No. of Recommendations: 7
This is going to be a monkey wrench for early retirees, potentially.

https://thehill.com/policy/healthcare/421511-federal-judge-i...
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If you read the article, both Democratic and Republican legal experts see little chance the ruling will survive Supreme Court review.

intercst
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Yes, I read it. Sheesh.

I agree, there seems to be little chance the full decision will be upheld, but I can also see that the uncertainty of a final decision and/or the possibility that provisions could be eroded further could affect someone's decision to retire early and rely on ACA coverage.
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If you read the article, both Democratic and Republican legal experts see little chance the ruling will survive Supreme Court review.

Would you bet your life on it?

Andy
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buynholdisdead asks,

<<If you read the article, both Democratic and Republican legal experts see little chance the ruling will survive Supreme Court review.>>

Would you bet your life on it?

</snip>


I would, but fortunately I live in a Blue State with strong, consumer-focused, insurance regulation, so I don't have to.

If I still lived in Texas, or another Red State crap hole, I'd be more worried.

intercst
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I haven't read 50 stories on it yet but all I get from this is the penalty for not buying insurance is dis-allowed. Nobody has "struck down the ACA." Altho language like that has been used in articles e.g. "ACA cannot be allowed to stand...." Wrong. At least in my early readings.

What I'd like to know (and I'll bet intercst probably already has the numbers, heh heh) is:

Just how many people were "forced" into buying insurance due to the penalty?
How many people said "Screw it" and paid the penalty?
How much money was that and how salient to propping up the ACA was it?

I keep hearing that the ACA ultimately affected relatively few people anyway, hence it's
not-overwhelming support. IOW I guess, even without that penalty "herding" people into buying insurance how many would stop buying insurance and therefor undermine the structure?
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No. of Recommendations: 36
The strike down is because of the mandate, but “because the mandate cannot be separated from the rest of the law, the rest of the law is also invalid.”

Your comment
I keep hearing that the ACA ultimately affected relatively few people anyway, hence it's
not-overwhelming support. IOW I guess, even without that penalty "herding" people into buying insurance how many would stop buying insurance and therefor undermine the structure?
is interesting.

The ACA has actually affected A very large number of people: pretty much anyone with health insurance obtained either thru the exchanges or employer sponsored or on Medicare. Please recall that it allows kids to remain on their parents’ policy until age 26. It mandates certain things be paid for at 100% by carriers—mammograms, colonoscopies, etc if one has no history. It closes the “donut hole” for Medicare drug coverage. It prevents someone from being denied health insurance fire pre-existing condition. All of these individual things HAVE, in fact, had overwhelming support by the majority of Americans.

Anyone who says it doesn’t affect that many people is incorrect. All of that stuff I listed above potentially goes away if the ACA goes away.
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OK, I thought it was evident due ti my referencing of the individual mandate. I meant didn't affect many individuals buying individual insurance. Of course it affected lots of people en toto
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Just how many people were "forced" into buying insurance due to the penalty?

I'm more interested in how many people could finally afford insurance for themselves and their families. And how many people who were previously considered "uninsurable" and can now finally have meaningful coverage.




I keep hearing that the ACA ultimately affected relatively few people anyway, hence it's
not-overwhelming support.


I don't know if that's because of who you are listing to or because of how you define "relatively few". The numbers I'm finding indicate that approx 10 million people made at least their first month's premium payment last year. And about half that many were also aided by the medicare expansion programs.
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From the article.

U.S. District Court Judge Reed O'Connor ruled that the law's individual mandate is unconstitutional, and that because the mandate cannot be separated from the rest of the law, the rest of the law is also invalid.

This seems to be a questionable ruling as the ACA Individual Mandate Penalty has been reduced to $0.00 for 2019. Congress effectively eliminated the Individual Mandate provision of the law by setting the penalty to $0.00 in 2017.
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This seems to be a questionable ruling

Probably an Activist trying to make some kind of statement. i.e. "Let 'em die!"
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This seems to be a questionable ruling as the ACA Individual Mandate Penalty has been reduced to $0.00 for 2019. Congress effectively eliminated the Individual Mandate provision of the law by setting the penalty to $0.00 in 2017.

IANAL, but I read that the Supreme Court (essentially: Roberts) ruled that the only thing that made ACA constitutional was by calling the Individual Mandate Penalty a tax. If this "tax" is now gone, then that peg is no longer there to make it constitutional.

Not that legal reasoning has anything to do with the matter. Long ago the SC decided that they could do whatever they wanted, they just needed to find (or ignore) various words in the Constitution that would give them a fig leaf to rule the way they wanted.

And as intercst said up above, each state can decide on its own what it wants to do with insurance. No reason that Kansas should be able to tell California what kind of health insurance they must have. Or vice versa.
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And as intercst said up above, each state can decide on its own what it wants to do with insurance. No reason that Kansas should be able to tell California what kind of health insurance they must have. Or vice versa.

That isn't what is happening. The Federal government is telling the states what they have to have for insurance and the states can then add onto that as they see fit. No state is telling another state what they must have.

Andy
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Please recall that it allows kids to remain on their parents’ policy until age 26.



+++
+++


Thanx for reminding us of the ACA's Snowflake & Slacker Protection provision.


{How did we ever exist BEFORE this protection?}
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Thanx for reminding us of the ACA's Snowflake & Slacker Protection provision.


{How did we ever exist BEFORE this protection?}


Well, back then we had people that thought this way, begging people for money to pay their healthcare bills. And then claiming they weren't snowflakes or slackers.

Andy
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Thanx for reminding us of the ACA's Snowflake & Slacker Protection provision.


{How did we ever exist BEFORE this protection?}


Well, since you asked: the reality was that many, many younger people opted to go without insurance. And do you know what happens when people don’t have insurance and have a catastrophic illness or injury? They end up in bankruptcy court, and/or hospitals and providers end up compromising or forgiving the bills.

Which means, of course, the rest of us end up paying, one way or another.

Most people like this provision. Especially parents/kids in college and grad school who often had to navigate through substandard policy options.
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{How did we ever exist BEFORE this protection?}

By YOU paying for it anyway, and paying more than you otherwise would.

#1 cause of bankruptcy in America? Catastrophic medical costs without insurance coverage, or insurance denials because the condition was “pre-existing” and no coverage was available.

To cover those unreimbursed costs hospitals and doctors goosed all their other bills, including yours, to make up the difference. People who rolled the dice and didn’t have health care, or couldn’t get it because of how insurance companies assigned risks and who had large bills didn’t pay. So everybody else’s bills went up because the hospitals and doctors still needed to make payroll and buy things.

So “before” this protection, you paid, and they didn’t. And you OVERpaid to compensate.

Starting to understand yet?
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So “before” this protection, you paid, and they didn’t. And you OVERpaid to compensate.


So are you saying that hospitals, et al., now have lower pricing because ACA has corrected the need for them to OVERcharge us? (and if we're still overpaying, then what's the benefit?)

--T
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So are you saying that hospitals, et al., now have lower pricing because ACA has corrected the need for them to OVERcharge us?

Oh come now, the problems with our medical industry has taken several generations to manifest and will take a long time to resolve. ACA did not fundamentally change the way the medical industry works, it set standards for insurance plans and created a common marketplace, nothing revolutionary.

To change the problems with our medical industry changes similar in size and scope to the changes which caused the problem are needed.
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MissEdithKeeler,

You wrote, Well, since you asked: the reality was that many, many younger people opted to go without insurance. And do you know what happens when people don’t have insurance and have a catastrophic illness or injury? They end up in bankruptcy court, and/or hospitals and providers end up compromising or forgiving the bills.

Which means, of course, the rest of us end up paying, one way or another.


Yeap… But this stuff still happens. And I'm ashamed to say my daughter was one of these people.

She decided she couldn't afford insurance premiums because of her financial situation (separated, going through a divorce and no steady work) and was apparently too proud to ask for help. So rather than ask questions and look into how the system actually worked and figure out that she probably qualified for fully(?) subsidized insurance, she bought into the rhetoric and blew it all off.

And then a drunk driver hit her truck head on and put her in the hospital for a few weeks.

The hospital and associated providers had to write off about $500,000 in medical bills that neither she, the drunk driver nor either of their auto insurance coverages would pay. I suppose we all get to foot that bill in the end either way you look at it, but it was stupid for her to not have been insured when that insurance would mostly have been paid for by the federal government …

Well, at least now she knows she'd been foolish. But some people only figure these kinds of things out when hits them in the face … so to speak.

- Joel
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And then a drunk driver hit her truck head on and put her in the hospital for a few weeks.

The hospital and associated providers had to write off about $500,000 in medical bills that neither she, the drunk driver nor either of their auto insurance coverages would pay.


Very sorry that this happened to her...

But let's walk thru the options for paying.

In what I think many believe is the ideal, we'd have a single payer system where the government pays and that means working people (generally) pay taxes to cover this.

In the current real world she should have signed something giving her insurance which would then have insurance subsidized by the government and it would be paid for by taxes on working people and then by insurance companies.

What happened is she didn't sign up so the bills got paid by the hospital, insurance or the government...which got paid by, mostly working people who have insurance.

Mike
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Well, since you asked: the reality was that many, many younger people opted to go without insurance. And do you know what happens when people don’t have insurance and have a catastrophic illness or injury? They end up in bankruptcy court, and/or hospitals and providers end up compromising or forgiving the bills.

How is this different than any other form of catastrophic liability insurance? Remember, the ACA functions as catastrophic liability insurance. It is a financial product, not an access product.

So a young person is working, has a dependent or two and then falls ill and cannot work at his former job. Did he carry catastrophic disability insurance to replace some/most of his lost income? If not, that was his decision. Should we all have to pay for his unwillingness to carry catastrophic coverage? And the biggie here isn't medical...its auto liability, where one can find their way into Chapter 7 insolvency very quickly with inadequate coverage. And from my limited experience with those households who have to deal with Insurers filing to recoup their payouts to the insured individuals injured in the auto accident, these debts are not 'forgiven', as insurance companies are like terminator machines and have no sense of morality, pity or remorse...they just go after whatever they can get.

BruceM
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BruceCM,

You wrote, … It is a financial product, not an access product.

This statement isn't precisely true. There are plenty of providers that won't provide services unless you either pay at time services are rendered or provide proof of insurance. Providing proof of insurance isn't actually proof you can pay.

My daughter went through this after she got out of the hospital when she was trying to get physical therapy. Most providers that take insurance will let you set up a repayment plan for any remaining balance, so just having insurance coverage can provide you access that you might not have had without it.

So perhaps "access" isn't quite the word you were looking for...?

- Joel
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And the biggie here isn't medical...its auto liability, where one can find their way into Chapter 7 insolvency very quickly with inadequate coverage. And from my limited experience with those households who have to deal with Insurers filing to recoup their payouts to the insured individuals injured in the auto accident, these debts are not 'forgiven', as insurance companies are like terminator machines and have no sense of morality, pity or remorse...they just go after whatever they can get.


I’m really not getting your analogy here. Liability coverage is there to protect you when you screw up an injure someone else. Most (all?) states require you have coverage.

People are legally entitled to recover for their damages from a tortfeasor. If a carrier pays out that much to their own policyholder for damages and injuries (presumably under Un-or underinsured motorist coverage) why shouldn’t they collect back?

Again, people not paying for stuff they owe causes costs to go up for everyone. A carrier doesn’t get reimbursed for their payments, they have to make it up in additional premium elsewhere.

I work in insurance and this is what I do.
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Did he carry catastrophic disability insurance to replace some/most of his lost income? If not, that was his decision. Should we all have to pay

But—you are. If that person goes on Medicaid to pay his medical, you, the taxpayer, are paying. If that person has to go on SNAP because of medical bills or disability, you are paying. If the hospital writes off bills as a loss, they recoup it with higher fees to others.

One way or another, we all pay. (Which to me is the argument for universal health care).
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MissEdithKeeler writes,

A carrier doesn’t get reimbursed for their payments....

What about subrogation?


Update: Wal-Mart drops subrogation claim
https://www.overlawyered.com/2008/04/update-wal-mart-drops-s...

“Wal-Mart Stores Inc. is dropping a controversial effort to collect over $400,000 in health care reimbursement from a former employee who suffered brain damage in a traffic accident. The world’s largest retailer said in a letter to the family of Deborah Shank of Cape Girardeau County in Missouri that it will not seek to collect money the Shanks won in an injury lawsuit against a trucking company for the accident.

</snip>


intercst
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How is this different than any other form of catastrophic liability insurance? Remember, the ACA functions as catastrophic liability insurance. It is a financial product, not an access product.

A couple ways. For one, the ACA is both a financial product and an access product. Specifically, the Medicaid expansion, coverage for pre-existing conditions, no coverage caps, and subsidies for lower income individuals or families.

Another reason is that we as a society don't like the idea of people dying due to lack of medical treatment. If your uninsured warehouse burns down causing you catastrophic financial loss, bummer for you. But if are uninsured and develop cancer, you will probably get treatment.
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Yes, I’m talking about subrogation. But if someone doesn’t have insurance, or has insufficient limits and no significant personal assets, there’s no money to get.

Some carriers will opt to get a judgment anyway, arguing “well, he could win the lottery in the future...”

But technically health care providers/health insurance carriers are legally entitled to recover their payments from the at fault driver.
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