Smokers Penalties

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AlyssaEimers's picture
Joined: 08/22/06
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Smokers Penalties

Penalty could keep smokers out of health overhaul - Yahoo! News

Do you think these Penalties will be a deterrent to smoking? Is it discrimination?

bunnyfufu's picture
Joined: 10/21/05
Posts: 203

I'll have to think about this. Health care stuff is so difficult because it is complicated.

I do hope that it will be a deterrent but don't know if it will.

Health care is incredibly expensive and the numbers cited don't match anything like the reality of what we pay, or even close to what our annual numbers are for our part of the employer funded plan.

What a mess.

bunnyfufu's picture
Joined: 10/21/05
Posts: 203

From the article:
Insurers won't be allowed to charge more under the overhaul for people who are overweight, or have a health condition like a bad back or a heart that skips beats — but they can charge more if a person smokes.

--------------

Smoking is a huge contributor to preventable disease and treating those diseases can be costly . . . but how is that not true for obesity? So maybe on the discrimination. :confused:

wlillie's picture
Joined: 09/17/07
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For the under 30 crowd it might be. For the ones it will hurt the most, no. They've already tried to quit by now and can't find a program that will work for them. Affordable healthcare for everyone. LOL

Joined: 05/31/06
Posts: 4780

I feel like we have done versions of this one a thousand times and it always ends badly. I'm fine with it. I'm fine with penalizing lifestyle choices, like life insurance does, including obesity. If we don't do that, I'm fine with rewarding healthy lifestyle lifestyle choices (like how I get money back if I call in from my gym more than 150 times/year when I am there to work out I get one amount of money back, more than 250 times I get more money back). Both are great options. We ought to reward people who work hard to be healthy because it impacts insurance companies bottom lines, as well as out nations bottom line. Healthy does not include regular tobacco use or other unhealthy lifestyle choices. I'm fine with penalizing them or rewarding healthy people. We ought to. It simply makes financial sense.

Alissa_Sal's picture
Joined: 06/29/06
Posts: 6427

I disagree with it. I wouldn't mind Melissa's suggestion that people who live healthy lifestyles get some money back as an incentive to keep being healthy, but according to the article we are talking about the potential to charge almost 50% more to some smokers. The whole point of the thing was that having people go uninsured is actually more costly to society in the long run since they don't get the preventative care in the long run, and then may find themselves using the ER as their primary care since they can't be turned away, and then just not pay for it. Also, people shouldn't die from not being able to afford healthcare. I believe those things are true whether we're talking about the healthiest person out there, or a 40 year 2 pack a day smoker. Yes, I realize that smokers are more likely to suffer illnesses, but I don't see how making it too expensive for them to afford healthcare solves that problem, since we're back to the "no preventative care/using the ER when they have to" scenario, which means that the ERs still have to charge huge prices to cover those costs, which get passed along to us. I would like to see lighter fees if we are going to add fees to smokers, and heavy pushing of cessation programs.

I don't believe that it's impossible to quit if you're a long time smoker. Is it hard? Yes, I'm sure it really really is. I smoked for about 5 years during my late teens and early twenties, and it was hard for me to quit too, so I can imagine that it's that much harder for someone who has done it for the majority of their life. But I don't believe that they simply can't. My boss is in his late 50's and has been smoking since he was a teen, and he quit about 6 months ago after his wife was diagnosed with COPD (they both quit together.) I'm sure it was awful to go through, but they did it. I believe that people *can*, but they need a lot of support and incentive. I would hope that insurance companies would pay to provide lots of both.

AlyssaEimers's picture
Joined: 08/22/06
Posts: 6568

I think that it too much. Healthcare should not cost anyone such a high portion of their income. Not making it so they have to chose between having health insurance and having food to eat or a place to live.

GloriaInTX's picture
Joined: 07/29/08
Posts: 4116

I was so proud of my best friend from high school because she quit smoking last year after smoking for 30 years. She had smoked since she was 16 years old. So it can be done, but it is not easy. No I don't think it will be a deterrent. If the actual cost of smoking is not already a deterrent than this won't be. It is just a penalty, and yes I think it is discrimination. Smoking is a legal activity and the government is getting alot of money already from the extra taxes that should cover any cost differences.

Joined: 08/17/04
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Smoking is not a pre existing condition so it doesn't qualify for protection under this act. I'm not really sure where I stand on it. It is a risk factor and a costly risk factor but so isn't alcoholism however, that is classified as a disease.

I don't think I'm okay with it.

I disagree that long term smokers have tried everything to quit. My mom has smoked for a long time and I don't think I've ever seen her try to quit. My dad quit almost 3 years ago after smoking about 40 years. No set backs.

Joined: 05/31/06
Posts: 4780

"wlillie" wrote:

For the under 30 crowd it might be. For the ones it will hurt the most, no. They've already tried to quit by now and can't find a program that will work for them. Affordable healthcare for everyone. LOL

Nope, I don't buy that any more that I buy an obese person throwing up their hands and saying "i've tried to lose weight and can't find a diet that works for me". Logic, not emotion, right?

wlillie's picture
Joined: 09/17/07
Posts: 1796

It's still ironic that the Federal government is using a law that penalizes them for not having insurance and penalizes them for making a choice the Federal government doesn't like that is absolutely None of their Business all in the name of making healthcare affordable. I'm all for companies deciding on their own, but let them decide on their own about everything. You are right Melissa, I'm sure there is a program that will work for everyone. It still doesn't make the fact that it's wrong to allow one and not the other any more right.

Joined: 08/17/04
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Companies can decide on their own Lillie. Per the article it is only allowing them to charge higher. Does not mean that they will or if state law will prohibit it. (In Mass, it does not occur for example. We do not take risk factors like this into account)

wlillie's picture
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No, they are allowing companies to choose for smoker. But saying that they can't charge people for other risks factors like obesity is discrimination. They are discriminating against smokers and saying it's ok to be fat, we've got your back. If you are going to allow companies to charge for one risk factor, it's insane to pretend like it's not discrimination against them when other risk factors aren't included. Women of child bearing age would be more expensive than smokers, any fat person, and anyone with a pre-existing disease, but we don't allow them to charge more for that, so it's not OK to charge smokers more.

Joined: 08/17/04
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I never said that. I agree. I said that the gov't is not forcing the insurance companies to charge higher for smokers they are allowing them to do so. You said they are forcing people to buy insurance and then the govt is forcing the companies to allow for higher premiums and that it should be up to the companies what they charge. I just corrected it to say that they are allowed to make that decision.

MissyJ's picture
Joined: 01/31/02
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I could be a supporter of those 'incentive' programs -- offering rewards/discounts for healthy behaviors (exercising, joining a smoking cessation program, etc.) vs. imposing penalties. These should *not* be restricted solely to those that cost a lot of money (such as requiring gym membership.) As pointed out within the article, many of those smokers/obese/etc. are among the poor that could ill-afford these extra costs.

Two thoughts also came to mind:

1)At what point would a former smoker no longer be penalized? Since the negative health impacts of smoking can show up long after quitting, would someone like Alissa have to pay more despite stopping many years back? (Example: A relative that stopped smoking more than40 + years ago today now battles emphysema and other lung problems that they link to his previous -- somewhat sporadic smoking that ended DECADES before.)

2)Do you believe this threat will actually deter more people from seeking the healthcare they need? Now rather than going to the doctor for regular check-ups / preventative care, they may fear having their FAMILIES pay a penalty through far higher fees... or -- perhaps having that same fear drive them to lie to their physicians.

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"MissyJ" wrote:

I could be a supporter of those 'incentive' programs -- offering rewards/discounts for healthy behaviors (exercising, joining a smoking cessation program, etc.) vs. imposing penalties. These should *not* be restricted solely to those that cost a lot of money (such as requiring gym membership.) As pointed out within the article, many of those smokers/obese/etc. are among the poor that could ill-afford these extra costs.

Two thoughts also came to mind:

1)At what point would a former smoker no longer be penalized? Since the negative health impacts of smoking can show up long after quitting, would someone like Alissa have to pay more despite stopping many years back? (Example: A relative that stopped smoking more than40 + years ago today now battles emphysema and other lung problems that they link to his previous -- somewhat sporadic smoking that ended DECADES before.)

2)Do you believe this threat will actually deter more people from seeking the healthcare they need? Now rather than going to the doctor for regular check-ups / preventative care, they may fear having their FAMILIES pay a penalty through far higher fees... or -- perhaps having that same fear drive them to lie to their physicians.

'
I don't know that a gym has to cost a lot of money, many are quite inexpensive, especially YMCA's. The problem with not tying it to some sort of gym is that it makes it awfully hard to police ~ even with my gym someone could technically *be* at the gym but go and sit in the cafe and eat or read a book....not workout. How would the insurance company have any way to verify if it was things like "took a walk today" or things like that if it was 100% self reported and tied to getting money back? I suppose you could tie it to measurable things like weight loss or something, but then you have to have employees out monitoring such things/more overhead for the insurance company.

Anyway, don't cigarettes cost like $7 a pack these days? Most people who can afford to smoke COULD afford a gym, its just a matter of shifting priorities, of course.

1. I would argue that only active smokers could be penalized. Like life insurance, I would think a simple blood test to test for tobacco would be sufficient. Former smoking would be like a pre existing condition, to me. People can't change that they used to smoke but had the good sense to quit, but they can change if they currently smoke and would like to quit.

2. No, I don't

mom3girls's picture
Joined: 01/09/07
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I really dont know how I feel about this one. If insurances are allowed to charge for smoking, they should be allowed to charge more for any lifestyle choice that makes a person in a higher risk category for disease. Obesity could be charged more. Gay males could be charged more (CDC numbers say gay males account for 61% of all new cases)

On the other hand, insurances are businesses, they are in the business to make money. I see why they want to charge smokers more

mom3girls's picture
Joined: 01/09/07
Posts: 1537

I really dont know how I feel about this one. If insurances are allowed to charge for smoking, they should be allowed to charge more for any lifestyle choice that makes a person in a higher risk category for disease. Obesity could be charged more. Gay males could be charged more (CDC numbers say gay males account for 61% of all new cases of AIDS)

On the other hand, insurances are businesses, they are in the business to make money. I see why they want to charge smokers more

Joined: 08/17/04
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"mom3girls" wrote:

I really dont know how I feel about this one. If insurances are allowed to charge for smoking, they should be allowed to charge more for any lifestyle choice that makes a person in a higher risk category for disease. Obesity could be charged more. Gay males could be charged more (CDC numbers say gay males account for 61% of all new cases)

On the other hand, insurances are businesses, they are in the business to make money. I see why they want to charge smokers more

Gay males are 61% of new cases for what? Obesity?

Melissa~ my company reimburses you for your membership but you have to remaina mbr for at least 4 mos in a cal. year and it's typically only 150.00 per membership not per person. Some businesses want to pay their employees more though. It's hardly an incentive to pay and just sit there.

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"AlyssaEimers" wrote:

I think that it too much. Healthcare should not cost anyone such a high portion of their income. Not making it so they have to chose between having health insurance and having food to eat or a place to live.

But they would not be choosing between having health insurance and food or a place to live. People who smoke are choosing to smoke over food for themselves and their families. I don't know how much a pack or carton of cigarettes costs, but I imagine that it's not that cheap.

All they have to do is stop smoking. I realize it's an addiction, but it's one that causes Medicaid/Medicare extraordinary amounts of money when people start creeping up in their lateish 40ies and beyond. Taxpayers are the ones footing their extra bills because of their nasty habit. People who smoke are getting food stamps whereas if they didn't smoke they could probably afford more food and be fine with less food stamps if any.

It is a strange society we live in, one of such entitlement and expectations. We have a government that has been catering to people for so long and it's so expected by virtue of birth place.

So to answer the debate question, I am not really for increased rates. I don't think that is going to work. I think people will lie. They'll do all sorts of creative things to make sure their clothes don't stink when they go to the dr. They'll lie on forms. How can it be proven?

We get a discount on our insurance for not smoking, but no one ever made us try to prove it. I don't see how this is going new bright plan is going to work though.

mom3girls's picture
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"Jessica80" wrote:

Gay males are 61% of new cases for what? Obesity?

Melissa~ my company reimburses you for your membership but you have to remaina mbr for at least 4 mos in a cal. year and it's typically only 150.00 per membership not per person. Some businesses want to pay their employees more though. It's hardly an incentive to pay and just sit there.

Sorry, they are 61% if new AIDS cases

AlyssaEimers's picture
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"myyams" wrote:

But they would not be choosing between having health insurance and food or a place to live. People who smoke are choosing to smoke over food for themselves and their families. I don't know how much a pack or carton of cigarettes costs, but I imagine that it's not that cheap.

All they have to do is stop smoking. I realize it's an addiction, but it's one that causes Medicaid/Medicare extraordinary amounts of money when people start creeping up in their lateish 40ies and beyond. Taxpayers are the ones footing their extra bills because of their nasty habit. People who smoke are getting food stamps whereas if they didn't smoke they could probably afford more food and be fine with less food stamps if any.

It is a strange society we live in, one of such entitlement and expectations. We have a government that has been catering to people for so long and it's so expected by virtue of birth place.

So to answer the debate question, I am not really for increased rates. I don't think that is going to work. I think people will lie. They'll do all sorts of creative things to make sure their clothes don't stink when they go to the dr. They'll lie on forms. How can it be proven?

We get a discount on our insurance for not smoking, but no one ever made us try to prove it. I don't see how this is going new bright plan is going to work though.

I truly and honestly do not understand the reasoning. We have had debates where people have acted as though universal health care is the end all necessity. That it is a basic necessity of life and that it is cruel to have health care only available for the rich. At the same time, people think it is perfectly fine to charge so much for health care for smokers that either no one will be able to afford it, or they will have to stop going to the doctor so no one finds out they smoke.

I have never tried smoking before, thankfully. However, I do not think smoking makes you sub human and unworthy of health care any more than being poor does.

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Again, I don't like that they are picking and choosing what bad habits are okay to charge more. Not too sure it is a bad thing though.

Risk factors cause everyone to pay more money. What we live in is a society that focuses on the "ME" and not the overall "US" Because YOU choose to smoke I pay a higher insurance premium even though I don't. I have to pay for your health issues. Your meds, your treatment for lung cancer etc.

I pay more in my car insurance because I was in a minor accident that I was at fault for and this year I'll finally eliminate that extra point. Smoking is something in your control. Obesity is often in our control but there are people who are obese that is the result of a medical condition or related to medication for another disease which is not the fault of that person. That is very hard to police.

I think drug and alcohol problems are a huge cost contributor as well but since they are classified as a disease and not a habit (which to me...addiction is addiction...should be all disease) they are not subject to this.

AlyssaEimers's picture
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What was the whole point in having a health care law that says everyone is required by law to have healthcare, just to make it so that it is unaffordable to a certain group of people? Why eliminate being able to deny or charge extra for a pre existing condition if it was as you wished where only skinny healthy people could qualify? To me, if you are going to make it LAW that you have to have insurance, that insurance has to be obtainable to everyone. Does your car insurance cost you 24% of your income? (That was the amount the articles said a 60 year old smoker making $35,000 a year would pay) How is that even reasonable? That is not even counting deductibles and co-pays. If you had a car accident and your car insurance went up so much that you could no long afford it, you could just not have a car and take the bus or subway everywhere. That is not an option with this law. Having to pay $20/ month extra penalty is reasonable. The amount they are saying is in no way a reasonable expectation. It might not seem like a lot of money to someone making a $100,000 or more a year, but it is a devastating amount to someone making $20,000-$30,000/year.

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Since when is smoking a pre existing condition?

Also, there is no bus or subway to get me anywhere around my town. So my car is just as important as health insurance.

Again, I disagree with it but again there is nothing saying that health insurance companies are required to do this. Aren't you always about letting the individual company make their own business decisions? Would it be just as easy for a health insurance company to say "hey! We won't charge you extra for smoking like Company X will!" and get more people to sign on?

MissyJ's picture
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"Jessica80" wrote:

Risk factors cause everyone to pay more money. What we live in is a society that focuses on the "ME" and not the overall "US" Because YOU choose to smoke I pay a higher insurance premium even though I don't. I have to pay for your health issues. Your meds, your treatment for lung cancer etc.

As you stated, the "picking and choosing" of what is ok to charge more for can be a problem.

What if the decision is made to charge more for those women of childbearing age that "choose" to become pregnant and need to use maternity care? Obviously they are costing more vs. those that opt not to have kids -- or a single man for that matter.

Also -- smoking -- or rather the horribly expensive *after effects* could be "pre-existing" if the person stopped such as in my scenario with a relative that stopped smoking (and wasn't even a chain smoker!) more than 40+ years ago yet is still met with high health care costs supposedly related to that prior use.

I believe that Bonita was making the case that while many objected to the "Affordable" healthcare act, that IF people are forced to have it, and it was expected to be "for all", that it would seem discriminatory against this one particular group (many that ARE also poor) to the point that they cannot get healthcare. Their families could also be denied.

There may not be something that states that health insurance companies are required to do this, but it would be discriminating against this group over other "choices" that could result in higher health care costs for the 'greater whole.' This is different than life insurance charging smokers more as no one is being forced to carry a particular level of life insurance no matter the cost.

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"AlyssaEimers" wrote:

I truly and honestly do not understand the reasoning. We have had debates where people have acted as though universal health care is the end all necessity. That it is a basic necessity of life and that it is cruel to have health care only available for the rich. At the same time, people think it is perfectly fine to charge so much for health care for smokers that either no one will be able to afford it, or they will have to stop going to the doctor so no one finds out they smoke.

I have never tried smoking before, thankfully. However, I do not think smoking makes you sub human and unworthy of health care any more than being poor does.

Which part do you nt understand? I am not saying only rich people should get health care. My answer to the debate is that I do not think any incentive program or punitive program either is going to work. We do need to have access to affordable healthcare, no one is denying this. I do not think this particular idea is going to work.

Take a look at the formula...using the formula if a person did not smoke, they would get access to affordable health care. The smoker is causing their and their family's problem. Due to lower income they get great tax credits toward their premiums, but since they smoke they go up. People need to be responsible and accountable for their choices.

Today I asked my mom how much my (step)dad's smoking costs and she said $200-250 per month. Now I pay my mom's premium and deductibles so she can have health insurance. She has not had ins in so long, and she desperately needs to see a dr....for ages now. They say they can not afford it. I obviously did not say this to my mom they could pay half the premium or at least the deductible if he did not smoke. It is about choices and the priorities get thrown out when their lifestyle demands changing.

And so again thatnit is completely a flawed plan because how will anyone know if a person is telling the truth? It would be very appealing for smokers to lie and not pay higher premiums.

AlyssaEimers's picture
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"Jessica80" wrote:

Aren't you always about letting the individual company make their own business decisions?

The businesses have already lost the right to make health insurance choices. Missy is right. This "Affordable Health Care Act" makes health insurance unattainable for a large group of people. In my understanding that is in direct contradiction to the purpose of the law.

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"AlyssaEimers" wrote:

The businesses have already lost the right to make health insurance choices. Missy is right. This "Affordable Health Care Act" makes health insurance unattainable for a large group of people. In my understanding that is in direct contradiction to the purpose of the law.

This is correct in and of itself. If you are in a smoking cessation program then you do not get higher premiums though employer insurances. But penalties may be charged through private ins. Usually lower income individuals are ones without employer provided ins. But then again......so what will people do? Lie.

But the thing is that addictions can be broken.

AlyssaEimers's picture
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"myyams" wrote:

But the thing is that addictions can be broken.

If the government is going to dictate that smoking is not acceptable, they should make it illegal. Not withhold health insurance from the people who need it most. Making health insurance cost 24% of your income, is withholding it.

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"AlyssaEimers" wrote:

If the government is going to dictate that smoking is not acceptable, they should make it illegal. Not withhold health insurance from the people who need it most. Making health insurance cost 24% of your income, is withholding it.

The govt is not dictating this. Private insurance companies are saying they want to charge their own penalties because smokers, particularly older smokers, cost them more money.

Joined: 05/23/12
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Take a hypothetical 60-year-old smoker making $35,000 a year. Estimated premiums for coverage in the new private health insurance markets under Obama's law would total $10,172. That person would be eligible for a tax credit that brings the cost down to $3,325.
But the smoking penalty could add $5,086 to the cost. And since federal tax credits can't be used to offset the penalty, the smoker's total cost for health insurance would be $8,411, or 24 percent of income. That's considered unaffordable under the federal law. The numbers were estimated using the online Kaiser Health Reform Subsidy Calculator.

See 3325 is 277 per month, almost what my dad pays for his smoking.....and is the premium of a non smoker his age. However due to his refusal to quit, he has to pay more money because his care will cost much more. Insurance companies are not in the let's lose all of our money and go bankrupt business. So they have to charge more to accommodate the additional gamble. Now I am not for all of this, but that this is why they have to do it.

AlyssaEimers's picture
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As an aside, can I ask some questions? Just to understand better and to be able to pose a better debate. How much would an unemployed person, or someone just making minimum wage pay for health insurance under the new law? If you did not have an employer to buy health insurance from, how much are we talking about? Will it still very on your health and age? Are we still talking several hundred dollars a month per family? Is the health care bill actually helping anyone who did not have health insurance before get health insurance now (or in 2014)?

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"AlyssaEimers" wrote:

As an aside, can I ask some questions? Just to understand better and to be able to pose a better debate. How much would an unemployed person, or someone just making minimum wage pay for health insurance under the new law? If you did not have an employer to buy health insurance from, how much are we talking about? Will it still very on your health and age? Are we still talking several hundred dollars a month per family? Is the health care bill actually helping anyone who did not have health insurance before get health insurance now (or in 2014)?

You can play around with the calculator. I do see people being able to get more affordable insurance to some degree at least.

Health Reform Subsidy Calculator - Kaiser Health Reform

Rivergallery's picture
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mistake

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Bonita~I didn't click on the calculator yet but I wanted to explain what happens here. Someone who makes minimum wage and does not have employer sponsored health insurance is most certainly going to qualify for MassHealth (our Medicaid). There are various plans under our Medicaid program. There are plans that you still pay a copay but no premium. There are plans that Masshealth pays your private insurance premium if you have work sponsored insurance but can't afford your deductions. There are so many available options that a lower income individual or family could get.

There are still people caught in the middle. My brother is one. His employer is not required to carry insurance because they do not employ the amount of people to be required to provide it. He makes too much money (just over) for Medicaid but private insurance would take too much of a percentage out of his pay. So he files a waiver and does not get tax penalized. He is still in the same boat he would have been without the law and it stinks that he doesn't have health insurance but at least he isn't penalized and the majority of the people in the state have insurance.

Alissa_Sal's picture
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"Jessica80" wrote:

Companies can decide on their own Lillie. Per the article it is only allowing them to charge higher. Does not mean that they will or if state law will prohibit it. (In Mass, it does not occur for example. We do not take risk factors like this into account)

Am I the only one cynical enough to believe that if the law allows them to charge higher rates, they absolutely will? LOL

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Well I think that like anything else it is market demand. My company is not the cheapest insurance locally. We still have a huge customer base. I just switched my car insurance to another company because it saved us 600.00/yr compared to our old one. Same coverage and same customer service. I think if a company Y charges, for example, 7000.00 for a smoker there will be company X will make it a promo to charge the same to smokers to keep customers. I also don't think it will increase a lot like they are allowing.

Also, many state DOI's prohibit large increases for insurance, most employer plans do not take these risk factors into consideration etc.

Alissa_Sal's picture
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Or the companies could get together and agree that they are all going to charge $8000 for smokers, since everyone has to have insurance by law and they have a pretty assured customer base.

I think the article was talking about self-insured smokers, not those on a company plan.

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I think so as well. I don't know. As I said we have a few major health plans and Mass. and my company is not the cheapest by far. Cost does keep some people from purchasing our plans. The other plans do things that we don't do and we do things they don't do. We don't "get together" to charge the same because that's not a good business practice. It would be like Target and Walmart meeting to decide costs on shampoo.

Alissa_Sal's picture
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Im not saying they would actually sit down and have a meeting about it; I think that's called price fixing and is illegal. But I think that when companies know they sort of have you over a barrel, the rules of competition don't always apply. An example of this is the rates that Visa and MasterCard charge merchants to be able to accept their their cards from customers. I doubt they're "colluding", but they know that even though merchants are ALLOWED to say "I will take Visa but not MasterCard" because of the cost involved, no merchant is actually going to do that because that means turning away customers. So the result is that whenever one raises the prices, the other does too because they know they can get away with it. I think to a certain extent, that's a possibility here too since they know that people can't simply opt to not have insurance. They may not go up to the full extra 50%, but it wouldn't be surprising to see them set a fairly high "going rate" because they can.

All of this is why I don't think that for profit insurance companies in combination with the "free market" is actually a great solution for our healthcare woes. The free market is more complicated than simple supply and demand and whoever has the best price wins.

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Well not all insurance is for profit either. My company isn't. Nobody makes more for denying claims or for raising rates and all premium increases have to be approved by our DOI. Just because it is allowed doesn't mean it will happen. There are checks and balances that private insurers have to go through.

Alissa_Sal's picture
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I'm a much bigger fan of the not for profit insurance company model, if that makes you feel any better. I think for profit insurance companies are proof of true evil in the world, but I take a much much softer stance on insurance companies that are simply covering their operating costs. Smile I would be a much bigger fan of Obamacare if they got rid of the for profit companies and stuck with companies like yours.

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Posts: 2226

Me too ;). hahaha. More business for us.

But with NHCR...remember companies *have* to show that they are using a certain percentage of their premium dollars to cover claims. I don't know the exact percentage off hand...88%, 90%...so that will help reel in a lot of what for profit companies charge and puts their claim payment policies under the spotlight.

*forgot to say earlier....as usual, all the things I say here are my thoughts and not the thoughts of my employer"

Alissa_Sal's picture
Joined: 06/29/06
Posts: 6427

"Jessica80" wrote:

Me too ;). hahaha. More business for us.

But with NHCR...remember companies *have* to show that they are using a certain percentage of their premium dollars to cover claims. I don't know the exact percentage off hand...88%, 90%...so that will help reel in a lot of what for profit companies charge and puts their claim payment policies under the spotlight.

*forgot to say earlier....as usual, all the things I say here are my thoughts and not the thoughts of my employer"

That's a good point; I forgot about that. I do like that provision, very much. Smile It should help with a lot of the problems that I have with (for profit) insurance companies. I feel like the point of insurance companies should be to provide payment for healthcare as deemed necessary by the patient and their doctor, in the understanding that we pay them every month whether we need it that month or not (like with car insurance.) I feel like the actual point of for profit insurance companies is to simply make money for insurance companies. Like, I'm paying you every month for WHAT again? LOL I don't mind if they make a profit, but I need it to not be at the expense of me getting the medical care that my doctor and I are agreeing upon as necessary.

AlyssaEimers's picture
Joined: 08/22/06
Posts: 6568

"Jessica80" wrote:

Bonita~I didn't click on the calculator yet but I wanted to explain what happens here. Someone who makes minimum wage and does not have employer sponsored health insurance is most certainly going to qualify for MassHealth (our Medicaid). There are various plans under our Medicaid program. There are plans that you still pay a copay but no premium. There are plans that Masshealth pays your private insurance premium if you have work sponsored insurance but can't afford your deductions. There are so many available options that a lower income individual or family could get.

There are still people caught in the middle. My brother is one. His employer is not required to carry insurance because they do not employ the amount of people to be required to provide it. He makes too much money (just over) for Medicaid but private insurance would take too much of a percentage out of his pay. So he files a waiver and does not get tax penalized. He is still in the same boat he would have been without the law and it stinks that he doesn't have health insurance but at least he isn't penalized and the majority of the people in the state have insurance.

I understand what you are saying, but the article in the OP really disillusioned me. Those numbers are really over the top. I had gotten the impression that the new health care law was supposed to make insurance more affordable for all. With the exception of people under the age of 26, that does not seem to be the case so far. It could be that I am just not understanding everything, (and that is what I am hoping) but it seems to me that insurance will be affordable to less people, not more.

Joined: 05/23/12
Posts: 680

"AlyssaEimers" wrote:

I understand what you are saying, but the article in the OP really disillusioned me. Those numbers are really over the top. I had gotten the impression that the new health care law was supposed to make insurance more affordable for all. With the exception of people under the age of 26, that does not seem to be the case so far. It could be that I am just not understanding everything, (and that is what I am hoping) but it seems to me that insurance will be affordable to less people, not more.

Well I can tell you that I got a quote from private insurance for my mom and it was over $800 and did not cover any of her preexisting and very current issues. Now that the govt is providing insurance for people with pre existings and almost half the price...there are definitely people benefiting. I am really happy that she has insurance at just over $400 and covers anything!! Now my poor mom can go to the dr for once after 10 years or so. I would say that she's getting a decent deal compared with the current alternatives. Now, next year will be great because that $400 will be significantly cut to.....ZERO with very little out of pocket expenses as she'll be covered by Medicaid under the new laws due to lower income.