Trump Rule Permits Health Plans by Self-Employed, Small Businesses That Skirt Obamacare

By | January 5, 2018

  • January 5, 2018 at 11:27 am
    PolarBeaRepeal says:
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    This is another component of ‘HEALTH CARE SPPECIFICCS’. Can you guess which letter(s) it represents?

    The FREEDOM to choose is the Constitutionally granted liberty being restored in this proposal. It allows competitive markets to achieve equilibrium and avoid chaos and failure; e.g. ‘failure’ as in a Death Spiral situation we currently face.

    • January 5, 2018 at 1:44 pm
      Craig Cornell says:
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      I love the down votes. People who want someone else to make their decisions for them.
      Freedom: so stressful. What were the Founding Fathers thinking? Much easier to have someone else decide what I want (and hopefully pay for it too!).

  • January 5, 2018 at 1:29 pm
    Jack Kanauph says:
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    The health system won’t get fixed until the users have “skin in the game” and become partly $$$ responsible for services.
    As far as this goes, why should a small business have to pay for maternity or addictions if they employ no women or no married males or children for a pregnancy to even be involved, or if they are drug free?

    • January 5, 2018 at 1:52 pm
      Ron says:
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      What happens if one the male employees gets married and adds his wife to the plan? Or will that not be allowed?

      What if one of the employees does make a mistake and gets involved in drugs and needs rehab to keep being a functional employee?

      Things do happen after someone gets a job.

      • January 5, 2018 at 5:36 pm
        FFA says:
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        Ron, there is not enough info to comment on the Marriage thing. As in years past, there was always an open enrollment for the new spouse. I like the fact I wont have to pay maternity any more. We are well past child bearing years and makes no sense to me that, after paying my way for all them years, all of a sudden I have to again. As far as your Drug issue goes, people need to be able to plan for the unforeseen. If they find their way into the drug / addict situation, with out coverage, that’s on them. I will continue to take that coverage so if that happens to me / my wife, we are covered financially. But maternity – its gone!

        • January 8, 2018 at 8:11 am
          Ron says:
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          FFA,

          Do you even know how much of your premium goes toward maternity?

          What do you think will happen to your premiums and co-pays for coverage that you will need later in life (prescriptions, additional lab tests, nursing facilities, etc) that the younger, healthier people do not need and no longer need to pay for?

          What happens to premiums when you only paying for coverage that you will most likely use?

          • January 8, 2018 at 2:25 pm
            FFA says:
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            Ron, I don’t know how much goes to maternity. No Clue. I know it was 2x the normal premium when it was optional coverage. I already know what happens to Co Pays. At the ER again this Am with my wife. $325.00 Co Pay. The younger people need to pay for it because they are not invincible. Of course, they need to understand that point. Things can change in an instant. I am very informed on the cost of Skilled Nursing facilities. But most in them facilities are on Medicaid or riding the LTC Policies. Ive been in the health market a long time. Never has it cost this much (considering premiums & OOPs) annually. Premiums get adjusted accordingly. When people think with their head and not their check book – anything can change in an instant – they will be properly covered.

          • January 8, 2018 at 2:40 pm
            Ron says:
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            FFA,

            The biggest reasons it has increased is because HI companies cannot underwrite and rate properly, and the fact that younger, healthy people are not enrolling as needed to keep overall premiums down.

            What do you think would happen to premiums of high risk people if companies were allowed to underwrite and charge appropriately, which is required under a free market?

            “The younger people need to pay for it because they are not invincible.” Agreed. Which is why the mandate was required. Without that, less of these people will be enrolling.

          • January 8, 2018 at 3:42 pm
            FFA says:
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            In my mind, one of the biggest factors involved in the increase is because of the middle man put in place. In particular – 1-800 useless customer service. Wonder how much payroll goes to staff that layer. The frequently dis functional web site – nothing was wrong with the infrastructure between the agent and the carrier – as well as the massive amount of paper that gets sent out including the other language assistance page. How much ink & paper gets wasted not to mention the postage. Should have left distribution in the hands of the agents that have the local knowledge.

            If people purchased the policies before illness / injury, nothing should happen to the premium for med conditions. I paid in before I was ILL for all them years to balance off later in life issues.
            Forcing someone to purchase a product is just Un American in my mind.
            I am sure you can understand the desire to know what the line item on my annual budget is. The never ending co pay – no true stop loss- is one thing that just feels like a stick in my butt.

          • January 8, 2018 at 3:43 pm
            Stinky says:
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            These are questions the market can answer. For congress to involve itself in health insurance legally, the Constitution must be amended. Leftard parasites don’t care for the rule of law, they just want their free stuff.

          • January 8, 2018 at 3:53 pm
            Ron says:
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            “If people purchased the policies before illness / injury, nothing should happen to the premium for med conditions.” What if you are born with a chronic condition?

            “If people purchased the policies before illness / injury, nothing should happen to the premium for med conditions. I paid in before I was ILL for all them years to balance off later in life issues.” While I agree with you, this goes against free market insurance principles.

            “Forcing someone to purchase a product is just Un American in my mind.” I agree. We also need to require people to prove that they have coverage, or a means to pay, prior to any treatment. Otherwise, who ends up paying those bills?

          • January 9, 2018 at 8:02 am
            PolarBeaRepeal says:
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            @Ron; the prexer situation is addressed, subtly, in HEALTH CARE SPPECIFICCS. If you recall what I said was represented by HEALT, you’d understand. Apparently, you weren’t paying attention when I discussed it almost a year ago.

          • January 9, 2018 at 5:45 pm
            FFA says:
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            Ron, prior to the PPACA, New Born were automatically eligible after being 15 days old. so that was addressed.

          • January 10, 2018 at 7:52 am
            Ron says:
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            So, that person born with a chronic condition would never have to pay more in premiums than a healthy person for the rest of their lives? Assuming they always maintained coverage.

            While that is the right thing to do, it does go against free market insurance principles.

          • January 10, 2018 at 12:57 pm
            bob says:
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            “So, that person born with a chronic condition would never have to pay more in premiums than a healthy person for the rest of their lives? Assuming they always maintained coverage.
            While that is the right thing to do, it does go against free market insurance principles.”

            It is not the right thing to do. Let’s change this:

            “The healthy person should have to pay higher premiums for someone else’s chronic ailment for the rest of their lives” Is that more moral? I’m not going to state my moral position here, but this is life. Neither of those is moral.
            I like take things away from the moral argument, because it has no place when discussing what is best for all.
            You like to define yourself in it, and bask in moral superiority.
            It actually makes you very prone to being immoral, and to breaking systems. You just said the free market is not the solution, and you’re dead wrong (pun intended). When you break insurance enough to make it more for everyone, it’s a problem. Clearly what Obama talked about was supposed to lower premiums and had all your same ideals. It didn’t. As much as people say it slowed premium growth, I have also showed that didn’t happen either. It depends on how you count costs at that point. Premiums, or care, or other factors. The most logical route shows we definitely have a cost issue from this law more so than before it. Which also shows that any law would be better, but you have also said that removing it would be worse than having it (wrong) because you believe people would lose insurance who were poor, from the state, well I propose more people would then be able to buy what they can afford, and would be able to make end’s meet. It would somewhat balance out in some ways, and be better in others. You focus on the moral aspect though, and that’s why you mess up that equation, and also, it’s what makes you a jerk here.

            You constantly berate the morality of those on the right here, that they don’t care about the uninsured, etc. This high and mighty complex is why Polar reams you. You need to grow up, and learn. You don’t get to talk to people like that.

          • January 10, 2018 at 1:10 pm
            bob says:
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            For example:

            When we thought about my wife losing insurance coverage not working, we specifically looked into birthing centers. With insurance our first birth was $4,000 dollars. Without even meeting our deductible from a birthing center it was $900 for the birth itself. There were some appointments which were not much at all, and the most expensive was the ultra sound. It was maybe $1,500.

            So let’s say someone loses pregnancy coverage, and this encourages them to shop around to more efficient avenues. They may even come out ahead.

            Let’s say they then have to shop a chiropractor. My wife also did that without insurance coverage a few years back for chronic back pain, (which her insurance didn’t cover). It was not much at all, so much not at all, I decided to take my kids (babies at the time) to fix a tilt they had.
            You will find that most forms of preventative care are best handled by paying cash to a doctor, nutritionist, etc, that you found yourself and didn’t involve insurance with. That’s not the point of insurance as it is. The pregnancy care Obama added, the rules with regards to chiropractic care (which would fall into pre existing conditions before hand) this will encourage people to go to their insurance company for things they shouldn’t be, more than it covers things it should.

            For things people cannot afford, the states handle it best. This is for the same reason I’ve said about social security. Federal programs with set amounts don’t work. States and rural areas have different costs of living. Operations will not cost the same in every area. Setting an amount to pay is disastrous due to this. It will either harm a place which can do it less, or will make it impossible to make sense in high cost areas. Practitioners are not all the same in every location in terms of costs. The free market would fix these problems, regulated costs would worsen them.

            You’re simply wrong about the free market not being able to solve the problem. The over regulated nature of the market is precisely the problem.

          • January 10, 2018 at 1:13 pm
            bob says:
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            By the way: The insurance company paid $10,000 for my first birth. That was our cost out of pocket, the $4,000.

            Clearly, insurance for pregnancy drives up the cost unless we encourage people to shop around and find a way of doing that.

          • January 10, 2018 at 1:17 pm
            Ron says:
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            bob,
            I said it before and I will say it again, go bully someone else.

          • January 10, 2018 at 1:34 pm
            bob says:
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            I’ll say this again:

            Keep calling me a bully when I retort your commentary, and I will take action.

            That is a form of harassment. I will continue to call your posts immoral, and point out why, however, when I do, if you’re going to call me a bully each time I’ve had it.

            It’s a method of shutting down debate instead of engaging in it. Grow up.

          • January 10, 2018 at 1:36 pm
            bob says:
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            This bullying comment is especially true considering who you don’t call a bully and reply to
            (Polar and Agent)

            I’m on to your game. Try and retort that all you want and scream bully and victim all you want. That’s true bullying and it’s why I’m shutting you down.

            You’re trying to get others to join in and intimidate me into silence. It won’t work.

            Debate my items, call me wrong, if you desire. A bully does not say this.

            You are however not free to call me a bully. It is not productive even if I was, child. That’s not how you deal with a bully, child, that’s bullying in itself.

          • January 10, 2018 at 2:04 pm
            FFA says:
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            Ron – “While that is the right thing to do, it does go against free market insurance principles.”
            This is exactly what the free market demanded.

      • January 7, 2018 at 1:24 pm
        PolarBeaRepeal says:
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        @Ron; why don’t you consider the possibility that a free market will respond to whatever demand for coverage exists? (rather than force specific, unnecessary peril coverage upon everyone? Do you want to pay additional premium for the exposure created by zillions of dollars of jewelry owned by the 1%-ers in a HO-1, 3, 5, … policy, or would you rather keep those items separate from standard HO forms and continue to use endorsements / riders / IM floaters to cover ‘unique’/ rare exposures that do not affect all policyholders? ACA decided for us what we must pay for in a HI policy. We have freedom to choose, and insurers have freedom to offer different coverages in standard forms, or use endorsements to cover age/time-specific perils; e.g. maternity and hip replacements.

        • January 8, 2018 at 8:21 am
          Ron says:
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          The free market will only work if you have minimal restrictions on underwriting and actuarial sound rates. That is why it works in P&C.

          This means only the most preferred will pay reasonable premiums or people will be buying coverage that offer few if any tangible benefits, and likely low limits.

          As I have said multiple times, there is a place for free market principles to work. Health insurance just is not one of them.

          Why are you still asking me to defend a law for which I have been opposed since it was signed?

          I believe there is a free market for “fine jewelry” of health care that can supplement a single payer system where basic coverage is provided to all CITIZENS. If you want private rooms, elective treatments, named brand drugs, you can get a separate policy (endorsement).

          • January 9, 2018 at 8:11 am
            PolarBeaRepeal says:
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            @Ron; It is YOUR OPINION that the free market won’t work for Health Insurance. You are too close minded to consider novel ideas for insuring health perils. How do high risk drivers get auto insurance when premiums are prohibitive? How did employers limit their liability and workers gain ground in regard to workplace injuries before 1910? Think about those market equilibrium problems that were resolved with creative thinking outside the cubicle before responding that you can’t do something that has already been done in a different line of insurance facing similar perils.

          • January 9, 2018 at 2:30 pm
            Ron says:
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            “How do high risk drivers get auto insurance when premiums are prohibitive?”
            Answer: They don’t. Then it becomes a problem for those upon whom they they cause harm.

            If your argument for free market solutions is based on other lines of insurance, you are unqualified to hold this debate.

            HI is extremely unique and cannot be compared to other lines of insurance.

          • January 9, 2018 at 5:53 pm
            Tax Cuts 4 PolaRich Bears says:
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            I know several high risk drivers who got non-stdd risk policies.

          • January 10, 2018 at 7:53 am
            Ron says:
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            If they have policies, then the premiums, by definition, are NOT prohibitive.

        • January 9, 2018 at 4:57 pm
          Agent says:
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          The good news is that the Fine/Tax for not purchasing this disaster is going away. That is a win no matter how you look at it.

          • January 10, 2018 at 7:54 am
            Ron says:
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            Except that it will lead to more adverse selection since insurance companies cannot exclude people with pre-existing conditions or charge them more.

          • January 10, 2018 at 1:55 pm
            bob says:
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            “Except that it will lead to more adverse selection since insurance companies cannot exclude people with pre-existing conditions or charge them more.”

            Except that doesn’t matter, because it clearly didn’t work. If it had, premiums would have gone down. They didn’t. This was a theory, and I understand what you are saying conceptually. It didn’t work. End of story. As this law does this it will not make costs less having the mandate.

          • January 12, 2018 at 3:40 pm
            Agent says:
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            Polar, there is a high risk Auto carrier out there call Progressive and they will write almost anyone for a price. Once the driver gets rid of their tickets and accidents or the problem kid straightens up, the premiums come down to normal. We have a lot of these on the books. We didn’t want to ruin our loss ratio with our standards.

      • January 8, 2018 at 3:41 pm
        Stinky says:
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        Where do we find congress empowered to be involved with health care or insurance in the Constitution? We don’t.

    • January 8, 2018 at 4:16 pm
      PolarBeaRepeal says:
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      @Jack: there is a feature of the new plan I’ve seen that involves patients so they have ‘skin in the game’. I can’t discuss it …. yet. stay tuned. Hint: R R.

  • January 5, 2018 at 1:31 pm
    JACK says:
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    Polar- I just got my new premium amount for a family of 5. I’m up to $1100 a month. Think about that, $13,200 a year and that’s after taxes so I have to earn $16,500 just to pay for it. Obamacareless is doing exactly as planned by the liberal elite. And I say liberal elite because the average liberal is too ignorant to see what’s happening.

    “the premium for the average family will drop $2500 a year” – Obama

    What a boldface lie! You have to be ignorant to think it that was going to occur.

    • January 5, 2018 at 2:38 pm
      perplexed says:
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      Yes, Ron…I want to see your response to JACK’s post.

      • January 8, 2018 at 8:40 am
        Ron says:
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        I agree with Jack.

        Anything else?

        • January 9, 2018 at 8:15 am
          PolarBeaRepeal says:
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          Yes, I have a follow up to perplexed’s question; what are you going to do in regard to the repeal and replace efforts that will be pursued by Congress in 2018? Will you support complete repeal? Will you have an open mind for creative solutions that will be / have been proposed? Or, will you just troll here by objecting to most of what you read by others having informative and stimulating discussions?

          • January 9, 2018 at 9:24 am
            Ron says:
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            1. What are you going to do in regard to the repeal and replace efforts that will be pursued by Congress in 2018? Answer: Depends on with what it is to be replaced.
            2. Will you support complete repeal?
            Answer: No because the uncertainty would create even more problems than the law itself.
            3. Will you have an open mind for creative solutions that will be / have been proposed?
            Answer: The only solution that has been proposed that I support is Single Payer. I am open-minded to other solutions, but will not make my decision until presented in full.

            That is how you answer questions. Maybe you should try it sometime, troll.

          • January 9, 2018 at 5:59 pm
            Tax Cuts 4 PolaRich Bears says:
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            1. Dodged the question.
            2. Retaining ANYTHING will block progress in fixing the mess.
            There is not going to be uncertainty when HEALTH CARE SPPECIFICCS elements are revealed. Unfortunately, you have to wait because of the rude, trolling behavior here.
            3. Single Slayer, er, Single Delayer, er, Single Payer is available in Cana-duh! Move there and be content in your bad selection, while being unable to get adequate, timely treatment for serious illnesses.

          • January 10, 2018 at 1:15 pm
            bob says:
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            “The only solution that has been proposed that I support is Single Payer. I am open-minded to other solutions, but will not make my decision until presented in full.”

            No you’re not, or you wouldn’t be supporting single payer. It does not encourage shopping to reduce costs, and does result in lower standards of care. The free market is the best option.

          • January 10, 2018 at 1:30 pm
            Ron says:
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            Provide a free market solution that offers comprehensive coverage (because nobody KNOWS what they may need) and does not exclude or charge higher premiums to people with pre-existing conditions, for all U.S. citizens at an affordable rate and I will listen.

            All of the free market solutions I have seen allow people to pick what they want to be covered. What happens if you need treatment for something that is not covered such as cancer or a heart attack, that you did not elect to choose because you are young, believe you are healthy, and have no family history?

          • January 10, 2018 at 1:48 pm
            bob says:
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            “Provide a free market solution that offers comprehensive coverage (because nobody KNOWS what they may need) and does not exclude or charge higher premiums to people with pre-existing conditions, for all U.S. citizens at an affordable rate and I will listen.”

            Single payer engages in all of these. This is life. The free market is dispersal of capital to where it is needed at the best possible cost. What you are talking about removes this, and harms for all the reasons I just said. I cannot create a utopia with the free market. Your request is unreasonable.

            “All of the free market solutions I have seen allow people to pick what they want to be covered.:

            This is the only way to encourage people to shop around. For pregnancy for example, they may choose to not get that coverage, and then when hit with pregnancy, they may finally shop around, saving everyone money. Pregnancy for all makes it more expensive.

            “What happens if you need treatment for something that is not covered such as cancer or a heart attack, that you did not elect to choose because you are young, believe you are healthy, and have no family history?”

            This happens to very few people, we should not be talking about the abstract to talk about averages in cost spread to the whole pool for one, and for two, abstract scenarios are precisely that and will always exist. What will happen is they will receive care, as they do now. They will then get a bill. The vast majority who couldn’t afford insurance will receive government assistance, whether federal or state. The vast minority, will have to file for bankruptcy. There is nothing wrong with this solution. A random heart attack in your 20’s will probably be a one time thing. Also: In the absence of the ACA, you could buy a catastrophic plan as a 20 year old for FAR less than it is now. You’re being clueless again. This is the area that over doubled. There are MORE people now who are forced to buy coverage that includes everything as 20 year olds, including pregnancy etc, who cannot afford the insurance than there were before. You’re 20 year old with a heart attack, there will be a 15% poverty rate there as well buddy, and unless you’re living in poverty, you won’t get a subsidy. So my point here is, that say it’s 1/100 people in their 20’s that have a heart attack, you want to force the other 99 to buy insurance that they cannot afford, (adding coverages they don’t need) and then to claim you helped them all? You didn’t. The 99 should have bought catastrophic care. In my scenario if say the uninsured rate is 20% in that age range, it is 1/100 compared to 1/20 who will be harmed. In yours it is 99/100 harmed to save the 1 additional costs, and I’m going to guess the numbers are actually higher than 1/100 by the way. Your abstract doesn’t pencil out. The catastrophic care would be less than half the cost and would cover the heart attack for the rest, or at least make it affordable with a payment plan after the co pay and deductible. This is my problem with your system. And you again derailed saying how much you love people and want them to never be in a situation of turmoil. To hell with you Ron, neither do I! We’ve thought it out a little bit better than you, and don’t use abstract scenarios to justify the norm.

            Here’s my question: Let’s say we can get healthcare costs 30% lower than single payer nations, (and I believe this is possible if we encouraged this through schools, etc, and taught people to shop around through the free market which does it itself) and we removed all things unneeded from health insurance (preventative care, like it or not, should NOT be on insurance)

            Would you support this if it left 15% uninsured (BY CHOICE).

          • January 10, 2018 at 2:07 pm
            FFA says:
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            (because nobody KNOWS what they may need)

            I know for a medical fact, my wife will never get pregnant again.

          • January 10, 2018 at 2:08 pm
            Ron says:
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            “Let’s say we can get healthcare costs 30% lower than single payer nations, (and I believe this is possible if we encouraged this through schools, etc, and taught people to shop around through the free market which does it itself) and we removed all things unneeded from health insurance (preventative care, like it or not, should NOT be on insurance)

            Would you support this if it left 15% uninsured (BY CHOICE).”

            Yes, but only if those who choose to be uninsured have no access to care, unless they pay in full upfront or prove they have the means to pay. I do not want to pay for deadbeats through increased costs from providers to cover those people..

          • January 10, 2018 at 2:09 pm
            Ron says:
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            FFA,

            That works for you, but what about the married couple using birth control and it fails? They did not select maternity because they did not think she would get pregnant.

          • January 10, 2018 at 2:45 pm
            Confused says:
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            …and their new plan which includes maternity won’t actually cover them for this pregnancy because it’s considered a pre-exissting condition they had before they requested the new policy

          • January 11, 2018 at 2:38 pm
            FFA says:
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            “but what about the married couple using birth control and it fails?”

            Product Failure is always a risk that needs to be addressed. I know too many people this happened to – product failure (faulty rubbers, the pill while taking anti biotics). If they fail to plan for this possibility, that’s on them.

    • January 5, 2018 at 2:39 pm
      Agent says:
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      Jack, perhaps you can get a plan now that gives you the freedom to choose what you want covered instead of having the government pick it for you with no choices.

      • January 5, 2018 at 3:17 pm
        Jack says:
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        Agent- I have a grandfathered high deductible plan that’s been quoted out several years in a row now. The premiums can’t be beat. Exactly what the liberal elite wanted, higher premiums so people would start yelling for single payer insurance. It’s been the plan all along. To think anything else is ignorance.

        • January 5, 2018 at 4:46 pm
          Agent says:
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          Jack, I have a PA daughter working for a large, multi-location practice that offers primary care for a low cost monthly amount per employee. They are being swamped by many companies and individuals signing up for it. They then buy a catastrophic high deductible plan for the emergency/serious things. Overall cost is a fraction of the nasty Obamacare coverage.

        • January 8, 2018 at 7:27 am
          PolarBeaRepeal says:
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          @Jack; good points and good use of personal experience with the ACA disaster! I hope you can get better coverage at better rates in the near future.

          Answer to my cryptic question in my first post in this thread: The letters ‘EC’ in HEALTH CARE SPPECIFICCS represent Essential Coverages that are needed in repeal & replace efforts, so that people can choose the best coverage for their needs at different ages. With the option to ADD coverage perils via endorsements and riders to an Essential Cover policy, consumers in the HI market tailor their coverage to their needs, and demand / participation in the insurance ‘pool’ increases because the market satisfies the demand for various combinations of coverage.

          I believe Ted Cruz introduced this proposal to the R&R bill late in 2017. But it was removed before the failed vote.

      • January 11, 2018 at 3:13 pm
        Agent says:
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        FFA, In a country where people sue at the drop of a hat for anything, the contraceptive that fails will suffer under Products liability. Of course, there would be a burden of proof, but the plaintiff attorneys can always browbeat a company into paying for their product failure.

        • January 11, 2018 at 6:12 pm
          FFA says:
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          Has that law suite ever been won?

          • January 12, 2018 at 3:35 pm
            Agent says:
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            The McDonalds hot coffee suit won. Why not a rubber or a pill?

    • January 8, 2018 at 3:45 pm
      Stinky says:
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      0b00ba actually said it was 1,200%, several times, until someone with a brain corrected him.

  • January 5, 2018 at 2:21 pm
    Lefty says:
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    Once again with the headline editorializing. It no more “skirts” Obamacare than a large self-funded single employer or an existing regulated MEWA does, and in fact still has elements very similar to the Obamacare community rating requirements for exchange business. Read the proposal and understand it before making subjective statements.

    • January 5, 2018 at 3:07 pm
      Agent says:
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      Please give us how many exchanges are still operating in this country. Most have failed miserably as they should have.

      • January 5, 2018 at 5:11 pm
        Lefty says:
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        Agree. Exchanges are a miserable failure as we knew they would be. Creating flexibility in the determination of permitted Association Health Plans is positive, although the nondiscrimination requirements may limit the appeal. For the uninformed please note that in the context of the proposed rule these “nondiscrimination” requirements could be better described as pricing and rating rules.I didn’t make the point clearly; it is not that Obamacare has been good and therefore the elements of Obamacare which appear in the proposed rule are positive. It is that this proposed change, using the rule-making process correctly (as opposed to the Obama Administration’s Agency-made-law through rule-making abuse) doesn’t “skirt” Obamacare. That usage of the verb “skirt” (American Heritage Dictionary Fourth Edition, to “avoid or evade”) is typical progressive slant that is not grounded in the facts.

        • January 8, 2018 at 4:19 pm
          PolarBeaRepeal says:
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          If I understand your point about discrimination, as I glanced thru your post because I need to leave my PC very soon…. discrimination is a problem. IT will be solved by re-establishment of high risk pools. Excuse me if I misinterpreted your remark in a hasty reading.

        • January 12, 2018 at 3:33 pm
          Agent says:
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          Exchanges = fail. Pools used in past for people with bad health. Small part of the total population and it actually worked. Had they subsidized the Pools, they wouldn’t have near the problem as it turned out to be.

  • January 5, 2018 at 4:24 pm
    Dennis J. byrne says:
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    Here Comes Another Effort To Undermine Obamacare’s Rules For Health Insurance. It could mean cheaper, skimpier coverage for healthy people — and higher costs for others. Like all new regulatory shifts, they must first go through a formal review process, with opportunity for public comment, before they become final. The proposal is also likely to prompt legal challenges, because it calls for changes that may exceed what executive agencies can do on their own, without new acts of Congress. But if the regulation eventually takes effect, Republicans will be closer to their goal of creating an insurance system with fewer rules on what or whom plans must cover. And the health care landscape would look very different as a result. People in good health would have access to cheaper, less generous policies. But it would also mean those who want or need more comprehensive coverage would have a harder time finding it. When the Obama administration wrote the regulations to implement the Affordable Care Act, it was careful to make sure AHPs were subject to the same guidelines on benefits and pricing ― including protections for people with pre-existing conditions ― as other insurance plans serving individuals and small businesses. In other words, the Realtor association’s AHP is subject to the same rules as policies that insurers sell to individuals, directly or through Obamacare’s exchanges. Similarly, the state business organization’s plan is subject to the same rules for all small employers. By writing the regulations in this way, the Obama administration had two goals in mind. One was to protect consumers by making sure all policies were sufficiently comprehensive to cover all medical needs. The other was to ensure all individuals and small businesses were part of the same insurance pool, so that there were enough healthy people paying premiums to cover the high bills of those who needed extensive medical care. Combined with Obamacare’s other features, including subsidies for low- and some middle-income people, this put comprehensive coverage within reach for millions who couldn’t get it before. But it also raised premiums for individuals and small businesses who previously were able to find coverage for much less money ― in part because their plans lacked full coverage for mental health, maternity care, rehabilitative services, or prescriptions

    • January 5, 2018 at 4:49 pm
      Agent says:
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      How about Freedom of Choice instead of mandating coverage that many people didn’t want or could afford. Obamacare’s record is abysmal and no sugar coating will make it palatable.

    • January 5, 2018 at 5:14 pm
      Craig Cornell says:
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      Your “lacking full coverage” line revealed your bias. Who are you to tell me or anyone else what “full coverage” means?

      There are a hundred ways to run a railroad, and you could address the poor and the sick without having to muck up the entire system. Simply subsidize those who need help . . . and leave everyone else alone.

      Presto. A much cheaper system overall, one that doesn’t leave people behind, and one that also allows most healthy people to gain from taking care of themselves by buying cheaper coverage that meets their needs as they see fit. This might not be “full” coverage for you, but I will let you decide that when you buy your own insurance.

      • January 10, 2018 at 1:54 pm
        bob says:
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        Bingo on the subsidize the poor and leave everyone else alone.
        I’ve said this before, and liberals have refused it. It shows a lot about how they need to control others, as much as they claim it is conservatives who want to do so.

        • January 10, 2018 at 2:09 pm
          FFA says:
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          Didn’t Trump up the subsidy? I ran several renewal quotes with Zero Premium for some.

          • January 10, 2018 at 2:18 pm
            bob says:
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            I believe that was an automatic trigger that occurred. I haven’t fully looked into that one. I had heard about it.

          • January 11, 2018 at 2:40 pm
            FFA says:
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            Well Bob, its true. Seen it with my own eyes.

    • January 5, 2018 at 7:40 pm
      CarrierGuy says:
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      Dennis, by your logic, I would guess that you would treat drivers with pre-existing conditions like several claims or a DUI the same as drivers with clean records. Otherwise, it would make it harder for some drivers to access auto insurance. They might have to pay more. Does risk-based pricing make sense in one case but not the other?

      • January 8, 2018 at 7:39 am
        PolarBeaRepeal says:
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        @Carrier Guy; ever hear of buses? Driving is a privilege, not a right. You may not want to admit it because you might lose those hyuuuuge non-std auto market driver premiums you collect commissions on while taking no risk. Why should multi-accident drivers be allowed to harm or kill innocent drivers? Transportation to / from work is NOT an excuse that stands up to challenge, as I did in my opening sentence. Further, why should good drivers have to share in a risk pool of ALL drivers?

        In regard to an HO policy, would you agree to pay higher premiums for the 1%-ers who might insure their million$ of jewelry or art collections under a standard HO-2 – 8 form? Why is there a market for property cover endorsement and riders, separate from the HO forms? If you lived high on a hill or mountain range, would you agree to cover flood risks under a standard HO – 2-8 form, with or without ANY limitations imposed?

        • January 8, 2018 at 2:34 pm
          Agent says:
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          Polar, I would think that good drivers should not subsidize poor drivers. Obamacare was subsidizing people with poor health and making healthy customers pay for it. That is not the American way. Let Freedom ring. We aren’t tired of winning.

        • January 9, 2018 at 8:34 am
          PolarBeaRepeal says:
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          @Agent; yes, subsidies should be removed or minimized to such a small level that they don’t disturb market equilibrium and adverse selection ensues. ACA removed high risk pools and changed aspects of the McCarran-Ferguson Act of 1945 in regard to anti-trust exemptions it set aside for states to handle to ‘make it legal’.

          Restoring high risk pools, possibly repealing the McC-F Act modification of 2010, and actually making an aggressive effort to control costs that most affect those risks; e.g. pharma costs for life-altering drugs, is a more efficient approach than expansion of subsidies and expansion of Social insurance such as Medicare and Medicaid expansion. It is more efficient in terms of costs and the number of people who will participate in the voluntary pool of risks. And that is based on economics and actuarial classification principles that are also supported by / required by FASB standards.

      • January 8, 2018 at 8:25 am
        Ron says:
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        CarrierGuy,

        Are you seriously comparing someone with a DUI or a poor driving record to people with pre-existing medical conditions?

        Thank you for revealing a core reason why we cannot compare HI to P&C.

        • January 9, 2018 at 8:36 am
          PolarBeaRepeal says:
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          @Ron; yes, we can compare the two situations. Your continuing resistance to do so reveals your inability to think outside the bo … cubicle.

  • January 5, 2018 at 7:04 pm
    Ivan del Jesus says:
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    “………….Republicans dealt their biggest blow to the healthcare program in their tax overhaul, which Trump signed into law last month. The law in 2019 repeals the individual mandate, the requirement that most Americans purchase health insurance or else pay a fine……….”

    The REPUBLICANS are exagerating the effect the Repeal of the Mandate would have on the Health Insurance market

    Of the subtypes of health insurance coverage:

    employer-based insurance covered 55.7 percent of the population
    Followed by Medicaid (19.4 percent),
    Medicare (16.7 percent),
    Direct-purchase (16.2 percent),
    Military coverage (4.6 percent).

    • January 8, 2018 at 7:43 am
      PolarBeaRepeal says:
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      What ACA mandates exist on employers with > 50 workers, or whose workers work > 30 hours per week?

    • January 9, 2018 at 8:43 am
      PolarBeaRepeal says:
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      I assume you don’t know what those percentages are based on; i.e. the denominator and numerator dollar values. What is the sum total of the percentages you listed? Let’s count together; here I go with a cumulative total tally….

      55.7 + 19.4 = 75.1
      75.1 + 16.7 = 91.8
      91.8 + 16.2 = 108.0

      Ooops! We’re already over 100% and we still haven’t counted the military coverage!

      Let’s finish while I have the digits on my paws registering the cumulative totals already made….
      108.0 + 4.6 = 112.6.

      Someone must be buying an excess of coverage at the level of about 12% – 13% over what is needed. OR, someone doesn’t understand what they are copying and pasting here from a source article on a liberal website, so as to act as a troll posting falsehoods on an insurance website.

  • January 5, 2018 at 7:12 pm
    Ivan del Jesus says:
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    It’s very simple:

    You get what you pay . Individuals and small businesses will be able to purchase crappy policies with lots of exclusions, High Deductibles and High Copayments

    • January 8, 2018 at 7:42 am
      PolarBeaRepeal says:
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      Wrong. Read my other posts that point to freedom of selection of needed coverage by the market. THAT is the only way to stabilize the HI market, and satisfy the demand for the product. Those who cannot afford HI are eligible for Medicaid.

      • January 8, 2018 at 8:39 am
        Ron says:
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        “Those who cannot afford HI are eligible for Medicaid.”

        Two problems with this:

        1. Do you know the income requirements for medicaid? There will be millions of people who could not afford a free market HI policy nor Medicaid.
        2. Your republican friends are trying to gut Medicaid to make even less people eligible.

      • January 11, 2018 at 3:06 pm
        Agent says:
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        Polar, correct me if I am wrong. Haven’t we been arguing about the disaster for right at 8 years now? Gee, there must be something rotten in Denmark if the law is this bad.

        • January 11, 2018 at 3:24 pm
          Ron says:
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          Agreed

    • January 8, 2018 at 2:35 pm
      FFA says:
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      Ill pay for a real stop loss. That way, I can budget accordingly. For example, when I had a flat $5000, I could take that $5000 and divide it by 12 and stash that $$ knowing I was going to incur that cost. Instead, with no stop loss, I am buried again in med bills. This year isn’t off to a good start – I had my wife at the ER this AM – and I just don’t know how bad this is going to screw me again this year. For me, not knowing what my expense will be is a bad thing. How do you plan for that unknown? .

      • January 8, 2018 at 2:42 pm
        Ron says:
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        “For me, not knowing what my expense will be is a bad thing. How do you plan for that unknown? ” Single payer would solve this dilemma.

        • January 8, 2018 at 3:45 pm
          FFA says:
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          Or when you say stop loss, let it actually mean that. Max OOP should mean only that. No exceptions like were created by the PPACA.

        • January 9, 2018 at 12:50 pm
          Agent says:
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          Sorry Ron, but you aren’t getting your Single Payer. This country has had enough of Progressive Socialism and is going to Free Market solutions.

          • January 9, 2018 at 2:25 pm
            Ron says:
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            Then we will continue to have issues regarding health care/insurance from a coverage, premium, and/or cost perspective.

        • January 9, 2018 at 4:50 pm
          Agent says:
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          Single Payer will cause many more dilemma’s than it will solve and be three times more expensive and thousands more Federal Employees to monitor and regulate to death.

      • January 9, 2018 at 12:53 pm
        Agent says:
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        FFA, no one on this forum has had more trouble with Oblamacare like you have had. I hope you find a free market policy that will give you the coverage you select and with good benefits.
        Hope you aren’t freezing up there in Wisconsin. Bet you have been using a lot of firewood this year.

        • January 9, 2018 at 2:27 pm
          Ron says:
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          “I hope you find a free market policy that will give you the coverage you select and with good benefits.”

          If it is a free market policy, based on his wife’s medical history, he should be paying far more than he is now.

          • January 9, 2018 at 5:57 pm
            FFA says:
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            Ron, my premiums were actually higher pre ACA. My Annual oop were capped at $5000. With the invention of the never ending co pay, my annual medical expense has increased dramatically. After the latest round of issues, the stack got over $8000 and I was paying something on them every month. There were so many providers involved, most had been getting only $25.00 @ month. I finally have it whittled down to just 6 providers and shelling out a minn of $800 @ month on them. So, yes please. Give me my higher premium back. I would love to know what my annual expense is going to cap out at.

        • January 9, 2018 at 5:52 pm
          FFA says:
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          Agent, I find it funny how many people think its just me having issues. I don’t know how many people read this forum, but I am guessing its a very small fraction of the actual population. Based on what people say on this, I am the only agent on this forum actually selling these policies and as far as I can tell, I am the only one with one of these policies.
          And yes, I have burnt a lot of fire wood this year. Three stacks about 20 feet long 6 ft high.

          • January 10, 2018 at 5:13 pm
            Agent says:
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            Correct FFA. People that have no skin in the game should not comment on the disaster we know as Obamacare. Hopefully, the liberal pansies will take a hike when the new free market policies come out and selling across state lines come about. Stay warm on the frozen tundra friend.

          • January 11, 2018 at 8:08 am
            Ron says:
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            The mandate=skin in the game.

            Yet, you are against it.

          • January 11, 2018 at 8:10 am
            Ron says:
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            You are aware that insurance companies currently are, and have always been, allowed to sell in multiple states, right?

          • January 11, 2018 at 2:45 pm
            FFA says:
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            I just don’t understand how selling across state lines is gong to do anything. Dean Care in Wi is not going to go into IL priced with Wi actuarial stats. They are going to use Il stats and end up in the same ball park as everyone else. BCBS will not come into Wi with IL actuarial data. They will use WI.
            So, selling across state lines – in my mind – wont solve anything.

            In my personal life, the only ones that support this thing are people that are not on it or enjoy the exclusions from it.

          • January 11, 2018 at 3:28 pm
            Ron says:
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            FFA,

            The principle behind that is that companies would not have to submit for regulatory approval in each state. That would, in theory, save them a bunch of money and encourage companies to enter more markets, leading to more competition, then lower premiums.

            Problem is that one of the following would be required:
            1. Removal of any regulation of health insurance
            2. Federal regulation of health insurance
            3. Forcing states to allow health insurance policies that may not meet their laws and regulations.

          • January 11, 2018 at 6:16 pm
            FFA says:
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            Ron, if you cut the govt out of the mix, premiums will naturally come down as people wont have to pay for corrupt politicians. IL is a perfect example of how politicians line their own pockets through their policies. Last I heard, any state filing in IL starts at $10,000.

          • January 12, 2018 at 8:34 am
            Ron says:
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            I have no problem cutting the government out of the administration, but we need regulations. The question becomes, should it be by the states or feds?

          • January 12, 2018 at 3:27 pm
            Agent says:
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            FFA, I am not going to tell you it was a bad move to sell the disaster since you already know it now. Man, I took a look at this from the start and decided I would stick to P&C. I didn’t want the E&O exposure when people started complaining about it. Guess who they hold accountable, the guy who sold it to them.

          • April 16, 2019 at 3:43 pm
            Agent says:
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            Hey everyone, now that some time has passed on this article, I wish to announce that Ron wants Medicare for All. Trillions wasted after we wasted hundreds of billions on the disaster. He should volunteer for Bernie’s campaign.

    • January 10, 2018 at 2:11 pm
      FFA says:
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      Higher then what we got now? Really? No OOP Max (even though the coverage explainer still has that very mis leading phrase)?

  • January 11, 2018 at 11:26 am
    martin says:
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    All I know is health insurance carriers use to be accommodating to the agent.. Since Obamacare they have thrown the agent under the bus.. They lowered commissions, customer service stinks, and they don’t even cover certain counties in certain states. The carriers have the golden parachute from the government and they are making money hand over fist.. The problem with Doctors and Hospitals? They have too much business.. Too many sickly people and too many people running to the Doctor with a Butt Ache. We live in a sickly country with obesity, pill poppers, low exercise and movement, illegal aliens filling our emergency rooms, and Doctors and Hospitals charging too much.. Personally, I try to stay in shape.. If the Doctors had to count on me for their living, they would have to go door to door like a Vacuum salesman.. Quite going to the Doctor for every little thing…

    • January 11, 2018 at 2:47 pm
      FFA says:
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      For me personally, they are pure profit. Went for my 50 yr old exam and they told me not to come back for 10 years. so that door is slammed shut for now.

      • January 11, 2018 at 3:44 pm
        Agent says:
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        FFA, I go annually for my exam. Call me cautious. A lot of things can pop up on health issues like heart, cancer etc.

    • January 11, 2018 at 6:20 pm
      FFA says:
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      Martin, That is so true. When agents were sold to buy in this, we were promised full new business commissions at 15%. Day one of the new law, they told us 5% was new business commissions. At that point, I was too far into it to back out. For the first time in all my sales days dating back to high school, this is the only product I sold but did not like. Turns out this was the worst business decision I ever made in 27 years and counting sitting on Main St USA. .

      • January 12, 2018 at 3:55 pm
        Agent says:
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        Well, they couldn’t get Single Payer as Oblama wanted, so they decided to lie to agents and the American People on how wonderful it would be, how a person could keep their doctor, keep their plan and save a family $2,500. When you pass a law strictly by deceit, it will come back to haunt you. Progressives are the worst. By the way, their Coup failed and the swamp is still being drained. Let the Grand Juries be seated.



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