(03-25-2020 12:06 PM)b0ndsj0ns Wrote: Yes with the current marketplace. Do you think the GOP is gonna keep the marketplace and the subsidies?
(03-25-2020 12:25 PM)b0ndsj0ns Wrote: Of course it is, COBRA has existed for a long time, but is completely un-affordable for anyone that lost a job. Are you saying you support keeping the subsidies around?
Jons.... you keep saying this but it misrepresents the facts.
You are not required to use COBRA and COBRA is merely the actual cost of your previous policy. You have the ability to go buy a new policy and a marketplace for that, subsidized or not, has always existed. It's just that previously it was an individual policy and now you are in a government created 'group' policy. While you can argue about that the GOP will or will not do, to think that they have or would have the 60% necessary to ram through 'whatever they want' (which means, whatever you assign to them) is silly. Not even all Republicans would support eliminating the turning of the individual marketplace into a 'group' marketplace.... and large portions of the 'subsidy' for policies now comes from the states. Individual states could still keep this sort of practice even if the feds eliminated it, and you can buy across state lines. The 'hole' would now be for the 'expanded' Medicaid
As for Bismarck... even if we did that, I seriously doubt any current politician would call it that. Bernie calls what he offers M4E, and it's quite different from Medicare.... in fact, it would be a MASSIVE expansion of Medicare for current participants... OR... it more likely (in order to control costs) would be a massive expansion of 'Medicare Advantage' plans and they would be put under the government... which makes no sense, taking away from private business something they were doing better than the government before, so that's why I know it would happen.
If Republicans offered well checks, preventative and catastrophic insurance with no deductibles or copays (which are really pretty immaterial if you have a $100,000+ bill), it would essentially be Bismarck.
Option 1, offer preventative, wellness and catastrophic coverage with no deductibles or copays to everyone.... Bismarck.
Option 2, offer the above with deductibles and copays and let the states cover that portion for 'those it decides can't afford it', including potentially even more coverage... Bismarck that retains state control and the taxing mechanisms there.... IMO, most likely...
Option 3, same as 2, but then decide that at some level, you (or your employer) MUST opt out/pay for the basic coverage.... highly probably only to prevent it from being described as a gift to the wealthy
That's the other thing... People who have company policies are sometimes still better off with Medicaid, especially single moms with kids. This is money that a company WOULD pay, that would save the state money, but because there is no option, the state burns money.
The biggest/only reason I'm against 'straight' Bismarck is that it removes 'responsibility' from the equation... and that is precisely what is kicking our butts right now. I most want people to pay for illnesses/diseases of choice. lick a toilet seat and get sick from that or go bungee jumping, pay the consequences. Buy supplemental insurance for that.