area where these mythical expensive policies exist and report back here. I'm skeptical.
There is so much intentional misinformation spewed out about the ACA and I am tired of hearing it. I had heard about how expensive and horrible it would be and it wasn't true. Just political dishonesty for the most part.

Richard Simpkins in reply to MDSMDS

Charles Gaba thinks 5%, but 10% isn't out of the question. The real $64 question is how many off-exchange enrollments there have been. We won't get that answer until mid-summer, probably, but it will be in the millions, and we haven't been counting them at all.

Richard Simpkins in reply to ParksDept

"For a country that supposedly had 45 million uninsured..."
57 million according to the CBO.
We should count the cancellations, but only if you ALSO count the same people re-upping with their insurance companies. These are part of off-exchange enrollments, and nobody is counting those, either. The reason neither of these figures are being reported is that the Media are obsessed with the number on the exchanges themselves, and neither cancellations nor replacements nor new-off exchange enrollments are being counted. Washingon State, the only state that is reporting, says that it gets more off-exchange enrollments than on-exchange. That millions (which makes sense, give the number of cancellees who had to re-up).
The benefits aren't limited to protection from being dropped. It's also so that your application process is as simple as possible and so that you need not put all of that sensitive information in your online application.
"are insurers enrolling enough young people to keep premiums down next year?"
Well, that number of 18-34 was reported at 21% in December, and had risen to 27% in February. At current rates that should hit around 30%. Including the under 18ers, more like 37%. That's not as high as is ideal, but it's within industry parameters. It would require participation below 20% to result in even a 1.5% increase in premiums. That's nowhere near what would be necessary for a "death spiral" to occur, which is why you haven't heard that particular term bandied about in recent months.
80% is pretty darned good, considering 1/3 of premiums don't come due until March 31. At any rate, Kaiser and Blue Cross both put that number at 85-87%, now. By the time the bills are due, it's likely to be 95%: http://j.mp/1gkBqyk

I'm not trying to be political. I just want to point something out so you aren't in shock when the tax man cometh. The penalty is $95 *or* 1% of your income, whichever is greater. If you are 28, the cheapest plan you can get is $500, that tells me you don't qualify for any subsidies, which tells me that you earn north of 400% of the federal poverty line. Assuming your are single you probably make north of 50k/year. If you only make that, then your fine is $500, not $95, as you assumed.
While that may still seem like a better deal to you, keep in mind that gets larger each year. In two years, it will be 2.5%, which, if you really do just make 50k, will be $1,250...and you will remain uninsured, to boot. So, if you get in an accident or get suddenly sick, you are on the hook for everything, even though you payed over a grand to the tax man. Being 100k in debt doesn't strike me as a very good deal.
Finally, where do you live that it costs $500 bucks a month at your age (again, I assume you are single). And how is it that you don't have insurance through your job if you make north of 50k? This story doesn't add up.



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