Forum Discussion
GMandJM
Aug 11, 2015Explorer
I'm not sure I can agree with everything you're saying, westernrvparkowner, but it does give us something to think about.
Yes, the overly-optimistic scenario of the ACA mandate was that it would push younger, healthier people into the insurance "pool". It seems, as many suspected, they chose less expensive HMO's. No shocker.
Totally agree with you there. But I'm seeing something else:
Health insurance companies use statistics to figure out which insureds are cost-effective and which aren't and they can cut up the "pools" any way they want. In this instance they've divided it between employed/employer-based PPO insureds vs self-employed/not-employed PPO insureds.
What would their cost analysis have been had they considered ALL PPO insureds as one pool? Or self-employed vs. non-employed? (We'll never know.)
And it makes me wonder who might be next? Cut the pool smaller and say "We're not going to offer PPOs to businesses with less than 10 employees"? 50 employees?
I realize that an BCBS-TX is a for-profit entity and not a charity....I just don't like the trend they're setting. A very valuable insurance option for self-employed/not-employed people is gone and that's upsetting (to me, anyway).
(And I won't even mention that someone, somewhere PROMISED we'd be able to keep whatever insurance coverage we already have.)
And as for the wallet thing, I might agree with you except if I did DianneOK would yell at us for talking politics. So let's don't go there. ;)
Yes, the overly-optimistic scenario of the ACA mandate was that it would push younger, healthier people into the insurance "pool". It seems, as many suspected, they chose less expensive HMO's. No shocker.
Totally agree with you there. But I'm seeing something else:
Health insurance companies use statistics to figure out which insureds are cost-effective and which aren't and they can cut up the "pools" any way they want. In this instance they've divided it between employed/employer-based PPO insureds vs self-employed/not-employed PPO insureds.
What would their cost analysis have been had they considered ALL PPO insureds as one pool? Or self-employed vs. non-employed? (We'll never know.)
And it makes me wonder who might be next? Cut the pool smaller and say "We're not going to offer PPOs to businesses with less than 10 employees"? 50 employees?
I realize that an BCBS-TX is a for-profit entity and not a charity....I just don't like the trend they're setting. A very valuable insurance option for self-employed/not-employed people is gone and that's upsetting (to me, anyway).
(And I won't even mention that someone, somewhere PROMISED we'd be able to keep whatever insurance coverage we already have.)
And as for the wallet thing, I might agree with you except if I did DianneOK would yell at us for talking politics. So let's don't go there. ;)
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