Thursday, September 05, 2013

Oncoming Affordable Care Act

Three weeks from now, Covered California and every other state health care marketplace goes "live" for purchases under the new Affordable Care Act.

This is important for TAG members who aren't qualified for Motion Picture Industry health coverage and are without a medical plan because there will now be alternatives to high-deductible, low-quality individual insurance.

... There are at least two insurers participating in each of the exchanges. ... Participating insurers generally will offer a number of plans at various tiers of coverage (catastrophic, bronze, silver, gold, or platinum), and they also typically offer more than one plan option within a given coverage tier.

As a result, the number of plans available to consumers will be significantly greater than he number of insurers participating. A variety of plan types (e.g., HMOs or PPOs)are offered in most exchanges. In almost all states coverage is also available to individualsoutside of the exchange, offering additional competition in the market. ...

There's been a lot of fear-mongering about how health insurance rates will explode, but the good news, according to a detailed Kaiser Family report about ACA coverage, is pretty much the opposite:

... While premiums will vary significantly across the country, they are generally lower than expected. For example, we estimate that the latest projections from the Congressional Budget Office imply that the premium for a 40-year-old in the second lowest cost silver plan would average $320 per month nationally.

Fifteen of the eighteen rating areas we examined have premiums below this level, suggesting that the cost of coverage forconsumers and the federal budgetary cost for tax credits will be lower than anticipated. ...

A number of TAG members work steadily for years, then hit a career rough patch where they can't get a studio staff job to save their lives. They are forced to eke out a living doing free-lance, and still pay for kids, keep up the house payments, AND purchase independent health insurance because the MPI insurance has run out.

The Affordable Care Act will change some of that, because getting health coverage and rates that don't bankrupt families and individuals will be way more accessible:

... If you are a 40-year old single mother of three earning $35,000 per year, your costs for health insurance might be as much as $8,784 per year if you were to pay the entire premium. However, if eligible, you will qualify for about $7,416 in tax credits to help pay your health insurance premiums. After applying the tax credit, you would be responsible for $1,368 annually – about $114 each month – for premium payments. ...

Over the next few weeks, TAG will be putting up more information about Covered California, and how members who fall out of Motion Picture Industry Coverage will have viable alternatives to minimalist insurance with fifteen thousand dollars out of pocket expenses.

So watch this space, and also the Animation Guild website.


Oswald Cox said...

"If you are a 40-year old single mother of three"...

What the HELL are you talking about??

You've really gone beyond the pale with providing coverage for this pathetic piece of legislation when you cherry pick a single slice of desperation and tout a supposed rainbow of relief from the Affrdable Care Act.

You want to post some real numbers next time for real working families? How many single women with three children are working in our guild? Not so many.

Crunch the numbers on rates for real working families that inhabit middle class California for us Steve. Two incomes struggling to provide health care for their children.
Then we'll see an explosion of rates and a reduction of coverage.

The parents, 40 and 38, have two children and a household income of $65,000 annually.

Insurers on the state exchange will sell four different levels of coverage labeled as Bronze, Silver, Gold and Platinum.

Bronze is the lowest-cost option because it offers the least amount of insurance coverage toward a person's medical bills. Coverage increases from there up to the most-expensive Platinum plans.

In the state's example, the website recommended Bronze and Silver plans as the most affordable options for the family of four.

The family also qualified for a monthly subsidy of $300 a month based on their income.

Taking that into account, the family's monthly premiums for a Bronze plan ranged from $284 with L.A. Care Health Plan to $374 a month with Anthem Blue Cross.

The price for a Silver plan ranged from $425 a month with Health Net Inc., to $477 with Anthem Blue Cross, to $495 a month with L.A. Care.

Officials acknowledged that some cash-strapped consumers may bristle at those rates.,0,3963045.story

With the claptrap that working americans can keep their plan if they like it (who said that again?), no one appreciates you in here trying to sussy up a rosy picture that doesn't exist.

Be honest.

Steve Hulett said...

Hey Oswald!

I cut and pasted the example from Covered California. Sorry you think it sucks.

The larger issue, which is the Kaiser Family Analysis, says that rates will be lower overall:

Ain't me saying it bro, it's a foundation that has a wee bit of experience in health care analysis.

So what claptrap about keeping the plan you already have? This blog is aimed at Animation Guild members. Those members participate in the Motion Picture Industry Health Plan. And (surprise!) the Plan will be the SAME as it's been for the past four years. Single change: Premiums started in 2013 -- $0 for particpant with no dependents, $25/mnth for participant with one dependent, $50/mnth for two or more dependents.

The premiums, by the way, have nothing to do with ACA. The AMPTP insisted on premiums in the 2012 negotiations. SAG, DGA and WGA have had premiums in their plans for a dozen years. The AMPTP demanded the same from the IA and Teamsters. I was in the room when the demand happened.)

But let's go to the global health care situation. The easily-Googled facts on health care? The U.S. pays top dollar for okay but not great health care results. We are Number One with a bullet in costs, and number 17 in results.

Canada, by way of contrast (and despite the American Right's constant waving of the "anecdotal evidence" flag) spends considerably less than the U.S. with superior results. Longer life-spans, lower infant mortality, etc., etc.

I don't think ACA is an ideal solution. I would much prefer single payer/Medicare for all, but we've got a plan that's a close cousin to RomneyCare in Massachussets, and that's that.

My purpose for the post was to alert TAG members that there is an oncoming option for health coverage if they're no qualified for MPI Health Insurance. (You know, the insurance that's still there? Which you maintain -- "sussy up a rosy picture that doesn't exist" -- is a fantasy in my fevered brain.)

Oswald Cox said...

Of course our health plan has maintained affordability. But that doesn't change the crappiness of the ACA. What we have is a distinct and marked downturn from what we had for artists and people who need health care.
(Not every single person I know and associate with is in our guild Steve)

Look no further than this overview of the how people in the creative industry are getting the dirty end of the stick:
Obamacare versus artists, writers, musicians, actors, et al.

and in light of the facts of that article, and the sentiment from our own artistic communities, you shouldn't be surprised that I am frustrated for you to come in here trumpeting a dubious tidbit from the new law where a single mother of three living in near poverty gets a fair shake. How about focusing on the middle class and what kind of shake they are going to get. Not a good one.
You're guilding the lilly again.

Also worth noting: low enrollment numbers for young health Californians is an absolute certainty by every estimate and without that revenue those rates will climb higher and higher for working families for every year forward.

Steve Hulett said...

Wow. You reference Bill Kristol's rag. Bill Kristol*, who hasn't been right about much of anything in eighteen years, and who despises expanded health care of any sort. (He hated HillaryCare too. His observation was if HC passed it would hurt the Republican party. Forget whether it might have been GOOD for anybody.)

Why don't you try responding to the Kaiser Study? Tell us how they're completely wrong, etc.? Instead of, you know, linking to the Weekly Standard, which says:

...The membership of these organizations should worry. Unless they are older or suffer from some preexisting condition that made coverage hard to obtain, freelance artists, designers, and musicians forced to enter the state-run exchanges are far more likely to see their rates go up—or to face the individual mandate penalties. This will be especially true, as alert observers of Obamacare implementation have noted, for those under the age of 30. ...

You will note the artful "far more likely" which is Kristol-speak for "Hey, we don't KNOW, but we'll cast this thing in the worst light possible!"

Here's the deal: ACA, despite its flaws, is the law. It offers newbies to the industry who are making crap wages at places like ADHD (they offer NO benefits, by the way) to buy into a low-cost plan. I would have drafted something different, but the ACA has certainly helped ME, as my 22-year-old son is still covered while he attends college, and will be covered for 3+ more years.

Real-life, real-time specifics. For the better.

As to your frustration, I know you're conservative and that's fine. But I have to deal with the facts on the ground: ACA is the deal going forward, and I'm alerting people to its existence. And how it might work for them.

I know you'd prefer that I crap all over it, or ignore it, but I don't see any point to that. Sorry.

* I was privileged to see Bill Kristol at the Universal Amphitheater in 2004, where he was adament that things were going swimmingly in Iraq, that it was a noble war, and that there was indeed a bright light at the end of the tunnel.

Like I say, wrong about everything.

Oswald Cox said...

Shoot the messenger much Steve?

Did Bill Krystol write the statement on health care denials by the College Art Association?

Did he compose the cancellations of The Entertainment Industry Group Insurance Trust? The American Federation of Television and Radio Artists? The Dramatists Guild? the Graphic Arts Guild? NY Women in Film and Television?

You're clearly deficient of the facts and in here trying to sell a political spin when you desperately start looking for scapegoats to explain the facts. Bill Krystol didn't write the article. Ben Schachterr, a professor of visual arts at St. Vincent College did.

No one cares what you have to say about Bill Krystol. Try to stay on topic and maybe the union members will respect your opinion more.

Oswald Cox said...

The Kaiser study is NOT the final say on the matter... although you desperately wish it was. In fact, with its early estimation oif such a gigantic bill that will have such hiurdles in implementation and has already had key elements delayed, it will probably be the least accurate take on the ACA.

The Manhattan institute has already cited problems with the Kaiser study. The analysis in Forbes also criticizes the Kaiser study for not comparing to pre-Obamacare rates.

Steve Hulett said...

I've got an idea. Why don't you wait until the ACA actually kicks in before rolling it into the ditch?

If you want to cite a professor of visual arts in a right wing magazine as some kind of authority, fine by me. (Professor S. points to some postings on web sites, and observes: "These folks should worry." If that ain't conclusive, I don't know what is.)

The prof is just brimming with facts and figures. And nothing says "health care expert" like a PhD in movies, television, painting or whatever the hell else Professor Shcachterr happens to teach. Clearly the Weekly Standard thinks this guy is the Voice of Authority on the subject. But I don't. In fact, I think citing some guy that clearly has no serious background in the subject is seriously silly.

Yet surprise, I agree with you that Kaiser Family ain't the final say. We'll find out of the ACA flies about 24-36 months out. And in the meantime, we'll see if the Right Wing screams of "Disaster! Disaster! DISASTER!" come true or not.

But as I've said to other right wing pals: "Okay, you think ACA sucks big time. So we roll it all back and we replace it with .... what? Something? Nothing? A big unfunded program like Medicare Part D?" (The gift to big pharma that keeps on giving, courtesy of the party wo worried -- now -- about The Debt.)

See, my problem here is, I would be happy to see what the other party proposes to expand health coverage. But they never seriously push anything. The fact that we've got this balkanized health care system that is expensive and mediocre at the same time seems not to be any kind of a problem, so far as they're concerned. They're against lots of stuff, but for very little. (Did you know that Jim Demint, former senator and current Heritage Foundation honcho, supported Romney in 2008 because he LIKED RomneyCare, and pointed that out in stump speeches? Naturally, by 2012, he thought both RomneyCare and ObamaCare were awful. But hey. Consistency is the hobgoblin of little minds.)

But let's take it back to the post above that you're so outraged about. I'm writing about ACA because

1) It's an option for our members who may not qualify for MPI Health Coverage.

(And if you think the example of a mother of three earning thirty-five grand is non-reflective of anyone in TAG, you must not encounter the free lance board artists, designers, animators who scrape along on that kind of money the way I do. I get them in my office on a regular basis.)

2) I think it's important for people to KNOW what health coverage is out there. Knowledge is power.

3) I want the ACA to succeed. (I get that you want it to fail because you think it's the devil's brew. We just differ on this.)

So why don't you lay out for me what kind of post I should actually write?

"ACA is terrible! The end!" Think that would be useful? Do let me know if I should bay at the moon, as you like to do.

Always happy to hear your thoughts.

Steve Hulett said...

Oswald declares:

... low enrollment numbers for young health Californians is an absolute certainty by every estimate and without that revenue those rates will climb higher and higher for working families for every year forward.

"Absolute certainty." Gadzooks. Somebody's got themselves a slide rule.

Then there's this from USA Today:

Estimates from 19 states operating health insurance exchanges to help the uninsured find coverage show that at least 8.5 million will use the exchanges to buy insurance, a USA TODAY survey shows. That would far outstrip the federal government's estimate of 7 million new customers for all 50 states under the 2010 health care law.

Why don't we stipulate here that nobody knows for sure HOW this pup will shake out.

But why don't we also stipulate that Oswald uses ringing, sweeping generalities based on his own hunches and prejudices.

Oswald Cox said...


Yoiu HAVE to expect to be called out when you run to the forum and state that rates will be lower and that we all need to recognize that news to the counter of that is "fear mongering". Its not. The ACA is bad. And that is the end-all-be-all of the discussion. Don't try to obfuscate the issue with there not being another alternative. The alternative was to not support it. The democrats OWN this legislation. Not a single vote was cast for it on the other side of the aisle, and there is compelling evidence that everything would be better if it didn't exist.

Here is Ezra Klein, a proponent of Obamacare admitting that the picture is not rosy. Its rough for people in the middle class - like the members of our guild. He puts it bluntly : The poor pay next to nothing. The rich pay full freight.

The shocking truth about Obamacare’s rate shock

You don't oversee a guild of poor people, we are middle class and we just got crunched.

Unknown said...

While I would have preferred Single Payer, I can't WAIT for ObamaCare to be completely rolled out. Portable, cost effective, great insurance....that can't be denied by the "death panels," (aka the insurance companies and their cornies in the gNOp)

Since a vast majority of Americans are for this, and it will bring down costs for everyone, anyone who is against it really is just spreading fear and ignorance.

The "middle class" gets crunched when the "poor" don't get health insurance. Instead, they run to the emergency room late, and guess who has to pay for it? The middle class will be FAR better off with Obamacare!!!!!

Grant said...

"The ACA is bad. And that is the end-all-be-all of the discussion"

That is, of course,, complete and utter horse sh*t from someone whose ignorance is on full display with every word they write. It's the same sort of "non-thinking" that will drag us back to the bush era third world thinking American's rejected.

The ACA is not perfect, nor is ANY bill. But all Americans deserve cost effective health care without the fear of it being yanked when they need it most.

Oswald Cox said...

I would have preferred single payer too. And all Americans do deserve cost effective health care without the fear of it being yanked when they need - and the ACA ids yanking it from our brothers and sisters in the arts community. Where is your sense man?

Get ready to bite the pillow when your health insurance costs explode.

Grant said...

But they won't. You're a nut to worry about things that haven't happened--and from all accounts other than paranoid conspiracy sites--won't. Take a pill before the gNOp "death panels" take it away.

Steve Hulett said...

Oswald, what bothers me is your sweeping generalizations with mediocre sourcing. (And a professor of visual arts in Weekly Standard is beyond mediocre sourcing.)

Your support of Single Payer is news to me, but if that's where you truly want things to go ...

Rush Limbaugh -- the beating heart of conservatism -- is convinced that Obamacare will lead inexorably to Single Payer. So ... what are you worried about? Per Rush, will get to single payer in due course.

I don't think ACA is ideal, but to label it horrible before it rolls out is overreach. The components that are already in play -- extended coverage for children, no caps, no exclusions for pre-existing conditions -- have helped the public and been received positively.

So again. Declare that it's shitty AFTER it's been put into operation and we see bad results. Right now the jury is out.

Oswald Cox said...

What if I had Aetna Steve? Then I would have lost my health insurance because of the ACA.

If you can't see whats coming, you are willfully ignorant.

I'll stop by with a "told you so" in the coming year.

Steve Hulett said...

Since you like to reference L.A. Times articles, there is this:

As President Obama's healthcare law rolls out next month, even supporters acknowledge there will be problems. But Americans who live in states backing the Affordable Care Act will receive substantial protections and assistance unavailable to residents in states still fighting the 2010 law. That could mean confusion and higher insurance premiums for millions of consumers in states resisting the law.

Leaders in these resistant states have not set up consumer hot lines. Several state insurance regulators are refusing to make sure health plans offer new protections required by the law, such as guaranteed coverage for people who are ill. In response to the law, Florida suspended its authority to review how much insurance companies charge consumers.

"I would certainly rather be in a state that is trying than in one that is not," said Alan Weil, executive director of the National Academy for State Heath Policy. "There are going to be some big differences.",0,2881371.story

To summarize: The states that hate the law, are doing everything they can to sabotage ACA, while states that support the law are putting a lot of effort into making it succeed.

So your "I told you so"? I think it will be pretty accurate in places like Texas and Florida, and not accurate in Oregon, California, Massachusetts, Vermont, etc.

We'll see. I know you hate it, but it's still the law of the land and it's important that members know about it, even though 90% will be under MPIHP and not under ACA.

Steve Hulett said...

Owald laments: "What if I had Aetna Steve? Then I would have lost my health insurance because of the ACA."

True. But the odds are low that an individual would own an individual Aetna policy. As the Wall Street Journal explains:

Aetna said it currently has about 49,000 individual policyholders in California. In 2011, when it had substantially bigger membership, it was the fourth-biggest player in the state's consumer market, with about 5.2% of the plans sold that year, according to a report from Citigroup Inc. C -1.28%

Aetna isn't one of the 13 insurers participating in the state's new consumer insurance marketplace set to launch this fall under the federal law. Like several other major national carriers, it has said it would join only a limited number of these exchanges. A carrier can still offer consumer plans without being in the exchange.

Aetna said it will continue selling health insurance in California to employers and Medicare beneficiaries, as well as dental and life-insurance products. The insurer said it is "fully committed to serving the needs of our 1.5 million members in the state." A company spokeswoman declined to comment about the reasons for Aetna's individual-business withdrawal.

Maybe it withdrew because its individual policy business in the State was miniscule. It's pulled out of other states because it couldn't come to agreement on rates.

Like all health insurance companies, Aetna is a middle-man for health services. The doctors, hospitals and medical facilities are still there. So participants will have to find some other middle-man besides Aetna to act as their pipeline.

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