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Politics : The Trump Presidency -- Ignore unavailable to you. Want to Upgrade?

To: RetiredNow who wrote (45234)	11/15/2017 5:58:49 PM
From: neolib	Read Replies (2) \| Respond to of 364829

Fundamentally what happened is that the group plans, whether large group or small group, already were prevented from excluding based on pre-existing conditions. They did often have a waiver period of 6-months to a year, but after that you were covered. The Indy market did not. Which is why the problem of preexisting conditions is largely an artifact of unemployment. But as a result, the group plan premiums have reflected the increased cost of covering those with preexisting conditions all along, whereas the Indy market has not, and the huge inflation in the Indy market has mostly been driven by this issue. It actually has been worse in the Indy market because its a smaller market, and the pool of people uninsured was enhanced with the sick. What Obama, and many others failed to understand is that health care cost inflation has been killing wage growth for years. That is employee cost to a company have not been stagnate for the last 2-3 decades, as is often claimed for the middle class, its just that most the increase compensation has gone to healthcare premiums, and in recent years, companies have started to force more of that as cost share on the employee. But there has been constant steady increases in the cost of insurance even in the group markets. That is money which could have gone home with the employee, as far as the company was concerned, its a cost of having the employee to them. The problem in the USA prior to the ACA is that IF you developed serious health problems, then often that would lead to loss of employment, and that would then shortly lead to loss of insurance, and then you would find yourself in the Indy market, where preexisting conditions allowed you to be excluded. It was a double wammy as well, because there is well known employment age-discrimination, and part of that is because older employees have more health issues, and hence drive up the group premiums. So companies and insurers had great motivation to see older employees exit the work force, and get pushed into the Indy market, where those with health issues could be screwed. The ACA correctly tried to fix that problem, but they should have fixed it by spreading the cost over the entire health insurance market of cr 200M people, rather than just the Indy pool of cr 20M. That was a major screwup.