WaPo: "Suddenly, Obamacare Is More Unpopular Than Ever"

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You have to give credit where credit's due to the Republican Lie Machine. The Democrats could never pull a con like this off.

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The problem is that people are seeing their rate increases/benefit reductions, which have been demonstrated to be lower on average this year than in pre-ACA years, and blaming it entirely on Obamacare.

Secondly, people don't grasp that, at least in individual health insurance, each age has a different rate. Therefore, if there's a rate hold, each individual gets a higher rate the next year because they're a year older. The only way an individual will see their rate stay the say is if the overall rates go down. This makes rate increases look worse to the individual. I wish insurance companies would do a better job of publicizing this fact.

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You could just as accurately argue "The only people who oppose ACA are those who believe it's something other than what it actually is."

It's not a government takeover of health care, it's not death panels, it's not causing millions of people to lose their insurance, it's not responsible for the all of the rate increases people are seeing, it's not remotely Socialist or Communist, it's not "literally killing people," it's not forcing Catholics to take buy control, etc., etc., etc.

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It doesn't have "death panels"......anymore.

It never had death panels and there has not been a change that could be spun as "removing them."

It did cause millions to lose their health insurance when private insurers dumped people into the government system.

People who had "insurance" that covered a couple doctor visits a year with 5-digit deductibles and no drugs didn't have health insurance at all. For whatever reason, people are extremely short-sighted and go for whatever they can find with the lowest premiums, not the lowest expected combined costs out of pocket. Thankfully, the ACA has stepped in and made sure that people's insurance caps out-of-pocket spending at $6350 (will rise yearly with inflation).

Oh, and stupidly, Obama allowed such "insurance" to be renewed through 2016 anyway, so the "cancellations" aren't really an issue yet except for people who live in a few Democratic states that overruled Obama on this.

Covering people with pre-existing conditions, expanding coverage to non-insurable services, and forcing various demographics to subsidize care for other demographics is the cause of rate increases.

Everyone's rate didn't increase. The younger and healthier you are, or if you're male, the more likely it is that your premium rate went up, but even then it most likely included more robust benefits.

People who are female, older, or most importantly, have pre-existing conditions, may have seen their rate go down, or they may have been finally allowed to purchase insurance.

Yes, the overall average rate had to go up because 10s of millions of the most "expensive" people were immorally locked out of the system. There's really no way around this other than to say shame on our society for locking those people out for so long. However, by mandating full coverage on screenings and preventive services and putting in programs like Risk Adjustment that encourage insurers to get all of their members in for preventive checkups, the ACA over the years will cut down on the preventible costs.

ACA is obviously socialistic in nature, though it doesn't impose single-payer or nationalized healthcare.

What? You're just going to say a capitalistic program is "obviously socialistic" because even you know that's indefensible? Regulation is not the same thing as socialism.

ACA is forcing employers to buy birth control services, regardless of the owner's religious convictions; however, the Hobby Lobby ruling allows religious exemptions for certain kinds of birth control procedures and medication.

Yet again, paying part of someone's insurance bill is not the same thing as paying for what that insurance covers. Funny how no one cares about Jehovah's Witnesses being "forced" to pay for blood transfusions or Christian Scientists being "forced" to pay for any kind of medical treatment. No, the only reason the Right gets fired up about birth control is because they don't think women should be having sex unless it's specifically to get pregnant.

You like ACA because you don't know what it is.

Oh right...

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I don't pretend to know everything about the law, but your understanding of ACA and the economics of insurance is not substantial enough for us to have meaningful conversation.

Whatever man. Anyone who doesn't have the same opinion as you just doesn't know what he's talking about. Even if said person is a health actuary.

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What are some of the features that a Gold plan has that a Silver doesn't, or a Silver vs. a Bronze? I really thought it was just about access to a broader network of doctors and lower copays and deductibles. Do you know of any examples?

I recall your mentioning some months ago how women in that age group were not pleased to be paying for contraceptive coverage because they didn't need it, but that I believe is common to all levels.

The only definite difference in the metal levels is the Actuarial Value, which is the expected % of claim dollars the insurance will pay for a member. In actuality this will vary wildly, but the average Gold member will have to pay 20% out of pocket (copays + deductible + coinsurance), while the average Silver member will pay to pay 30% out of pocket.

Depending on the company, Gold plans might also have better networks, more drugs covered or other extras, but they don't necessarily have to.

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What are some of the features that a Gold plan has that a Silver doesn't, or a Silver vs. a Bronze? I really thought it was just about access to a broader network of doctors and lower copays and deductibles. Do you know of any examples?

I recall your mentioning some months ago how women in that age group were not pleased to be paying for contraceptive coverage because they didn't need it, but that I believe is common to all levels.

Unfortunately I didn't take enough notes last year to answer that. I do recall that a frequent complaint was from people who wanted to keep their network of doctors, and were willing to pay more for co pays or deductibles. However, they complained that as one went up the ladder all aspects improved and of course got more expensive. There wasn't the kind of trade off one might find for other types of insurance where only one aspect was improved.

That's the fault of the insurance company for not offering the exact plan the member wants, rather than the fault of the ACA. There's nothing preventing insurance companies from offering dozens of combinations of networks and copay/deductible combos, as long as they have enough actuaries and time to calculate the rates.

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I was thinking more like car insurance. There's a mandated minimum policy that is set by the state. You can then add on additional liability and collision coverage, as well as separate items like loaner cars or vehicle replacement. PPACA has a mandated minimum plan, but I should be able to separately price co-pays, deductibles and service coverage beyond that minimum. Most of the complaints I heard during the initial rollout were from women with adult children but too young for Medicare. They had existing insurance that was cancelled and they found that bronze was below what they were used to, but silver had service networks below their expectation but priced up other pieces which didn't matter as much to them. Gold simply was way above their previous price point and had lots of features they wouldn't normally request of a policy that clearly drove up the cost.

That would be a whole lot of work for the actuaries, thus raising the administrative costs of the plan. How much specialization do you advocate?

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I assume that "gold" plans cover more stuff and "silver" plans have higher premiums or out-of-pocket expenses, whereas "bronze" plans must be the sort of insurance that paranoid but healthy young adults would have bought even without a mandate, and are just in case of seriously catastrophic events. 

It's ... really not that hard. The higher on the list, the more benefits a plan has (lower deductibles and copays, and potentially but not necessarily a better network), but it also costs more in premiums:

Platinum
Gold
Silver
Bronze

Anyone confused by this is trying to be confused.

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I was thinking more like car insurance. There's a mandated minimum policy that is set by the state. You can then add on additional liability and collision coverage, as well as separate items like loaner cars or vehicle replacement. PPACA has a mandated minimum plan, but I should be able to separately price co-pays, deductibles and service coverage beyond that minimum. Most of the complaints I heard during the initial rollout were from women with adult children but too young for Medicare. They had existing insurance that was cancelled and they found that bronze was below what they were used to, but silver had service networks below their expectation but priced up other pieces which didn't matter as much to them. Gold simply was way above their previous price point and had lots of features they wouldn't normally request of a policy that clearly drove up the cost.

That would be a whole lot of work for the actuaries, thus raising the administrative costs of the plan. How much specialization do you advocate?

The same level that I can find for car insurance. That level of flexibility involves a simple table for each feature and has not driven up car insurance costs.

Health insurance is a whole lot more complicated than car insurance. A car insurance policy is going to max out in the low 5 digits, and in the 4 digits for most people. There are all kinds of complicated induced demand factors for every feature, making the mix-and-match options not really viable. If you make everything ala carte, you have to factor in that only people who need the features are going to buy it and adjust the numbers accordingly (but avoiding the "death spiral").

ACA or no ACA, health insurance companies just aren't going to be able do that.

Having said all that, if you find the Illinois Exchange website not user-friendly enough, aren't you in the perfect position to actually do something about it for 2015? You don't seem like the "We'll never do a single thing to help Obamacare in the slightest type, even that means hurting our constituents!!!!1" type of Republican that are so widespread in DC.